Health conversations with artificial intelligence (AI) chatbots are rapidly increasing; 17% of US adults consult AI chatbots about health monthly, and the figure reaches 25% among those under 30. In Korea, generative AI use reached 33.3% in 2024, nearly doubling from the previous year. Yet academic discourse has largely focused on information accuracy and patient safety. I propose reframing AI health conversations as a potential mediator of health behavior change. Drawing on systematic reviews showing that AI chatbots can support physical activity and smoking cessation, I connect these findings to the transtheoretical model processes of change and the health belief model construct of self-efficacy. I describe the “information-to-action question shift” as a mechanism that may drive the transition from contemplation to action, and discuss intersections with Korea’s Fifth National Health Plan (HP2030) health literacy goals.

Background: This study investigated how perceived knowledge, threat, and coping appraisals, moral obligation, and social approval influence voluntary mask-wearing intentions within an integrated framework combining Protection Motivation Theory (PMT) and the Theory of Reasoned Action (TRA). Understanding the drivers of protective behaviors after mandates are lifted is essential for sustaining public health practices. In the United States—where mask wearing is not culturally normative—such behaviors rely on internal motivations rather than external enforcement. Methods: Using data from a nationwide online survey of 360 U.S. adults, structural equation modeling was employed to test relationships among perceived knowledge, threat appraisal, coping appraisal, moral obligation, social approval, and behavioral intention. Results: Perceived knowledge significantly predicted both coping and threat appraisals. Coping appraisal influenced moral obligation, while threat appraisal affected both moral obligation and social approval. Among all predictors, only moral obligation significantly predicted behavioral intention, which in turn predicted protective behavior. Conclusions These findings highlight the central role of moral obligation and coping appraisal as key drivers of voluntary health protective intentions. The integrated PMT–TRA model provides actionable insights for sustaining motivation in low-threat contexts and offers guidance for shaping future public health strategies.

Background: Handgrip strength (HGS) is an indicator of late-life health, associated with disability, cardiovascular and all-cause mortality. While exercise helps maintain HGS, diabetes may reduce its benefits. This study investigated the association between exercise and low HGS (LHGS) stratified by diabetes status and sex. Methods: Data from 16,443 participants in the 2017–2019 Korea National Health and Nutrition Examination Survey were analyzed. HGS was measured using a digital dynamometer. Exercise type and frequency were assessed by questionnaire. Three-way and twoway interaction terms were analyzed for exercise, sex and diabetes. Results: Aerobic exercise, resistance exercise, and diabetes were significantly associated with LHGS (P<0.05). A significant interaction between diabetes and aerobic exercise was observed in females (odds ratio [OR] of LHGS=1.704, 95% confidence interval= 1.073–2.707). Among males, both exercise types were associated with lower odds of LHGS regardless of diabetes status, except for aerobic exercise in non-diabetic males. Among males, the ORs of LHGS for aerobic and resistance exercise were 0.479 (0.278– 0.827) and 0.317 (0.165–0.611) with diabetes, 0.757 (0.554–1.035) and 0.536 (0.360–0.798) without diabetes. Among females, the ORs of LHGS for aerobic exercise and resistance exercise were 1.109 (0.716–1.719) and 0.529 (0.224–1.249) with diabetes, 0.676 (0.539–0.848) and 0.795 (0.564–1.121) without diabetes. Conclusions The modifying effect of diabetes on the relationship between exercise and grip strength was observed in females but not in males. Females with diabetes may require tailored exercise guideline to prevent LHGS.

Background: This study aimed to investigate the effects of upper-extremity heat stress combined with resistance training and resistance training alone on body composition, skill and basal fitness, isokinetic muscle strength, and anabolic hormone levels in wheelchair rugby athletes with spinal cord injury. Methods: Fourteen male national wheelchair rugby athletes with cervical-level spinal cord injury were randomly assigned to the heat stress combined with resistance training (n=7) or resistance training group (n=7). Both groups completed a 10-week upper-extremity resistance training program. Additionally, heat stress was applied to the upper-extremity of the heat stress combined with resistance training group using steam-generating thermal sheets three times per week. Measurements conducted pre- and post-intervention included body composition, skill and basal fitness (one-hand throw, chest throw, 28 m shuttle sprint, and 20 m sprint), isokinetic strength (using the Cybex system at 60°/sec and 180°/sec), and anabolic hormones (growth hormone and insulin-like growth factor). Non-parametric tests (Wilcoxon signed-rank and Mann-Whitney U test) were used for statistical analysis (α=0.05). Results: The heat stress combined with resistance training group showed significant increases in skeletal muscle mass and upper-extremity isokinetic elbow joint strength, particularly in flexion (%BW) and extension (%BW) at 60°/sec. Growth hormone levels increased significantly only in this group, while insulin-like growth factor levels showed marginal improvement. Both groups improved in 28 m shuttle sprint and one-hand throw; however, the heat stress combined group showed a greater effect size in the 20 m sprint. No significant changes were observed in body mass index or body fat percentage. Conclusions The combination of heat stress and resistance training may provide additional benefits in enhancing upper-extremity muscle strength and stimulating anabolic hormone responses in wheelchair rugby athletes with spinal cord injury. These findings suggest a promising and practical strategy for optimizing training adaptations in this athletic population.

Background: This study examined the factors influencing digital literacy among older adults aged 65 and older, focusing on the roles of social capital and life satisfaction in urban and rural contexts. Methods: A secondary analysis was conducted using microdata from the Digital Information Gap Survey 2023, a nationally representative dataset collected by the National Information Society Agency. Data from 974 seniors aged 65 or older who have experience using the internet and own a mobile device were analyzed using descriptive statistics. In this study, digital literacy was measured by personal computer use ability and mobile use ability. Pearson’s correlation, and hierarchical regression analyses to identify predictors of digital literacy. Results: Digital literacy was significantly higher in urban areas than in rural areas (t=–5.954, P<0.001). In both settings, younger age,men gender, higher educational attainment, and greater household income were associated with higher digital literacy. Social capital was a significant predictor in urban (β=0.089, P=0.008) and rural (β=0.230, P=0.003) groups, whereas life satisfaction significantly influenced digital literacy only in urban areas (β=0.070, P=0.036). For rural older adults, household type (non-single-person households) was also a significant predictor. Conclusions The findings highlight distinct patterns in the determinants of digital literacy between urban and rural older adults. Enhancing social capital and addressing socioeconomic disparities are essential to narrowing the digital divide, particularly in rural areas. Context-sensitive and community-based programs should promote digital inclusion and improve the quality of life among older adults.

Background: Maternal mental health is a critical component of overall well-being, influencing both mothers and their children. In Ethiopia, maternal mental health disorders are prevalent but remain under-addressed due to limited healthcare infrastructure, social stigma, and a shortage of trained mental health professionals. Community-based interventions (CBIs) have shown promise in improving maternal mental health outcomes in low- and middle-income countries. Methods: This systematic review evaluates the effectiveness of CBIs in improving maternal mental health outcomes in Ethiopia, identifying key intervention strategies and challenges. Following PRISMA guidelines, a comprehensive literature search was conducted across multiple databases (PubMed, Scopus, Google Scholar, and CINAHL) for studies published between 2000 and 2023. Eligible studies included randomized controlled trials, quasi-experimental studies, cohort studies, and qualitative research on CBIs targeting maternal mental health in Ethiopia. A total of 65 studies were screened, with 29 meeting the inclusion criteria. Data were synthesized narratively to highlight key themes. Results: CBIs included peer-support groups, health extension worker (HEW)-led home visits, integrated maternal health services, and community awareness programs. Peer-support groups reduced depressive symptoms by 40% to 50% by fostering emotional resilience and reducing social isolation. HEW-led interventions improved mental health literacy and increased help-seeking behaviors by 25%. Integrating mental health care into routine maternal services enhanced screening rates by 60%. However, key barriers included stigma, lack of HEW mental health training, and resource constraints. Conclusions CBIs are effective in improving maternal mental health in Ethiopia. Scaling up successful programs requires enhanced HEW training, community engagement, and integration into existing healthcare frameworks. Addressing social stigma and sustainability challenges is crucial for long-term impact.

Background: Middle-aged cancer survivors lack specific health guidelines compared to young and old cancer survivors. Their increased prevalence necessitates the establishment of tailored health guidelines. This study aimed to investigate the health-related behaviors of middle-aged cancer survivors compared to those of the general population. Methods: This cross-sectional study analyzed 17,332 adults aged 40–65 years who participated in the sixth and seventh Korea National Health and Nutrition Examination Survey (2013–2018). Data on cancer screening, alcohol consumption, smoking, physical activity, sedentary time, and dietary management were collected via self-reported questionnaires. Propensity score matching (1:5) revealed 591 middle-aged cancer survivors and 2,955 non-cancer controls. Descriptive statistics, chi-square tests, and logistic regression analyses were conducted to compare the demographic characteristics and health-related behaviors of both groups. Results: Multivariate analysis revealed that middle-aged cancer survivors were significantly less likely to consume alcohol (odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.51–0.81) and smoke (OR: 0.65; 95% CI: 0.43–0.99) and more likely to engage in aerobic physical activity (OR: 1.33; 95% CI: 1.08–1.64) and practice dietary management (OR: 1.47; 95% CI: 1.17–1.84) than the non-cancer controls. However, no significant differences in cancer screening adherence and sedentary time were observed between both groups. Conclusions Overall, this study provides fundamental data for the development of tailored health guidelines and patient education programs for cancer survivors.

Background: This study aim to compare between middle and high school students on the relationship of high-caffeine drinks and mental health. Methods: This national cross-sectional secondary study used data from the 20th Korea Youth Risk Behavior Survey (2024). The respondents of this study were 54,653 middle and high school students. Descriptive statistics, chi-square analysis, and complex sample logistic regression analysis were performed using IBM SPSS Statistics 25.0. Results: Respondents of ‘much’ perceived stress consumed 1.493 times (P<0.001) more high-caffeine drinks in middle school and 1.699 times (P<0.001) in high school than those of ‘little.’ Respondents of ‘yes’ sadness & despair consumed 1.189 times (P<0.001) more high-caffeine drinks in middle school and consumed 1.142 times (P<0.001) in high school than those of ‘no.’ Suicidal ideation and loneliness variables were statistically significant in middle school, but not in high school. Conclusions It was concluded that middle and high school students who were more stressed and experienced sadness & despair consumed more high-caffeine drinks. However, only middle school students who experienced suicidal ideation and loneliness consumed more high-caffeine drinks. Recognizing each characteristic of middle and high school students, tailored intervention program should be developed based on the community and school.

Background: The stimulatory effects of caffeine contribute to poor sleep quality. However, the relationship between caffeinated beverages and sleep quality, considering frequency or types of caffeinated beverages, were not extensively studied. Methods: Data were collected from 160 urban workers (75 men [46.9%] aged 20–69 years; with an average age of 41.8±12.3 years) using a structured, self-administered online questionnaire. Sleep quality, time, satisfaction; types and frequency of caffeinated beverages (number of cups per week; Q1: 0 cup, Q4: 14 or more cups per week), demographics, and health behaviors were asked. Sleep quality were evaluated using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). Multiple regression analysis was conducted on the association between the frequency of caffeinated beverages consumption and sleep quality. Results: The most frequently consumed beverages were unsweetened coffee (22.8%) and the most common time for caffeine was between 12 pm to 5 pm (58.2%). The average sleep quality score based on the PSQI-K was 6.0±2.0 overall, 5.3±1.6 in Q1, and 6.6±2.2 in Q4 (frequent caffeinated beverage drinkers), indicating poorer sleep quality in Q4 (P=0.022). In Q1, 13.3% rated their sleep quality as ‘very good,’ while in Q4, only 2.5% gave the same rating. Poor sleep quality was significantly associated with the frequency of caffeinated beverages per week (β=0.232, P=0.004) and self-reported stress level (β=0.256, P=0.002). Conclusions Frequent consumption of caffeinated beverages appears to be associated with poor sleep quality among urban workers. While reducing caffeine intake may contribute to improvements in sleep quality as a health promoting behavior, this hypothesis requires validation through future studies employing personalized intervention approaches.