Health Literacy Initiatives Research Articles

Public Health Literacy, Knowledge, and Awareness Regarding Antibiotic Use and Antimicrobial Resistance during the COVID-19 Pandemic: A Cross-Sectional Study.

Multi-drug-resistant (MDR) organisms pose a global threat to modern medicine, which has grown as a result of irrational antibiotic use and misuse. This study aimed to assess general public knowledge in Jordan and awareness of antibiotics and antibiotic resistance during the COVID-19 pandemic. A cross-sectional study was carried out utilizing the WHO multicountry public awareness survey. The study population was composed mainly of social media users, and a total of 1213 participants completed the online survey. According to the findings, more than half of the participants were well versed in antibiotic use and resistance. Those with adequate health literacy were found to better understand antibiotics (OR = 1.37, p = 0.017) and antibiotic resistance (OR = 1.46, p = 0.003). The vast majority (88.5%) recognized at least one antibiotic resistance term; however, 53.2% believed that antibiotic resistance is a problem in other nations. The participants in this study reported using antibiotics incorrectly, believing that they were treating sore throats, colds, and flu. The participants were well aware of antibiotic resistance solutions and their consequences on health. Age, education, health literacy, and antibiotic knowledge were found to be substantially (p < 0.05) associated with greater awareness of antibiotic resistance. The findings highlight the need for antimicrobial resistance education campaigns, health literacy, and antibiotic stewardship initiatives.

Health and Wellness Literacy Initiatives for Immigrant Populations Delivered Through Faith-Based Entities

Background: Health literacy has been shown to be low among immigrant populations globally, leading to limited ability to locate, access and use health information. Religious entities are often the initial contact for many immigrants regarding health and social supports, there are a lack of knowledge about how initiatives to improve health literacy of the immigrant population may be offered through faith-based entities. The objective of this proposed scoping review is to identify available evidence on health literacy initiatives delivered through faith-based entities for immigrant populations.&#x0D; Methods/Design: Using a scoping review framework we will complete a comprehensive search of relevant keywords in major academic and grey literature databases. Eligible articles will be identified through screening by two independent reviewers according to predefined inclusion and exclusion criteria to include articles relevant to our research question. Selected articles will be charted into data extraction tables for analysis, synthesis and presentation of narrative description and visual graphics.&#x0D; Discussion: This scoping review will identify and assess existing health literacy initiatives delivered through faith-based entities to improve health literacy of immigrant communities. This review will inform which initiatives are commonly practiced, and which immigrant groups are most benefitted from and can potentially be benefitted. It will also describe how to conduct those initiatives and what resources are needed and identify the stakeholders of such initiatives those needed to be engaged with to conduct a successful and acceptable program. The challenges and facilitators of those initiatives will also be identified.

Who or what is to blame? Examining sociodemographic relationships to beliefs about causes, control, and responsibility for cancer and chronic disease prevention in Alberta, Canada

BackgroundBeliefs about causes and responsibility for chronic diseases can affect personal behaviour and support for healthy policies. In this research we examined relationships between socio-demographics (sex, age, education, employment, political alignment, perceived health, household income, household size) and perceptions of causes and responsibility for health behaviour, chronic disease correlates, and attitudes about cancer prevention and causes.MethodsUsing data from the 2016 Chronic Disease Prevention survey in which participants (N = 1200) from Alberta, Canada responded to items regarding how much they believed personal health behaviours, prevention beliefs, and environmental factors (i.e., healthy eating, physical activity, alcohol, smoking, and where a person lives or works) are linked to getting cancer. Participants also responded to questions about causes and responsibility for obesity, alcohol, and tobacco (i.e., individual or societal). Relationships were examined using multinomial logistic regression on socio-demographics and survey items of interest.ResultsMen (compared to women) were less likely to link regular exercise, or drinking excessive alcohol, to reducing or increasing cancer risk. Similarly, men were less likely to link environmental factors to cancer risk, and more likely to agree that cancer was not preventable, and that treatment is more important than prevention. Finally, men were more likely to believe that alcohol problems are an individual’s fault. Left and central voters were more likely to believe that society was responsible for addressing alcohol, tobacco, and obesity problems compared to right voters. Those with less than post-secondary education were less likely to believe that regular exercise, maintaining a healthy body weight, or eating sufficient fruits and vegetables were linked to cancer - or that society should address obesity - compared to those with more education. Households making above the median income (versus below) were more likely to link a balanced diet with cancer and were less likely to think that tobacco problems were caused by external circumstances.ConclusionsThese results provide insight into the importance of health literacy, message framing, and how socio-demographic factors may impact healthy policy. Men, those with less education, and those with less income are important target groups when promoting health literacy and chronic disease prevention initiatives.

Reducing Stress and Anger Among Family Members.

Reducing Stress and Anger Among Family Members.

Public libraries as health literate multi-purpose workspaces for improving health literacy.

Now more than ever, in this COVID-19 pandemic, our individual and collective ability to access, understand and apply information to inform our health care and broader lifestyle decisions ie, to be health literate - has life or death consequences. This paper reflects upon the proposition of public libraries as health literate multi-purpose workspaces for improving health literacy. We draw upon our combined experiences as evaluators of organizational health literacy initiatives, and library sector development, engagement and advocacy. Key ideas were presented as part of the 2020 State Library Victoria seminar series on 'Libraries: The Heart of a Healthy Community'. Key messages included: Public libraries are well positioned to contribute to the health literacy movement, as they provide the general public with: universal free access to information and services; extensive in-house and outreach educational collaborative learning opportunities; and health and wellbeing support by being welcoming, safe, and trusted community spaces. To date, limited discussion exists about conceptualizing public libraries as health literate multi-purpose workspaces for supporting and sustaining public library health literacy efforts. A health literate organizational framework is suggested to support libraries simply supporting health information literacy to being recognised as health literate organizations. Five workspace principles (empowerment, equitable, inclusive, collaborative and integrated) are suggested to provide directions for public libraries as health literate multi-purpose workspaces for improving the health literacy of individuals, communities, organizations and indeed systems. To inform the design, implementation and evaluation of public libraries as workspaces for improving health literacy, key principles-focused evaluation questions are suggested for consideration. SO WHAT?: Public Libraries as welcoming, safe, and trusted community organizations are well placed to be health literate multipurpose workspaces for improving health literacy.

Abstract 17213: Myocardial Infarction and Stroke Awareness Among US and Foreign-Born Adults in the 2014 and 2017 National Health Interview Survey

Background: Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States (US). MI and stroke symptom awareness reduces delays in hospitalization and mortality. We hypothesized that foreign-born persons will have lower stroke and MI symptom awareness than US-born persons. Methods: We analyzed cross-sectional data from the 2014 and 2017 National Health Interview Surveys (NHIS) on US-born and foreign-born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). Our outcomes were stroke and MI symptom awareness, and the best action to take during a stroke or MI event. Awareness was defined as knowing all 5 symptoms of MI or stroke respectively, and choosing “call 911” as the best action to take in the event of an MI or stroke. Generalized linear models with Poisson distribution and a logarithmic link was used to assess disparities in awareness between foreign-born and US-born persons. We compared responses from 2014 and 2017 to assess improvement in awareness. Results: We included 63,439 participants, with mean age 38.2 years; 51% were female and 50% had less than high school education. After adjusting for age, sex, and education, we observed significant variation in MI and stroke symptom awareness and best action to take by region of birth [Table]. In comparison to US-born, foreign-born persons were less aware of MI and stroke symptoms and the best action to take. Improvement in awareness was not significant in all groups between 2014 and 2017. Conclusion: These findings suggest a disparity in MI and stroke symptom awareness among immigrants in the US. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.

The Evolving Role of Health Literacy in Improving Oral Health.

This chapter provides a review of the evolution of oral health literacy including its impact on oral health outcomes, the current status of oral health literacy initiatives and future research needs. Using the Healthy People 2010 definition, the chapter describes opportunities needed to improve oral health literacy among health providers as well as individuals/patients, communities and policy-makers. Studies of the two most prevalent dental diseasesâĂŤdental caries and periodontal diseases - reveal that increasing the oral health literacy of the public and health care providers can play a major role in reducing these diseases. Increasing oral health literacy by creating access to accurate knowledge and supporting use of science-based preventive measures is essential. A major part of the chapter describes oral health literacy's influence in the integration of dental and medical care. The chapter provides an extensive list of research needed to further our understanding of the impact of oral health literacy on health disparities and the health of the population.

Applying Lessons Learned from CDC's Health Literacy Initiatives.

This report describes health literacy initiatives at the Centers for Disease Control and Prevention (CDC) and the lessons learned from more than 20 years of commitment to health literacy. Efforts described include CDC's training and tools, the Science Ambassador Fellowship program, and an action plan and report card. The report concludes with recommendations on how to meet the needs of communities and systems.

Building Health Literacy Coalitions and NGOs.

This report describes several health literacy initiatives by non-governmental organizations (NGOs). Specifically, the authors discuss the vision, history, and establishment of the International Health Literacy Association and similar regional organizations, as examples of collaboration across professional and geographic boundaries to advance health literacy research and practice. The authors provide some observations to build future health literacy initiatives by NGOs around the world.

Health Literacy Initiatives and Lessons Learned within Public Health Agencies.

Located in the northeastern part of the United States, New York State is extremely diverse - from the perspectives of culture, history, language, geography, economy, to name a few. Spreading across approximately 55,000 miles and taking into consideration the diversity of health needs across the state, the New York State Department of Health (NYS DOH) is dedicated to improving the health of all New Yorkers. This is evident in a Prevention Agenda which is New York State's health improvement plan, the blueprint for state and local actions to improve the health and well-being of all New Yorkers, and to promote health equity in all populations who experience disparities [1]. In addition, strategies for successful partnerships include long standing relationships with local health departments, community health centers, hospital systems, community-based organizations, individuals and groups who rely on the State Department of Health for quality services to achieve health equity and eliminate health disparities. This report provides an overview of previous, current, and forthcoming health literacy activities spearheaded by the New York State Department of Health Office of Minority Health and Health Disparities Prevention that support the importance of effective communication and health literacy across the Department.

Integrating Health Literacy Into Core Curriculum: A Teacher-Driven Pilot Initiative for Second Graders.

Limited research has addressed the effects of health literacy interventions in elementary schools. However, school-aged children's health literacy is critical because children make decisions about their health every day. The purpose of the pilot project was to explore the feasibility of integrated health literacy lesson plans for second graders. A pretest-posttest evaluation was conducted with second grade students following implementation of health literacy lessons that were integrated into core curriculum (language arts, science, and social studies). Health educators, a hospital/health care system, and a school district developed a partnership. A research team of teachers, administrators, health literacy experts and health care organizations designed and implemented health literacy lesson plans. A developmentally appropriate measure of health literacy was adapted from the Newest Vital Sign. Data showed that students' health literacy scores significantly increased after implementation of 4 lesson plans. This was an exploratory, pilot project that provided a useful starting point for discussing how to integrate health literacy into elementary school curriculum. An interdisciplinary team developed integrated health literacy materials that acknowledged the needs of teachers, the resources available, and the developmental stages of children. This intervention serves as a model for future health literacy initiatives in schools.

Health and well-being literacy initiatives focusing on immigrant communities: an environmental scan protocol to identify "what works and what does not"

IntroductionMost of the major cities in the developed western countries are characterized by an increasing multiculturalism brought by the immigrant population. The immigrant communities face challenges in the new environment with their health and wellness related unmet needs. It is imperative to find sustainable ways to empower these diverse communities to champion their health and wellness. Community-based health and wellness literacy initiatives (CBHWLI) focusing on immigrant communities can be an important step towards citizen empowerment in this regard. The aim of the present environmental scan is to identify the key factors that might impact a CBHWLI in immigrant communities in Canada in order to facilitate the process in practice and identify the competencies and training required for its implementation.MethodsThis study will gather information from existing literature and online sources as well as will capture expert and lay perspectives on the factors that can impact the effectiveness and sustainability of CBHWLIs through conducting a comprehensive environmental scan: (i) a systematic scoping review of published literature and grey literature, (ii) a comprehensive Internet search, (iii) key informant interviews, and (iv) community consultation. Specific methodological and analytical frameworks will guide each step.Ethics and disseminationThis study is the first step in establishing a practical base for developing CBHWLI implementation research. Once the initial findings have been generated, the second step will involve inviting experts to provide their input. We first plan to disseminate the results of our scoping review and Internet scan through meetings with key stakeholders, to be followed by journal publications and conference or workshop presentations. Ethical approval is not required for the scoping review or Internet scan; however, approval to conduct interviews with key informants and community consultations in the second stage of the study will be sought from the Conjoint Health Research Ethics Board.

Posttraumatic stress in organizations: Types, antecedents, and consequences

AbstractResearch indicates that the well‐being and productivity of over 100 million people in the global workforce may be compromised by posttraumatic stress (PTS). Given that work‐related experiences are often the source of the trauma that leads to PTS, and that PTS due to any cause can interfere with employees’ job performance, organizations would do well to consider the antecedents and consequences of PTS. This review of research—primarily within fields adjacent to business—on the types, antecedents, consequences, and organizational implications of PTS is presented to advance inquiry within the field of business. The definition of PTS requires attention to the new classification of complex posttraumatic stress disorder that can result from threats that are not life‐threatening such as bullying and sexual harassment. PTS antecedents include organizational and extraorganizational traumas, and risk and resilience factors. Absenteeism, impaired cognitive functioning, strained relationships, and growth are among the consequences of PTS. Organizations can assist through disaster planning, empathetic leaders, mental health literacy initiatives, and employee assistance programs. Many research questions arise that, when answered, will allow organizations to better understand how they can improve employee productivity and well‐being by attending to PTS.

Improving Organizational Health Literacy Responsiveness in Cardiac Rehabilitation Using a Co-Design Methodology: Results from The Heart Skills Study.

For health services, improving organizational health literacy responsiveness is a promising approach to enhance health and counter health inequity. A number of frameworks and tools are available to help organizations boost their health literacy responsiveness. These include the Ophelia (OPtimising HEalth LIteracy and Access) approach centered on local needs assessments, co-design methodologies, and pragmatic intervention testing. Within a municipal cardiac rehabilitation (CR) setting, the Heart Skills Study aimed to: (1) Develop and test an organizational health literacy intervention using an extended version of the Ophelia approach, and (2) evaluate the organizational impact of the application of the Ophelia approach. We found the approach successful in producing feasible organizational quality improvement interventions that responded to local health literacy needs such as enhanced social support and individualized care. Furthermore, applying the Ophelia approach had a substantial organizational impact. The co-design process in the unit helped develop and integrate a new and holistic understanding of CR user needs and vulnerabilities based on health literacy. It also generated motivation and ownership among CR users, staff, and leaders, paving the way for sustainable future implementation. The findings can be used to inform the development and evaluation of sustainable co-designed health literacy initiatives in other settings.

Health Literacy as a Tool to Ease Pressure on Long-Term Care Systems: Perspectives and Issues on Healthy Aging Across the Life Course

This paper aims to heighten attention and awareness surrounding the need for collective actions to advance health literacy interventions and initiatives within a life-course framework. Placing health literacy within a life course approach is held to be a precursor to healthy aging and an effective means of a) increasing healthy life expectancy in later life and b) reducing escalating costs associated with the operation of long-term care systems established to provide long-term care for the aged. Governments worldwide and their respective public health systems are encouraged to initiate policy developments that promote health literacy as a national health imperative. The significant actual and potential contributions of a strengthened focus on health literacy are highlighted as offering a pathway for a cultural shift leading to patient and consumer empowerment, increased health care equity, and improvements in organizational and health system outcomes. Making health literacy an essential part of health care policies warrants an understanding of the complex and dynamic interplay of components operating at the individual, community, and health system levels.

Development of a Clinical-Academic-Community Collaboration to Improve Health Literacy.

Limited health literacy is associated with poor patient health outcomes and increased hospitalization rates. Patient-provider communication plays an important role in patient health literacy and the understanding of medical terminology. This study demonstrates how a collaboration between clinical, academic, and community partners was instrumental in the design and implementation of a clinic readiness assessment and a clinic-based pilot intervention to encourage patient-provider communication and improve patient health literacy. A state hospital association, academic research team, and community adult literacy center director collaborated to develop a 60-item clinic readiness assessment and an evidence-informed pilot intervention. The clinic readiness assessment captured clinics’ motivation and capacity for pilot implementation and providers’ current communication strategies. The intervention centered around AskMe3™ educational materials and involved 2 patient visits (initial and follow-up visits). Data collection instruments for the intervention were administered verbally and included questions about patient demographics and communication needs, and a single-item health literacy measure. Descriptive statistics (frequencies/percentages) were used to analyze results from the clinic readiness assessment and pilot intervention. Establishment of the partnership, and collaborative, iterative development of the clinic readiness assessment and pilot intervention are described. This pilot project resulted in important lessons learned which led to critical modifications that will inform future expansion of the intervention. Collaboration between healthcare leaders, researchers, and community partners is recommended for developing clinic-based health literacy initiatives.

Consumer Health and the Hospital Library- A Literacy Initiative

ABSTRACTConsumer health is the latest buzzword in public librarianship. There is current research supporting integrating consumer health literacy initiatives into public libraries and that these initiatives are beneficial to public library patrons; however, there is very little research on integrating consumer health information and literacy into hospital libraries. The present study addresses the question of whether hospital patients have an interest and would be receptive to adding a clinical librarian to their health care provider team. Data collected from patrons in a hospital setting revealed that patients supported the addition of literacy care and instruction into direct patient care.

Communicating the environmental health risk assessment process: formative evaluation and increasing comprehension through visual design

The environmental health risk assessment process informs clean-up activities at hazardous waste sites. Ensuring this process is accessible and transparent to communities is crucial for environmental health literacy initiatives. The goals of this project were to develop plain language and effective visuals that can be used when communicating the risk assessment process and methods used to predict excess cancer risk(s) due to environmental exposures. In this study, a community factsheet entitled, “Understanding Environmental Health Risk Assessment” was developed and a participatory design and formative evaluation approach was implemented with a set of representative users (n = 11). Community members living in the vicinity of two Arizona hazardous waste sites as well as three public health professionals/researchers were asked to evaluate the functionality and accessibility of the factsheet, particularly the graphics and whether the text was written in plain language. Participant responses revealed the following major findings: 1) form follows function, 2) graphic elements should outweigh text, 3) line of sight and layout is critical to information accessibility, 4) color coding dramatically aids the reader, 5) content should be strategically grouped, 6) concepts per figure should be minimized to ensure comprehension, 7) interactive content is preferred over static content, and 8) communication efforts need to interweave new information with the targeted audience's past and current environmental health understandings to aid in their ability to retain new concepts. Based on participant feedback, new and improved layout decisions, infographics and accompanying text were designed and prepared. This research demonstrates the need and importance of participatory design, information design prototyping, formative evaluation, and a cultural model of risk communication.

Talking the Talk: Enhancing Clinical Ethics with Health Literacy Best Practices.

A significant proportion of the U.S. population exhibits low health literacy. Evidence suggests that low health literacy is correlated with higher medical costs and poorer health outcomes. Even more concerning, evidence suggests that low health literacy threatens patients' and families' autonomy and exacerbates injustices in patients who are already vulnerable to difficulties navigating the health care system. There is also, however, increasing evidence that health literacy interventions-including initiatives such as plain language practices and teach-back-improve comprehension and usefulness of health care information. I show how health literacy best practices can enhance the work of clinical ethicists in their primary roles of policy, consultation, and education. In the final section, I suggest ways health literacy initiatives may be enhanced with insights from clinical ethicists.

A national child mental health literacy initiative is needed to reduce childhood mental health disorders.

Half of all lifetime mental health disorders emerge in childhood, so intervening in the childhood years is critical to prevent chronic trajectories of mental health disorders. The prevalence of child mental health disorders is not decreasing despite the increased availability of evidence-based interventions. One key reason for the high prevalence and low treatment uptake may be low levels of child mental health literacy in the general community. Mental health literacy refers to knowledge and beliefs about mental health disorders that aid in their recognition, prevention and management. There is emerging evidence of poor recognition of child mental health problems in the community and low levels of parental knowledge about how to seek help, along with high levels of stigmatising attitudes. Although Australia has been a world leader in research and practice in improving mental health literacy for adolescent and adult mental health disorders, particularly depression and anxiety, mental health literacy for childhood disorders has been largely overlooked. In order to improve knowledge of child mental health disorders, reduce stigma, improve appropriate help-seeking and impact on the prevalence of child mental health disorders, we argue that a national initiative focussing on increasing mental health literacy for childhood disorders is urgently needed.