https://dspace.ewha.ac.kr/handle/2015.oak/171574 Sun, 05 Apr 2026 02:36:05 GMT 2026-04-05T02:36:05Z https://dspace.ewha.ac.kr/handle/2015.oak/274965 Title: Effect of social and digital media mental health messaging on mental health help-seeking behaviors in the sub-Saharan African population: A systematic review protocol Ewha Authors: Peter J. Schulz Abstract: Mental health is a major public health concern, with disproportionate burdens in sub-Saharan Africa (SSA), where access to care is limited and stigma remains high. Social and digital platforms, including social media, mobile health (mHealth) applications, and SMS-based messaging, provide opportunities for information sharing, peer engagement, and tailored interventions that may enhance literacy and normalize help-seeking. Yet, they pose risks, including misinformation, exposure to harmful content, and reinforcement of stigma in diverse contexts. Despite this potential, evidence from SSA on the effects of social and digital media messaging on mental health knowledge, attitudes, behaviors, and help-seeking is scarce. This systematic review will assess the effect of social and digital media mental health messaging on help-seeking behaviors in SSA. Electronic databases, including PubMed, Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Communication and Mass Media Complete, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Educational Resource Information Centre (ERIC), ProQuest Sociology, Google Scholar and Embase will be systematically queried using predefined keywords without language restrictions to ensure comprehensive evidence capture. Eligible studies will include interventions delivering mental health messaging through social media, mHealth applications, SMS, web-based platforms, or hybrid approaches, analyzing behavioral and psychological outcomes, and any kind of intervention studies. Methodological quality and risk of bias will be assessed using validated tools appropriate to each study design, including the Cochrane Risk of Bias 2 (RoB 2) tool, Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Where appropriate, data will be synthesized with or without meta-analysis. This synthesis will clarify how social and digital media shape mental health outcomes, describe patterns across delivery channels, identify gaps, and inform culturally sensitive interventions to improve communication and promote mental health help-seeking in SSA. © 2026 Boateng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Thu, 01 Jan 2026 00:00:00 GMT https://dspace.ewha.ac.kr/handle/2015.oak/274965 2026-01-01T00:00:00Z https://dspace.ewha.ac.kr/handle/2015.oak/274957 Title: Investigating the role of executive function in brain responses to infant crying among new parents Ewha Authors: Pil Young Kim Abstract: Infant crying is a fundamental communication signal that captures caregiver attention and elicits caregiving responses. Executive function (EF) is critical in managing the cognitive and emotional demands of parenting, particularly in processing infant cues. This study explored the relationship between experienced EF difficulties and neural responses to infant crying among biological birthing parents. Participants were pregnant individuals from the Relationships of Parent–Infant Social, Emotional, and Brain Development project who completed the Behavior Rating Inventory of Executive Function—Adult Version during the third trimester. Postpartum, functional Magnetic Resonance Imaging measured brain activation in response to their own and other infants’ cries, as well as control sounds. Greater experienced EF difficulties during pregnancy were prospectively associated with increased cry-evoked activation in lateral temporal regions, including a conjunction cluster in the left middle temporal gyrus shared across all four EF subdomains, and overlapping recruitment of regions such as the left superior temporal gyrus and right inferior frontal gyrus across multiple subdomains. These findings suggest that caregivers who report greater EF difficulties engage heightened auditory–temporal and control-related neural responses when processing infant distress signals, underscoring the relevance of EF-related individual differences for early parenting neurobiology. © The Author(s) 2026. Published by Oxford University Press. Thu, 01 Jan 2026 00:00:00 GMT https://dspace.ewha.ac.kr/handle/2015.oak/274957 2026-01-01T00:00:00Z https://dspace.ewha.ac.kr/handle/2015.oak/274934 Title: Seeking But Not Discussing Online Health Information With Physicians: Cross-Sectional Survey Study of eHealth Literacy–Empowerment Profiles and Patient-Centered Communication Ewha Authors: Peter J. Schulz Abstract: Background: Patients frequently search for health information online and value physician support in evaluating and interpreting their findings, yet many hesitate to share their online searches with their physicians. This hesitation hinders shared decision-making and compromises patient care. While extensive research has examined patients’ online health information–seeking behaviors, little has focused on patients’ disclosure of this information to their physicians during consultations. Objective: Guided by the Health Empowerment Model and the Linguistic Model of Patient Participation in Care, this study aims to (1) identify distinct patient profiles based on eHealth literacy and psychological health empowerment levels, (2) examine how these patient profiles differ in online health information seeking and disclosure to physicians, and (3) investigate whether patient-centered communication (PCC) promotes information disclosure and whether this effect varies by patient profile. Methods: This cross-sectional study surveyed 2001 Chinese participants recruited through convenience sampling. Patient profiles were identified using k-means cluster analysis with standardized z scores of eHealth literacy and psychological health empowerment. Differences between profiles in information behaviors were examined using 1-way Welch ANOVA, chi-square tests, and pairwise comparisons. Regression analyses examined the association between PCC and disclosure of online health information. Moderation analyses using the Hayes PROCESS macro assessed whether this association varied across patient profiles. Results: Four distinct patient profiles were identified: effective self-managers (996/2001, 49.8%), moderate-needs dependent patients (408/2001, 20.4%), high-needs patients (68/2001, 3.4%), and dangerous self-managers (529/2001, 26.4%). Profiles differed significantly in information-seeking intentions (F3,289=62.09; P<.001; η2=0.12) and disclosure intentions (F3,299.41=66.08; P<.001; η2=0.09). “Effective self-managers” showed the highest seeking (mean 4.01, 95% CI 3.96-4.06) and disclosure intentions (mean 3.43, 95% CI 3.36-3.50), while “high-needs patients” showed the lowest intentions for both behaviors. Actual information-seeking rates also differed significantly across profiles (χ23=103.4; P<.001), with “effective self-managers” having the highest rate (800/996, 80.3%) and “high-needs patients” the lowest (25/68, 36.8%). Among seekers, disclosure rates varied significantly (χ23=23.1; P<.001), with “high-needs patients” showing the highest disclosure (16/25, 64%) despite having the lowest seeking rate. PCC was positively associated with actual information disclosure behavior (odds ratio 1.26, 95% CI 1.04-1.53; P=.02), with no significant moderation by patient profiles (χ23=1.7; P=.64). Conclusions: This study extends existing literature from information-seeking behavior to patients’ disclosure of online findings to physicians. Unlike prior research that examined eHealth literacy and psychological health empowerment separately, this study integrated these constructs to identify meaningful patient profiles with distinct information behavior patterns. PCC facilitates disclosure regardless of patient profile. For practice, physicians should adopt a PCC that acknowledges patients’ online research efforts, promoting safer information use and stronger patient-physician relationships. ©Qianfeng Lu, Wen Jiao, Angela Chang, Peter Johannes Schulz. Thu, 01 Jan 2026 00:00:00 GMT https://dspace.ewha.ac.kr/handle/2015.oak/274934 2026-01-01T00:00:00Z https://dspace.ewha.ac.kr/handle/2015.oak/274921 Title: Linking women’s empowerment to modern contraceptive use: evidence from the Tanzania demographic and health survey 2022 Ewha Authors: 강민아 Abstract: Background: High fertility rates in sub-Saharan Africa underscore the importance of contraceptive use in managing population growth. While previous studies have linked women’s empowerment to contraceptive behavior, this study adopts a multidimensional approach, emphasizing decision-making autonomy, resource access, and negotiation skills. By examining these distinct dimensions, the study provides a more comprehensive understanding of how empowerment influences modern contraceptive use among women in Tanzania, offering insights for targeted reproductive health strategies. Methods: This cross-sectional study analyzed data from the 2022 Tanzania Demographic and Health Survey (TDHS), which focuses on 8236 currently married, non-pregnant women aged 15–49 years. The empowerment indicators included participation in household decision-making, attitudes toward intimate partner violence, negotiation of sexual relationships, property ownership, and social independence. Descriptive and bivariate analyses were conducted, followed by multivariate logistic regression to assess associations. The analyses incorporated complex survey design adjustments for national representativeness. Results: Modern contraceptive use was reported by 34.9% of women. The significant factors associated with greater contraceptive use included education, household wealth, employment, media exposure to family planning messages, and empowerment indicators. Women participating in all three household decision-making domains (AOR 1.64, 95% CI 1.36–1.98), negotiating sexual relationships (AOR 1.41, 95% CI 1.19–1.67), and owning both a house and land (AOR 1.47, 95% CI 1.27–1.70) presented significantly higher odds of modern contraceptive use. Conclusions: Women’s empowerment significantly influences modern contraceptive use. Enhancing women’s autonomy, decision-making power, and socioeconomic opportunities should be prioritized in family planning initiatives. Addressing structural and social barriers that limit women’s agency will help ensure informed reproductive health choices, ultimately promoting gender equity and sustainable development. © The Author(s) 2025. Thu, 01 Jan 2026 00:00:00 GMT https://dspace.ewha.ac.kr/handle/2015.oak/274921 2026-01-01T00:00:00Z