Health Promotion International最新文献

Noncommunicable diseases (NCDs) cause significant human and economic costs globally. Each year, 17 million people die from an NCD before age 70. The burden of NCDs is associated with socioenvironmental, cultural factors and social behavior, including modifiable risk factors like tobacco use, unhealthy diets, physical inactivity and alcohol consumption. NCDs can be prevented if healthy environments are guaranteed by the promotion of effective public policies that control the behavior of the tobacco, food and alcohol industries. The regulation of marketing strategies of unhealthy products, and even its ban, has been demonstrated as an effective measure to protect the right to health and promote human rights. However, companies that produce and commercialize these ultra-processed food products argue that protecting measures restricting marketing violate their constitutional right to freedom of speech, among others. Regarding tobacco product marketing activities, the Supreme Court of Justice of Argentina has ruled that it is afforded less constitutional protection than political speech and could be restricted to protect public health and human rights. This article examines the tobacco marketing case and, using an analytical framework argues that the proportionality test used by the Supreme Court could indeed be applied to ultra-processed food products. It is concluded that a complete ban on ultra-processed food product marketing would be constitutionally valid.

Cervical cancer is the second most common malignancy among South African women and the load of abnormal cervical smears has clinical, programmatic and policy implications. This cross-sectional study of women who presented for cervical cancer screening aimed to determine the prevalence of abnormal cervical smears and associated factors in primary health care (PHC) facilities in Gauteng-the most densely populated province in South Africa. A questionnaire collected data on socio-demography, tobacco use, sexual behaviours, HIV status, past treatment for sexually transmitted infections (STI) and cervical cancer screening in the past 10 years. Cytology reports were extracted from the laboratory reports. Of 749 participants, most were black (89.7%), aged 30-49 years (62.2%), single (57.5%) and attained high school education (76.8%). About 43.9% were HIV positive with almost all (97.2%) on antiretroviral therapy. Cytology results were available for 612 (81.9%) participants. Of these, 25.8% (159) were abnormal: 13.2% low-grade squamous intraepithelial lesion; 5.7% atypical squamous cells of undetermined significance and 4.9% high-grade squamous intraepithelial lesion. In bivariate and multivariable analysis, abnormal cervical cytology was not associated with any sociodemographic characteristics, HIV status, tobacco use status, sexual behaviours or past treatment for STI. In conclusion, the prevalence of abnormal cervical smears is high across all demographic groups and irrespective of HIV status and highlights the need to increase screening uptake, including advocacy for self-sampling. It also calls for capacity building to allow for the devolution of some downstream clinical care from specialist to district hospitals and large PHC facilities.

Alcohol marketing, as a commercial determinant of health, presents an emerging threat to global health and is of particular importance in low-resource settings. This study is composed of data from 'The Onward Project On Wellbeing and Adversity' (TOPOWA) project, a multicomponent prospective cohort study examining the mechanistic pathways of adverse mental health conditions among women aged 18 to 24 years living in the Kampala slums in Uganda. The cohort consists of 300 women recruited in 2023 from three study sites (i.e., Banda, Bwaise, and Makindye). In this study, we deployed an underutilized tool, daily diaries, for assessing the exposure to alcohol marketing and an alcohol-promoting environment among young women living in the urban slums of Kampala, Uganda to spur new research and action. At baseline, participants completed a 5-day daily diary and an interviewer-administered survey. Findings show that alcohol-related neighborhood features were most frequently reported, including bars (Mean = 3.88 days), people drinking alcohol (Mean = 3.75), alcohol selling points (Mean = 3.45) and alcohol ads on TV (Mean = 2.51). Women who were exposed to bars (PR = 1.31) and alcohol ads on billboards (PR = 1.14) in a day were more likely to report alcohol use. Similarly, those exposed to alcohol ads on billboards (PR = 1.76) and bars (PR = 2.02) every day were more likely to report alcohol use. Higher cumulative exposure to different alcohol-related features was associated with a greater likelihood of alcohol use, particularly in the group with the highest exposure level. These findings underscore a need to develop alcohol counter-marketing strategies and harm reduction approaches. Daily diaries proved to be a feasible strategy in capturing real-time exposure data, which could in turn support prevention measures and the evaluation of intervention strategies.

This study sought to explore the relationship between sociodemographic-, mental health-, knowledge-, attitudinal-, and conformity to masculine norms variables with suicide literacy, suicide stigma, and help-seeking attitudes among men in a university setting (n = 471) in Ireland. Multiple linear regression with backward elimination was used to determine the independent variables associated with suicide literacy, suicide stigma, and help-seeking attitudes. Lower suicide literacy was associated with an ethnic minority background, living in a rural community, postgraduate students compared to undergraduate students, no depression symptoms in the past year, decreasing loneliness, greater suicide stigma, more negative help-seeking attitudes, lower resilience, greater conformity to the masculine norm power over women and lower conformity to the masculine norm emotional control. Greater suicide stigma was associated with a non-ethnic minority background, all departments of study compared to health and sports science, lower suicide literacy, more negative help-seeking attitudes, and greater conformity to the masculine norms of power over women, dominance, and heterosexual self-presentation. More negative help-seeking attitudes were associated with no generalized anxiety disorder symptoms in the past year, depression symptoms in the past year, greater suicide risk, lower suicide literacy, greater suicide stigma, greater resilience, and greater conformity to the masculine norms emotional control, self-reliance, violence, and heterosexual self-presentation. Findings highlight a need for gender-responsive psychoeducational programmes to target suicide literacy, suicide stigma, and/or help-seeking attitudes among men in university settings. They also highlight that such initiatives need to be co-produced alongside ethnic minority and rural-dwelling men to ensure they are culturally sensitive and acceptable.

Patient navigation shows promise for improving healthcare access and health information, though its impact on health literacy among underserved populations in developing countries remains underinvestigated. This study evaluated the effectiveness of patient navigation services in improving health literacy in the Philippines. Using a quasi-experimental, one-group pretest-posttest design over 2 months, 105 participants were recruited through random sampling from a tertiary hospital. The intervention provided personalized guidance on healthcare access, health information, appointment scheduling, and referrals. Health literacy was assessed across four dimensions (Access, Understand, Appraise, Apply) using a researcher-developed questionnaire. Participant demographics showed a majority aged 18-30 years (68.6%), female (75.2%), single (63.8%), and college/university educated (53.3%). Nearly half (45.7%) had no income, while 31.4% earned below minimum wage. Participants reported using patient navigation to consult a doctor (75.2%) and were made aware of the available services mostly through other family members (28.6%). Follow-up data revealed significant improvements across all health literacy dimensions (P < .001). In the Access dimension, participants who strongly agreed increased from 18% to 35% in knowing where to find information, and from 16% to 34% in having easy access. The Understand dimension showed gains from 20% to 39% for comprehending provider information, and 21% to 38% for understanding risks and benefits. The Appraise dimension improved from 22% to 36% for evaluating accuracy, and 24% to 39% for asking pertinent questions, while the Apply dimension increased from 25% to 35% for making informed decisions, and 23% to 37% for taking health action. These results suggest that patient navigation services can effectively enhance health literacy among Filipino adults, demonstrating the potential of this patient-centered approach in promoting health equity in similar settings.

Family meals are a familiar concept and are practised in many Western households. While academics have been researching family meals for decades, there is much about the family meal we still do not understand. Meanwhile, the promotion of an 'ideal' of family meals across media, health and social discourse ensues. An extensive pool of research has indicated cross-sectional associations between the frequency of family meals and optimal health outcomes. However, evidence surrounding what specifically it is about the family meal that could offer health benefits is limited. Furthermore, family meals carry a level of moral value, evoking pressure for parents to 'achieve' a family meal ideal, unattainable for many. Family meals research has traditionally focussed on mothers' perceptions and roles in family mealtimes. While literature is starting to emerge on the often-overlooked cognitive contribution required to plan and execute family meals, little structural supports exist to streamline these efforts or make them more achievable for contemporary families. The published literature is only starting to include cultural and demographic diversity, making it difficult to understand and promote realistic and feasible family meals across populations. The popular depiction of family meals needs to evolve alongside changes in social norms. Our call to action to address these issues is to draw on existing family meal practices, continue to diversify our investigations, and broaden our definitions and understandings of what a family meal is or could be, and how it should be measured.

Inadequate nutrition intake during pregnancy elevates the risk of adverse health outcomes during pregnancy, with potential long-term repercussions for both mother and child, extending to subsequent generations. Current initiatives to improve individual dietary habits emphasize promoting nutrition literacy (NL), which encompasses the ability to access, comprehend, and use basic nutrition information and services necessary for making appropriate nutrition decisions. However, there were limited data on the NL of pregnant women in Vietnam. Therefore, this study aims to explore the NL levels of Vietnamese pregnant women and examine the factors related to their NL. A total of 360 Vietnamese pregnant women participated in the study from May to September 2023. A validated questionnaire (Nutrition Literacy Assessment Instrument for Pregnant Women, NLAI-P), assessing the knowledge, behavior and skill, was applied. A general linear model with univariate linear regression analysis was conducted to identify predictor factors of NL. The findings revealed that 70.3% of participants had inadequate NL. Among the three dimensions, nutrition knowledge was particularly low, with no respondents achieving an adequate level and 94.7% scoring at an inadequate level. High household monthly income, age, normal prepregnancy weight and indoor work were statistically associated with higher NL scores. This study highlights the limited NL among Vietnamese pregnant women. Increasing NL is crucial for supporting their optimal healthy diet, enhancing the health of pregnant women and their offspring and future generations.

Pregnancy and infant loss, in the form of miscarriage, stillbirth or early neonatal death, occurs in 20-25% of all pregnancies. Despite its prevalence and associated physical and psychological impacts, there remains a lack of public awareness and understanding of pregnancy loss, including amongst people of reproductive age. Drawing on evidence from a preliminary review of peer-reviewed and grey literature, we make the case for enhancing pregnancy loss and (in)fertility awareness, specifically focusing on young people in second-level education. We situate our work within reproductive health and reproductive justice frames, recognizing the impact of social factors on people's reproductive lives, and the need for multi-level interventions to enable people to fully realize their reproductive rights and goals. Although schools provide an important setting to learn about and discuss topics relating to sexual and reproductive health-including pregnancy loss and fertility-current evidence suggests that this is not happening, despite young people's desire to engage in such conversations. While there are barriers to addressing sexual and reproductive health issues within schools (including lack of access to teacher training, continuing professional development, appropriate and engaging resource material, teacher discomfort and lack of confidence), it is important that interventions are developed in collaboration with all relevant knowledge users, including young people themselves. This will help to ensure that any interventions developed are relevant, acceptable, feasible and effective. Further research is needed to explore how education around pregnancy loss and fertility can be best delivered within school settings.

Employees' psychological wellbeing is of special interest to employers, as mental illnesses are still the second most common reason for work absences. The psychological wellbeing of employees is determined by factors at an individual, interpersonal and organizational level. Health literacy encompasses both the individual and the organizational level and thus offers a good concept against the background of employees' psychological wellbeing. Furthermore, demographic change increases skills shortages, while recently, other working models, such as increasing home office arrangements, benefit and challenge both employees and employers. Therefore, this study examines the associations between individual and organizational health literacy, work-from-home culture, and the psychological wellbeing of employees who mainly work from home. An anonymous open online survey via Facebook and Instagram advertisements was conducted in June 2023 in Germany. The questionnaire included nine thematic groups with validated and nonvalidated scales (e.g. WHO-5 Wellbeing-Index). Data from 103 participants were suitable for data analyses in IBM SPSS Statistics 23. Of the participating employees, 17% were assigned to males and 83% to females. The mean age was 49.5 years. Individual and organizational health literacy and work-from-home culture were positively associated with employees' psychological wellbeing. Organizational health literacy mediated the effect of individual health literacy on employees' psychological wellbeing. Individual and organizational health literacy totally mediated the impact of work-from-home culture. The study results highlight that individual and organizational health literacy provide useful concepts for practitioners and researchers regarding the psychological wellbeing of employees working from home and that both might play a crucial role in mediating the effect of organizational culture aspects on employees' psychological wellbeing.

Patient online access to medical records can foster patient empowerment and advance patient-centered healthcare. Despite high patient interest, user rates often remain low. While previous research has identified determinants influencing the adoption of online access, this study assessed the relevance of these determinants. By doing so, this study aimed to point towards measures to improve adoption efficiently. Furthermore, supporting patient-informed decision-making about using online access might facilitate sustained use. Therefore, conducting a nationwide online survey study among Dutch adults, we examined the relevance of 22 psychological determinants for the use of online access (N = 1888) and decisional conflict (as an indicator of uninformed decision-making) regarding use (N = 3403). Analyses concerned visualization of univariate distributions of determinants and their associations with (i) use and (ii) decisional conflict regarding use. Greater relevance was indicated by lower means and stronger associations. Results showed that secured data privacy and feeling sufficiently instructed were most relevant for use. Concerning decisional conflict regarding the use, additionally, patients' beliefs about the effects of online access on their ability to participate in their healthcare process and on the patient-provider relationship were most relevant. Overall explained variance was low (R2 = 0.17 for use and R2 = 0.19 for decisional conflict). Efficiently supporting the use of online access and informed decision-making about use might be achieved by addressing data privacy, providing clear instructions and communicating potential effects. The low explained variance indicates the need for additional measures, such as facilitating easy opportunities and understanding individual patient preferences.