ABSTRACT
INTRODUCTION AND OBJECTIVE: The prevalence of Covid-19 has become a clinical threat worldwide. However, knowledge about this new virus is limited. Therefore, this study was conducted to determine the preventive behaviors of Covid-19 based on the constructs of health belief model (HBM) in the clients of health centers in Zabol, Iran. METHODS: This descriptive-analytical (cross-sectional) study was performed on 160 people referring to health centers in Zabol by the available method. A researcher-made questionnaire was used to collect data. Data were analyzed using SPSS20 software and appropriate statistical tests. RESULTS: A positive and significant correlation was observed between preventive behaviors of Covid-19 and perceived benefit constructs (r = 0.29, P = 0.0001) and self-efficacy (r = 0.39, P = 0.0001). HBM constructs were able to predict about 36% of the variance of Covid-19 disease preventive behaviors, with self-efficacy (B = 0.134) being the strongest predictor. CONCLUSION: Since no specific and definitive treatment for Corona has been found yet, taking preventive measures can be the best way to prevent the spread of this disease in the community. Therefore, this can be achieved by raising awareness and preventive behaviors through health education.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Health Knowledge, Attitudes, Practice , Health Education , Health Belief ModelABSTRACT
With the declaration of the COVID-19 pandemic by the World Health Organization in March 2020, many elements of society were faced with attempting to assimilate public health recommendations for infectious control. Vital social organizations had to balance delivering their social services while attempting to stay up to date with COVID-19 information and comply with evolving regulations. In the realm of schools and school systems, guidance on how to best adapt to COVID-19 was often limited. School officials and staff had to assist with multiple public health crises as a consequence of the pandemic, from the pandemic's transmission prevention strategies (e.g., face masks and physical distancing) to the recognition that students would have personal tragedies related to COVID-19. In this review, we highlight the process and feasibility of implementing an international COVID-19 school-based initiative over two years of the pandemic, the Health Education and Training (HEAT) Corps program.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Pandemics/prevention & control , Hot Temperature , Infection Control , Health EducationABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection has brought new challenges to the global prevention and control of coronavirus disease 2019 (COVID-19) pandemic; however, current studies suggest that there is still great uncertainty about the risk of severe COVID-19 and poor outcomes after SARS-CoV-2 reinfection. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) of severity, outcomes and symptoms of reinfection. Random-effects were used to estimate the pooled odds ratios (OR) and its 95%CI of severity and outcomes between reinfections and primary infections. Nineteen studies involving a total of 34,375 cases of SARS-CoV-2 reinfection and 5,264,720 cases of SARS-CoV-2 primary infection were included in this meta-analysis. Among those SARS-CoV-2 reinfection cases, 41.77% (95%CI, 19.23-64.31%) were asymptomatic, and 51.83% (95%CI, 23.90-79.76%) were symptomatic, only 0.58% (95%CI, 0.031-1.14%) manifested as severe illness, and 0.04% (95%CI, 0.009-0.078%) manifested as critical illness. The PPs for SARS-CoV-2 reinfection-related hospitalization, admission to ICU, and death were, respectively, 15.48% (95%CI, 11.98-18.97%), 3.58% (95%CI, 0.39-6.77%), 2.96% (95%CI, 1.25-4.67%). Compared with SARS-CoV-2 primary infection cases, reinfection cases were more likely to present with mild illness (OR = 7.01, 95%CI, 5.83-8.44), and the risk of severe illness was reduced by 86% (OR = 0.14, 95%CI, 0.11-0.16). Primary infection provided some protection against reinfection and reduces the risk of symptomatic infection and severe illness. Reinfection did not contribute to extra risk of hospitalization, ICU, or death. It is suggested to scientifically understand the risk of reinfection of SARS-CoV-2, strengthen public health education, maintain healthy habits, and reduce the risk of reinfection.
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COVID-19 , SARS-CoV-2 , Humans , Reinfection , Health Education , HospitalizationABSTRACT
INTRODUCTION: Public knowledge and recognition of stroke and prompt calls to ambulance services when stroke is suspected are vital to the survival of stroke patients and to minimize their disability. In this study, our aim was to investigate the effectiveness of an online education session to increase middle school (11-14-year-old) students' awareness of stroke. METHODS: An interactive education session was organized for students using the online education portal of a local middle school. The effectiveness of this intervention was measured using knowledge measurement tests before, immediately after, and three months after the session. The compliance of the data with the normal distribution was checked with the Kolmogorov-Smirnov test. The McNemar chi-square analysis was used to compare the distribution of correct and incorrect answers among the tests, and one-way analysis of variance was conducted to compare the mean values of correct answers. RESULTS: The students' stroke knowledge levels were found to be higher in both tests applied after the educational session and all the questions compared to the baseline evaluation. Stroke awareness was also determined to be higher among the students living with a family member aged over 65 years. CONCLUSIONS: Online interactive education can increase students' awareness of stroke. Such programs can be included in the education curriculum of schools. Public awareness of vital diseases should continue even in extraordinary situations, such as pandemics.
Subject(s)
Health Education , Stroke , Humans , Aged , Child , Adolescent , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , Students , Stroke/diagnosis , Stroke/therapyABSTRACT
Despite challenges due to the COVID-19 pandemic, reports from regional and national meetings of the Expanded Food and Nutrition Education program (EFNEP) have provided anecdotal evidence that the program has persevered, pivoted, and continued to positively impact the lives of some of the nation's most vulnerable populations. However, there have been necessary changes to program delivery, inevitable changes in the lives of participants, and changes in the food environment that may have impacted program outcomes. This study compares national EFNEP data (demographics, behavior change data, and 24 h dietary recall data) of participants from two federal fiscal years, before the COVID-19 pandemic and during the pandemic. Linear mixed model analysis of variance and covariance were used to assess the effects of year on program outcomes. Results of this study provide quantitative evidence of the resiliency of EFNEP to facilitate positive behavior changes related to diet quality, physical activity, food safety, food resource management, and food security. Amidst changes in the food environment during the COVID-19 pandemic, these results emphasize the importance and value of federal nutrition education programs in any food environment.
Subject(s)
COVID-19 , Pandemics , Humans , COVID-19/epidemiology , Diet , Health Education , Health BehaviorABSTRACT
Systematic reviews have shown a prevalence close to 20% of gastrointestinal symptoms in COVID-19 positive patients, with nearly 40% of patients shedding viral RNA in their faeces, even if it may not be infectious, possibly because of inactivation by colonic fluid.According to current evidence, this virus is primarily transmitted by respiratory droplets and contact routes, including contaminated surfaces. The virus is quite stable on stainless steel, being detected up to 48-72 hours after application. Therefore, some individuals can be infected touching common contaminated surfaces, such as bathroom taps. Taps can be underestimated critical points in the transmission chain of the infection. Indeed, just by turning the knob, people leave germs on it, especially after coughing over their hands, sneezing, and/or blowing their nose. After handwashing with soap, user take back their germs when turning the knob. Paradoxically, the following user collects the germs back on his/her fingers by implementing a preventive measure, maybe before putting food into the mouth or wearing contact lenses.The Italian National Institute of Health recommends to clean and disinfect high-touched surfaces, but it is unrealistic and inefficient to do so after each tap use. As an alternative, new toilets should install long elbow-levers - or at least short levers - provided that people are educated to close them with the forearm or the side of the hand. This is already a standard measure in hospitals, but it is particularly important also in high-risk communities, such as retirement homes and prisons. It would be important also in schools, in workplaces, and even in families, contributing to the prevention both of orofaecal and respiratory infections.In the meantime, people should be educated to close existing knobs with disposable paper towel wipes or with toilet paper sheets.
Subject(s)
Bathroom Equipment/virology , COVID-19/prevention & control , Fomites/virology , Hand Hygiene , Health Education , SARS-CoV-2/physiology , COVID-19/transmission , Equipment Contamination , Equipment Design , Feces/virology , Female , Humans , Italy , Male , SARS-CoV-2/isolation & purification , TouchABSTRACT
With the global outbreak of coronavirus disease 2019 (COVID-19), public health has received unprecedented attention. The cultivation of emergency and compound professionals is the general trend through public health education. However, current public health education is limited to traditional teaching models that struggle to balance theory and practice. Fortunately, the development of artificial intelligence (AI) has entered the stage of intelligent cognition. The introduction of AI in education has opened a new era of computer-assisted education, which brought new possibilities for teaching and learning in public health education. AI-based on big data not only provides abundant resources for public health research and management but also brings convenience for students to obtain public health data and information, which is conducive to the construction of introductory professional courses for students. In this review, we elaborated on the current status and limitations of public health education, summarized the application of AI in public health practice, and further proposed a framework for how to integrate AI into public health education curriculum. With the rapid technological advancements, we believe that AI will revolutionize the education paradigm of public health and help respond to public health emergencies.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Artificial Intelligence , Curriculum , Health EducationABSTRACT
The Covid-19 pandemic revealed once again the unsustainable social inequities that resulted in a disproportionate number of illnesses and deaths among different social groups. Public health must take its leading role in public policy to advance the social determinants that affect the health and well-being of populations. Public policy and the workforce must continue to prioritize population's wellbeing and health equity by challenging the status quo. Thus, it is a pressing necessity to evolve and transform public health education by developing and integrating the culture of agile change, embracing structural transformations and shifting to a lifelong learning approach. The paradigm shift in public health education should emphasize interprofessional and intersectoral approaches, the development of human and social competencies, a lifelong learning perspective and the implementation of new pedagogical and technological strategies. A holistic curricular approach which highlights the importance of public policy and the right to health and social justice should also be emphasized. This transformation must occur taking into account/considering faculty development, investment in technology, flexibility for accreditation, and collaboration with employers in various sectors. Public health education must evolve in order to remain relevant and adequately prepare and equip the leaders and practitioners that the world requires. The current crisis is an opportunity to renew and redefine public health education.
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COVID-19 , Health Equity , Humans , Pandemics , Health Education , Public HealthABSTRACT
Massive open online courses (MOOCs) have emerged as an innovative educational technology relevant to and affecting higher education, professional development, and lifelong learning. This paper introduces the principles of MOOCs and reviews the development of these platforms over time. We reflect upon the considerable investment by institutions to develop, deliver and promote such courses, particularly in public health. While open to interpretation, the inherent power, influence, and effectiveness of MOOCs is unquestionable. The potential contribution of MOOCs to public health education is immense, with almost universal reach and access. However, apart from research into participant engagement and knowledge, MOOC-related research and evaluation continue to lag with the rapid proliferation of these courses in response to emerging challenges, as seen with the Coronavirus Disease 19 (COVID-19) pandemic. This makes analyzing the contribution of MOOCs to public health education, health promotion and community programs challenging. This perspective article provides a robust rationale for the necessity of MOOCs and their utility in upskilling health professionals and the general public. It builds on current knowledge to comprehensively explore the factors influencing the development, and application of MOOCs.
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COVID-19 , Education, Distance , Humans , Public Health , COVID-19/epidemiology , Health Education , Health PersonnelABSTRACT
BACKGROUND: Diarrhoeal diseases are an important cause of mortality in children younger than 5 years in sub-Saharan Africa. We aimed to evaluate the effect of three handwashing interventions on handwashing with soap (HWWS) after toilet use. METHODS: In this cluster randomised trial in Abidjan, Côte d'Ivoire, we randomly assigned communal housing compounds (1:1:1) to receive one of three interventions: a theory of normative social behaviour (TNSB) intervention, including provision of handwashing stations; handwashing stations only; and no intervention. The TNSB intervention was designed to shift the outcome expectation associated with HWWS from health to riddance of faeces-related disgust, and to increase the perceived descriptive norm and perceived handwashing publicness. Participants and fieldworkers were masked to the study objectives. The primary outcome was HWWS after toilet use, assessed at 1 month and 5 months follow-ups. Analysis was by intention to treat. This trial is registered at the Pan African Clinical Trial Registry, PACTR201501000892239. FINDINGS: Between April 10 and May 22, 2014, we identified 92 eligible compounds, of which 75 compounds were included. Follow-up data on HWWS were available for 23 compounds for the TNSB group, 25 compounds for the handwashing station-only group, and 25 compounds for the control group. The study ended in April, 2017. Compared with a frequency of 5% (29 of 604 occasions) in the control group, HWWS after toilet use increased to 9% (49 of 557 occasions; adjusted risk ratio 1·89, 95% CI 1·16-3·08) in the handwashing station-only group, and 24% (143 of 588 occasions; 4·82, 3·06-7·59) in the TNSB group, at the 1-month follow-up. The intervention effect was only sustained in the TNSB group (98 [22%] of 450 compounds; 2·68, 1·65-4·34). INTERPRETATION: A social norm-based handwashing intervention combined with disgust-inducing messages, with provision of handwashing stations, was effective at increasing HWWS after toilet use. The provision of handwashing stations alone had little effect. Future studies should investigate whether the same approach, when delivered via mass media, can have a similar effect to the face-to-face delivery used in this study. FUNDING: None.
Subject(s)
Diarrhea/prevention & control , Hand Disinfection/methods , Health Education/methods , Soaps/therapeutic use , Child , Child, Preschool , Cote d'Ivoire , Humans , Male , Sanitation/methodsABSTRACT
Massive open online courses (MOOCs) have emerged as an innovative educational technology relevant to and affecting higher education, professional development, and lifelong learning. This paper introduces the principles of MOOCs and reviews the development of these platforms over time. We reflect upon the considerable investment by institutions to develop, deliver and promote such courses, particularly in public health. While open to interpretation, the inherent power, influence, and effectiveness of MOOCs is unquestionable. The potential contribution of MOOCs to public health education is immense, with almost universal reach and access. However, apart from research into participant engagement and knowledge, MOOC-related research and evaluation continue to lag with the rapid proliferation of these courses in response to emerging challenges, as seen with the Coronavirus Disease 19 (COVID-19) pandemic. This makes analyzing the contribution of MOOCs to public health education, health promotion and community programs challenging. This perspective article provides a robust rationale for the necessity of MOOCs and their utility in upskilling health professionals and the general public. It builds on current knowledge to comprehensively explore the factors influencing the development, and application of MOOCs.
Subject(s)
COVID-19 , Education, Distance , Humans , Public Health , COVID-19/epidemiology , Health Education , Health PersonnelABSTRACT
BACKGROUND: Shortage of health professionals is one of the most important barriers for community health centers to provide quality primary care for chronic disease patients especially after the outbreak of COVID-19. Under such condition, medical students have been well-accepted as a force multiplier for community-based health service. Community service learning (CSL) based on medical student-led community health education service to support chronic disease self-management might be a valuable interactive learning tool in medical education. This study compared the attitudes toward medical student-led community health education service to support chronic disease self-management among three stakeholder roles in CSL, including medical students, faculty and patients. METHODS: This cross-sectional comparative survey was conducted using a self-developed questionnaire among the convenience samples of undergraduate students and faculty members from the Medical College, Wuhan University of Science and Technology, as well as patient volunteers with chronic diseases recruited from a free on-site clinic offered by a community health center. Attitudes toward medical student-led community health education service to support chronic disease self-management were compared among students, faculty and patients. RESULTS: A total of 515 valid questionnaires were obtained (342 were collected from medical students, 54 from faculty respondents, and 119 from patients). Overall positive attitudes toward medical student-led community health education service to support chronic disease self-management were positive. Among the three stakeholder roles, faculty and patients were more supportive of the current inadequate level of primary care provision within the community. However, patient respondents showed more negative attitudes towards using resources in higher medical education system to provide support for primary care practice, and participating in the medical student-led community health education service to support chronic disease self-management, and were most skeptical about the medical students' competency in supporting chronic disease self-management with their professional knowledge and skills. The educational value of CSL for medical undergraduates and the role of faculty instructors were most appreciated by faculty respondents. Additionally, > 62 years old and > 2 kinds of chronic diseases per patient exhibited significant correlations with positive patients' attitudes. CONCLUSIONS: Medical students, faculty and patients had overall positive attitudes towards CSL based on medical student-led community health education service to support chronic disease self-management. However, more should be done to create higher expectations and enthusiasm of patients about CSL.
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COVID-19 , Chronic Disease , Education, Medical, Undergraduate , Health Education , Self-Management , Students, Medical , Humans , Middle Aged , COVID-19/epidemiology , Cross-Sectional Studies , FacultyABSTRACT
Background: Successful media campaigns to reduce teen cigarette smoking indicate a similar approach may work for vaping, though message testing research is necessary to identify effective topics and approaches. Leveraging data from message testing studies across nine U.S. states, we identify promising topics and approaches and explore how the COVID-19 pandemic affected teens' reactions to vape education commercials. Methods: Teens ages 13-18 (N = 337) who vaped or were susceptible nonusers participated in focus groups and interviews (2018-2021) to review 35 creative concepts and commercials for Behind the Haze (BTH), a vaping education campaign. After viewing each video, participants assessed its perceived effectiveness (PE) and discussed their reactions. We conducted a reflexive thematic analysis of transcripts to identify crosscutting themes and compared PE scores for each video. Results: Key features of effective commercials included detailed facts accompanied by explanatory visuals, metaphors, and empathy. Promising topics included chemicals, physical consequences, and mental health, while addiction and industry deception messages were less impactful. The pandemic drew attention to mental health and immunity messages. Impact of one's vaping on friends emerged as a promising topic. Conclusions: While some tactics from successful cigarette prevention campaigns apply to vaping, others like anti-industry messaging do not. Fact-focused messaging on chemicals, physical consequences, and mental health accompanied by impactful graphics and attention-grabbing twists should be the focus of vape education campaigns. Frequent message testing research such as that conducted to inform BTH is necessary to identify promising and sometimes unexpected messaging approaches for timely and relevant teen vaping education materials.
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Health Education , Health Promotion , Vaping , Adolescent , Humans , COVID-19/epidemiology , Pandemics , Vaping/prevention & control , United States/epidemiology , Health Education/organization & administration , Health Promotion/methods , Health Promotion/organization & administration , Program Evaluation , Focus GroupsABSTRACT
BACKGROUND: Imported malaria cases remains a key health concern, especially during the COVID-19 pandemic. Providing accurate health information is important to improving people's awareness of malaria. WeChat is an excellent social media tool for health information dissemination, especially during the pandemic. This study explored the effect of malaria knowledge dissemination via a WeChat public account. METHODS: A questionnaire for data collection was constructed using the online survey tool Sojump. Questionnaires were sent to users who followed the Jiangsu institute of Parasitic Disease WeChat public account during the National Malaria Day 2021 period. A small incentive (WeChat Red Packet) was distributed to everyone who answered the questionnaire correctly on time. RESULTS: A total of 13,169 valid questionnaires were collected during the China National Malaria Day period. Questions in which participants focused mainly on information pertaining to themselves, such as infection, symptoms, and epidemic areas, reached highest accuracy (above 90%). Questionnaires were submitted through smartphones and most of them were completed during the period of 4 days from April 23 to April 26, 2021 when a WeChat Red Packet was offered. The accuracy of responses was related to bolded words and location and number of knowledge points that were shown at the beginning of the questionnaire. The number of users of the WeChat public account in question increased from 5961 to 12,339 in just 4 days of the activity. CONCLUSION: A WeChat public account is a convenient and accessible tool for spreading malaria-related health information to the public. Distribution of incentives (Red Packets) can effectively increase public attention to popular science and health information and activities.
Subject(s)
Awards and Prizes , COVID-19 , Malaria , Social Media , Humans , Pandemics , COVID-19/epidemiology , Health Education , Malaria/diagnosis , Malaria/epidemiology , China/epidemiologyABSTRACT
To promote COVID-19 preventive attitudes and behaviors among Latinx individuals, researchers and community partners implemented a culturally tailored health education intervention across 12 Oregon counties from February 2021 through April 2022. We did not identify any significant intervention effects on preventive attitudes and behaviors but did observe significant decreases in psychological distress. Although Latinx individuals' preventive attitudes and behaviors were not associated with the health education intervention, findings suggest the intervention has value in promoting their well-being (ClinicalTrials.gov Identifier: NCT04793464). (Am J Public Health. 2022;112(S9):S923-S927. https://doi.org/10.2105/AJPH.2022.307129).
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COVID-19 , Psychological Distress , Humans , COVID-19/prevention & control , Health Education , Research PersonnelABSTRACT
OBJECTIVE: To construct and validate a mobile application for health education about COVID-19. METHOD: Methodological study, developed in six stages, in the state of Rio de Janeiro, between June 2020 and August 2021, with 20 health professionals, using an electronic form. Validation took place through the Content Validity Index, whose indexes should be greater than or equal to 80%. RESULTS: The application called ROBOVID was constructed and validated by expert judges on the subject, with a Content Validity Index of 100% for the domains of content and cultural adequacy, and with a variation of 90 to 100% for the domains of language, illustration, and presentation, achieving 97% on the Overall Validity Index and 98% on the "ten golden rules" for use in health education. CONCLUSION: The ROBOVID application proved to be a valid technological tool for health education about COVID-19 among the Brazilian population.
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COVID-19 , Mobile Applications , Humans , Brazil , Surveys and Questionnaires , COVID-19/epidemiology , COVID-19/prevention & control , Health EducationABSTRACT
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
Subject(s)
COVID-19 , Delphi Technique , International Cooperation , Public Health , Humans , COVID-19/economics , COVID-19/epidemiology , COVID-19/prevention & control , Government , Pandemics/economics , Pandemics/prevention & control , Public Health/economics , Public Health/methods , Organizations , COVID-19 Vaccines , Communication , Health Education , Health Policy , Public OpinionABSTRACT
Although widespread vaccination in correctional facilities is crucial for preventing COVID-19 morbidity and mortality in these institutions and their surrounding communities, there are little data on how to effectively perform vaccine outreach to people experiencing incarceration who remain unvaccinated. In this article, we describe lessons learned from a successful vaccine education initiative in California state prisons and describe opportunities for application to other correctional settings. (Am J Public Health. 2022;112(11):1543-1545. https://doi.org/10.2105/AJPH.2022.307042).
Subject(s)
COVID-19 , Prisons , COVID-19/prevention & control , California , Health Education , Humans , Vaccination HesitancyABSTRACT
Bronchial asthma among children is a common chronic disease that may impact quality of life. Health education is one of the strategies to improve knowledge and quality of life. This study aims to assess the effect of health education via a mobile application in promoting the quality of life among schoolchildren with asthma in urban Malaysia during the COVID-19 era. A quasi-experimental, pre- and post-intervention design was used in this study involving a total of 214 students, randomly assigned into two groups (an intervention group and a control group). The control group received face-to-face health education, whereas the experimental group received health education via a mobile application. The findings showed that the total score of quality of life improved from a mean total score at pre-intervention of 5.31 ± 1.27 to post-intervention of 5.66 ± 1.28 for the control group, compared with the experimental group with a mean total score of quality of life at pre-intervention of 5.01 ± 1.36 and post-intervention of 5.85 ± 1.29. A comparison between the experimental and control groups using an independent t test showed statistically significant differences in their mean quality of life scores. The effect of health education via a mobile application showed a statistically significant improvement in the mean quality of life score from pre- to post-intervention ( F1,288 = 57.46, P < .01). As recommended, the use of mobile technology in health education improved the quality of life of schoolchildren with asthma as compared with the traditional methods of a face-to-face lecture and/or a handbook. Thus, educational modules using mobile applications do improve quality of life.