Health Promotion International最新文献

Patient health literacy is crucial for effective patient-physician communication, and interventions targeting health literacy can use measures based on either actual performance (competence) or self-ratings (confidence). This paper analyzed the development of these measures through three studies. Study 1 reviewed articles describing the development of novel measures; Study 2 examined the citations of these studies, and Study 3 evaluated data from clinical trials registries. The literature search was conducted from 14 April 2023 to 27 April 2023. PubMed was used as the main database in which studies on health literacy measures were searched for the systematic review (Study 1). We then used Google Scholar and the OpenCitations database to describe citation patterns of the included health literacy measures (Study 2). Finally, we evaluated confidence- or competence-based health literacy measures by extracting and analyzing trial data from ClinicalTrials.gov (Study 3). Our review included 55 health literacy measures, among which 23 (42%) were competence-based, 28 (51%) confidence-based, and 4 (7%) assessed both. Recent trends show a shift toward developing more confidence-based measures and a decline in creating new competence-based measures. Confidence-based measures were increasingly cited, whereas citations for competence-based measures have plateaued. Lastly, our findings showed a steady increase in the use of confidence-based measures in recent clinical trials and a decrease in the use of competence-based measures when controlling for sample size. This shift may be problematic because confidence-based measures do not improve our limited knowledge about patients' actual ability to meet demands of shared decision-making, especially regarding new technologies like artificial intelligence in healthcare.

Public disclosures of mental health problems on social media represent a potentially powerful informal avenue for increasing mental health literacy and reducing public stigma in relation to people with mental health problems. We investigated whether the audience reported any reduction in their own stigma toward people with mental health problems after exposure to disclosures. We also examined whether self-reported stigma reduction was associated with the characteristics of audience members, the disclosers and the disclosure messages. We used Prolific to obtain a convenience sample (N = 803) of adults who had been exposed to a disclosure. We administered an online survey to participants and conducted a series of logistic regressions to identify any associations between disclosure-related characteristics and audience self-reported stigma reduction. Our findings showed that certain aspects of the messaging process appeared to be associated with stigma reduction. These included explicit diagnoses from disclosers, particular message themes such as psychosocial causes of mental ill health, and positive and echoing comments from other users. In addition, audience members who reported greater levels of empathy toward, perceived similarity to and identification with disclosers tended to report reduced stigma. These findings contribute to the evidence base underpinning how, when and which public disclosures of mental health problems on social media have the potential for stigma reduction. They can further help inform future health promotion practices on social media aiming to mitigate mental health-related stigma at the population level. Future research may focus more on the dynamics and match between disclosers and audiences and their effects on stigma.

As Canada is implementing a new national school food program with a long-term vision of every child having access to nutritious food in school, understanding student eating perspectives and food choices in universal programs is paramount. The purpose of this study was to understand how students in two low-income and culturally diverse elementary schools in Saskatoon, Canada, perceived and participated in a 2-year, universal school lunch pilot. This study was part of a larger case study of the Good Food for Learning program. Eleven focus groups with 65 students in grades 5-8 and participatory observation in the schools were conducted. Data analysis followed a reflexive thematic analysis approach Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport, Exer Health 2019;11:589-97. doi:10.1080/2159676 × .2019.1628806, Braun V, Clarke V. Can I use TA? Should I use TA? Should I not use TA? Comparing reflexive thematic analysis and other pattern-based qualitative analytic approaches. Counselling Psychother Res 2020;21:37-47. doi:10.1002/capr.12360) using NVivo 12 Plus. Student perspectives centered around being well-fed at lunch. Students saw participation in the pilot as a matter of personal choice: student decision to participate was encouraged by the pilot's flexible and free design; availability of well-liked food; and the perceived healthiness of the food. Offering culturally diverse and inclusive food was important to students. Mitigating future barriers to student participation in universal lunch programs will require attention to student choice, agency, and diversity, and offering diverse portion sizes, adequate meal lengths, and student-centered infrastructure. School lunch programs that are universal, health promoting, tasty, and free, and offer flexibility and choice to students, may be a socially desirable way to improve student nutrition and wellbeing.

Creating supportive food environments has been identified as one of the most effective strategies to promote healthy diets. In this context, the present work aimed to characterize the retail food environment in a low-income area of the city of Montevideo (Uruguay). The study relied on a mixed-methods approach. A survey of food retail outlets was conducted. All the outlets were geocoded, and service areas were created considering a 600 m threshold. Quantitative information was supplemented with qualitative information from semi-structured interviews with residents and grocery store owners. A total of 415 outlets selling a variety of foods were identified. Adequate physical access to the foods recommended by the Uruguayan dietary guidelines was found in most of the residential areas. Small behind-the-counter grocery stores were identified as the key source of healthy foods in the area. However, the accounts of residents highlighted problems related to the price, variety and quality of the foods sold by the local grocery stores. Therefore, strategies to ensure access to healthy food in the study area should go beyond physical access and tackle food affordability, variety and quality. The promotion of short food supply chains in the area should be a key element of the strategies to achieve sustainable urban food systems in Montevideo.

To promote health literacy (HL) in children, it is crucial to recognize their unique social environment, experiences, and comprehension of health and HL. This study aims to gain insight into the perspectives of children aged 9-12 years regarding health and HL within the context of health promotion. We conducted focus group discussions with children at three primary schools in the Netherlands, covering (i) What health means to children (ii) How they engage with health information (HL), and (iii) How they respond to the items of an HL questionnaire (HLS-Child-Q15-NL). Thematic analysis was used to analyze data from nine focus groups with 46 children. We identified three themes: (i) perspectives of health and healthy living, (ii) information for healthy living, and (iii) sources of information for healthy living. Children rated being yourself, physical activity, and happiness as the most important health topics. They receive health information passively, mainly from caregivers and social media, and emphasize the need for simple language. Trustworthiness of sources and usefulness of information were also important. Responses to the HLS-Child-Q15-NL varied, with some items being unclear and leading to misunderstandings, though generally seen as easy. The findings highlight children's broad perspective of health and HL. Health-promoting activities should focus on developing HL skills related to children's lived experiences and health topics that they deem important. This will present an opportunity for children to engage with health information more actively and critically.

Health promotion efforts that enhance health literacy among individuals, organizations, and communities are gaining attention globally. Additionally, co-designed and community-led health promotion interventions have gained recognition as an effective strategy for addressing health issues through more effective and sustainable health outcomes. This qualitative study conducted in Tasmania, Australia, aimed to co-design the emerging Health Literacy Mediator (HLM) and to assess the support, expectations, and need for such a role. Following an Ophelia approach, data for this research were collected via focus group discussions within an online workshop, enabling diverse perspectives to emerge and be analysed via thematic analysis. Discussions around how the role could impact the individuals and families presented in the short case scenarios (vignettes) produced four strong expectations: that they are solution-focused, that they have a duty to facilitate change, that the role is based in community, and that the role targets those in the community who need them most to ensure the greatest impact. Participants also shared other recommendations and supporting ideas for the role. The potential role of HLM holds substantial promise in addressing health inequities for all individuals, regardless of background or socioeconomic status, by optimizing time management, simplifying navigation, ensuring the right care, and building community trust. By creating connections and advocating for individuals, HLMs could effectively break down barriers to healthcare access. This proactive approach not only addresses immediate health concerns but could also lay the groundwork for sustained improvements in public health outcomes in the future.

Becoming nature 'literate' may promote nature engagement in early adolescence, supporting both health and well-being, while nurturing a sense of environmental stewardship. This study aimed to advance the formative research necessary for the development of a nature-based literacy framework including a set of indicators specific to its measurement during early adolescence. An e-Delphi study design was used with an expert panel comprised of international academics (n = 18) and practitioners (n = 8). After three rounds, experts agreed key components of nature-based literacy were knowledge, competence, confidence, motivation, experience, connection, and stewardship. The nature-based literacy framework comprehensively represents the intrapersonal factors and related indicators that influence nature engagement, particularly during early adolescence. This will support the development of interventions designed to enhance early adolescent health outcomes, strengthen their connection to nature, and inspire them to value and protect the natural world.

Providing patients with falls prevention education reduces falls in hospitals, yet there is limited research on what influences successful implementation at the staff, ward and hospital levels. We engaged hospital-based health professionals to identify multi-level barriers and enablers to patient falls education that could influence the implementation of a Safe Recovery program. Purposive sampling was used to recruit hospital staff (n = 40) for focus groups and one-on-one interviews. Data were analysed using content analysis and categorized using a socio-ecological framework to understand the micro, meso and macro level influences of hospital falls prevention. We identified five overarching themes, on the barriers and enablers to implementation of the Safe Recovery program. The enablers to falls prevention education included sharing the responsibility to implement the program, setting clear goals for staff, showing the impact of delivering the program, involving family to reinforce the messaging, using falls champions to upskill staff and making the resources (video and booklet) readily available to patients at all times. Barriers included insufficient time for staff to deliver falls prevention education, lack of falls prevention training for staff during their clinical training, absence of standardized protocols and clinical guidelines across hospital settings and insufficient hospital marketing to promote the program. Using a systems thinking approach, this study showed that implementation requires more advocacy and support for patient falls prevention across different tiers of the hospital system to integrate into usual care.

Pasifika communities in Western Sydney experience significant health disparities, particularly related to chronic diseases such as cardiovascular conditions and diabetes. Physical activity is known to improve both physical and mental health, yet access to culturally responsive physical activity programs for Pasifika communities is limited. This study leveraged expertise from an Advisory Committee to adopt community-based participatory research (CBPR) through Talanoa to co-design a physical activity program specifically tailored for Pasifika people in Western Sydney. Pasifika mothers were identified as a priority population due to their central role in family health and well-being. The co-design process followed the four stages of Engage, Gather, Understand and Improve, guided by the Fonofale Model of Health to ensure a culturally responsive approach. We report on each stage of the co-design process and the results gathered, highlighting key findings such as the need for culturally safe environments, flexible scheduling, ensuring programs are community-led and addressing key barriers including caregiving responsibilities, sociocultural expectations and health status. The results from this study will guide the implementation of a culturally tailored physical activity program that meets the unique needs and values of the Pasifika community in Western Sydney.

To prevent and reduce mother-to-child transmission of HIV and maternal morbidity and mortality, the World Health Organization currently requires retesting for HIV during pregnancy and postpartum. This was a systematic review and meta-analysis in which PubMed, Cochrane Library, Embase, and clinicaltrials.gov were searched for articles published between January 2005 and February 2024. Retesting uptake was defined as the number of women who tested for HIV during pregnancy/breastfeeding periods following an initial HIV-negative test during these periods. Using random-effects models, we computed the pooled prevalence of HIV retesting uptake, incidence rates (IRs), and 95% confidence intervals (CIs). A sensitivity analysis was done by excluding studies that tested women during labor and reported 100% retesting uptake. A total of 37 studies with 1,999,621 women were analyzed. Overall, the pooled prevalence of HIV retesting uptake was 89.1% (95%CI, 81.0-95.2). Retesting uptake was significantly higher during breastfeeding compared to pregnancy (93.3% vs. 89.9%; P < 0.001). A sensitivity analysis showed that overall retesting uptake was 73.9% (95%CI, 60.1-83.8). A total of 1302 (0.2%) women acquired HIV. Twenty-two studies reported an IR; the overall pooled IR was 4.3/100 person-year (PY; 95%CI, 3.4-5.2/100 PY). The HIV incidence rate was significantly higher during pregnancy compared to breastfeeding (5.9/100 vs. 3.4/100 PY; P < 0.001). One to three in 10 women in sub-Saharan Africa do not retest for HIV following a negative test during pregnancy or breastfeeding periods. Emphasizing HIV retesting during these periods is critical to eliminate pediatric HIV given that the overall IR is beyond the WHO threshold (3.0/100 PY) for a substantial risk of HIV transmission.