Health Promotion International最新文献

The Wash'Em process was developed to improve the design of handwashing behaviour change programmes during outbreaks and humanitarian crises. It aims to rapidly create evidence-based, contextualized handwashing programmes. Wash'Em was widely used during the COVID-19 pandemic. This multi-country secondary data analysis compares data emerging from Wash'Em during the pandemic, to understand whether commonalities in programming constraints or the determinants of handwashing behaviour existed across countries. Wash'Em datasets (n = 38) were verified prior to inclusion in secondary data analysis; descriptively summarized and then statistical summaries of homogeneity were derived. Wash'Em was implemented as intended during the pandemic, typically taking a small number of humanitarian staff less than a week to complete. Most actors reported using the recommendations suggested by the process but did so within relatively short-term and poorly financed prevention programmes. Homogeneity in the responses to the Wash'Em tools was low indicating that the determinants of handwashing behaviour during the pandemic were predominantly shaped by pre-existing factors rather than the nature of the health threat. Hygiene programmes during outbreaks should avoid 'copying and pasting' interventions from one setting to another and instead make time to holistically understand the behavioural determinants in a specific context and develop programme activities that are designed to address these. Particular attention should be given to factors in the physical and social environment that may enable or constrain handwashing behaviour, pre-existing disease vulnerabilities and the secondary and non-health impacts of outbreaks. Wash'Em provides one feasible way of contextualizing handwashing interventions in outbreak or humanitarian settings.

Flavoured oral nicotine pouches, manufactured and marketed by global tobacco companies, such as Philip Morris International (PMI) and British American Tobacco, entered the Australian market in 2024. Despite it being illegal for Australian retailers to sell nicotine pouches, the products have been seized in government enforcement raids of Australian retailers, and have also been promoted to young people by Australian social media influencers. The Australian Federal Government has recognized and expressed concern about the rising profile of nicotine pouches in Australia and the promotion of these products as unproven vaping and smoking cessation aids. Yet to date, there has been no published research on nicotine pouches in Australia. Using focus group and interview data collected in early 2024 as part of Generation Vape, an ongoing Australian national study into adolescent and young adult vaping and smoking, we explored their attitudes to and perceptions of nicotine pouches, including first-hand experiences and drivers of use. The participants perceived an increase in the use and popularity of oral nicotine pouches, including PMI's Zyn brand, for reasons including claimed sport performance enhancement, vaping cessation and as part of partying and clubbing culture. Some participants perceived nicotine pouches to be a 'healthier' alternative to smoking or vaping. It is critical that research on nicotine pouches is collected now to inform public health policy and to prevent the proliferation of a new class of addictive recreational nicotine products in Australia.

Patient and public involvement is increasingly advocated in health policy, research and practice. Patients and people with lived experience, carers and the general public should have a say in how policy is generated, how services are delivered and how research is conducted. Through this perspective article, we hope to stimulate discussion and debate around industry influence in patient and public involvement, specifically pertaining to patient organizations, which often play a key role in patient and public involvement activities. As momentum gathers around patient and public involvement in many countries, it is timely to discuss the nature and extent of commercial influences in such activities, the (un)anticipated consequences of industry-patient interactions, including conflicts of interest and motivated bias, and how we might better manage, or negate, such interactions. Patient and public involvement must be integral to research, policy and practice. While further research is needed to examine the interactions, and consequences of pharmaceutical industry interactions with patients, several practical steps can be taken in the interim. Structures, processes and supports, which are fit for purpose, are needed to ensure independence, power and legitimacy within patient and public involvement activities, and that patient advocates have their voices heard, and ultimately acted upon.

Despite growing awareness of the importance of commercial determinants of health (CDoH), there has been limited development or evaluation of educational and practice-focused support for public health professionals. This article reports findings from an action-research approach bringing together people with academic and practice expertise (n = 16) to co-create workshop materials (called 'CDoH Essentials'), test and improve them through five trial workshops and explore their effects. Five English local public health teams co-facilitated the workshops in their organizations, with participants from public health teams and their internal partners (n = 94). Quantitative and qualitative data were collected throughout and analysed to understand: (1) whether the workshops met the expectations of participants, public health and academic observers, and (2) the effects of workshop participation on (a) participants' knowledge, understanding and critical CDoH literacy, and (b) subsequent working practices and attitudes. The co-created CDoH Essentials appeared effective in meeting expectations, improving knowledge and critical CDoH literacy and promoting action on CDoH. The proportion of participants reporting 'little' or 'no' CDoH knowledge fell significantly following the workshop (55.4% vs 2.7%). Participants' increased understanding supported reflection on the implications of the CDoH for their roles and for wider strategy and action. After 3 months, all five settings reported greater consideration of CDoH and had initiated or planned action. CDoH Essentials could be used to galvanize more effective public health action to tackle the CDoH in England and trialled in other public health contexts.

Adolescence is a critical period for health literacy (HL) development and for decision-making regarding substance use behaviors. Little is known about which sociodemographic factors are related to the three major components of HL (i.e. functional, interactive, critical HL) and the extent to which these components of HL moderate the relationship between sociodemographic determinants of substance use avoidance and avoidance for adolescents. This study aimed to identify sociodemographic determinants of functional, interactive, critical and composite HL among adolescents, and to assess HL's role as a determinant and moderator of substance use avoidance. Data were collected from 675 adolescents (mean age = 15.5 years, ~53% girls, ~32% Hispanic/Latine) through Qualtrics survey panels and in school settings. Participants completed surveys on social and demographic factors, HL, and substance use. Binary and multinomial logistic regressions were used to address the study aims. In adjusted analyses, adolescents who were girls, Hispanic/Latine (vs. White), food secure, English proficient, had private communications with health providers, and those without impaired decision-making had higher odds of having high HL. Having higher functional, interactive and composite HL increased the odds of substance use avoidance and moderated the effect of age, with younger adolescents with higher HL (vs. low HL) having greater odds of substance use avoidance. Our findings suggest that HL may act as a protective factor against the initiation of substance use in younger adolescents. Thus, HL may be a good intervention strategy to delay substance use initiation for younger adolescents.

Global food system governance increasingly relies on multistakeholder initiatives (MSIs) that aim to include those who are affected by and/or affected by an issue. Multistakeholderism's perceived legitimacy is premised on both its outcomes (output legitimacy) and processes (input legitimacy), the latter in turn based on four key rationales: inclusiveness, procedural fairness, consensual orientation and transparency. To date, evidence on the ineffectiveness of MSI's outcomes undermines its claims to output legitimacy. While individual case study assessments have also raised concerns over their processes, documenting instances of power asymmetries and corporate capture, there has hitherto been no comprehensive assessment of the input legitimacy of multistakeholderism. This work addresses that gap through interviews with 31 participants working either in or on MSIs. Participants noted significant challenges related to input legitimacy, including that (i) inclusion was often based on pre-existing networks of an MSI's founders-most of whom were based in the global North-and risked excluding less well-resourced or marginalized actors; (ii) pre-existing power imbalances, both internal and external to the MSI, considerably influenced its processes and structures; (iii) goal-setting was complicated by conflicts of interest and (iv) reliance on informal processes limited transparency. The similarities in challenges across MSIs indicate that these are not attributable to shortcomings of individual MSIs but are instead indicative of wider system constraints. Rather than rely on multistakeholderism as a 'good' governance norm, our findings add to evidence that MSIs do not meet output legitimacy and signal that the legitimacy of MSIs in their current form should be questioned.

Although there is extensive literature on the impact of urban design on health, little is known about the barriers to integrating health into urban design policies. As cities increasingly lead efforts to improve health equity and population health, understanding the perspectives and experiences of municipal actors on health and equity is essential. To address this gap, we conducted semi-structured interviews with 30 stakeholders engaged with urban design policy- and decision-making at the City of Regina in Saskatchewan, Canada. We analysed our data using a qualitative thematic framework. Our research uncovered a lack of shared understanding of health among municipal actors. Interviewees identified several barriers to integrating health and equity in urban design policies, including inaccessibility of evidence; insufficient resourcing; fragmented governance structure; limited legal power of local governments in Canada; a deeply ingrained culture of individualism and lack of representation. Our findings underscore the importance of adopting an integrated and holistic approach for healthy and equitable urban design. As urbanization continues to bring a greater share of the world's population into urban areas, it is crucial to understand how municipal governance can foster environments that promote residents' well-being.

The discourses promoted by powerful commercial actors whose business activities are damaging to health undermine the potential for the transformational changes urgently needed to address pressing public health and environmental threats globally. This piece provides an analysis of corporate discursive practices and the mechanisms through which they contaminate scientific and policy debates and harm public and environmental health. We refer to this phenomenon as 'discursive pollution' to reflect the parallels between the effects of informational strategies and the commercial activities of harmful industries. It aims to contribute to the literature on the commercial determinants of health by offering a cross-industry perspective of discursive practices and the contradictions that underpin industry-favourable discourses. We propose how the health community can facilitate the construction of alternative discourses by revealing the contradictions and assumptions underpinning industry-favourable discourses.

Health literacy-responsive health professionals will be increasingly important in addressing healthcare access and equity issues. This international scoping review aims to understand the extent and ways in which health professionals respond to healthcare users' health literacy, identifying tools used to measure health literacy responsiveness and training to support the development of these attributes. Four online databases were searched. Using Covidence software and pre-determined inclusion/exclusion criteria, all articles were screened by two authors. Data were extracted using a researcher-developed data extraction tool. From the 1531 studies located, 656 were screened at title and abstract and 137 were assessed at full text; 68 studies met the inclusion criteria and 61 were identified through hand searching resulting in 129 papers in total. Five overlapping thematic elements describing thirty attributes of health literacy responsive health professionals were identified: (i) communication, (ii) literacies, (iii) andragogy, (iv) social/relational attributes and (v) responding to diversity. Other concepts of 'tailoring' and 'patient-centred care' that cut across multiple themes were reported. Forty-four tools were identified that assessed some aspects of health literacy responsiveness. Thirty of the tools reported were custom tools designed to test an intervention, and 14 tools were specifically employed to assess health literacy responsiveness as a general concept. Seventy studies described education and training for health professionals or students. This scoping review provides a contemporary list of key attributes required for health literacy-responsive health professionals, which may serve as a foundation for future health literacy research including the development of curricula in health professional education and tools to measure health professional health literacy responsiveness.

People with intellectual disabilities (IDs) face health issues and barriers to physical activity. Health promotion programmes targeting this group are often short-term. Few programmes have been designed for people with IDs who live in supported housing staffed by social care workers (SCWs). The potential that SCWs hold as health promoters has recently come into focus within literature with a setting approach. Drawing on an ethnographic study, this article explores how SCWs articulate health promotion and enact health promoter roles at supported housing for adults with moderate to severe IDs. Our findings show that SCWs perceive sport and diet as health promotion activities. Because of their background within social education and not health promotion, few perceived themselves as health promoters. However, using the holistic concept of active living, which focuses on everyday lifestyle rather than short-term programmes, our ethnographic data reveal the more unspoken and unconscious practices that SCWs enact to 'build' customized active living routines among residents. Our results suggest that this 'silenced' capacity of SCWs to build healthy routines adds to previous findings by emphasizing that, rather than lacking a health promotion ethos, employees may have the potential to promote health by adapting a more holistic approach to health promotion. We argue the active living approach can contribute to building such a holistic health approach. Such an approach may help SCWs identify with and strengthen their enactment of health promotion roles.