Health Promotion International最新文献

This study contributes to ongoing reflections and debate on the legacy of the Ottawa Charter by illustrating how contemporary forms of intersectoral collaboration can be mobilized to address persistent health inequalities. Collaborations involving organizations from diverse sectors are often viewed as well-positioned to tackle complex health challenges, yet they frequently encounter political, organizational and cultural barriers that hinder their effectiveness. This paper uses a longitudinal approach to explore issues in relation to the formation and sustainability of a multi-sector collaboration in one geographic area in the UK, working under the banner of the Health Determinants Research Collaboration (HDRC)-a programme which seeks to further understand health determinants and to improve health outcomes in communities. Through qualitative interviews at two time points-12 months apart-with constituents of the collaboration, the data demonstrated a clear and shared vision for the collaboration and a neat 'dovetailing' of skill-sets related to community brokerage; academic rigour; and statutory legitimacy. While the collaboration under focus here was in its infancy, cultural, and practical tensions in ways of working; trust issues; pace of working; and philosophy were predicted to, and indeed did, emerge and required careful monitoring to ensure intended outcomes were not derailed.

Health professionals play an important role in addressing health literacy and ensuring that health systems and information are easy to understand, access, and navigate. We conducted a scoping review to identify and describe measures and tools that assess health professionals' health literacy competency related to knowledge, skills, practices, attitudes, self-efficacy, and behavioural intentions. Electronic databases MEDLINE, Embase, CINAHL, PubMed, and Scopus were searched in August 2023 and updated in November 2024. Articles were eligible if they included a measure of health professionals' knowledge, skills, and competencies related to health literacy. We included quantitative studies conducted in all clinical settings and all study types. Two authors independently screened titles, abstracts, and full text articles. The relevant data were extracted and narratively synthesized. In total, 128 articles were identified. We identified 88 unique measures to assess health professionals' health literacy competencies, which were applied across a range of health professional contexts. Overall 59% (n = 76) of tools were purpose-built and used only once. The most frequently assessed domain of health literacy competency was performance-based knowledge, assessed by 45 unique measures. Thirty-seven unique measures reported some form of validity and/or reliability testing, however, of these measures only 16% (n = 6) examined construct validity. This review provides a comprehensive overview of existing measures and highlights the need for rigorous and externally valid tools that are more closely aligned with health literacy competency frameworks.

The increased pressures associated with the cost-of-living crisis (CoLC) have been demonstrated to impact population health. Research has shown that women are particularly vulnerable to negative life and health experiences associated with cost-of-living pressures, which are exacerbated by a range of gendered structural inequities. To date, very few studies have qualitatively explored the impact of the CoLC on the lives of women. A qualitative online survey was conducted with n = 570 younger Australian women (18-40 years old). The study explored the health and social impacts of the CoLC on younger women's lives and their suggestions about the range of policy responses that could help women during times of economic crisis. Three themes were constructed from the data using a reflexive approach to thematic analysis. First, participants described the CoLC as a source of stress that shaped their everyday lives, particularly in relation to food insecurity, unaffordable housing, student debt, and insecure or underpaid employment. Second, the CoLC was perceived to have a direct negative impact on participants' health and social outcomes, with participants reporting that they were sacrificing basic needs, avoiding necessary medical and dental care, and experiencing impacts on their mental health. Third, participants called for consideration of equity in policy reform, housing and pricing reform, and expanded healthcare access. The findings highlight the urgent need for gender-responsive economic and social policies in order to reduce health inequities exacerbated by financial crises.

Ultra-processed food (UPF) production and consumption, associated with chronic disease and environmental degradation, is increasing globally. The UPF concept has gained public attention in recent years and has raised concerns of confusion among the public. This study aimed to explore Reddit-a popular online forum platform-discussions about UPFs to identify the main topics of discussion and how UPFs are discussed. A descriptive constructivist approach to qualitative content analysis was used to analyse threads from the r/ultraprocessedfood subreddit, with over 34 000 subscribers. The 'top' 50 threads from the subreddit (i.e. threads with highest engagement) were collected in January 2025. A coding framework was developed deductively to capture a range of UPF issues, including impacts and causal mechanisms. Two authors coded 50 threads comprised of 2730 comments and posted between 2023 and 2025. The most frequently discussed topic was food [n = 45 (90%) threads, n = 1188 (43.5%) comments], followed by dietary patterns [n = 37 (74%) threads, n = 415 (15.2%) comments], health [n = 43 (86%) threads, n = 404 (14.8%) comments], food system [n = 34 (68%) threads, n = 323 (11.8%) comments], and nutri-biochemical components [n = 34 (68%) threads, n = 322 (11.8%) comments]. The least discussed topic was planetary health [n = 13 (26%) threads, n = 25 (0.9%) comments]. Most comments contained information (n = 2,088, 76.5%) or personal strategies/experiences (n = 901, 33%), with a smaller number containing questions (n = 315, 11.5%) or expressing confusion (n = 15, 0.01%). Reddit users often expressed a love for cooking and anger towards unethical food industry practices and UPF harms. Public health communications may benefit from framing UPF messaging around social justice. This paper includes discussion of disordered eating.

A harmful algal bloom (HAB) has spread to a third of South Australia's coasts, has devastated marine life and is affecting human physical and mental health and the fishing and tourism industries. We examine Australian Federal and State environmental and agricultural public policies to determine how well they were prepared to prevent and respond to a HAB with human health consequences. Document analysis techniques were used to examine the framing of 63 Australian public policies selected from a data set of 180. All documents were coded in Nvivo and analysed for their content relevant to HABs. In the policies, we only found cursory mentions of HABs. We identified three main issues in terms of their attention to HABs. First, there was no evidence of policies that would have led to any detailed planning for a HAB. Second, in terms of strategic actions, economic considerations are uppermost. Third, we found little consideration of direct human health impacts or of intersectoral collaboration on the issue. Our policy analysis indicates a lack of attention, and so preparedness, for the South Australia HAB. Public policy in all countries needs to prepare better for climate-related disasters and act faster to reduce global warming.

A multi-sector coalition in southwest Montana was established to bring a Health in All Policies (HiAP) approach to a rural and micro-urban community in southwest Montana. This project recruited local steering committee members from public health, government, transportation, social services, development, preservation, and education and organized them into work groups to design and implement rural-specific HiAP activities in their community. Workgroups were focused on ensuring community relevance and buy-in, developing and delivering curriculum, and data and evaluation. The steering committee met regularly during the project period; outcomes included a locally relevant project name and developing and delivering customized curriculum to multiple audiences. Post-implementation interviews were conducted with HiAP steering committee members (n = 7). Steering committee members report that participation in the HiAP project helped them better to understand social determinants of health, they believed in the mission of the steering committee, and they trusted the leadership of this collaborative work. A specific HiAP approach led by a multi-sector steering committee may be beneficial in helping to integrate HiAP in rural and micro-urban communities.

Children and youth with disabilities have fewer opportunities for structured and unstructured active play than their peers without disabilities. This umbrella review explored how active play is defined and perceived among children and youth with disabilities and their adult facilitators, and identified barriers, facilitators, and interventions influencing active play among children and youth with disabilities. A total of 18 review articles were deemed eligible and synthesized guided by the Social Ecological Model (SEM). Among children and youth with disabilities, active play was defined as fun, spontaneous, and intrinsically motivated, with some seeking intense, meaningful experiences. Reviews also reported that children and youth with disabilities value active play as a means to maintain autonomy and connections but also feel excluded from peers. Adult facilitators appear to recognize the importance of active play and adapted activities to meet individual needs. This review has identified barriers and facilitators within the SEM: (i) individual: psychological factors, body function and structure, (ii) interpersonal: decision-making, social support, and socioeconomic status, (iii) organizational: adapted activity demands, program and staff availability, (iv) community: environment characteristics, activities, attitudes, and resources, and (v) public policy: policy gaps. Instructional and behavioral strategies, assistive technologies, and inclusive playground designs are identified as effective play-based interventions for children and youth with disabilities. Findings highlight the need to incorporate the perceptions and experiences of children and youth with disabilities into how active play is conceptualized and operationalized. Reframing active play in research, policy, and practice can promote equity, social inclusion, and health.

School-based health promotion is a key setting for fostering positive youth health behaviours. Digital and immersive technologies offer promising opportunities to engage young people. This study explores a virtual reality (VR) intervention designed to prevent alcohol, vaping, and cannabis use among secondary school students. The intervention allowed students to navigate realistic, branching scenarios simulating peer pressure and substance use, aiming to enhance refusal strategies, critical thinking, and decision-making skills. A mixed-methods evaluation involving 277 students and nine teachers across four Australian schools was conducted. Postintervention surveys assessed engagement, immersion, emotional responses, and skill development, while focus groups and interviews explored participant experiences. Results indicate that students found the VR experience immersive and valuable, particularly for rehearsing peer resistance and evaluating the consequences of risky behaviours. Teachers viewed the intervention as a powerful tool for prompting reflection and discussion and a strong complement to existing health education curricula. Thematic analysis highlighted the importance of realism and interactivity for student engagement. While some technical and content improvements were identified, both students and teachers considered the VR tool effective for enhancing health literacy and behavioural readiness. This study shows that immersive VR can be a scalable, engaging addition to school-based health promotion, improving prevention skills and confidence in managing substance-related situations. As adolescent health behaviours are increasingly shaped by digital environments, immersive interventions such as VR offer a promising avenue for skill building and reflection. Further research should assess long-term impacts, with greater attention to implementation and equity considerations.