Health Promotion International最新文献

There is a notable lack of engagement in reproductive and lifecourse research with and from men, with a disproportionate focus on women. While studies investigating the lack of men's engagement with services exist, there is little evidence on their engagement with reproductive and lifecourse research. This article qualitatively examines men's engagement in such research in the Bukhali trial in South Africa. Single, in-depth interviews were conducted with 19 male partners of Bukhali participants, and data were thematically analysed. Results were grouped into three domains: (i) motivators for engagement, (ii) barriers to engagement, and (iii) recommendations to improve engagement. Motivators to engage included partner support, desiring to learn and gain knowledge, and taking the opportunity to access the same perceived trial benefits as their partner. Barriers included having misconceptions around the research, fear and mistrust of hospitals and illness, gendered ideas around 'women's health issues', hesitance around sharing personal details, and lack of time and perceived (financial) benefits. To increase engagement, male partners recommended increasing awareness and creating safe research spaces for men. Each theme was inflected with male partners' sociocultural and contextual realities and provided valuable insights into obstacles and opportunities for improving men's engagement in reproductive research.

Foods in commercial squeeze pouches are a widely used feeding option for children, yet growing concerns exist about their nutritional quality and impacts on feeding development. There is limited evidence on how and why parents use these products, leaving critical gaps in understanding how to design policy and food environments that support positive nutrition choices. This study aimed to explore Australian parents' experiences and motivations for providing commercial squeeze pouches to infants and children. An online survey was distributed nationally to parents, containing an open-ended question inviting them to describe the role of squeeze pouches in their child's diet and their reasons for use. Responses were inductively thematically analysed to understand motivations, perceptions, experiences, and feeding contexts. A total of 179 parents, mainly mothers (78.1%), participated, revealing five intersecting themes: societal and behavioural drivers, feeding supplement strategies, feeding confidence and nutritional perceptions, commercial food environment, and environmental impact considerations that influenced their use of squeeze pouches when feeding their child. Within the themes, parents frequently described how squeeze pouches are a practical solution to managing time pressures, fussy or neurodivergent eating behaviours, and feeding during illness or travel. However, many also expressed concerns about cost, packaging waste, and feeding skill development. Overall, a broader societal paradox emerged where convenience and modern parenting demands often outweighed nutritional or environmental ideals. The complex insights provided by parents demonstrate the need for policy and practice responses that address structural and commercial drivers of food choice, while supporting families with accessible, evidence-based feeding guidance.

Despite their conceptual similarities and importance for effective health management, the relationship between health literacy and eHealth literacy remains poorly understood. This systematic review investigated the statistical association between health literacy and eHealth literacy in adults, along with study-level moderators and biopsychosocial correlates. CINAHL, Embase, Emcare, PubMed, ProQuest, PsycINFO, and Web of Science were searched until January 2025. Methodological reporting quality (QualSyst Checklist) was assessed and between-study heterogeneity explored using random and mixed-effects modeling. Twenty-three observational studies (N = 25 505 participants), all characterized by high methodological quality, were included. A weak positive relationship between overall health literacy and eHealth literacy was identified [r = 0.29, CI (0.21, 0.37)], with Category 2/comprehensive measures of health literacy correlating more strongly with eHealth literacy than Category 1/functional measures. Individual-level factors, including higher educational attainment, economic advantage, positive health behaviors, strong self-efficacy, and the ability to use digital resources were consistently linked to higher health literacy and eHealth literacy. The findings suggest that health literacy and eHealth literacy should continue to be researched in tandem to understand their impact on health outcomes in the digital age. Further research is also needed to understand how the surrounding environment, together with individual factors such as age and cultural background, influences the development of health literacy and eHealth literacy. Such studies are crucial for addressing disparities and enhancing access to health information and services.

Heatwave-health vulnerability index (HVI) map is an important tool for mitigating heatwave. However, the perspectives of heatwave-health management professionals (HMPs) about heatwave vulnerability have not been examined. This study aims to understand HMP's perception and experiences of applying the HVI tool for heatwave-related health adaptation and mitigation. A semi-structured interview with HMPs was conducted between June and October 2024 across the Australian state agencies. We conducted an online interview, which lasted ∼31 minutes. Participants were asked to share their perspectives about the HVI tool, its policy applications, challenges, and recommendations. Twenty HMPs, the majority (75%) within 40-59 years old, 10 female (50%), and with a median (range) heat-health work experience of 6 (2-11) years participated in the study. The HMPs were from Health (50%), Climate/Environment (15%), Emergency Services (10%), Meteorology (10%), and City Councils (15%). The five themes identified were the following: (i) HMPs have moderate levels of awareness of heatwave vulnerability, particularly in the context of locating the hottest areas, (ii) HVI is considered an important tool for heatwave planning, public information, and urban design, (iii) adherence to traditional heat management strategies, low national awareness, and resourcing problems are perceived as key barriers to a national HVI, (iv) the current HVI is faced with methodological inconsistencies, limited understanding, and low confidence among policymakers, and (v) HMP are well positioned to evaluate HVI and encourage broader engagement of the index in Australia. This study offers critical insight for improving policy awareness and enhances the evaluation of the HVI through a multidisciplinary approach.

The aim of this study is to analyse alcohol industry submissions to an Australian national parliamentary inquiry to understand the industry arguments and their implications for alcohol policy-making, and to test, for the first time, the applicability of Campbell and colleagues' typology of framing mechanisms to alcohol industry submissions. We undertook a directed content analysis to code policy positions and arguments made by industry actors in the ten industry submissions, followed by thematic analysis to examine coded data for patterned responses according to the framing mechanisms. We identified four framing mechanisms: 'equating', 'contesting', 'dichotomizing', and 'cropping', which alcohol industry submitters used to highlight their corporate social responsibility efforts, industry leadership, self-regulation and community partnerships, while undermining effective evidence-based public health policy action. Industry submitters consistently used the inquiry as an opportunity to make arguments that supported maintenance of the regulatory 'status quo' and the continued inclusion of commercial actors as partners in policy decision-making. We identified heightened and direct attacks on public health evidence not previously seen within the Australian context. While examinations of frames remain important, stepping back and examining the framing mechanisms and actions employed can also offer insights about how to critique the discursive strategies-not just the specific arguments-being utilized by industry. From this critique, it is possible to (i) understand how some frames and arguments have gained acceptance, and others have not, and (ii) to respond to dominant frames and arguments by exposing the flaws in the discursive techniques that underpin them.

The purpose of this scoping review is to identify different measures that have been used to assess the global impact of nongovernmental organizations (NGOs) to reduce healthcare challenges, explore different strategies, interventions, and resources that have been used by NGOs in addressing barriers to accessing healthcare services, and share the lessons learned and future recommendations to maintain a sustainable impact in the reduction of obstacles to attaining quality healthcare. The study was guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. The York methodology created by Arksey and O'Malley served as the basis for this scoping review. The 22 included studies were published between 2012 and 2024. Main strategies to help bridge healthcare challenges in low-income and rural communities include community mobilization and creation of mobile clinics to help increase access to care. The evaluation tools that were used to assess impact of intervention on the target population included questionnaires and surveys given to target population (n = 8); new morbidity cases (n = 3); and validated framework analysis (n = 2), among others. Two hundred and eleven implementation strategies (n = 211) were identified, corresponding to 48 of the SISTER strategies (64%). A range of 4 through 18 were reported in any 1 study. The most commonly reported SISTER strategies, identified in 45% of included studies, were: "Distribute educational materials" (#42) and "Develop educational materials" (#41). Findings from this review may contribute to the establishment and dissemination of a standardized framework for adaptation by NGOs to improve global health outcomes.

Given that news media play key roles in shaping public and policy responses to food poverty and insecurity, this study analysed how newspapers frame these issues across the island of Ireland, comparing coverage between jurisdictions (Republic of Ireland and Northern Ireland) and newspaper types (national versus regional/local). Using LexisNexis and Irish Newspaper Archives, we searched for articles containing 'food poverty' or 'food insecurity' published between January 2018 and January 2023. We used Entman's framing theory to code articles for problem definitions, causal interpretations, solutions, moral evaluations, and social actors. Analysis of 80 articles from 14 newspapers revealed coverage peaked during school holiday periods (December and Summer), reinforcing episodic attention to 'holiday hunger'. Although structural causes appeared in 66% of articles-including inadequate income, living costs, and welfare failures-proposed solutions were predominantly charitable (79%) rather than structural (39%), with food banks cited most frequently. National newspapers more frequently discussed structural causes and policy solutions, while regional publications focused on charitable responses. Articles predominantly featured voices from charities (88%) and government officials (50%), while only 10% incorporated voices from those experiencing food poverty and insecurity. This disconnect between acknowledged structural causes and proposed charitable solutions perpetuates normalization of food poverty and insecurity, obscuring state responsibility for ensuring the right to adequate food. Such framing impedes recognition that this issue in wealthy nations results from political choices requiring systemic reform, not charitable intervention.

Early childhood education and care (ECEC) services are a recommended setting to deliver interventions improving children's physical activity (PA). Indoor-outdoor free play, where children move freely between indoor-outdoor environments, can increase child PA. However, these programmes in ECECs are often not sustained. This study aims to assess the acceptability, feasibility, impact, adoption and cost of the Sustaining Play, Sustaining Health (SPSH) programme on sustainment of indoor-outdoor free play programmes in ECECs. A 6-month parallel-group pilot randomized controlled trial was conducted with 16 ECEC services across New South Wales, Australia, following removal of COronaVIrus Disease of 2019 (COVID-19) recommendations. Services implementing indoor-outdoor programmes were randomized to (i) SPSH programme (n = 8) or (ii) usual care control group (n = 8). The intervention included eight strategies to target identified barriers, informed by the Integrated Sustainability Framework. Primary outcomes at 6 months were acceptability, feasibility, adoption, cost, and barriers/facilitators. Potential impact (sustainment) was measured at 6 (primary) and 12 months using nonparametric analysis. Overall, 31.48% (17/54) of eligible services consented and 16 randomized. Statistically insignificant mean differences between groups in indoor-outdoor free play were 26.27 minutes at 6 months, and 2.87 minutes at 12 months, favouring the intervention group. The SPSH programme was considered acceptable and feasible and costed AUD $452.38 ($289.74 USD) to deliver per service. There were no changes in sustainability barriers/facilitators. This pilot found mean differences favouring the intervention group for sustaining indoor-outdoor free play programmes in ECECs, particularly at 12 months. Future fully powered trials should consider addressing broader barriers including staff turnover, motivation/attitudes, and fit within broader contexts to increase impact.

Early childhood education and care (ECEC) settings are crucial for promoting healthy eating (HE) and physical activity (PA) among young children. However, the implementation of health promotion strategies in these settings is often inconsistent and suboptimal. This study applied a systems thinking approach to identify potential leverage points for improving HE and PA promotion in Australian ECEC settings. The study involved qualitative systems mapping through a desktop review and interviews with a purposive sample of stakeholders from the ECEC sector, to explore gaps, opportunities, and strategies, for strengthening HE and PA promotion. Interview data were analysed in NVivo 14 using reflexive thematic analysis within a constructivist paradigm. The desktop review showed that although ECEC quality is regulated in Australia, the standards for HE and PA promotion are vague and inconsistently assessed. Implementation support is provided at the state/territory level, but the availability and intensity of this support vary widely across jurisdictions, resulting in fragmented practices. Interviews with 16 participants, including ECEC providers (n = 4), quality assurance bodies (n = 2), and health promotion support organizations (n = 10) identified three key themes: (i) a mismatch in problem perception, (ii) the 'carrot or stick' approach, and (iii) the need to build sector capacity. From a systems thinking perspective, these findings highlight the need for a nationally coordinated approach to align quality standards, implementation support, and workforce development in the ECEC sector.

The shift to a digitalized health system brings particular challenges for immigrant mothers who experience a triple adaptation: becoming a mother, navigating a new healthcare system and using technology. This study aims to explore digital health literacy barriers perceived by immigrant mothers and facilitators that could sustain their empowerment related to their health and that of their family. An ethnographic study based on the socioecological model was used to analyze data collected from three individual interviews and two focus groups. The results of the interviews and focus groups allowed us to understand the cultural impact of the lack of digital literacy in the context of healthcare for immigrant mothers in their host country, as well as the barriers and facilitators to access and use digital health information. This study identifies individual, organizational and global level barriers to accessing digital health services amongst immigrant mothers. It also highlighted potential strategies that could support their empowerment in accessing and using digital health resources for their health and that of their family. For instance, training and coaching to help immigrant mothers navigate the health care system are needed. It is also important to adapt public policies to better support the integration of immigrant families in their host country.