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1.
Evaluating the benefits and implementation challenges of digital health interventions for improving self-efficacy and patient activation in cancer survivors : single-case experimental prospective study
Umut Arioz, Urška Smrke, Valentino Šafran, Maja Ravnik, Matej Horvat, Vojko Flis, Izidor Mlakar, 2025, original scientific article

Abstract: Cancer survivors face numerous challenges, and digital health interventions can empower them by enhancing self-efficacy and patient activation. This prospective study aimed to assess the impact of a mHealth app on self-efficacy and patient activation in 166 breast and colorectal cancer survivors. Participants received a smart bracelet and used the app to access personalized care plans. Data were collected at baseline and follow-ups, including patient-reported outcomes and clinician feedback. The study demonstrated positive impacts on self-efficacy and patient activation. The overall trial retention rate was 75.3%. Participants reported high levels of activation (PAM levels 1–3: P = 1.0; level 4: P = 0.65) and expressed a willingness to stay informed about their disease (CASE-Cancer factor 1: P = 0.98; factor 2: P = 0.66; factor 3: P = 0.25). Usability of the app improved, with an increase in participants rating the system as having excellent usability (from 14.82% to 22.22%). Additional qualitative analysis revealed positive experiences from both patients and clinicians. This paper contributes significantly to cancer survivorship care by providing personalized care plans tailored to individual needs. The PERSIST platform shows promise in improving patient outcomes and enhancing self-management abilities in cancer survivors. Further research with larger and more diverse populations is needed to establish its effectiveness.
Keywords: cancer survivorship, self-efficacy, satisfaction, patient activation, digital health interventions
Published in DKUM: 25.04.2025; Views: 0; Downloads: 0

2.
School-based exercise programs for promoting cardiorespiratory fitness in overweight and obese children aged 6 to 10
Stefan Mijalković, Dušan Stanković, Mario Tomljanović, Maja Batez, Maki Grle, Ivana Grle, Ivan Brkljačić, Josip Jularić, Goran Sporiš, Suzana Žilič Fišer, 2022, review article

Abstract: The aim of this study was to conduct a systematic review of the school-based exercise programs for promoting cardiorespiratory fitness in overweight and obese children aged 6 to 10. Electronic databases (Web of Science and PubMed) were used as searching tools for collecting adequate studies published in the past 20 years. A total of 13 studies met the criteria for inclusion in this review, with a total of 2810 participants, both male and female. According to the results of this systematic review, overweight and obese children aged 6 to 10 who underwent certain interventions had their CRF improved. Furthermore, evidence suggested that interventions carried out during a longer period of time suggested led to greater improvement of cardiorespiratory fitness than a shorter one, but the level of cardiorespiratory fitness gradually decreases after the intervention.
Keywords: physical activity, physical fitness, motor competence, children, health, monitoring and promoting, sport, sedentary behavior, obesity, well-being
Published in DKUM: 07.04.2025; Views: 0; Downloads: 3
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Does health literacy mediate sociodemographic and economic inequalities in fruit and vegetable intake? : an analysis of Slovenian national HLS19 survey data
Andrej Kirbiš, Stefani Branilović, Maruša Lubej, 2025, original scientific article

Abstract: Health literacy plays an important role in promoting healthier behaviors. However, less is known about its impact on dietary habits, such as fruit and vegetable (FV) intake. This study examines the mediating role of health literacy in the relationship between FV intake and demographic and socioeconomic factors among Slovenian adults. We used Slovenian national data from the 19-country Health Literacy Survey 2019–2021 (HLS19) (n = 3360). Results indicate that health literacy plays a complex role in mediating the relationship between demographic and socioeconomic factors and FV intake. Women and financially stable individuals have higher levels of health literacy, which positively predicts higher FV intake. While older individuals demonstrated greater FV intake, they reported lower health literacy, suggesting other mechanisms may drive their dietary behavior. Additionally, while higher education was associated with improved health literacy, its direct relationship with FV intake was negative, though health literacy partially mitigated this effect. These results underscore the importance of health literacy as a mediating factor in improving dietary behaviors and highlight the need for targeted interventions and policies to enhance nutritional education, particularly for marginalized groups.
Keywords: health literacy, fruit and vegetable intake, mediation analyses, health, demographic inequalities, socioeconomic inequalities
Published in DKUM: 18.03.2025; Views: 0; Downloads: 4
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5.
The validity and reliability of the Slovenian version of the health literacy questionnaire short-form (HLS-EU-Q16) among adults and older adults
Monika Lamot, Andrej Kirbiš, 2024, original scientific article

Abstract: Introduction: Health literacy is an important predictor of health behavior and self-rated health, playing a crucial role in shaping public health outcomes. Valid and reliable health literacy assessments are essential for effectively tailoring health interventions, particularly in different cultural contexts. Several questionnaires have been developed to measure health literacy, including the widely used 47-item Health Literacy Questionnaire and its shorter versions. However, the validity of these shorter and more time efficient HLS-EU versions, such as the 16-item HLS-EU-Q16, has been less extensively researched in different age subgroups. Given Slovenia’s aging population and the differences in health literacy between adults and older adults, it is important to assess whether the HLS-EU-Q16 performs reliably across these groups. Therefore, the present study aimed to examine the validity and reliability of the 16-item health literacy questionnaire (HLS-EU-Q16) in Slovenia across two age groups: adults and older adults. Methods: We analyzed representative Slovenian sample data from the Health Literacy of Adults study. The sample included 2,327 adults aged 23–64 years (53.7% women) and 876 older adults aged 65–99 years (55.7% women). Results: Construct validity revealed a modified three-factor structure of the HLS-EU-Q16 among adults, reflecting a broader conceptualization of health literacy that encompasses overlapping domains of health promotion, disease prevention, and health care. In contrast, a two-factor structure emerged among older adults, indicating a more consolidated approach where these domains are perceived as part of an integrated health management strategy. This suggests that adults may conceptualize health literacy across multiple, yet interconnected dimensions, while older adults approach it more holistically. Convergent validity, reliability, concurrent-predictive, concurrent, and discriminant validity results were satisfactory for both age groups. Predictive validity, however, provided somewhat inadequate results, as the tool poorly predicted certain health behaviors, such as smoking, alcohol consumption, and physical activity, in both age groups. Conclusion: Overall, the HLS-EU-Q16 demonstrated adequate validity and reliability among both adults and older adults, indicating that it is an appropriate instrument for assessing health literacy in Slovenia.
Keywords: HLS-EU-Q16, Slovenia, health literacy, adults, validity
Published in DKUM: 14.03.2025; Views: 0; Downloads: 9
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6.
Are health literacy and physical literacy independent concepts? A gender-stratified analysis in medical school students from Croatia
Marijana Geets Kesic, Mia Perić, Barbara Gilić, Marko Manojlovic, Patrik Drid, Toni Modric, Željka Znidaric, Nataša Zenić, Aleksander Pajtler, 2022, original scientific article

Abstract: Health literacy (HL) and physical literacy (PL) are concepts responsible for achieving and maintaining positive health behaviors. This study aimed to investigate gender-specific associations: (i) between PL and HL; and (ii) among HL, PL, and body composition. We observed 253 students attending health-area high schools from southern Croatia (181 girls; 16.9 ± 1.4 years). HL was assessed by the European Health Literacy Survey Questionnaire, PL by the PLAYself questionnaire, and body composition by bioimpedance analysis. The t-test was used to assess the differences between genders, and Pearson’s correlation coefficients were calculated to establish the associations between variables. The results showed a similar level of HL (t-test = 0.2; p = 0.83) and PL (t-test = 0.01; p = 0.99) in boys and girls. Significant but small correlations were identified between HL and PL only in the girls (<10% of common variance). The body composition indices were significantly correlated with PL only in the boys (15–20% of common variance). Our research highlights the necessity of the independent evaluation of HL and PL in adolescence. Further studies evaluating other indices of health status in relation to PL and HL are warranted.
Keywords: health behavior, knowledge translation, public health, community-engaged research, youth, body build
Published in DKUM: 12.03.2025; Views: 0; Downloads: 4
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7.
Sweet, fat and salty: snacks in vending machines in health and social care institutions in Slovenia
Urška Rozman, Igor Pravst, Urška Pivk Kupirovič, Urška Blaznik, Primož Kocbek, Sonja Šostar-Turk, 2020, original scientific article

Abstract: Vending machines in health and social care facilities are often the only possible choice for a quick snack for workers and visitors, in many cases providing unhealthy dietary choices. Our study aimed to analyse the variety and nutritional quality of foods available in vending machines placed in social and health care institution in Slovenia. The available snacks were quantitatively assessed, using traffic light profiling. The model used for nutrient profiling was that of the Food Standards Australia New Zealand (FSANZ). Vending machines in 188 institutions were surveyed, resulting in 5625 food-items consisting of 267 unique product labels. Sweet products dominate in vending machines offers (about 70%), while nuts and seeds (8.4%), yoghurts (2.1%), fruits (1.4%) and milk (0.3%) are present in a very small proportion or are not available at all. According to FSANZ, 88.5% of all displayed food items in vending machines can be considered as lower nutritional quality or less healthy products. The authors’ future activities will be focused on ensuring wider availability of healthy dietary choices and on including official guidelines in tender conditions for vending machines in health and social care institutions in Slovenia.
Keywords: snacks, vending machines, social care institutions, health care institutions, Slovenia
Published in DKUM: 10.03.2025; Views: 0; Downloads: 6
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8.
Exploring the feasibility of generative AI in persona research : a omparative analysis of large language model-generated and human-crafted personas in obesity research
Urška Smrke, Ana Rehberger, Nejc Plohl, Izidor Mlakar, 2025, original scientific article

Abstract: This study investigates the perceptions of Persona descriptions generated using three different large language models (LLMs) and qualitatively developed Personas by an expert panel involved in obesity research. Six different Personas were defined, three from the clinical domain and three from the educational domain. The descriptions of Personas were generated using qualitative methods and the LLMs (i.e., Bard, Llama, and ChatGPT). The perception of the developed Personas was evaluated by experts in the respective fields. The results show that, in general, the perception of Personas did not significantly differ between those generated using LLMs and those qualitatively developed by human experts. This indicates that LLMs have the potential to generate a consistent and valid representation of human stakeholders. The LLM-generated Personas were perceived as believable, relatable, and informative. However, post-hoc comparisons revealed some differences, with descriptions generated using the Bard model being in several Persona descriptions that were evaluated most favorably in terms of empathy, likability, and clarity. This study contributes to the understanding of the potential and challenges of LLM-generated Personas. Although the study focuses on obesity research, it highlights the importance of considering the specific context and the potential issues that researchers should be aware of when using generative AI for generating Personas.
Keywords: user personas, obesity, large language models, value sensitive design, digital health interventions
Published in DKUM: 14.02.2025; Views: 0; Downloads: 4
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9.
Well-being and satisfaction of nurses in Slovenian hospitals : a cross-sectional study
Mateja Lorber, Sonja Treven, Damijan Mumel, 2020, original scientific article

Abstract: Introduction: Well-being is one of the most important factors in whether nurses decide to remain in the nursing profession. This study aims to examine well-being and satisfaction among nurses working in Slovenian hospitals and to identify the related demographic factors. Methods: This descriptive cross-sectional study uses standardised instruments. The sample included 640 nurses working in Slovenian hospitals. The difference between individual variables were analysed using the Mann-Whitney and Kruskal-Wallis tests. Results: Nurses self-assessed their satisfaction and well-being as moderate. Forty-seven per cent of nurses were satisfied with their job, 49% assessed their psychological well-being as good, 52% were often exposed to stress at the workplace and 30% were always exposed to stress at the workplace. Levels of job satisfaction (p=0.031), psychological well-being (p=0.029) and subjective well-being (p=0.014) were found to differ significantly according to level of education, while levels of job satisfaction (p=0.005), life satisfaction (p<0.001), psychological well-being (p<0.001) and subjective well-being (p<0.001) were also found to differ according to years of nursing service and from hospital to hospital (p<0.001). Conclusions: The key finding of the study is that nurses are moderately satisfied with their work and life and that they display moderate levels of psychological and subjective well-being. Hospitals can be successful and achieve the goals of the organisation if their employees are satisfied with work and enjoy good levels of well-being. Hospital management have to recognise the importance of ensuring that nurses and other employees are satisfied and healthy.
Keywords: hospitals, nurses, satisfaction, health
Published in DKUM: 28.01.2025; Views: 0; Downloads: 345
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10.
Academic general practice/family medicine in times of COVID-19 - Perspective of WONCA Europe
Adam Windak, Thomas Frese, Eva Hummers-Pradier, Zalika Klemenc-Ketiš, Sonia Tsukagoshi, Josep Vilaseca, Shlomo Vinker, Mehmet Ungan, 2020, original scientific article

Abstract: COVID-19 outbreak has significantly changed all aspects of general practice in Europe. This art-icle focuses on the academic challenges for the discipline, mainly in the field of education,research, and quality assurance. The efforts of the European Region of the World Organisationof National Colleges, Academies, and Academic Associations of General Practitioners/FamilyPhysicians (WONCA Europe) to support academic sustainability of the discipline in the time ofpandemic are presented. Medical education was affected by the pandemic, threatening both itsproductivity and quality. Emerging new educational methods might be promising, but theresults of their rapid implementation remain uncertain. A relatively small number of publicationsrelated to COVID-19 and general practice is available in the medical literature. There is a short-age of original data from general practice settings. This contrasts with the crucial role of GPs infighting a pandemic. COVID-19 outbreak has opened widely new research areas, which shouldbe explored by GPs. Maintaining the quality of care and safety of all patients during the COVID-19 pandemic is the utmost priority. Many of them suffer from poor access or inadequate man-agement of their problems. Rapid implementation of telemedicine brought both threats andopportunities. The COVID-19 pandemic also challenged doctors' safety and well-being. Theseaspects will require discussion and remedy to prevent deterioration of the quality of primarycare. WONCA Europe is making a multi-faceted effort to support GPs in difficult times of thepandemic. It is ready to support future efforts to uphold the integrity of family medicine as anacademic discipline.
Keywords: infectious diseases, quality of care, public health, community medicine, health care organisation, management, medical education
Published in DKUM: 07.01.2025; Views: 0; Downloads: 4
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