Health Promotion International最新文献

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.

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.

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.

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.

The World Health Organization defined health as 'a condition of full physical, mental and social well-being'. Nutrition and food safety are intertwined and two of the most influential determinants of human health. This study primarily aimed to design and implement a specialized curriculum focused on food hygiene, and Taiwan's daily food guide to enhance health literacy among junior high students in Taiwan. A student-centered approach, based on active learning and constructivist principles, was used to engage students in interactive discussions and hands-on activities related to dietary guidelines and food hygiene. Four classrooms, with a total of 92 students, participated in this study. The students were randomized into a control group (n = 46) and an experimental group (n = 46). The average age ranged from 13 to 15 years. An illustrated questionnaire underwent pilot testing and expert review, followed by pre- and post-intervention assessments to measure knowledge improvements. The results showed a significant connection between the Taiwan daily food guide and health literacy. Although food hygiene education played a lesser role, the intervention improved students' health literacy, supporting positive health outcomes. In addition, recognizing the lack of suitable assessment tools in this field, we developed a reliable and valid illustrated questionnaire to measure the effectiveness of the intervention and track changes in students' knowledge. The questionnaire demonstrated high internal consistency (Cronbach's alpha of 0.883) and strong inter-rater reliability (intraclass correlation factor above 0.7), confirming its effectiveness as a tool for educational research.

Health literacy may play an important role in the attainment of the United Nations Sustainable Development Goals. The aim of this study was to assess the psychometric properties of the Persian version of Health Literacy for School-Aged Children (P-HLSAC) employing data that covered the entire school path. This cross-sectional study was conducted in 2023-24 among 605 school-aged students in Isfahan, Iran. Reliability indices as well as content, predictive and concurrent validity were evaluated. The factor structure of P-HLSAC was assessed and confirmed employing exploratory and confirmatory factor analysis, respectively. The scale content validity indices, Cronbach α and intraclass correlation coefficient were acceptable. A significant correlation was found between quality of life and health literacy (Pearson's r = 0.28, p < 0.001) demonstrating a good predictive validity. The mean of health literacy in those with daily self-health learning behavior was significantly higher than those without it (33.60 vs. 31.9, p < 0.001) highlighting the concurrent validity of P-HLSAC. Confirmatory factor analysis approved both one- and two-factor structure of P-HLSAC. The model indices verified an adequate model fit for both one- and two-factor structure of P-HLSAC. This study confirmed the reliability and validity of the P-HLSAC for estimating health literacy in an Iranian cultural context among primary to upper secondary school students. Considering its briefness, the psychometric characteristics of P-HLSAC were approved for its utilization in large-scale studies among entire school-path Iranian school-age children.

Health literacy (HL) is essential to understanding health information and achieving health goals. Unfortunately, limited information is available on how parent HL impact child health outcomes. This is critical to understand in areas of the world where access to healthcare services is limited or unavailable. Thus, the purpose of this study was to assess the moderating influence of access to care on the relationship between parent HL and child health outcomes in Mexico. Using a geographically stratified convenience sample survey design, we gathered a sample of 373 parent-child dyads throughout Mexico in August of 2021. Using the HLS-Q12, the Warwick-Edinburgh Mental Wellbeing Scale, healthcare access questions developed by Levy and Janke, a single-item self-report overall health measure, and questions about substance use frequency, we found that parent HL was positively associated with youth mental wellbeing and overall health. Limited healthcare access was associated with increased youth cigarette, marijuana and alcohol use. Our results indicate that efforts to increase parent HL may be effective in improving youth health behaviors and outcomes.