Health Promotion International最新文献

The COVID-19 pandemic and current cost of living crisis have highlighted socioeconomically patterned health disparities, bringing renewed focus on equity in public health. Despite political rhetoric invoking cultural narratives of egalitarianism and opportunities for class mobility, social class remains a significant factor in health outcomes in the Australian context. For social scientists, class (despite robust critiques) is a key analytical concept that has been theoretically broadened to encompass social and cultural practices (habitus). In public health, however, concepts of social disadvantage have expanded toward frames such as health equity and socioeconomic status in ways that can obscure 'class' and habitus. Understandings and operationalization of concepts of class and equity not only impact collaborative and interdisciplinary relationships, but also the framing of public health problems and health promotion interventions and policies. In this article, we draw on our experiences as anthropologists conducting ethnography in and of Australian health promotion programs to map and re-evaluate the intersection of concepts of social class and equity. We trace how representations of class emerged in these programs, and the versions of class and equity that materialized across different public health contexts. We argue for a conceptual repositioning of class that recognizes its shape-shifting qualities and of its materializations in different politics, disciplines and everyday contexts. In doing so, we highlight 'class' as a salient dimension of the design, implementation and evaluation of health promotion programs.

The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is available in multiple languages, and shortened versions have also been developed. This study aimed to examine the reliability and validity of the short version of the questionnaire (HLS-Q12) developed for community-dwelling older adults in Japan. The HLS-Q12 was developed using 12 of the 47 items of the Japanese version of the HLS-EU-Q47. In this study, the survey was conducted by distributing self-administered questionnaires to community-dwelling individuals aged 65 years and older who consented to participate; their responses were collected by mail. The correlation between the HLS-Q12 and the HLS-EU-Q47 was tested to assess criterion validity. To test construct validity, nine novel hypotheses were proposed. We also conducted a confirmatory factor analysis of the HLS-Q12. Based on a resurvey after 5-7 days, test-retest reliability was examined using interclass correlation coefficients (ICCs) and Bland-Altman analysis. In total, 118 individuals provided valid responses to the questionnaire. The Spearman rank correlation coefficient between the HLS-Q12 and the HLS-EU-Q47 was r = 0.98 (p < 0.001), and eight of the nine hypotheses were supported. The ICC was 0.96 (p < 0.001), and the 95% limit of agreement was -0.26 ± 5.9, suggesting no systematic error. Thus, the Japanese version of the HLS-Q12 was found to be reliable with high criterion validity and reproducibility. Hence, the HLS-Q12 is a useful scale for measuring health literacy among older adults in Japan.

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.

This systematic review collected evidence on the burden of non-communicable diseases (NCDs) among professional drivers and reported on the most common factors that increase the risk of NCDs in this specific population in low- and middle-income countries (LMICs). The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO). We conducted a thorough search on PubMed/MEDLINE, EMBASE, Scopus, Global Health, Web of Science and Africa-wide information databases on 11 May 2023. We adapted the Joanna Briggs Institute (JBI) tool to assess the quality of the studies. We estimated the prevalence of hypertension, prediabetes, diabetes mellitus (DM), overweight and obesity among professional drivers using a random effect model to compute pooled and subgroup analyses. In addition, we conducted a narrative synthesis of the risk factors and recommendations presented in the included studies. Forty-one studies, including 48 414 study participants, met the criteria for inclusion. The pooled prevalence of hypertension, DM and obesity among professional drivers was 36.7% [95% confidence interval (CI): 31.8-41.6%], 15.2% (95% CI: 7.0-23.4%) and 27.2% (95% CI: 18.7-35.8%), respectively. Unsupportive environment, work stress, sedentary lifestyle, consumption of unhealthy foods and shift work were the most common modifiable risk factors reported. Our findings also show a significant burden of hypertension, DM and obesity among professional drivers in LMICs. The prevalence of DM and obesity was two- and three-fold higher than findings in general populations, respectively. Our findings indicate an urgent need for tailored interventions for different occupation-related risk factors for NCDs among professional drivers in LMICs.

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF-LPF frameworks and suggestions to increase the transformative power of future studies.

Limited health literacy is linked to unhealthy behaviors, adverse health outcomes, poor quality of life and financial burdens on society. However, little is known about the level of health literacy, especially among school-going children. This cross-sectional study assesses health literacy levels and their determinants in 354 school children from Kathmandu Metropolitan City, utilizing a multi-stage cluster sampling method. The 10-item Health Literacy for School-Aged Children was used to measure the student's literacy levels. Bivariate analysis and multivariable logistic regression at the significance level of 0.05 were performed to determine factors associated with limited health literacy. The majority of participants (76.6%) had moderate health literacy, while 13.8% had a high level and 9.6% had a low level of health literacy. Students from nuclear families had lower odds [adjusted odds ratio (aOR): 0.4; 95% CI: 0.2-0.8] of having limited health literacy. Students whose mother education was up to secondary school (aOR: 10.1; 95% CI: 1.3-78.9), students with pre-existing mental health conditions (aOR: 3.7; 95% CI: 1.4-9.6) and students with unsatisfactory health status (aOR: 3.9; 95% CI: 1.5-10.5) had higher odds to have limited health literacy. These results suggest the importance of prioritizing school health promotion and education activities for students with pre-existing mental health conditions and mothers with low educational attainment. Implementing peer support group programs for children with mental illnesses, mobilizing school health professionals and introducing interventions such as vocational training of mothers can collectively improve health literacy among school-going children.

This study examined changes in physical and mental health quality-of-life and health services access before and after the onset of the COVID-19 pandemic among individuals of lower and higher socio-economic status (SES) in Australia. Difference-in-differences and logistic regression models were undertaken using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and government data on COVID-19 lockdowns between January 2020 and February 2021. Individuals from higher SES reported larger decreases in mental health quality-of-life scores than those from lower SES after the onset of the pandemic. Those from lower SES reported less disruption with any health services (24.2% vs 30.4%; OR = 0.68; p < 0.001), specifically dental services (8.2% vs 15.4%; OR = 0.51; p < 0.001) and allied health services (5.9% vs 8.5%; OR = 0.60; p < 0.001), compared with those from higher SES. Additional days under lockdown were associated with reduced access to all health services (OR = 1.19). Furthermore, long-term health conditions (higher SES: OR = 1.54) and scores indicative of poorer physical (lower SES: OR = 1.17; higher SES: OR = 1.07) and mental health (lower SES: OR = 1.16; higher SES: OR = 1.12) were associated with increased health services disruption. While individuals from higher SES were more likely than those from lower SES to experience greater relative declines in mental health and increased disruption with health services access, individuals with a greater apparent need for health services, regardless of SES, may have faced inequalities in accessing these services during the COVID-19 pandemic.

Cancer is one of the most important societal challenges in the world, with over 23 million new cases/year and 10 million deaths/year, that will only be properly tackled with a stronger focus on prevention. This calls for an informed population, aware of risk factors and willing to adopt preventive behaviors and early cancer screenings. For that purpose, 2' Life-changing minutes was created, the first ever televised Entertainment-Education series on cancer prevention. This study aims to evaluate the impact of 2' Life-changing minutes, a novel E-E format for cancer prevention, on knowledge gains and behavior changes. Two complementary studies were performed involving a total of 1314 participants: a test-screening (TS) study targeting potential viewers of the series, and a natural-screening (NS) study targeting those that spontaneously watched the series on television. We found (i) very high levels of appreciation and narrative engagement, and also willingness to see more episodes; (ii) statistically significant knowledge gains, ranging from 17% to 44%, on all four topics tested; (iii) evidence of effective behavior change. Regression analysis showed that narrative engagement was the best predictor of behavior change [NS: odds ratio (OR) = 3.38, 95% confidence interval (CI) = 1.70-6.74, p = 0.001; TS: OR = 2.05, 95% CI = 1.13-0.371, p = 0.018]. This study demonstrates the series' real impact and serves as a proof-of-concept for a novel strategy of cancer prevention that is based around compelling health narratives, rather than information or data, to engage viewers, increase knowledge and induce behavior change.

Research has shown that blue space (i.e. water-based environments) can be good for physical and mental health, with one possible reason being that people are physically active when visiting blue space environments. However, little is known about how active people are when visiting blue space. We used the System for Observing Physical Activity and Recreation in Natural Areas to systematically record whether people were active while visiting eight different blue space locations in Australia. We first calculated the proportion of people who were moderately or vigorously active at each location and then conducted a series of linear regression models to determine which demographic and environmental factors predicted higher activity levels. We identified that 44% of people visiting blue space locations were active. However, there were significant interactions between both age and gender, and type of blue space. Males (β = -0.25, p = 0.018) and females (β = -0.26, p ≤ 0.001) were less active at built-up riverfronts than coastal beaches. Females were also less active at inland beaches (β = -0.15, p = 0.013) and watering holes (β = -0.20, p = 0.011) compared with coastal beaches. Children (β = 0.16, p = 0.006) and adolescents, however, were more active at inland beaches (β = 0.32, p ≤ 0.001) than coastal beaches. These results are important to consider when making decisions around access to, and infrastructure within, blue space environments, as different blue space environments influence human behaviour differently for different people.

Child drowning is a significant public health issue in Indonesia, however, there is insufficient understanding of the issue and its associated risk factors within communities. This qualitative study aimed to explore parental and community perceptions and practices related to child drowning in Indonesian communities, and the perceived causes and risk factors. Seven focus group discussions (n = 62) were conducted with parents of children aged under-5 years and village community leaders in seven villages across all districts of Lombok Island, West Nusa Tenggara Province of Indonesia. Participants were recruited using purposive and snowball sampling. The thematic analysis, guided by Braun and Clarke's framework, used both deductive approaches, utilizing the Health Belief Model's constructs and inductive approaches. Most participants were unaware of the susceptibility of their children and others in their community to drowning and of the potential severe outcomes of drowning such as injury, disability and death. Participants generally associated drowning with beaches or open seas. Unprotected wells, tubs and buckets were identified as notable risk factors for child drowning in and around the home, shaped by some experience of child drowning incidents in the community. Supervision was identified as protective factor, however, mothers were often unavailable to supervise children, and supervision responsibility was often delegated to other family and community members. This study highlights the urgent need to enhance public awareness regarding children's susceptibility to drowning. Further exploration of local contexts and social determinants of drowning in Indonesian communities is crucial for ensuring effective water safety and drowning prevention strategies.