Enhance Health Literacy Research Articles

Health literacy and loneliness among physically inactive Danes aged 18–65: a cross-sectional study

IntroductionBoth physical inactivity and loneliness are public health threats bringing huge costs to society and quality of life. The two health challenges often co-exist, suggesting physically inactive and lonely individuals to be a high-risk group. Health literacy as a concept is understood as a modifiable health determinant, and it has been proposed for promoting equity in future health promotion.AimThe aim of this study was to examine the association between health literacy and loneliness among physically inactive adults.MethodsA representative sample of 6,196 Danish adults, aged 18–65 years, was invited to a screening on a set of health outcomes for physical inactivity, which was based on the International Physical Activity Questionnaire-Short Form. A total of 1,033 adults were classified as physically inactive and therefore received the full questionnaire screening on a set of different health outcomes including the Health Literacy Questionnaire (HLQ) and the Three-Item Loneliness Scale (T-ILS). Two statistical approaches were applied: (1) health literacy expressed as nine different continuous variables corresponding to the domains of HLQ using logistic regressions analyses to examine the association between health literacy and loneliness; (2) health literacy expressed as nine different binary variables showing proportions of low literacy among lonely versus non-lonely participants. Statistical analyses were performed using Stata/IC version 16.1.ResultsAmong a sample of 1,010 physically inactive adults, 23.7% felt lonely with a T-ILS score below ≥7. Regression analyses predicted a negative association between health literacy and loneliness in all HLQ domains, after adjusting for gender, age, education, and occupation. Adjusted ORs ranged from 0.21 (95% CI: 0.16; 0.27) to 0.69 (95% CI: 0.57; 0.83) in domains 1–5 and 0.50 (95% CI: 0.41; 0.61) to 0.70 (95% CI: 0.55; 0.89) in domains 6–9. A similar pattern was found in the analysis with health literacy as a binary variable as the proportions of low health literacy were the highest among persons with loneliness in all HLQ domains.ConclusionEven after adjusting for sociodemographic factors, a negative association was predicted between health literacy and loneliness in physically inactive adults. This suggests that strategies for improving physical activity among inactive individuals might be more effective if they include a focus on enhancing health literacy and addressing loneliness.

Variations in health literacy and influential factors affecting the categories of social support among rural patients with diabetes mellitus

ObjectiveThe aim of this study is to explore the inherent classification of social support among individuals residing in rural areas of China. Additionally, we aim to examine the attributes and variations in health literacy scores among patients with diabetes mellitus (DM) within diverse social support categories.DesignCross-sectional study.MethodsEmploying the multi-stage stratified sampling technique, we enrolled 2,178 patients diagnosed with DM residing in the rural regions of Guangxi Province. We utilized the General Information Questionnaire, Social Support Rating Scale (SSRS), and Functional, Communicative and Critical Health Literacy Instrument.ResultsThe rural patients with DM were categorized into four distinct groups based on the types and levels of their underlying social support. These groups included a low-level social support utilization group (43%), a low-level objective social support group (17%), a moderate-level social support group (20%), and a high-level social support and high-level utilization group (20%). Statistical analysis revealed significant differences among the four groups in terms of age, disease duration, and blood sugar control level (p < 0.05). Furthermore, health literacy scores and scores across various dimensions for rural patients with DM demonstrated variability in accordance with latent profiles of social support, with statistically significant differences observed (p < 0.05). A positive correlation was identified between the level of social support and all dimensions of health literacy among rural patients with DM (p < 0.05).ConclusionThe social support available to individuals with DM in rural settings can be categorized into four distinct types, and its manifestation is influenced by demographic factors. The health literacy of rural patients with DM is intricately linked to the extent of social support they receive. For enhanced outcomes, interventions targeted at enhancing health literacy and quality of life among rural patients with DM should be tailored to address the heterogeneity observed in latent profiles of social support.

Low health literacy is associated with health-related institutional mistrust beyond education

Abstract Background Institutional mistrust, the lack of confidence and overall suspicion towards authorities or systems, usually governmental, but also extending to the health sector, poses a major obstacle towards public health policies and actions. Lower educational attainment has been linked to higher mistrust, but the role of health literacy in particular remains unclear. Methods Cross-sectional study in the general adult population of Greece and Cyprus following proportional quota sampling (January 2022 to May 2023). The current analysis is based on a sub-sample of 292 participants, with complete information on health literacy (main exposure, assessed via the validated HLS-EU-Q16) and health-related institutional mistrust (main outcome, assessed via a new culturally adopted questionnaire comprising 11 items). Multiple linear regression was used to determine associations between the aforementioned factors, adjusting for educational attainment and other potential confounders. Results Exploratory factor analysis revealed 3 health-related institutional mistrust dimensions, towards: (a) governmental authorities and the media (i.e., the system), (b) doctors and other health professionals, and (c) the scientific community. Health literacy was negatively associated with all mistrust dimensions, with associations being particularly strong with mistrust towards the system (B, 95% CI per unit increase in the HL scale: -0.87, -1.58; -0.15) and the scientific community (-0.71, -1.11; -0.32). These association remained robust to adjustment for educational attainment and other sociodemographic factors. Conclusions Mistrust towards a perceived system, comprising the government and media, as well as towards the scientific community on health-related matters, is higher among individuals with low health literacy, irrespective of educational attainment. Enhancing health literacy could act as a novel target for public health approaches aiming to tackle health-related institutional mistrust. Key messages • Health-related institutional mistrust is a complex phenomenon, which appears to have different dimensions, relevant to the perceived system, health professionals, and the scientific community. • Low health literacy is an independent predictor of health-related institutional mistrust, rendering it a novel target for attempts towards reversing this phenomenon and its adverse health consequences.

Enhancing Health Literacy Among Disadvantaged Youth: A Participatory Approach in School Settings

Abstract Background School-based health literacy interventions have the potential to significantly impact the health of disadvantaged youth. However, the effectiveness of such interventions varies. The aim of the ‘health literacy among youth’-intervention was to improve the health literacy of disadvantaged youth in two school settings in Denmark. Methods The intervention began with identifying the health literacy needs of 128 students. Groups of teachers from each school participated in workshops facilitated by the research team to develop activities to address the specific needs of the students. Over the course of one school year (August 2023 to May 2024), these activities were implemented. Questionnaires were administered to students before, during, and after the intervention, and semi-structured interviews were conducted among teachers and students. Results Teachers at each school created activities aligned with the organizational structure and the needs of the students, focusing on occupational diseases and injuries, and physical activity and mental well-being, respectively. However, contextual factors such as time constraints, students’ characteristics, and teachers’ professional backgrounds and varying levels of motivation, influenced the implementation. Conclusions The intervention design offered flexibility in tailoring health literacy activities and their implementation to suit the unique contexts of the two schools. While the participatory approach facilitated targeted and organizationally aligned health interventions, its feasibility varied across contexts. Our findings highlight the importance of involving participants in developing health interventions to ensure relevance and alignment with specific needs of the target group. Key messages • Despite contextual similarities, the outcome of participatory intervention approaches may vary across contexts. • Co-creation contribute to health literacy interventions that are tailored the needs of the target group.

Digital Health Interventions’ Impact on Health Literacy: A Systematic Review

Abstract In the digital era, health literacy is crucial for informed health decisions and outcomes. This systematic review evaluates the effectiveness of digital health interventions (DHIs) in enhancing health literacy, as defined by the World Health Organization. We included a variety of studies, such as cross-sectional studies, surveys, and case reports, focusing on interventions like mobile health apps, online platforms, and telehealth services. Our search, adhering to PRISMA guidelines, spanned databases like PubMed, IEEE, and ACM, covering publications from 2013 to 2023. From 1,029 initial articles, 58 met our inclusion criteria after rigorous screening and duplicates removal. Our findings highlight that DHIs, including multimedia tools and remote sessions, significantly bolster health literacy across diverse populations. However, the impact varies due to the digital divide, influenced by factors like age and socioeconomic status. This review underscores the potential of DHIs in public health and the necessity to address accessibility to reduce health disparities. The full synthesis of data and methodological details will be discussed in the presentation, aiming to guide future digital health strategies and policies. Key messages • Digital Interventions Enhance Health Literacy Across Diverse Populations. • Addressing the Digital Divide to Ensure Equitable Access to Health Benefits.

1.K. Scientific session: Health literacy of children and adolescents across Europe

Abstract Health literacy is developed throughout the life course. Enhancing health literacy at an early age is especially important since it may impact both current and future health skills and outcomes. Low health literacy in child and adolescent populations has been linked to worse health outcomes and health disparities in Europe, making health literacy of children and adolescents an important public health topic. Developing and delivering targeted interventions and services for these age groups requires insight and data on the development and state of health literacy in early age. However, child and adolescent health literacy is still an under-researched topic. This is partly due to a lack of appropriate measurement instruments and methods to involve children in research. In the past years, new studies on child and adolescent health literacy have emerged in several European countries. In this workshop, innovative studies from Germany, the Netherlands and the UK on HL in childhood and adolescence are introduced and discussed. Both methodological findings as well as empirical data will be presented. In Germany, an instrument to measure child health literacy was developed and validated for primary school children. This instrument, the HLS-Child-Q15, has been used both in Germany and in the Netherlands to study the relationship between children’s health literacy and their health behaviors and outcomes. In the UK, methods of involving primary school children in health literacy research were studied. Experiences with a Children’s Advisory Group will be shared. Another study in the Netherland focuses on the health literacy profiles and needs of adolescent patients with rheumatic diseases. The format of this workshop will be 4x10-minute presentations (including questions) followed by a 20-minute interactive discussion, reflecting on the relevance of these results to further research, health promotion and health services. which will be followed by Q&A and an open discussion with the audiences. This workshop offers a forum for researchers, health educators, practitioners and policy-makers interested in health literacy measurement and research in children and adolescents. Key messages • Child and adolescent health literacy is an important, yet under-researched public health topic. • Child health literacy is an important predictor of their health behavior and outcomes.

Co-creation of migrant health interventions in Portugal: Insights from the VO(I)CES project

Abstract Background International migration is increasing both globally and in Europe, highlighting the need for responsive interventions that cater to the diverse needs and strengths of migrants. Although genuine involvement of stakeholders in the design and implementation of interventions is vital to enhance their relevance, responsiveness, and ownership, co-created migrant health interventions remain limited. This study aims to address this gap by collaboratively developing health literacy interventions with meaningful involvement from migrants and professionals from both the social and health sectors. Methods As part of the VO(I)CES project, twelve idea-generation workshops were conducted in Portugal, applying the Ophelia (Optimising Health Literacy and Access) process, engaging over 70 stakeholders (migrants, social and healthcare professionals). To guide discussions, these workshops used case vignettes developed from 16 health literacy profiles that were identified in a previous study among 1,126 migrants. The discussions aimed at eliciting detailed insights into the potential actions that are responsive to migrants’ challenges. Results Several key interventions were identified by the stakeholders, including the enhancement of cultural and linguistic training for healthcare providers, the use of community health agents/mediators to improve service delivery and community engagement, and the creation and dissemination of multilingual, multi-format health information materials. Specific interventions for groups experiencing increased vulnerabilities such as pregnant women were also proposed, alongside suggestions for creating citizen spaces and improving digital skills among healthcare staff. Conclusions The co-creation approach facilitated the development of tailored context-specific interventions that are anticipated to enhance health literacy, improve healthcare accessibility, and promote health equity for migrants. Key messages • Ideas Generation Workshops provide a platform for a wide range of groups to have their say and know their voice is being heard. • Co-creation tailors interventions to diverse needs, avoiding a one-size-fits-all approach.

Health literacy in the evolving era of personalised medicine and digital health

Abstract Health literacy is pivotal for advancing public health, empowering individuals to grasp health information and make informed decisions. However, health literacy levels are often influenced by social and economic factors, with lower levels correlating with reduced disease-specific knowledge and underutilization of preventive health services. As healthcare technology rapidly evolves, particularly with the advent of personalised medicine (PM) and novel genetic testing methods, there’s an increasing demand for heightened health literacy to effectively navigate these transformative innovations and optimize health outcomes. The European ExACT project aims to assess the understanding of PM and related technologies across the EU. In this context, through a survey conducted in several European countries, including Italy, France, Spain, Poland, the Netherlands, Romania, Hungary, and Germany, demographic data and attitudes towards PM, genetic testing, health portals, and big data were gathered. Logistic regression analysis identified factors influencing knowledge and attitudes. Among 6581 respondents, the results highlight a broad awareness of genetic testing (81%) and health portals (54%) yet a lesser familiarity with PM (48%) and big data (37%). Education level, age, and gender influenced awareness, with Hungary showing significant awareness across all topics (OR 2.09 95%CI 1.46-2.98), Spain excelling in big data (OR 1.88 95%CI 1.55-2.27), and Poland leading in genetic testing knowledge (OR 2.68 95%CI 1.82-3.96). Differences between countries may indicate successful policies and factors that can be replicated. Overall, the study emphasizes the importance of enhancing health literacy and sheds light on the predicting role of sociodemographic factors. It underscores the significance of bolstering health literacy to effectively navigate the advancements in PM and digital health, improving health outcomes in light of these evolving healthcare landscapes. Key messages • In Europe, awareness of personalised medicine, health portals and big data is lacking. Educational initiatives are crucial for effective navigation of innovations, considering regional differences. • Social and economic factors affect health literacy levels, impacting disease-specific knowledge and healthcare utilization.

5.K. Scientific session: Health literacy in Ireland: A participatory action approach with Sláintecare Healthy Communities

Abstract This workshop offers a comprehensive exploration of the dynamics, challenges, and opportunities surrounding health literacy in Ireland. In 2023, Dublin City University and Sláintecare Healthy Communities, driven by a commitment to foster equitable healthcare access and outcomes, embarked on a research project aimed at deciphering the intricacies of health literacy and its implications for public health in Ireland. The series of interactive presentations will transparently share learnings from the process and outcomes of this project, which can be applied across different sectors, contexts, and countries. The workshop will begin with an overview of the rationale underpinning Sláintecare Healthy Communities’ engagement in this research project. This is one of the first pilot programmes of its kind. By transparently exploring the driving forces and strategic approaches of this organisation, participants will gain insight into the imperative of addressing health literacy from the perspective of a cross-government and multi-discipline initiative. Following from this, a series of presentations will detail the rigorous scientific approaches undertaken. This includes an umbrella review of international conceptualisations of health literacy and a systematic review of health literacy research conducted on the island of Ireland in the last decade. Findings from these reviews highlight the evolving challenges and emerging trends shaping health literacy practices nationally and internationally. It is also recognised that responsive health literacy development requires thoughtful involvement of diverse local communities. Programmes and actions that ‘leave people behind’ can exacerbate health inequalities. As a result, meaningful community based participatory research, including innovative design thinking approaches, were utilised throughout this project. The Sláintecare Healthy Communities Programme identified two contrasting areas to participate in this work, presenting both an urban and rural context. The health literacy strengths, needs and issues encountered in these communities will be presented in the community members own words. This workshop will close with the presentation of a series of co-designed, and crucially actionable, recommendations for evidence-based best practices in health literacy promotion in Ireland. Leveraging the synthesis of research findings and stakeholder insights, a number of actions aimed at enhancing health literacy proficiency and fostering health equity will be detailed. This presentation in particular will be interactive, and will challenge participants to identify health literacy promoting actions that may be suitable for their own contexts. This workshop offers a timely and pragmatic exploration of health literacy promotion in Ireland. By fostering dialogue, knowledge exchange, and collaboration, the workshop serves as a catalyst for transformative change, paving the way towards more inclusive, equitable, and health-literate societies, both in Ireland and beyond. Key messages • This workshop offers a timely and pragmatic exploration of health literacy promotion in Ireland. • Presenters from both practice and research will detail how the needs analysis was conducted, and how we suggest these co-designed recommendations can be actioned.

11.K. Scientific session: Roots of public health: school health literacy to enhance population health outcomes in Europe

Abstract This workshop will present empirical results from three representative studies on health literacy and digital health literacy conducted in primary and secondary schools in Wales and Germany: (1) Digital Health Literacy in Schools, (2), HLCA HL-Kids, (3) WHO HBSC Wales. While research on child and adolescent health literacy has gained traction in the past decade, only a few studies focus on health literacy in schools. While the European Commission and WHO, as well as most European governments, highlight the importance of schools to support children’s health literacy, schools remain neglected as a research context. With only little evidence available, it is difficult to derive strategies and programs to promote health literacy in schools. We aim to provide practical novel knowledge and contribute to closing the school health literacy gap that is prevalent in Europe. In turn, this will also contribute to European public health development and population health outcomes. Levels of health literacy in child and adolescent populations across European countries and age groups are alarmingly low, making low health literacy a severe risk factor for health outcomes. Low health literacy is associated with worse health conditions and unhealthy behaviours, and in turn, impacts school attainment and educational outcomes. Evidence suggests that health literacy acts as a determinant of health and itself is influenced by other social determinants of health, such as education, intertwining health and education. All studies conducted so far provide evidence that low health literacy follows a social gradient, with children from less affluent families being more likely to have lower health literacy, widening preexisting health inequities observed in almost all health domains within Europe. While effective interventions on the individual and system levels are needed to enhance health literacy, implementation and evaluation research concerning children’s health literacy is rare. Workshop objectives The aim of this workshop is to present findings from three representative studies on health literacy and digital health literacy in primary and secondary schools: (i) The 1st speaker will introduce a study on health literacy and health behaviours of children aged 8-11 (ii) The 2nd speaker will discuss the influence of living environments on health literacy in 4th-grader school kids (iii) The 3rd presentation will have its focus on navigating the infodemic through digital health literacy in adolescent students (iv) The 4th speaker will show links between digital health literacy and health behaviour in adolescent students The format of this workshop will be 4x10-minute presentations followed by a 20-minute panel discussion with the audience, reflecting the relevance of the results to public health research, practice, and policy. The chairs will provide a brief introduction to the concept and moderate the presentations and panel discussion. Key messages • Our results show that health literacy should be addressed as early as in primary schools and that the places, households, and environments children grow up are critical social determinants of health. • Digital health literacy has proven to be a valid learning topic in secondary schools and is linked to digital and media literacy, allowing us to define it as a targeted curriculum item.

Contemporary understanding of health literacy across the Island of Ireland

Abstract This presentation will detail two reviews that provided contextual understanding for this project. The first, an umbrella review which explored i) How is health literacy currently defined and operationalised nationally and internationally? And ii) What are the key components and principles of health literacy? The search was limited, most notably, to systematic reviews published after 2012. A total of 12 studies were included for data extraction and narrative analysis. Findings provided an update of the conceptual understanding of health literacy, emphasising the complex and multidimensional nature of the concept. Dimensions are common, but growing, and moving beyond just individual capabilities. The second, moving beyond the definition, details a systematic review that aimed to gain a contemporary understanding of health literacy through identifying and appraising existing research conducted in an Irish context. Seven electronic databases were searched between October and December 2023. Initial search identified 551 records, following screening, 37 studies were included in this review. Narrative analysis indicated that across the Island of Ireland in the last decade, many studies had narrow populations of focus (i.e. Dublin based, adults, chronic illness populations), limited research design and methodologies (cross-sectional, narrative, and primary research with short time frames), and lacked rigorous monitoring and evaluation of health literacy as a primary or secondary outcome. While studies highlighted clinical, education and community implications, a limited focus on mental health was also observed. Findings from this systematic review offer valuable insights and recommendations for future efforts to enhance health literacy and the health and well-being of individuals across the island of Ireland.

The relationship between cyberchondria and health literacy among first-year nursing students: the mediating effect of health anxiety

BackgroundFirst-year nursing students are at a critical juncture in their education. They are transitioning from laypersons to healthcare professionals, and students are frequently exposed to medical information in academic settings and through personal research. This exposure can sometimes lead to cyberchondria; improving health literacy and managing health anxiety are critical strategies for reducing the incidence of cyberchondria.AimInvestigate the mediating effect of health anxiety on cyberchondria and health literacy among first-year nursing students.MethodsA cross-sectional correlational research design was used in this study. The study was conducted with 475 students in October 2023 during the first semester of the academic year 2023–2024.ResultsCyberchondria and health literacy levels were both moderate. In addition, the degree of health anxiety among first-year Nursing Students was mild, too. The results showed that the association between Cyberchondria and Health Literacy was partially mediated by health anxiety.Conclusion and implicationsThis study highlights the sophisticated relationship between cyberchondria, health literacy, and anxiety among first-year nursing students. It demonstrates that lower health literacy can lead to increased health anxiety, which in turn exacerbates cyberchondria. To mitigate these issues, it is essential to enhance health literacy and provide support for managing health anxiety within nursing education programs. By doing so, we can help nursing students navigate online health information effectively and reduce unnecessary health-related anxieties, promoting better educational outcomes and overall well-being.

Factors influencing health literacy in overweight management among late adolescents in Thailand: A cross-sectional study.

Health literacy is crucial in managing health outcomes, including overweight, which is a significant issue among late adolescents. Despite the importance of health literacy in weight management, research focusing on this population remains limited. This study aimed to investigate the factors influencing health literacy in overweight management among late adolescents in Thailand. A cross-sectional study was conducted with late adolescents from five higher education institutions in Ubon Ratchathani Province, Thailand. A total of 403 participants were selected through multistage random sampling. Self-report questionnaires, validated for reliability and accuracy, were used to collect data from March to May 2023. Multiple regression analysis was employed, with a significance level set at 0.05. The sample consisted predominantly of females (91.10%) with an average age of 20-21 years (54.30%). The prevalence of overweight/obesity among participants was 25.06%. Four factors were significantly associated with health literacy in overweight management: access to health and weight control resources (r = 0.368, p <0.001), access to online social learning resources (r = 0.321, p <0.001), access to books, journals, and websites (r = 0.340, p <0.001), and management of weight control behaviors (r = 0.145, p <0.001). These factors together accounted for 20% of the variance in health literacy (R2 = 0.200). The study identified key factors that enhance health literacy in overweight management among late adolescents in Thailand. It is recommended that nurses and other healthcare professionals develop targeted interventions focusing on these factors to effectively manage overweight in this population.

Integrating digital and interactive approaches in adolescent health literacy: a comprehensive review.

Adolescent health literacy is critical for navigating the complex landscape of modern healthcare and making informed decisions that influence long-term health outcomes. This comprehensive review synthesizes current research on integrating digital tools and interactive learning approaches to enhance health literacy among adolescents. We explore the use of digital technologies, such as mobile apps and virtual reality, which cater to the preferences of this tech-savvy generation, offering personalized and accessible health information. The effectiveness of interactive learning methodologies, including simulations and role-playing, is also examined, highlighting their potential to increase engagement and retention of health-related knowledge. We address the importance of mental health literacy and the role of social media and peer education in disseminating health information effectively. Our review identifies gaps in the current literature, particularly the need for studies that consider long-term outcomes and the impact of socioeconomic and cultural factors on health literacy initiatives. We propose a multidimensional approach to health literacy education that incorporates innovative technologies and interactive methods to meet the diverse needs of adolescents in various contexts. The findings suggest that an integrated approach, including digital and critical health literacy, is essential for developing comprehensive health education programs that are both informative and engaging for adolescents.

The role of health literacy in the association between social support and self-rated health: a Danish population-based study in 10,787 individuals with a long-term condition.

Managing a long-term condition requires higher health literacy. Social networks may play a crucial role for self-management. However, the pathway is not entirely understood. This study aimed to examine whether the association between social support and self-rated health is mediated by health literacy among individuals with a long-term condition. This cross-sectional study used data from the "How are you?" 2021 survey in Central Denmark Region. Social support was assessed using a single question, health literacy with two dimensions from the Health Literacy Questionnaire (HLQ): 'Understanding health information' and 'Engaging with healthcare providers', and self-rated health with a single question from SF-36. Multiple logistic regression analyses were used to examine the associations, and multiple mediation analyses were performed using the Karlson-Holm-Breen method. A total of 10,787 individuals with a long-term condition were included in the study, whereas 6% (n = 595) reported a low level of social support. Both health literacy scales mediated the association between social support and self-rated health, particularly the ability to engage with healthcare providers, accounting for 25% of the variance. After adjustment for sociodemographic factors, individuals with a low level of social support had significantly higher odds of reporting difficulties in understanding health information (OR 2.53 (95% CI: 1.84-3.48)) and engaging with healthcare providers (OR 3.77 (95% CI: 2.96-4.79)). Health literacy, particularly the ability to engage with healthcare providers, was a mediator between social support and self-rated health. Additionally, a low level of social support was associated with higher odds of reporting lower health literacy. These findings suggest that strategies to enhance health literacy, improve health outcomes, and reduce health inequities may benefit from strengthening individuals' social network, particularly focusing on those with limited support.

Evaluating Ocular Healthcare Accessibility and the Severity of Emergencies during Times of Crisis.

Background/Objectives: The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, including the delivery of ophthalmic emergency services. This study examines the impact of the COVID-19 pandemic on the clinical presentation of emergencies and the accessibility of healthcare in ophthalmology. Methods: The study employed a single-center, consecutive case series design with historical controls to examine electronic health records over a 21-day period during the COVID-19 pandemic and a matched period from the preceding year. Records were analyzed for demographic variables, diagnosis, length of stay, travel distance, and referral status. The urgency of cases was evaluated by three independent graders using the BaSe SCOrE (BAsic SEverity Score for Common OculaR Emergencies). Results: A total of 1229 patients were included in the study, with 786 patients in the 2019 cohort and 443 patients in the 2020 cohort. During the pandemic period, there was a significant decrease in the number of patients and the duration of their visits (p < 0.0001, p < 0.0001, respectively). There was an increase in walk-in patients (p = 0.03), who took significantly longer journeys to be treated as compared to referred patients (p < 0.01). At the same time, the severity of emergencies increased (p = 0.02). The 2019 logistic regression model found that age (p = 0.003), referral status (p < 0.001), distance (p = 0.009), and first presentation (p = 0.02) were significant predictors of the severity, while gender was not (p = 0.78). The 2020 model found that only age (p < 0.001) and referral status (p < 0.001) were significant predictors of severity. Conclusions: The observed decline in patient volume, increased severity of emergencies, and shifts in predictive variables within the logistic regression models are indicative of significant barriers to healthcare access. Therefore, enhancing health literacy and ensuring low-threshold access to emergency services are crucial, especially during crises.

The role of primary care practitioners in cancer control in South Africa: a systems-based case study

Aim Cancer care has largely been the domain of oncology specialists. With increased awareness of the importance of primary care in the context of universal health coverage, there has been a shift to explore the role of primary care in comprehensive cancer management. This includes health promotion, screening, diagnosing, referral to oncology services, and longitudinal care that includes co-ordination of care, survivorship, and palliative care. This paper focuses on the role of primary care practitioners in health promotion, early detection and care co-ordination. Nurses and doctors who work in primary care are included as primary care practitioners. Methods Using a patient vignette narrative tool, the triad of patient empowerment in the form of enhanced health literacy, clinical competence, and system effectiveness, are discussed as the basis for early cancer detection. A complex intervention to improve primary-level cancer care and the implications thereof for the important role of care co-ordination undertaken by primary care practitioners, is also presented. Findings For effective patient assessment, primary care practitioners must be trained in screening and diagnostic techniques as part of their clinical competencies as generalists. These competencies include risk identification, counselling skills, expert clinical examination, interpretation of basic x-rays, minor surgical skills, interpreting blood tests, and point-of-care ultrasound. Against a backdrop of ongoing budget constraints, consumables and equipment needed for diagnosis should be readily available and referral pathways for patients and specimens should be clearly defined and resourced. Conclusions Primary care practitioners in community-based facilities are well-placed to engage with the psychosociocultural dimensions of care. The SA health system places primary care at the point of closest contact with communities. Efficient care pathways are needed by primary care practitioners to adopt the role of care co-ordinator when patients with suspected or confirmed cancer enter these pathways. When considered alongside the overburdened primary care patient-load and the ever-increasing mix of co-morbidities, the complexity of primary care is appreciated. Understanding the complexities of primary care in the context of cancer control is an important component of a holistic cancer control programme.

Perceptions of ChatGPT in healthcare: usefulness, trust, and risk.

This study explores the perceptions of ChatGPT in healthcare settings in Taiwan, focusing on its usefulness, trust, and associated risks. As AI technologies like ChatGPT increasingly influence various sectors, their potential in public health education, promotion, medical education, and clinical practice is significant but not without challenges. The study aims to assess how individuals with and without healthcare-related education perceive and adopt ChatGPT, contributing to a deeper understanding of AI's role in enhancing public health outcomes. An online survey was conducted among 659 university and graduate students, all of whom had prior experience using ChatGPT. The survey measured perceptions of ChatGPT's ease of use, novelty, usefulness, trust, and risk, particularly within clinical practice, medical education, and research settings. Multiple linear regression models were used to analyze how these factors influence perception in healthcare applications, comparing responses between healthcare majors and non-healthcare majors. The study revealed that both healthcare and non-healthcare majors find ChatGPT more useful in medical education and research than in clinical practice. Regression analysis revealed that for healthcare majors, general trust is crucial for ChatGPT's adoption in clinical practice and influences its use in medical education and research. For non-healthcare majors, novelty, perceived general usefulness, and trust are key predictors. Interestingly, while healthcare majors were cautious about ease of use, fearing it might increase risk, non-healthcare majors associated increased complexity with greater trust. This study highlights the varying expectations between healthcare and non-healthcare majors regarding ChatGPT's role in healthcare. The findings suggest the need for AI applications to be tailored to address specific user needs, particularly in clinical practice, where trust and reliability are paramount. Additionally, the potential of AI tools like ChatGPT to contribute to public health education and promotion is significant, as these technologies can enhance health literacy and encourage behavior change. These insights can inform future healthcare practices and policies by guiding the thoughtful and effective integration of AI tools like ChatGPT, ensuring they complement clinical judgment, enhance educational outcomes, support research integrity, and ultimately contribute to improved public health outcomes.

"Microbiology can be . . . " Student Competition to Develop Resources about Infectious Diseases that Improve Health Literacy.

The European Association of Establishments for Veterinary Education emphasizes the importance of communication skills and teamwork for student success in clinical practice. Traditionally, many veterinary curricula lacked standardized formal training in acquiring these essential skills.Effective communication and collaborative teamwork are not only crucial for fulfilling the clinical responsibilities of the veterinary profession but also play a pivotal role in the broader societal context. Veterinarians, in their social role, serve as scientific communicators for the community. This role involves conveying scientific concepts, even complex ones, with a particular emphasis on their significance for public health, reaching a diverse audience. Currently, there is a growing public health necessity to improve health literacy, which refers to the ability to access, understand, appraise, and use information to support healthy choices by society, especially for topics like infectious diseases and vaccination. This became more evident during the global COVID-19 pandemic. This teaching tip describes the development, organization, and broad outcomes of a student competition introduced during a standard veterinary medicine course to design novel resources on microbiology and infectious disease-enhancing health literacy. Three separate events were organized during the academic years 2020-2023. The third-year veterinary medicine students attending the 3-month course on infectious diseases of small animals participated in a student competition aimed at promoting creativity and innovation. Their task was to develop novel resources that delivered informative content to the public concerning microbiology and infectious diseases. Participation was voluntary and students participated in groups of 5-6. Overall, 125 students created 22 projects on microbiology and infectious diseases that were able to enhance health literacy. This approach allowed students to engage with the content and convey foundational knowledge to others in an easily accessible way. This skill of communicating with the public using easy-to-understand language is essential for success in the veterinary medicine profession. The resources produced, such as drawings, comics, games, and videos, constitute informative sources. Thus, they were published online on a scientific journal to disseminate knowledge of infectious diseases to a broader audience.

Health Literacy Levels of Women Attending a Perinatology Outpatient Clinic for High-Risk Pregnancy Follow-Up.

Health literacy, defined as the ability to obtain, understand, evaluate, and apply health information with knowledge, motivation, and skills, is crucial for maintaining and improving quality of life. Despite the availability of health information, limited health literacy is linked to health disparities, inadequate self-management of chronic diseases, and poorer health outcomes. The purpose of this study is to assess the health literacy of pregnant women who visit the Perinatology Outpatient Clinic for follow-up care. It seeks to identify gaps in knowledge and understanding that may impede effective healthcare delivery and inform targeted health education and public awareness programs to enhance health literacy. This prospective survey study included 210 pregnant women aged 18 to 40 years attending the Perinatology Outpatient Clinic at Giresun Obstetrics and Gynecology Training and Research Hospital, Turkey. Participants completed a questionnaire on health literacy, sociodemographics, and basic health status via Google Forms (Google Inc., Mountain View, CA, USA). Statistical analysis was performed using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA), employing tests such as Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, Student's t-test, ANOVA, Spearman, and Pearson correlation, and multivariate linear regression analysis. The mean age of participants was 29.97±5.44 years, with a mean health literacy score of 29.89±7.05. Education level and living place significantly influenced health literacy scores, with higher scores among those with higher education and urban living (p = 0.014 and p = 0.038, respectively). Economic status also significantly impacted health literacy, with lower scores among those with poor economic status (p<0.001). Health literacy scores were higher among those receiving health information from healthcare professionals (p = 0.006) and lower among those finding medical information from doctors insufficient (p = 0.008). Health literacy is significantly influenced by education level, living place, and economic status. The study emphasizes the necessity of focused health education initiatives, especially for individuals with lower educational attainment and those residing in rural regions. Improving health literacy via efficient communication from medical professionals can benefit expectant mothers and their unborn children by lowering medical expenses and improving health outcomes.