Health Promotion International最新文献

It is well-documented that health-harming industries and the groups they fund use a range of tactics that seek to interfere with academic research. With the development of scholarship relating to the Commercial Determinants of Health (CDoH), an increasing number of public health researchers are working to examine the activities of health-harming industries and the impacts they have on health and equity. However, there has been limited research investigating the experiences of these researchers and the range of strategies that could be used to support them. This qualitative interpretivist study involved 10 online focus groups with 28 public health researchers (ranging from PhD students to emeritus professors) in Australia and the UK. The researchers worked on issues related to the alcohol, gambling, tobacco or ultra-processed food industries. Participants outlined a range of personal and professional risks relating to their research, including social media attacks, complaints to university personnel and funders, attempts to discredit their research, legal threats and freedom of information requests. Some described the impacts this had on their overall well-being, and even on their family life. They commented that current university systems and structures to support them were variable and could differ between individuals within institutions. This often left researchers feeling isolated and unsupported. Universities should recognize the risks to researchers working on issues relating to health-harming industries. They should proactively develop strategies and resources to inform and support researchers to conduct research that is important for public health and equity.

Parental supply of alcohol to adolescents is associated with increased risk of subsequent adolescent alcohol use and harms, so identifying factors associated with parents' decision-making is critical. This study examined how parental supply is associated with attitudes toward adolescent alcohol use, perceived norms of parental supply, perceived behavioural control and perceived acceptable age to drink alcohol. A total of 1197 Australian parents with children aged 12-17 years completed an online cross-sectional survey assessing their parental supply behaviours, attitudes and perceptions in April 2022. Logistic regression was used to explore associations between attitudes, perceptions and parental supply of alcohol to their child. Forty-three percent of respondents nominated an acceptable age to drink a full drink of alcohol below 18 years, and 23% reported supplying a full drink of alcohol to their adolescent. Parents were more likely to report supplying a full drink of alcohol if they nominated an acceptable drinking age below 18 years (<16: adjusted odds ratio [AOR] = 14.75, 95% confidence interval [CI] = 8.23-26.42; 16-17: AOR = 5.68, 95% CI = 3.69-8.73), appraised alcohol as more beneficial (AOR = 1.31, 95% CI = 1.02-1.69) and less harmful (AOR = 0.49, 95% CI = 0.36-0.68) for adolescents, and perceived that parent friends (AOR = 2.91, 95% CI = 1.80-4.70) and other parents (AOR = 2.23, 95% CI = 1.37-3.62) supplied alcohol in unsupervised contexts. Perceived behavioural control was not associated with parental supply. These findings suggest there may be value in trialling interventions that target parents' perceptions about the acceptable age to drink a full drink of alcohol, attitudes toward adolescent alcohol consumption, and perceived norms of parental supply to influence parents' supply intentions.

A school food service, which is the way children access food during the school day, is one of the many aspects in creating a health-promoting school environment. School-provided meal services differ greatly, depending on the country, region and school contexts, however, there is limited understanding of the diverse meal delivery within these settings. Therefore, the aim of this study was to understand different school-provided meal systems across different countries and contexts. This study used a qualitative, naturalistic observation, using an interpretative epistemology and a multiple-case design to explore food service across seven schools, mapped against a school meal food service framework. This included three schools with an established school-provided meal system (England, France and Sweden) and four schools with emerging school-provided meal systems (Australia). Mapping captured findings across the domains of Menu offering, Food service system, Administration, Eating environment, Mealtime experience and Post-meal. Results demonstrate the need for tailored school food programmes, designed appropriate to the country, region and school context, including considering cultural underpinnings and available resources. Furthermore, a positive eating environment and elements of student choice and responsibility were all noted as principles important in a school food service. This knowledge can be used to inform planning of future systems, particularly for regions transitioning into a school-provided meal model, and those looking to implement improvements to existing systems.

Disadvantaged adolescents, including those from lower socioeconomic status (SES) or geographically remote backgrounds, engage in higher rates of risk behaviours, including poor diet, alcohol and tobacco use. While digital interventions targeting lifestyle risk behaviours show potential, few studies have focused on their implementation and relevance for this population. This study conducted a process evaluation of 'Health4Life', a universal school-based digital program targeting multiple behaviours, among a sample of disadvantaged adolescents. Participants were from six schools classified as low SES (Index of Community Socio-educational Advantage percentile score ≤ 25%), and/or regional using the Australian Statistical Geography Standard. Self-reported student (n = 214) and teacher evaluations (n = 16) assessed Health4Life's acceptability, with qualitative questions capturing areas for improvement. Teacher-reported implementation data (n = 16) measured intervention fidelity and feasibility. Quantitative data were analysed using descriptive statistics and open-ended responses were thematically analysed. Compared to the entire sample, this subset of students evaluated Health4Life less favourably (66% versus 75%), with fewer enjoying the stories (63% versus 75%) and planning to use the skills and information (60% versus 70%). Teacher evaluations were mostly positive and aligned closely with the entire sample. Fidelity data also indicated comparable levels of student engagement (~92% versus ~85%). Key themes for refinement included improving content relevance and technical execution to better resonate with disadvantaged adolescents. While teacher evaluations suggest Health4Life is a valuable program in low SES or regional contexts, students' lower ratings indicate refinements are needed. Identified areas for improvement will guide co-designing the program's adaptation to improve effectiveness and relevance for disadvantaged adolescents. Trial registration: The Health4Life trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123).

There is increasing evidence that commercial determinants impact mental health. Addressing the commercial determinants may therefore be a way of improving population-level mental health. This umbrella review aimed to provide an overview of evidence in this field and identify knowledge gaps. Five databases (MEDLINE, Embase, PsycINFO, Scopus and Cochrane Library) were searched on the 18/19 of July 2022. Eligible papers were systematic reviews published after 31 December 2011. No geographical limits were applied. Eligible interventions were those that targeted the behaviours or products of commercial actors. Ineligible interventions included individual behaviour change interventions, such as those seeking to educate consumers. Included mental health outcomes were anxiety, depression, self-harm and suicide, whilst surrogate outcomes included product consumption. Industry involvement and the quality of included reviews (critical components of A MeaSurement Tool to Assess systematic Reviews - AMSTAR 2) were assessed. A narrative synthesis was used to compare the findings by industry, and a typology of interventions was developed. Eight reviews with mental health outcomes were included, each with multiple methodological weaknesses. There is some evidence that reducing the availability of alcohol or pesticides may lower suicide rates. Despite the known links, no evidence on the mental health impacts of population-level interventions tackling the social media, tobacco, gambling and ultra-processed foods industries were located. All gambling reviews were identified as having links to industry. Future high-quality evaluations of commercial determinants interventions developed specifically with the aim of achieving positive mental health outcomes and/or that evaluate mental health outcomes and are free from industry links are needed. PROSPERO ref. number CRD42022346002.

Unhealthy commodity industries (UCIs) such as tobacco, alcohol, gambling, ultra-processed food and beverage producers are known to influence policy-making to advance their interests, often to the detriment of public health goals. This study mapped the complex system underpinning UCI's influence on public health policy formulation in the UK and identified potential interventions to shift the system towards being able to better attain public health goals. We conducted a participatory systems mapping workshop with ten experts to build a causal loop diagram (CLD) and identify potential interventions to address UCI's influence on public health policy development. The resulting CLD depicts a highly interconnected and reinforcing system driving UCI's involvement in public health policy formulation across five thematic areas. Among the most connected elements were the 'dominance of market mechanisms', 'perception of partnership as good governance principle', 'industry involvement lending perceived legitimacy to the policy formulation process', 'industry is seen as part of the solution' and 'industry ties to policy-makers'. Participants identified a total of 22 interventions within this system. Analysis of the CLD and interventions identified the potential for two key paradigmatic changes in this complex system: de-normalizing the perception of unhealthy commodity industry actors as legitimate stakeholders in policy formulation; and prioritizing public health and wellbeing objectives over profit and economic gain. In order to shift the system towards better attaining public health goals, interventions should reinforce each other and be supportive of these two key paradigmatic shifts.

Health literacy (HL) is a key social determinant of health (SDoH) and is of increasing importance in public health research and intervention for improved health outcomes. Definitions of HL and digital health literacy (DHL) have evolved over time as the field has expanded conceptualization from an individual focus to the broader community and organizational levels. Careful consideration of HL and DHL for a variety of contexts and audiences is critical given increased global adoption of digital technologies and responses to emerging public health challenges. This study aimed to capture researchers' conceptualizations of HL/DHL and their motivations to engage in this research with attention to SDoH and equity principles. We developed a survey comprising 32 open-ended and multiple-choice questions from which we present participant demographics and overall research affiliations (n = 193), and results from two multiple-choice and three open-ended questions. The three open-ended questions were inductively reviewed and coded using thematic analysis and iterative discussions between multiple coders, while the two multiple-choice questions were descriptively analyzed via SPSS. Findings are situated within the context of the coronavirus disease 2019 (COVID-19) pandemic and inform the international field of HL/DHL research by highlighting momentum and opportunities for increased scholarship.

Health literacy is a vital asset needed to empower individuals to take control of their health. An individual's health literacy is the ability to find, use and apply health information and services to manage their health. They interact with the health services and members of their community who can offer additional support. Creating the role of a health literacy mediator (HLM) may help to improve health literacy outcomes for all. For this role to be accepted by individuals within a community, the community itself should be involved in the development of the roles and associated responsibilities. The aim of this study was to engage with community members to acquire their perspectives on the potential of this role. Qualitative semi-structured online interviews were used to engage in discussions with local community members. This study implemented a constructivist epistemology with qualitative research design. Data were thematically analysed to identify evolving themes that were important to the HLM role. The analysis identified three main themes that need to be considered when adopting an HLM role: (i) health empowerment of individuals, organizations and communities, (ii) meeting the needs of the community and (iii) addressing the existing barriers in navigating and accessing the healthcare system. Those working in the health promotion space must adopt novel and innovative ways to improve HL on both a local and an international scale. This study concluded that for the role of a HLM to be accepted, it would need to encompass these attributes.

eHealth involves using digital technologies, like electronic health records and telemedicine, to enhance healthcare delivery and outcomes. For older adults, eHealth helps manage chronic conditions, access services remotely, and engage in preventive health, improving physical and psychological well-being. This study investigates the association between online patient-provider communication (OPPC) and older adults' quality of life (QoL, i.e. sleep quality, exercise and psychological health). The study also explores how health literacy and health self-efficacy mediate the relationship between OPPC and QoL. This study utilized data from the National Cancer Institute's Health Information National Trends Survey, collected in 2019 (HINTS 5 Cycle 3), specifically targeting individuals aged ≥ 60 (N = 2587). The associations among variables were analysed using structural equation modelling. OPPC was positively and significantly associated with health literacy (β = 0.53, p < 0.001). Health literacy was positively and significantly related to health self-efficacy (β = 0.02, p < 0.001). Health self-efficacy was significantly related to five dimensions of QoL: sleep quality (β = 0.20, p < 0.001), fruit and vegetable consumption (β = 0.13, p < 0.010), exercise (β = 0.59, p < 0.001), sedentariness (β = -0.58, p < 0.001) and psychological health (β = 0.24, p < 0.001). Besides, health literacy and health self-efficacy also mediated the influence of OPPC on QoL sequentially, being identificators as two serial mediators between OPPC and older adults' QoL. This study suggests that OPPC plays an important role in older adults' QoL.

Having a job is important for the well-being and inclusion of people with limited capability for work (LCW) due to physical and/or mental disability. This study explores salutogenic mechanisms that contribute to work-related sense of coherence (Work-SoC) of employees with LCW, i.e. perceiving their work in nature as manageable, comprehensible and meaningful. Semi-structured interviews (26 in total) were conducted with employees with LCW, employee supervisors, job coaches and foresters, all working in nature management. Interviews were held at four worksites of a governmental organisation in the Netherlands that provides permanent jobs for people with LCW. Employees with LCW contributed to the design and analysis of the study as co-researchers. Thematic analysis was used and member checks were carried out on preliminary findings. We identified six salutogenic mechanisms that contribute to nature-based Work-SoC of employees with LCW: (i) having constructive working relationships, (ii) experiencing structure and clarity, (iii) receiving practical and emotional support, (iv) support in the creation of meaning, (v) experiencing and learning in practice and (vi) physical activity and (absence of) stimuli. Identified mechanisms can create a positive effect when leveraged, thereby boosting (new) salutogenic mechanisms. Our findings illustrate that nature-based work can provide resources that promote Work-SoC of employees with LCW through the identified mechanisms. However, employees with LCW, colleagues, supervisors and stakeholders must recognize, mobilize and use these resources to leverage identified mechanisms in order to facilitate health-promoting workplaces for people with LCW. This, in turn, can contribute to sustainable inclusion through enablement.