Communicative Health Literacy Research Articles

Mapping Adult Vaccine Confidence in Future Health Professionals: A Pilot Study among Undergraduate Students at Two Universities in Greece

Health professionals’ recommendations increase vaccine uptake. We aimed to document stances, practices regarding adult vaccination, and their predictors among undergraduate medical and biomedical science students, as well as their perspectives on increasing vaccine confidence. Among the 430 participants, third-year students from two universities in Greece, only 25.4% were in favor of all vaccines, while no refuters were detected. Predictors of recommending vaccination were the Attitudes Towards Adult Vaccination (ATAVAC) Value (OR 3.26, p < 0.001) and ATAVAC Safety subscales scores (OR 1.36, p < 0.05), being a medical student (OR 2.45, p < 0.05), and having better self-rated health status (OR 2.27, p < 0.05). The importance of getting vaccinated as health professionals was recognized by participants with a higher ATAVAC value (OR 5.39, p < 0.001), ATAVAC Safety scores (OR 1.46, p < 0.05), and increased knowledge regarding the National Immunization Program (OR 1.31, p < 0.05). The God Locus of Health Control (GLHC) was a predictor only in vaccination against COVID-19 (OR 0.91, p < 0.05). Improving community health literacy and health providers’ education, boosting trust in authorities, and adopting a person-centered approach emerged as the main themes regarding how to increase vaccine confidence. Mapping health professionals’ confidence in vaccines and providing lifelong training support is pivotal in supporting positive attitudes, enhancing their competence, and promoting vaccination in the post-COVID-19 era.

Community health literacy and community capacity building

Zusammenfassung Hintergrund Aus Sicht kritischer Gesundheitskompetenz sollten Kommunen die notwendige Kapazität dafür haben, um vor Ort die gesellschaftlichen Determinanten der Gesundheit zu gestalten. Obwohl sich in der kommunalen Gesundheitsförderung zunehmend Kapazitätsentwicklungsansätze verbreiten, sind diese in Deutschland noch kaum erforscht. Der Beitrag geht der Frage nach, wie verschiedene Facetten kommunaler Kapazität für Gesundheitsförderung in ausgewählten deutschen Städten und Gemeinden ausgeprägt sind und ob die COVID-19(„coronavirus disease 2019“)-Pandemie die kommunale Gesundheitsförderung beeinflusste. Methoden Datenbasis ist die von der CTC-EFF(„Effectiveness of the Community Prevention System Communities That Care“)-Studie in 2023 durchgeführte zweite Welle einer Befragung kommunaler Schlüsselpersonen (n = 235) aus 30 Städten und Gemeinden in Niedersachsen, Rheinland-Pfalz und Baden-Württemberg. Erhoben wurden Daten zu den lokalen Rahmenbedingungen und der kommunalen Kapazität für Prävention und Gesundheitsförderung (PGF). Es wurden deskriptive Analysen durchgeführt. Ergebnisse Kapazitätsaspekte, die in den meisten Kommunen ein gutes Level haben, sind Problemlösefähigkeit der Kommune, interorganisationaler Informationsaustausch sowie Rückhalt seitens der in den Kommunen lebenden Menschen gegenüber Maßnahmen zur Prävention von jugendlichem Problemverhalten. Facetten, die in vielen Kommunen Defizite aufweisen, sind die strategische Planung, Verknüpfung und Koordination von Maßnahmen, Ressourcenausstattung, interorganisationales Teilen von Ressourcen, evidenzbasiertes Vorgehen sowie Öffentlichkeitsarbeit zu den lokalen Angeboten. Die Coronapandemie hatte in den meisten Kommunen einen großen Einfluss auf die Präventionsarbeit. Es finden sich Hinweise auf Nachholeffekte in der Umsetzung von PGF-Maßnahmen. Schlussfolgerung Die Ergebnisse offenbaren einige Stärken und viele Schwächen in der kommunalen Kapazität für PGF. Um die kritische Gesundheitskompetenz der Kommunen zu steigern, sollten wirksame Kapazitätsentwicklungsansätze genutzt werden. Die Generalisierbarkeit der Ergebnisse ist limitiert und es besteht Forschungsbedarf zur untersuchten Thematik.

Revolutionizing community health literacy: The power of digital health tools in rural areas of the US and Africa

Access to quality healthcare remains a challenge in rural areas of both the United States and Africa, where limited resources and infrastructure hinder the delivery of essential services. This review explores the role of digital health tools in improving community health literacy and healthcare outcomes in these underserved regions. By leveraging digital technologies such as mobile applications, telemedicine, and educational platforms, communities can access valuable health information, connect with healthcare providers remotely, and receive timely support for managing their health. In rural areas of the United States, digital health tools have the potential to bridge the gap between patients and healthcare providers, especially for those living in remote areas with limited access to healthcare facilities. These tools enable individuals to monitor their health conditions, access educational resources, and receive virtual consultations, improving their overall health literacy and empowering them to take control of their health. Similarly, in rural Africa, where healthcare infrastructure is often lacking, digital health tools offer a lifeline for communities to access essential health services. Mobile health applications provide valuable information on preventive care, disease management, and nutrition, helping individuals make informed decisions about their health. Telemedicine services connect patients with healthcare professionals, enabling remote consultations and reducing the need for travel to distant healthcare facilities. However, the widespread adoption of digital health tools in rural areas faces several challenges, including limited internet connectivity, low digital literacy rates, and cultural barriers. Addressing these challenges requires a multi-faceted approach, including improving internet infrastructure, providing digital literacy training, and adapting digital health tools to meet the cultural and linguistic needs of local communities. In conclusion, digital health tools have the potential to revolutionize community health literacy in rural areas of the United States and Africa. By overcoming barriers to access and providing tailored health information and services, these tools can empower individuals to make informed decisions about their health, ultimately leading to improved health outcomes and well-being in underserved communities.

Examining Communicative, Critical Health Literacy and eHealth Literacy among International University Students Residing in Japan.

(1) Background: International students with sufficient health literacy are better equipped to respond to public health emergencies and reduce any unintentional harm that may occur during such events. This study aims to assess the current status of health literacy among international students and investigate the factors that influence health literacy. (2) Methods: A cross-sectional study was conducted in Tokyo on international university students using a questionnaire consisting of the Communicative and Critical Health Literacy and eHealth Literacy Scales. The study analyzed 205 valid responses. Descriptive statistics were utilized to assess the level of health literacy, and linear regression was used to identify the association of socio-demographic characteristics and disease status with health and e-health literacy. (3) Results: Health literacy and e-health literacy were low in 48.29% and 47.29% of international students, respectively. The mean scores of CCHL items ranged from 3.13 to 3.26, while the mean scores of eHEALS items ranged from 3.33 to 3.49. Both health literacy and e-health literacy were better with unmarried status (p = 0.015), and e-health literacy was worse with higher age (p = 0.007). (4) Conclusions: Overall, international students' health literacy and e-health literacy were at intermediate levels, with considerable room for improvement, and affected by certain student attributes.

Cross-sectional and Correlational Examination of Patients’ Preoperative Anxiety, Information Need, and Health Literacy in a Presurgical Consultation

PurposeThis study elucidates the preoperative anxiety (PA), information need (IN), and health literacy (HL) levels of an elective preoperative sample in Switzerland and examines the possible associations between PA and the patients’ characteristics. By knowing these patient dimensions, which can influence perioperative outcomes, one can tailor individualized nursing interventions to improve patients’ surgical experience. DesignThis was a cross-sectional and correlational study. MethodsThe sample consisted of 88 patients who underwent a preoperative consultation at a Swiss tertiary hosptial. Patients’ PA and IN were assessed using the Anxiety Preoperative and Information Scale, and their HL was measured using the Functional, Communicative, and Critical Health Literacy Scale. Data on other patient characteristics were collected from the patients, physicians, and electronic patient records. Association tests, as well as univariate regressions, were performed on PA, IN, HL, and patient characteristics. FindingsAmong participants, 40.91%, 78.41%, and 59% reported having PA, IN, and low HL, respectively. Finally, PA was associated with IN, HL, solitary living, and the American Society of Anesthesiology score. ConclusionsA high proportion of patients scheduled for presurgical consultation were found to be anxious. They presented high IN and low HL. An examination of patients’ PA–associated characteristics can help improve their surgical experience. More studies should examine PA–associated characteristics.

Translation and Validation of the Health Literacy Score-14 Questionnaire for Vietnamese Patients with Diabetes.

Health literacy (HL) is a crucial indicator for health promotion and diabetes care improvement, but the available measurements are mostly in English. This study aimed to translate and validate the 14-item Health Literacy Scale (HLS-14) questionnaire from English to Vietnamese for patients with diabetes in Vietnam. We translated HLS-14 into Vietnamese in accordance with the World Health Organization guidelines and conducted a cross-sectional survey among 571 outpatients with type 2 diabetes using the HLS-14 Vietnamese version (HLS-14 VN). The reliability and validity of the tool were assessed using Cronbach's alpha, composite reliability (CR), average variance extracted (AVE), and maximum shared variance (MSV), and confirmatory analysis was conducted. Cronbach's alpha coefficients for the three subscales as in the original version were 0.931, 0.810, and 0.928 for functional HL, communicative HL, and critical HL, respectively. However, AVE for critical HL was 0.488, which improved to 0.516 after the removal of one item in the communicative HL. For all subscales in the revised 13-item version (HLS-13 VN), CR was above 0.8, AVE was above 0.5, and MSV was less than AVE. Confirmatory analysis of HLS-13 VN revealed an acceptable fit with comparative fit index of 0.983, goodness-of-fit index of 0.963, and root mean squared error of approximation of 0.058. The reliability and validity of HLS-13 VN were confirmed. The tool is suitable for use in clinical settings in Vietnam to assess multidimensional HL in patients with type 2 diabetes.

Predictors of fall protection motivation among older adults in rural communities in a middle-income country: A cross-sectional study using the Protection Motivation Theory.

To evaluate factors associated with fall protection motivation to engage in fall preventive behaviour among rural community-dwelling older adults aged 55 and above using the protection motivation theory scale. A cross-sectional study. The study was conducted in a healthcare clinic in Malaysia, using multistage random sampling from November 2021 to January 2022. Three hundred seventy-five older adults aged 55 and older were included in the final analysis. There were 31 items in the final PMT scale. The analysis was performed within the whole population and grouped into 'faller' and 'non-faller', employing IBM SPSS version 26.0 for descriptive, independent t-test, chi-square, bivariate correlation and linear regressions. A total of 375 older participants were included in the study. Fallers (n = 82) and non-fallers (n = 293) show statistically significant differences in the characteristics of ethnicity, assistive device users, self-rating of intention and participation in previous fall prevention programmes. The multiple linear regression model revealed fear, coping appraisal and an interaction effect of fear with coping appraisal predicting fall protection motivation among older adults in rural communities. Findings from this study demonstrated that coping appraisal and fear predict the protection motivation of older adults in rural communities. Older adults without a history of falls and attaining higher education had better responses in coping appraisal, contributing to a reduction in perceived rewards and improving protection motivation. Conversely, older adults from lower education backgrounds tend to have higher non-preventive behaviours, leading to a decline in fall protection motivation. These results contribute important information to nurses working with older adults with inadequate health literacy in rural communities, especially when planning and designing fall prevention interventions. The findings would benefit all nurses, healthcare providers, researchers and academicians who provide care for older adults. Participants were briefed about the study, and their consent was obtained. They were only required to answer the questionnaire through interviews. Older individuals aged fifty-five and above in rural communities at the healthcare clinic who could read, write or understand Malay or English were included. Those who were suffering from mental health problems and refused to participate in the study were excluded from the study. Their personal information remained classified and not recorded in the database during the data entry or analysis.

Integrating community-based partnerships for enhanced health outcomes: A collaborative model with healthcare providers, clinics, and pharmacies across the USA

The Community Health Enhancement Initiative represents a significant advancement in the field of public health within the United States, targeting the improvement of health outcomes through a comprehensive, collaborative approach. This initiative, in partnership with an array of healthcare entities including renowned hospitals (e.g., Cleveland Clinic, Mayo Clinic, Johns Hopkins Hospital), federally qualified community health centers (e.g., Henry J. Austin Health Center, Chase Brexton Health Care), primary care practices (e.g., Kaiser Permanente, Geisinger Health System, Providence Medical Group), specialized clinics (e.g., Dana-Farber Cancer Institute, Cleveland Clinic Heart and Vascular Institute), and pharmacies with healthcare services (e.g., CVS Health, Walgreens, Rite Aid), aims to revolutionize community health services across the nation. This paper delves into the strategic framework of the initiative, which is designed to foster health literacy, disease prevention, and wellness in diverse American communities. It examines how the collaborative model not only leverages the strengths of various healthcare providers to offer comprehensive care but also actively involves communities in their health management through educational workshops and accessible services. By bridging the gap between healthcare providers and the public, the initiative seeks to build a more health-literate society that is better equipped to manage and prevent diseases. Furthermore, the paper evaluates the impact of this nationwide initiative on public health metrics, showcasing evidence-based outcomes and the potential for scalability in different regions. The initiative's alignment with national health objectives, its innovative use of partnerships to extend healthcare access, and its emphasis on health literacy as a pivotal component of community well-being underscore its relevance and importance to the broader health policy landscape in the U.S. In addition, the research addresses the challenges and opportunities presented by this model, including the integration of technology in healthcare delivery, the sustainability of partnerships, and the continuous engagement of communities. It concludes with policy recommendations for enhancing the initiative's effectiveness and potential for replication, contributing to the ongoing discourse on improving public health infrastructure and outcomes across the United States.

Healthcare Laboratories: a venture to ramp up health of rural India

Learning outcomes The learning objectives have been prepared following Bloom’s taxonomy (Bloom et al., 1956). After completing the case study, the students will be able to identify and recall the prerequisites necessary for establishing a pathology laboratory. (knowledge); analyze the micro- and macroenvironmental factors considered by Mr Sabihul Haque in the development of the strategic plan for Healthcare Laboratories (HCL) (knowledge and application); explain the key components of the Porter’s value chain and their significance in the operation of HCL (comprehension and evaluation); use the TOWS analysis to map the internal strengths, weaknesses, opportunities and threats of HCL (application and synthesis); and analyze the challenges faced by protagonist in managing HCL and generate suggestions for addressing the challenges (analysis and synthesis). Case overview/synopsis HCL, an enterprise established in 2018 in Sahdeo Khap, Gaya, Bihar, India, aims to provide high-quality pathological diagnostic services in semi-urban and rural areas. This health-care initiative is pioneering, offering pathology services to make high-quality, low-cost diagnostic services accessible in rural India. In rural settings, numerous health-care hurdles make it challenging for individuals to access the care they need. Since its inception, HCL has expanded its reach to connect more areas, facilitating diagnostic services for people in remote regions. The establishment of laboratories in semi-urban areas aims to reduce patient travel time, costs and health risks by bringing services directly to their doorstep. Haque, the chief executive officer of the lab, grappled with multiple challenges, including selecting an appropriate location for the lab, recruiting and retaining skilled workforce, managing logistics supply, collaborating with local health-care providers, dispelling the stigma among the population that superior services are only available in cities and enhancing health literacy in rural communities. Following numerous meetings with Ms Ummati Naiyyer, head of operations, they worked collaboratively to address these challenges, developing a blueprint and future plan to operate services in rural areas. This case study provides insights into the obstacles faced by HCL striving for success in rural areas. It elucidates the beneficial application of the Porter’s value chain, along with an analysis of macro- and microenvironmental factors. Unique challenges such as societal stigma and mistrust are specifically emphasized. Students engaging with this case study will enhance their problem-solving skills through brainstorming and providing recommendations, contributing to potential solutions for HCL’s difficulties. Complexity academic level The teaching notes for the HCL case is designed to enhance the learning experience of undergraduate and graduate students within the context of the course. This case study serves as a valuable teaching tool, allowing students to apply theoretical knowledge to real-world scenarios in the health-care industry. The notes provide a framework for instructors to facilitate discussions, encourage critical thinking and promote a deeper understanding of key concepts related to establishing diagnostic laboratories in rural areas. Supplementary materials Teaching notes are available for educators only. Subject code CSS3: Entrepreneurship.

Health literacy and its association with mental and spiritual well-being among women experiencing homelessness.

Low health literacy (HL) has been linked to low self-rated health, reduced efficacy of behaviour change, and challenges in preventing, treating, or managing health conditions. People experiencing homelessness are at risk of poor HL; however, few studies have investigated HL in relation to mental and spiritual well-being among people experiencing homelessness in general, or women experiencing homelessness specifically. This cross-sectional study of 46 women experiencing homelessness in Stockholm, Sweden, recruited during the period October 2019-December 2020, aimed to examine how HL was associated with mental and spiritual well-being among women experiencing homelessness. Participants answered questions about socio-demographic characteristics (age, length of homelessness, education) and digital technology (mobile phone/the Internet) use, in addition to Swedish language versions of three questionnaires administered through structured, face-to-face interviews: the Communicative and Critical Health Literacy Scale, the General Health Questionnaire 12 and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. Data were analysed using linear regression, which revealed statistically significant associations between HL and mental well-being (p = .009), and between HL and spiritual well-being (p = .022). However, neither socio-demographic characteristics nor digital technology use were significantly associated with HL. In conclusion, promoting HL may improve mental and spiritual well-being in this vulnerable population. An advisory board of women with lived experiences of homelessness (n = 5) supported the interpretation of the findings and emphasised the need to consider HL in relation to basic needs such as 'housing first'. Moreover, health information and services should be accessible to people with different degrees of HL.

Online health information searching and health literacy among middle-aged and older adults: A cross-sectional study.

Given the rapid increase in health information available, health literacy is now more important than ever when searching for health information online. Furthermore, health literacy and online health information searching are reported to be associated with support from others. In this study, we examined the associations of health literacy and social support with online health information searching among individuals in their 50s and 60s. Between March and May 2022, an anonymous self-administered questionnaire was administered among 750 middle-aged and older adults (age 50-69) living in northern Japan. The questionnaire items included personal characteristics, frequency of online health information searching, health literacy domains, and social support. A total of 237 respondents answered all the items (response rate: 31.6%). Multiple logistic regression analysis revealed that communicative health literacy was significantly associated with searching for information about illnesses and health promotion, while critical health literacy was significantly associated with searching for information about medical institutions. Controlling for personal characteristics, health literacy, was associated with online health information searching, suggesting that improving health literacy is important in a digital and information society.

Empowering Community Health Workers in Japan: Determinants of Non-Communicable Disease Prevention Competency

Background: Community health workers (CHWs), hailing from the general populace, play a pivotal role in fortifying healthcare systems, with a primary focus on mitigating non-communicable diseases (NCDs) and elevating overall life expectancy. To assess the aptitude of CHWs in NCD prevention, we introduced the Community Health Workers Perceptual and Behavioral Competency Scale for preventing non-communicable diseases (COCS-N). This study examines the multifaceted interplay of individual and community factors that influence CHWs’ COCS-N scores. Methods: The research design is a secondary analysis using data from a self-administered questionnaire survey of 6480 CHWs residing in municipalities across Japan, which obtained 3120 valid responses, between September to November 2020. The COCS-N was employed as the dependent variable, while the independent variables were individual-related factors, including years of community health work, health literacy, and community-related factors, such as CHWs’ sense of community. To ascertain the significance of associations between individual and community factors and CHWs’ competency, an analysis of covariance (ANCOVA) was utilized to compare the three groups Q1/Q2/Q3 by low, medium, and high scores on the COCS-N scale. Statistical significance was considered to be indicated by a p-value of less than 0.05. Results: The ANCOVA analysis revealed that three factors were significantly linked to CHWs’ competence. These comprised individual factors: “years of CHWs” (mean ± SD Q1: 6.0 ± 6.0, Q2: 7.8 ± 7.0, Q3: 8.2 ± 7.7, p < 0.001) and “health literacy” (Q1: 27.7 ± 6.6, Q2: 30.4 ± 6.9, Q3: 33.8 ± 7.8, p < 0.001), as well as a community factor: “Sense of community” (Q1: 14.8 ± 3.7, Q2: 16.5 ± 3.5, Q3: 18.2 ± 3.6, p < 0.001). Conclusions: Our finding is that a positive association was derived between COCS-N scores and certain determinants. Notably, “years of CHWs” and “health literacy” in the individual domain, along with the “Sense of community” in the communal context, were firmly established as being significantly associated with CHWs’ competency. Consequently, CHWs need training to increase their “health literacy” and “sense of community”, to acquire high competency in NCD prevention, which will lead to the empowerment of CHWs and maintain their motivation to continue.

The Stress of Advancement: A Nurse Practitioner's Exploration in Providing Culturally Competent Obesity Prevention Counseling in Black Women.

Black women are diagnosed, disabled, and die from obesity and associated chronic diseases at higher rates than any other sex or race. Advanced practice registered nurses (APRN) can potentially improve culturally relevant health education and counseling by using health literacy communication tools. Explore individualized barriers and APRNs' role in providing obesity prevention education and counseling by assessing the efficacy of the Teach-Back Method (TBM) to understand health habits and attitudes. Black women aged 18-45, previously diagnosed as overweight or obese, and identified with perceived barriers were recruited from a predominantly Black church in Atlanta. They engaged in weekly, 1-hour educational sessions via Zoom, addressing four common barriers identified in the literature. Sessions ended with a 5-10 minute Teach-Back session. Pre- and post-intervention Readiness to Change Questionnaire (RCQ) were completed. Descriptive statistics and quantitative data from surveys and pre- and post-RCQ were analyzed. Twenty women completed the intervention. Paired sample t-test revealed no statistical significance or correlation between pre- and post-RCQ scores after using TBM in educational sessions. However, Pearson's correlation showed positive associations between elevated body mass index levels as one advances their education and annual income, with a p-value of 0.05. Increased rates of obesity are experienced despite higher educational attainment or pay. Stress and high-coping mechanisms contributed to disordered eating, decreased physical activity engagement, and decreased motivation toward habit change. Clinicians should be held accountable for delivering culturally sensitive care using the TBM, addressing social determinants of health, performing routine stress assessments, and checking their implicit biases.

Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study

BackgroundNoncommunicable diseases (NCDs), such as health-related lifestyle diseases, are the leading cause of mortality and societal and economic burdens. Poor lifestyle behaviors, which are modifiable to improve health, can cause diseases, including NCDs. Health literacy has been recognized as an important determinant of health, and studies have shown that higher health literacy is associated with better health outcomes and positive health-related behaviors. However, few studies have investigated the association between health literacy and health-related lifestyle behaviors to understand the mechanistic link between them. Thus, this study investigated the extent to which health literacy at different levels influences health-related lifestyle behaviors.MethodsA cross-sectional study was conducted among Japanese health management specialists (N = 1,920). Functional, critical, and communicative health literacy were measured. Lifestyle behaviors (exercise, diet and nutrition, sleep, rest, smoking, and alcohol intake), in line with the Japanese National Health Promotion Program, were assessed and calculated into a total cumulative score of health-related lifestyle behaviors. Moreover, we analyzed the associations between the three levels of health literacy and lifestyle behaviors using regression analyses by adjusting for socio-psycho-demographic factors.ResultsMultiple linear regression analyses showed a significant association between the Japanese version of the European Health Literacy Survey Questionnaire and total health-related lifestyle scores (standardized β = 0.160, p < 0.001, R2 = 0.136) after adjusting for sociodemographic factors. Similarly, the association between communicative and critical health literacy and the total health-related lifestyle scores was significant (standardized β = 0.122, p < 0.001, R2 = 0.125). The analysis indicated that individuals who had higher level of health literacy (critical and communicative) than functional health literacy (Japanese version of the Newest Vital Sign score) had higher health-related lifestyle behaviors.ConclusionsA higher level of health literacy is associated with health-related lifestyle behaviors. Health literacy can be a target for interventions to achieve the national goal of lifestyle-related disease prevention and control.

A community health literacy Hub

Introduction: Being health literate is important to get sufficient health information, to navigate the health system, to access appropriate care and to be able to self-manage health. As such it is a key determinant of health. There is a need for innovative measures to improve health literacy among people living in socioeconomically vulnerable circumstances. In response to this need, a low treshold community health literacy hub was developed and implemented in a vulnerable neighbourhood in the city of Antwerp, within a broader project on the prevention of cardiovascular diseases (H2020 SPICES project)&#x0D; The health kiosk provides information on a healthy lifestyle and disease prevention in a low-threshold manner to people and groups in a socially vulnerable situation. These are the people for whom the current preventive offer is insufficiently accessible; because it is not sufficiently attuned to diversity in language and culture, it is insufficiently accessible or available, or because people have so many other concerns on their minds that they have less mental space to actively engage with health.&#x0D; Who is involved? The Health Kiosk is a partnership between Logo Antwerp, University of Antwerp, Antwerp District. Another important collaboration is with the Community Health Workers. These are people from the communities involved who direct people, often non-native speakers, to care. They speak to people in their own language, thus removing an important barrier. This cooperation also allows us to make good links between the preventive offer and primary care. To further operationalise the operation of the kiosk, ELZ Oost will also be involved. The focus will also be on first-line professionals.&#x0D; Results: The health kiosk grew out of the need to increase health literacy among vulnerable target groups, those who live under the radar. Yet the effect of the kiosk appears to go much further. The whole community gets involved: not just residents, but also organisations from different sectors, as well as the working population. Over the past year, the kiosk has become well embedded in the neighbourhood. A broad base of support has been created.&#x0D; Outreach work presupposes a lifeworld perspective. You can only succeed if you really connect with the living environment of local residents. Participative work is therefore indispensable when doing outreach work. It is crucial to involve people from the community right from the start of the project. &#x0D; Next steps: Now we need to take a step further. Looking to the future, it is important to link up even more with first-line professionals such as GPs, pharmacists, home nursing, etc. The pressure on first-line professionals, especially GPs, is high.

Stigma, Help-seeking and Factors Associated with Mental Health Literacy in Adults: A Literature Review

The article aims to review domestic and foreign research to provide information about the current condition of two of the three aspects of mental health literacy, namely stigma, and help-seeking, and the related factors to understand impact measures to help improve the adults' mental health literacy. This study uses a literature review method with English and Vietnamese keyword searching on PubMed and Vietnamese journals. Results show that stigma happens to be higher in Asian regions than in Australia, Europe, and America. Reducing stigma will improve treatment effectiveness and enhance the mental health literacy of individuals and communities. Regarding help-seeking, it shows that the rate of seeking help ranges from 28.2% to 76.9%. People with low mental health literacy are often less likely to seek help. Age, gender, education level, income, employment position, marital status, medical history, and alcohol use history are factors related to mental health literacy. Previous studies have shown that people with higher knowledge tend to seek help, while those with less stigma have a higher ability to seek help.&#x0D; Keywords: Related factors, mental health literacy, adults, stigma, help-seeking.

Factors associated with COVID-19 misinformation rebuttal among college students: a descriptive study.

The deluge of COVID-19 misinformation makes people confused, and acting on such misinformation can kill, leading to the tragic outcome of death. This makes it necessary to identify significant factors associated with college students' susceptibility. This descriptive study sought to ascertain factors significantly associated with college students' susceptibility to online COVID-19 misinformation. To assess college students' susceptibility to COVID-19 misinformation, we first chose as independent variables some demographic information, some well-developed, validated literacy tools, and the Patient Health Questionnaire-9 Items. Second, we selected as the dependent variable COVID-19 myths from some authoritative, official websites. Third, we integrated the independent and dependent variables into an online questionnaire. Fourth, we recruited students from Nantong University in China to participate in an online questionnaire survey. Finally, based on the data collected, we conducted quantitative and qualitative analyses to relate the independent variables to the dependent variable. Five hundred forty-six students participated in the survey voluntarily, and all questionnaires they answered were valid. The participants had an average of 2.32 (SD = 0.99) years of higher education. They have a mean age of 20.44 (SD = 1.52) years. 434 (79.5%) of the 546 participants were females. The frequency of their Internet use averaged 3.91 (SD = 0.41), indicating that they logged onto the Internet almost every day. Their self-reported Internet skill was rated 3.79 (SD = 1.07), indicating that the participants rated their Internet skills as basically "good." The mean scores of the sub-constructs in the AAHLS were 6.14 (SD = 1.37) for functional health literacy, 5.10 (SD = 1.65) for communicative health literacy, and 11.13 (SD = 2.65) for critical health literacy. These mean scores indicated that the participants needed help to read health-related materials "sometimes," the frequency that they knew how to communicate effectively with professional health providers was between "often" and "sometimes," and the frequency that they were critical about health information was between "often" and "sometimes," respectively. The sum of their scores for eHealth literacy averaged 28.29 (SD = 5.31), showing that they had a relatively high eHealth literacy level. The mean score for each question in the GHNT was determined at 1.31 (SD = 0.46), 1.36 (SD = 0.48), 1.41 (SD = 0.49), 1.77 (SD = 0.42), 1.51 (SD = 0.50), and 1.54 (SD = 0.50), respectively. These mean scores showed that a high percentage of the participants answered the 6 questions wrongly, especially Questions 4-6. Similarly, participants performed unsatisfactorily in answering the 3 questions in the CRT, with a mean score of 1.75 (SD = 0.43), 1.55 (SD = 0.50), and 1.59 (SD = 0.49) for each question, respectively. In the PHQ-9, the participants reported that they never felt depressed or felt depressed only for 1-3 days in the past week. The mean score for myths 1-6 and 9-10 ranged from 1.15 (SD = 0.36) to 1.29 (SD = 0.46). This meant that the participants rated these myths false. However, most of the participants rated myths 7-8 true (1.54, SD = 0.50; 1.49, SD = 0.50), showing that they were highly susceptible to these 2 pieces of misinformation. Through data analysis via Logistic Regression (forward stepwise), we found that (1) at an average threshold of 0.5, Internet use frequency, functional health literacy, general health numeracy, reflective thinking tendency, and depression severity were significant predictors of susceptibility to misinformation for both male and female students, (2) at a higher threshold of 0.8, aggregated general health numeracy scores and functional health literacy scores, as well as depression severity were predictors of susceptibility to misinformation for both male and female students, (3) functional health literacy, general health literacy, and depression predicted resistance to misinformation for female students, and (4) internet use frequency and self-reported digital health literacy predicted resistance to misinformation for male students. We revealed the complexity, dynamics, and differences in age, gender, education, Internet exposure, communicative health literacy, and cognitive skills concerning college students' susceptibility to online COVID-19 misinformation. Hopefully, this study can provide valuable implications for counteracting COVID-19 misinformation among Chinese college students.

Prevalence and determinants of health literacy among the adult population of Qatar.

Health literacy (HL) is both a direct determinant and a mediator of health outcomes. Research on the prevalence and determinants of HL in terms of its functional, communicative, and critical domains is scarce in the state of Qatar and its surrounding regions. Thus, this study aims to fill the knowledge gap in this area, estimate the levels of functional, communicative, and critical health literacy among the general adult population, and identify its determinants in the state of Qatar. An analytical cross-sectional study with a disproportionate stratified random sampling technique was conducted in 2022. A representative sample of phone numbers was obtained from the Cerner database at Hamad Medical Corporation and approached via well-trained data collectors. A socio-demographic and health-relevant factor questionnaire and the validated All Aspects of Health Literacy scale (AAHLS) were used to collect the data on functional, communicative, and critical HL and their determinants. Descriptive analysis, independent sample t-test, ANOVA, and linear regression were used and yielded the outcomes on HL levels as low, adequate, and high in percentages and the HL determinants. A total of 770 participants were included. The study found that 41.5%, 29.3%, and 29.2% of them have adequate, high, and low overall HL levels consecutively. People who participated in the study are older adult, are of Arabic ethnicity, are of Qatari ethnicity, have a lower level of education, have close relatives with a lower level of education, have a lower income, are non-migrants, are not living within a family, sought medical care within the last week, and who do not know if they have a chronic disease or do not have lower overall HL levels compared to the other groups. After linear regression analysis, only the participant's level of education and "last time sought medical care within last week" variable predict the overall HL score. Almost half of Qatar's adult population has an adequate HL level, comparable to the HL levels in other regions, despite the limitation in comparison due to variation in context and the HL measurement tools used. The possible determinants are amenable factors to focus on while designing HL interventions and providing healthcare.

Association between physical activity and health literacy in patients with Parkinson’s disease: an online web survey

BackgroundFor patients with Parkinson's disease (PwPD), promotion of habitual physical activity (PA) assists in the prevention of disease progression. Patients' health literacy (HL) is integral for meeting PA standards and turning it into a habit. This study evaluated the association between PA level and each HL domain in PwPD.MethodsOnline web-based assessment instruments and self-administered questionnaires, including the PA Questionnaire (IPAQ) Short Form and the Functional, Communicative, and Critical Health Literacy (FCCHL) scale, were used to assess PA levels and health literacy domains of PwPD.ResultsThe mean age of PwPD (n = 114) was 65.9 (SD = 11.6) years; 59.6% female, and the mean duration of disease was 6.4 (SD = 5.1) years. Of participants, 47.4% met the recommended criteria for PA. When comparing each HL domain by PA level, participants with lower PA had significantly lower critical HL (p = 0.03). Logistic regression analysis revealed that PA level correlated with critical HL (OR = 2.46; 95% CI = 1.16–5.19; p = 0.02).ConclusionsAdherence to recommended PA standards was associated with critical HL, but not other HL domains. Proactive attitudes to critically evaluate and utilize as well as understand health information may positively influence the promotion of PA.

Pathway analysis of the impact of health literacy, social support and self-efficacy on self-management behaviors in pregnant women with gestational diabetes mellitus.

The purpose of this study was to investigate the pathways by which health literacy (HL), social support, and self-efficacy influence self-management behaviors of pregnant women with Gestational diabetes mellitus (GDM) and the interrelationships between the variables. A total of 565 pregnant women with GDM was recruited. The Demographic Characteristics Form, Health Literacy Scale, Perceived Social Support Scale, General Self-efficacy Scale and GDM Self-management Behavior Scale were used for data collection. Descriptive statistics, zero-ordered correlation analysis, and multiple linear regression analysis were performed on the variables; Structural Equation Model (SEM) were constructed for pathway analysis. A positive correlation was found between health literacy, social support, self-efficacy, and self-management behaviors among pregnant women with GDM after adjusting for age, education level, income level, work status, parity, and family history of diabetes (r ranging from 0.203 to 0.533). A further multiple linear regression analysis showed that functional HL, communicative HL, critical HL, social support, and self-efficacy were all independent influences on self-management behaviors and accounted for 36.3% of the variance. Communicative HL and critical HL explained the strongest self-management behaviors (β = 0.316 and 0.255, respectively, p < 0.001). The SEM model was suitable for χ2/DF = 2.860, RMSEA = 0.060, IFI = 0.953, TLI = 0.943, and CFI = 0.952. The results showed direct positive effects of health literacy on self-management behaviors and self-efficacy, direct positive effects of social support on health literacy and self-efficacy. Social support and self-efficacy have had no significant direct impact on self-management behaviors, but social support may indirectly influence self-management behaviors through the health literacy mediation role. Healthcare providers should pay attention to the positive impacts of health literacy and social support on self-management behaviors of pregnant women with GDM. Improving the health literacy level of pregnant women with GDM should be the key point of intervention in practice, and the social support system should be fully mobilized to enhance emotional support and life support to promote the improvement of self-management behaviors.