Promoting Health Literacy Research Articles

Demands on Health Information and Clinical Practice Guidelines for Patients from the Perspective of Adults with Mental Illness and Family Members: A Qualitative Study with In-Depth Interviews.

(1) Background: "Patient health information" promote health literacy. "Patient guidelines" as a sub group reflect the current evidence about illnesses and treatment options adapted to the needs of laypersons. Little is known about factors promoting and hindering their use by people affected by mental illness and their relatives. (2) Methods: Telephone interviews (N = 15; n = 4 adults affected by mental illness, n = 5 relatives, n = 6 both applicable) were conducted according to the Sørensen model of health literacy. Data were recorded, transcribed and content-analyzed following Mayring. (3) Results: Health information is used regularly by individuals affected by mental illness and their relatives, but "patient guidelines" are largely unknown. Yet, there is a great willingness to use them. Main barriers are a lack of statistical knowledge, the complexity of health-related topics and cognitive impairment sometimes accompanying mental illnesses. Target group-oriented adaptation as well as transparent and even-handed presentation of (dis-)advantages of treatment options can increase trust. (4) Conclusions: Health information and guidelines can help affected persons and relatives to make treatment decisions by conveying unbiased, up-to-date knowledge. Target group-specific adaptations should be made for psychiatric illnesses and features specific to mental illnesses compared to physical illnesses should be included. Clinical practice guidelines must be distributed more widely to increase their impact.

'Advocacy groups are the connectors': Experiences and contributions of rare disease patient organization leaders in advanced neurotherapeutics.

Biomedical progress has facilitated breakthrough advanced neurotherapeutic interventions, whose potential to improve outcomes in rare neurological diseases has increased hope among people with lived experiences and their carers. Nevertheless, gene, somatic celland other advanced neurotherapeutic interventions carry significant risks. Rare disease patient organizations (RDPOs) may enhance patient experiences, inform expectationsand promote health literacy. However, their perspectives are understudied in paediatric neurology. If advanced neurotherapeutics is to optimize RDPO contributions, it demands further insights into their roles, interactionsand support needs. We used a mixed-methodology approach, interviewing 20 RDPO leaders representing paediatric rare neurological diseasesand following them up with two online surveys featuring closed and open-ended questions on advanced neurotherapeutics (19/20) and negative mood states (17/20). Qualitative and quantitative data were analysed using thematic discourse analysis and basic descriptive statistics, respectively. Leaders perceived their roles to be targeted at educational provision (20/20), community preparation for advanced neurotherapeutic clinical trials (19/20), information simplification (19/20)and focused research pursuits (20/20). Although most leaders perceived the benefits of collaboration between stakeholders, some cited challenges around collaborative engagement under the following subthemes: conflicts of interest, competitionand logistical difficulties. Regarding neurotherapeutics, RDPO leaders identified support needs centred on information provision, valuing access to clinician experts and highlighting a demand for co-developed, centralized, high-leveland understandable, resources that may improve information exchange. Leaders perceived a need for psychosocial support within themselves and their communities, proposing that this would facilitate informed decision-making, reduce associated psychological vulnerabilitiesand maintain hope throughout neurotherapeutic development. This study provides insights into RDPO research activities, interactionsand resource needs. It reveals a demand for collaboration guidelines, central information resourcesand psychosocial supports that may address unmet needs and assist RDPOs in their advocacy. In this study, RDPO leaders were interviewed and surveyed to examine their perspectives and roles in advanced neurotherapeutic development. Some participants sent researchers postinterview clarification emails regarding their responses to questions.

Promoting health literacy during Covid-19 pandemic–valuable partnership with Portuguese pharmacists

Abstract Issue/Problem COVID-19 pandemic has amplified the amount of health information available; however, hard-to-reach populations remain and much of the information available is not accurate. Therefore, the use of new proximity approaches in the promotion of health literacy is essential because people face challenges and barriers when trying to find information relevant to them. Description of the problem From the beginning of the COVID-19 pandemic in 2020, the Division of Literacy, Health and Wellbeing of the Directorate-General of Health in Portugal developed Social Mobilization and Community Engagement training sessions-which included a presentation and a toolkit of flyers/posters/videos. These sessions had the goal of disseminating public health measures through good practices in health literacy and communication methods/skills to promote efficient communication among people who play an active role (as microinfluencers) in prevention and mitigation of risks associated with COVID-19, as is the case of pharmacists. Results A total of 200 Portuguese pharmacists enrolled on the Social mobilization training session in November 2021. More than 150 initiatives were implemented thereafter by those microinfluencers (pharmacists) in the local communities-31% directed to children or young people, 31% to older adults, and 13.8% to migrants or tourists. 70% of the participants considered the materials of the toolkit as adequate and sufficient, and 62.1% answered that people in the community showed interest for those materials available in the pharmacies. Lessons This Social mobilization project was important because it assembled and preserved trust- basing the information of the training on reliable sources about COVID-19 virus. It also trained the microinfluencers (pharmacists) in communication strategies. All these approaches were important to prevent and mitigate the impact of COVID-19 via adoption of non-pharmacological measures and promotion of vaccination. Key messages • Portugal was pioneer in promoting Social mobilization and community engagement training sessions, maintaining a proximity communication, tailoring the information, and maximizing its impact. • Within the group of health professionals, pharmacists are a privileged group to promote these communication strategies and social mobilization due to their proximity with the local community.

A health promotion intervention for vulnerable schools (BeE-school): a cluster-randomized trial

Abstract Background Noncommunicable diseases (NCDs) share key determinants like unhealthy diet, unhealthy 24h- movement behaviour (sleep, sedentary behaviour and physical activity), leading to other risks including overweight, obesity and raised blood pressure. Although the manifest of the NCDs in childhood is rare, risk behaviours, obesity, and raised blood pressure that accelerates their development begin during childhood. The current study aims to analyze the effectiveness of the intervention program based on the promotion of health literacy and lifestyles, on children’s health literacy, lifestyles (e.g. dietary intake, 24hmovement behaviour) and overweight and obesity. Methods 478 children (6 schools) aged 6-12years old will participate in this cluster-randomized trial, having schools as the unit of randomization, assigned into intervention (239-3schools) and the control arm (239-3schools). This project is currently performing social listening (online and offline) and stakeholders’ involvement. Data collection includes sociodemographics, health literacy and infodemic resilience, dietary intake and children’s 24-h movement behaviour (e.g. accelerometry), anthropometry (e.g. weight, height and waist circumference) and blood pressure. It will occur at baseline and after the intervention (follow-up, 6 months after the beginning of the intervention). Results Expected outputs and outcomes include the 1-creation of a model for characterizing NCDs and health topics based on artificial intelligence techniques (e.g. deep learning, social network analysis methods).2- improved health literacy and infodemic resilience of children, families and teachers.3- enhanced children’s lifestyles. 4- reduce NCDs’ physical risk factors (e.g. overweight, raised blood pressure). Conclusions A feasible intervention program for school-aged children with vulnerabilities enhances tailored policies about health promotion and NCDs’ prevention, respecting the contextś singularities. Key messages • Health promotion and NCDs prevention are crucial for the well-being of our societies. • Feasible intervention programs advocates for evidence-based policies that respect local singularities.

Digital Health Literacy in the Training of Informal Caregivers – Community Intervention

Abstract Background Health Literacy allows optimizing healthy lifestyles and preventive and health protective behaviors (DGS, 2019). Low literacy can lead to a greater number of hospitalizations, a more frequent use of emergency services and a lower prevalence of preventive attitudes in the field of health. Internet-based interventions could have a positive impact on informal caregivers, reducing the geographical barrier, promoting self-efficacy in managing their own emotions, reducing burden. Aim Contribute to the training of informal caregivers of a primary health care unit in Lisbon, through the promotion of digital health literacy. Methods The Community Intervention project was carried out in the context of a home visit, focusing on 11 informal caregivers, through the presentation of an interactive digital manual. It was based on the methodology of health planning, through the elaboration of a diagnosis of the situation, definition of priorities, setting of objectives, selection of strategies, operational preparation and evaluation (Imperatori & Giraldes, 1993). Results It was found that not all informal caregivers have access to the internet or digital technologies, and it was necessary to deliver the printed manual. Caregivers who accessed the interactive digital manual rated its content as very important, having accessed the suggested links without difficulty. The possibility of forwarding the digital manual to other caregivers was valid for all. Conclusions Digital technologies promote communication in terms of health promotion, contributing to universal access and digital training in health, giving individuals the opportunity to increase care for their own health. The creation of digital health tools must be directed to the characteristics of the population. For individuals with low digital literacy, simple technologies must be created and for those who cannot or do not want to use digital tools, adequate alternatives must be created. Key messages • Primary care health professionals may use digital technologies to promote health literacy. • Vulnerable groups with low digital health literacy need support to increase access to digital technology that can promote health literacy.

Tool-HLCA: An intervention to promote the health literacy of school-aged children

Abstract Background In the age of ‘infodemic,’ children and young people encounter health-related information in digital environments at an early age. They should therefore learn how to deal with these in a health-competent way while still at school. Above all, it is relevant that they learn how to distinguish good health information from false. This can be achieved by promoting health literacy. The intervention “Toolbox” combines areas of media education in schools and health literacy to be implemented in schools and curricula in the long term. Methods The intervention was designed to address existing health topics in the classroom while strengthening digital health literacy in grades 7 to 10. The Toolbox was piloted in three school classes in Germany and the feedback provided by teachers and students was implemented in a new version of the intervention. Results The basic understanding of health literacy in the Toolbox is finding, understanding, evaluating and using digital health information. These steps are followed through using quality criteria for good health information. Students learn that they need to find out the type of information, analyze the author, investigate the media provider, and also the sources given. If they are unsure, they can conduct an adapted questionnaire regarding identify misinformation and disinformation. In addition, the students and teachers receive working materials for group work. Conclusions Recognizing disinformation is a relevant skill already for children and adolescents. The intervention should make it easier for students to recognize good health information. For teachers it should be made easier to address health literacy in school without additional effort.

Community-based health professionals in face of crisis – a practice example from Bremen, Germany

Abstract At the end of 2020, a district-based analysis of Covid-19-infection rates in Bremen uncovered differences between socially deprived and “better off” areas. The first analysis conducted on a district level in Germany revealed a social gradient in the Covid-19-affectedness with deprived areas having above-average incidences. These areas are characterized by poor living conditions, high migrant population, low education and health literacy levels, language barriers and precarious job situations. Bremen's Health Senator acted on this challenge early on, initiated and financed the deployment of community-based health professionals (CHP) in disadvantaged areas to tackle the rising Covid-19-rates while reducing social inequalities and promoting health literacy. The CHPs’ work is coordinated by the Association for Health & Academy for Social Medicine Lower-Saxony. The 14 CHP are multilingual, with a background in health professions, social work and public health. They cooperate with local partners in 18 disadvantaged districts in Bremen and Bremerhaven. In 2021, work focused on outreach work, low-threshold provision of multilingual information (e.g., on regulations, vaccination) and the support of local vaccination campaigns. Bremen currently has the highest vaccination coverage in Germany (87,5% of population with primary series, national average: 76,2%; 07/2022). Since 2022, CHPs’ work has shifted to health promotion activities aimed at mitigating the effects of the pandemic, e.g., physical inactivity, mental stress. Bremen was the first German city to pilot a large-scale implementation of CHP in socially disadvantaged areas. Due to their continuous presence, CHP quickly became people of trust and are integrated into local structures. Their work has received huge attention both in professional contexts and public media. The low-threshold outreach-work and close cooperation with local partners has high potential to address other health challenges in disadvantaged communities. Key messages

Promoting migrant HL, good practice in adult education and lessons learned for other interventions

Abstract Problem Migration is a global phenomenon, and migrants face myriad challenges, e.g., building context-specific health literacy (HL). To sustainably promote HL, translations, interpreters, or programs in other languages are insufficient. Courses that promote HL holistically are needed, e.g., second language courses. In the SCURA research project, part of the HLCA Consortium, we ethnographically studied language courses and developed interventions. The insights gained are relevant not only for courses promoting HL of migrants or in Germany but also for other target groups and countries. Description Based on extensive ethnographic research, we participatory created interventions to promote HL. As language courses promote HL to varying degrees but are severely limited by the rigid conditions and support, we identified strategies to improve HL therein and ensure uptake and sustainability: add-in, pimp-up, dive deeper. The multimodal intervention consists of an extensive collection of teaching ideas, materials to prepare and reflect on sessions, and a 6-part teacher training (in-house, online, and self-study course, based on adult learning principles). The 90-minutes sessions address Health in Language Courses, Health and Me, Using materials, Critically Analyzing Materials and Developing Empowering Activities, Promoting Family HL, and Mental HL. A hands-on tool was developed to help teachers intentionally promote the seven components of HL. Results The preliminary results of the ongoing evaluation showed that the flexibly adaptable and applicable offerings, the online workshop, and self-study courses, were well received. The teachers liked the choice of topics and the combination of short inputs and many recommendations for practice. Lessons The project’s success relies on knowing the context and setting, considering the needs of all stakeholders, and developing offerings that are a relief but not an additional burden, and that can be easily integrated into the program. Key messages • A thorough ethnographic understanding of the course is key to developing interventions that will be perceived to be appropriate and relevant. • HL promotion should integrate teachers’ HL, informal occasions on health information exchange, diverse and multilingual ways to engage with health information and a systematic, deliberate development.

4.K. Workshop: Promoting and enhancing health literacy through school interventions

Abstract The promotion and enhancement of health literacy in school-aged children is an important public health and education goal. To ensure healthy behaviours and attitudes in adulthood, children and adolescents have to learn about health and well-being early in life. Toward this goal, schools are considered the most important setting to address health literacy. Interventions delivered in schools can reach all children regardless of their social, cultural or development background. In the education sector, health literacy interventions can address not only the skills, attitudes and knowledge of students, but that of teachers, principals, health and education staff, as well as the whole school setting. Health literacy is linked to education, while it mainly addresses how people manage health information. In this context, health literacy enables children and adolescent to find, understand and critically appraise health information and use it to guide informed health decisions and promote health behaviour. While this understanding targets personal competencies of individuals, health literacy is also directed towards the environment. For example, the concept of organizational health literacy aims at increasing health literacy capacities of the environment and within settings, such as schools. This makes health literacy an important concept at the intersection of behaviour change (agency: personal health literacy) and social change (structure: organizational health literacy). While the behavioural approach is most promising to equip students with the necessary skills to act as their own agents of health information management and improve their health agency capacities, the social approach further includes consideration of social determinants of health to provide child- and adolescent-friendly environments and conditions. Therefore, effective health literacy interventions should aim at combining behavioural and social approaches, especially in such vulnerable groups as children and adolescents. The purpose of this workshop is to present and discuss four interventions on health literacy drawing on behavioural and social sciences. (i) The first presentation will introduce the Health Literacy Toolbox for Schools (Tool-HLCA). (ii) The second presentation will introduce a school curriculum for classroom based Mental Health Literacy (HLCA-IMPRES). (iii) The third presentation will provide the organizational health literacy school intervention: Health Literate Schools (HeLit-Schools). (iv) The fourth will present applied data on mental health literacy in teachers and an instrument to measure action competencies of teachers with respect to promoting their students’ mental health (MHAC). Each project will be given ten minutes to present their interventions and main findings, including time to discuss with the audiences and get feedback. The participants in turn will learn about recent empirical findings they can use in health literacy practice and policy. Key messages • Children and adolescent will benefit from early interventions to develop healthy behaviours and lifestyles in their life-course. • Health literacy is an important school topic and should be addressed within behavioural and social approaches.

Organizational health literacy and health promotion in health care settings: Results from Germany

Abstract Introduction Health care organizations (HCO) are increasingly required to provide health literate structures and processes to strengthen organizational health literacy (OHL). So far, little is known about the extent of OHL in HCO in Germany. Aims are therefore 1) to examine the level of OHL in health care organizations, and 2) to investigate the impact of organizations level of health prevention and workplace health promotion on the level of OHL. Methods Analyses are based on a nationwide cross-sectional study (online survey) among management staff (N = 564) in HCO (hospitals, nursing homes, facilities for disabled people). OHL was measured by the German version of the ‘Health literate health care organization 10 item questionnaire’ (HLHO-10). Health prevention and workplace health promotion were operationalized by the “Worksite Health Promotion Capacity Instrument’ (WHPCI). Uni- and bivariate analyses were carried out, on an item-basis and as an index (median-split). Results Regarding OHL, 55.1 % of the health care organizations reported below-average levels of OHL. On an item-basis, the highest below-average levels were given for the standard ‘communication’ (59.1 %) and the ‘provision of information to patients/residents via various media’ (57.4 %). Regarding the level of health prevention (51.8 %) and the existence of workplace health promotion structures (55.7 %), more than half of HCO reported a below-average level. In addition, results showed that HCO that indicate a below-average level of prevention and few structures of workplace health promotion also revealed a below-average level of OHL. Conclusions There is need to strengthen OHL in German HCO. Key messages • HCO are required to strengthen HLO, particular in communication and participatory approaches. • A higher level of prevention and workplace health promotion on HCO can contribute to the implementation of OHL initiatives.

School health promotion during the COVID-19 pandemic: Associations with school leaders’ health literacy

Abstract Background School leaders are credited with an important role when it comes to school health promotion. During the COVID-19 pandemic, much health-related information was available and had to be interpreted and acted upon by school leaders. Therefore, it is crucial that they have sufficient health literacy as the ability to gain access to, understand and use health-related information. A study in Germany showed that limited health literacy among school principals was associated with low levels of health promotion activities. This paper explores the association between school leaders’ health literacy and school health promotion in Switzerland, addressing the following questions: 1. What is the relationship between health literacy of school leaders and the implementation of school health promotion? 2. Does health literacy explain variance above and beyond other antecedents, such as principals individual mental health and attitudes? Methods The quantitative analysis is based on an online survey conducted among school leaders in the German- and French speaking parts of Switzerland in June 2021 as part of the project “COVID-19 health literacy school principals survey”. The final sample comprised N = 339 school leaders. The data were analyzed using stepwise regression with health literacy, stress, wellbeing and attitudes toward school health promotion as antecedents and COVID-19 related school health promotion as the outcome. Results The results show that health literacy of school principals has played an important role in the implementation of school health promotion during the COVID-19 pandemic. It explains additional variance beyond other antecedents. Conclusions One way to promote implementation of school health promotion is to strengthen the health literacy of school leaders.

Promoting migrant health literacy in adult education, from research to practice

Abstract Background As migration affects health, migrants need context-appropriate health literacy (HL) to maintain and promote health. Possible venues to improve HL are adult education programs, i.e., language courses (LC). However, empirical evidence on these courses and their contribution to HL is scarce. Moreover, general HL recommendations and conceptually developed HL programs often proved unsuitable in practice as they insufficiently incorporate the multiple influences. This paper’s purpose is to show, using key findings, how ethnographic research can contribute to developing appropriate programs and how the transfer from research to practice can succeed. Methods The SCURA project conducted extensive ethnographic research on HL in second LC, i.e., 100 h participant observation in 2 classes, 40 teacher interviews, analysis of 24 textbooks, and teacher training. On this basis, we designed programs and drew lessons from comparison with other programs. Results The study revealed that health and HL as a situational social practice play a key role in LC e.g., as prerequisites for attendance and learning, part of the syllabus, and an occasion for informal conversations. Multiple concepts of health and HL coexist and influence HL promotion. Besides the setting and course conditions, teachers strongly shape HL activities and students show varying degrees of HL practice. We exposed the complexity and diversity of HL situations, meaning-making processes, strategies to acquire and promote HL, and actual space of action. Then, we developed participatory practicable approaches to promote HL in the educational offer. Compared to other programs, the ethnographic study allowed us to address the major factors, tap into the actual space of action, and increase acceptance, uptake, and sustainability. Conclusions Improving HL in existing offers requires a profound understanding of the logic of the field. Ethnographic studies facilitate describing these peculiarities and tailoring interventions. Key messages • Ethnographic studies allow understanding the relevant factors, actors, situations, contexts, processes, strategies, the logic within and the scope for action. • The empirical evidence gained in ethnographic studies enable researchers to develop promising, accepted, and sustainable interventions.

Treatment Seeking Behavior of Pregnant Women about Malaria in Muzaffargard

Malaria during pregnancy and childhood is the major public health problem and about half of the population is at risk of developing malaria in the world. During pregnancy, it causes severe anemia, low birth weight babies, abortion and many other severe complications. Knowledge plays main role to prevent this disease and therefore in this study health seeking behavior of pregnant women is explored to determine frequency of malaria suspected cases and the reasons for non-utilization of Government health facilities by pregnant women. A total 312 pregnant women were selected through multistage random sampling. A structured questionnaire was used to know about the knowledge and practice of pregnant women about malaria. A survey was conducted Longmalan Village of Muzaffargard. Data was collected and analyzed by using SPSS version 20. Knowledge about malaria was found poor in the majority of the respondents. The major sources of treatment was private health facilities. The major reasons of non-utilization of public health facilities were poor accessibility to transport, lack of trust on public medical providers, and their bad attitude. On the basis of these findings, it was concluded that malaria knowledge has shown to be an important factor for prevention and treatment seeking practices about malaria health education and literacy promotion should strengthen the knowledge about malaria prevention and treatment seeking behavior.

Do Health Information Sources Influence Health Literacy among Older Adults: A Cross-Sectional Study in the Urban Areas of Western China.

Background: Previous studies have found that the dissemination pattern and delivery mechanism of information can provide crucial resources and empowerment for individuals to the promotion of health literacy. The present study investigates how health information sources are associated with health literacy among older adults in west China, and tries to explain the mechanisms underlying the link between health information sources and health literacy in the Chinese context. Methods: The cross-sectional study employed a representative sample of 812 urban citizens aged 60 and older in 2017 in Western China. Results: We found that health information sources including healthcare practitioners (B = 4.577, p < 0.001), neighbors (B = 2.545, p < 0.05), newspapers (B = 4.280, p < 0.001), and television (B = 4.638, p < 0.001) were positively associated with health literacy. Additionally, age (B = −1.781, p < 0.001) was negatively associated with health literacy, and the socio-economic status factors including minority (B = −10.005, p < 0.001), financial strain status of perceived very difficult (B = −10.537, p < 0.001), primary school (B = 11.461, p < 0.001), junior high school (B = 18.016, p < 0.001), polytechnic school or senior high school (B = 21.905, p < 0.001), college and above (B = 23.433, p < 0.001) were significantly linked to health literacy, and suffering from chronic diseases (B = 3.430, p < 0.01) was also positively related to health literacy. Conclusions: Health information sources including healthcare practitioners, neighbors, newspapers, and television have a strong influence on health literacy, which implies that the four main types of sources are the important patterns of health information dissemination in the reinforcement of health literacy. In addition, the present findings also indicate age, minority and disease differences in health literacy and confirm the influence of enabling factors including educational attainment and financial strain on health literacy. Based on these findings and their implications, specific evidence is presented for the reinforcement of health literacy in interpersonal and mass communication, and in the educational and financial settings in the Chinese context. The present results also suggest that the age-specific, minority-specific and disease-specific measures should be taken to promote health literacy among older adults.

The promotion of active aging through older adult education in the context of population aging.

We have entered an era of population aging, and many public health problems associated with aging are becoming more serious. Older adults have earlier onset of chronic diseases and suffer more disability. Therefore, it is extremely important to promote active aging and enhance health literacy. These involves full consideration of the need for education and the provision of solutions to problems associated with aging. The development of OAE is an important measure for implementing the strategy of active aging, and curriculum construction is a fundamental component of achieving OAE. Various subjective and objective factors have limited the development of OAE. To overcome these difficulties and ensure both active and healthy aging, the requirements for active aging should be implemented, the limitations of current OAE should be addressed, system integration should be increased, and the curriculum system should be improved. These approaches will help to achieve the goal of active aging. This paper discusses OAE from the perspective of active aging, based on the promotion of health literacy and provides suggestions to protect physical and mental health among older adults, while promoting their social participation. The provision of various social guarantees for normal life in older adults is a new educational concept.

Promoting health literacy and sense of coherence in primary care patients with long-term impaired work ability—a pilot study

Objective Evaluate feasibility, partnerships, and study design of intervention to minimise sick leave. Design and setting The design was a pilot single arm intervention study in primary health care. Outcome measures at follow-ups for each participant were compared with baseline data for the same person. Subjects Twenty primary health care patients with recurrent or long-term sick leave or health-related unemployment. Intervention Patient education through interactive study groups that met half a day a week for eight subsequent weeks. Groups were led by experienced but not medically trained facilitators. The intervention was designed to improve participant health literacy, sense of coherence, health-related quality of life, and patient involvement in healthcare. Main outcome measures Primary outcome was the level of sick leave. Sick leave data were obtained from medical records when available, otherwise patient reported. Secondary outcomes regarding health literacy, sense of coherence, and health-related quality of life were measured with validated questionnaires at baseline and follow-ups. Results Level of sick leave decreased significantly and participation in work preparatory activities increased during follow-up. Health literacy, sense of coherence (subscale sense of meaningfulness), and health-related quality of life (subscale social functioning) showed statistically significant improvement. Intervention, partnerships, and study design were feasible. Conclusion An educational programme, conducted in cooperation between primary health care and partners outside the healthcare system, was feasible and showed an impact on sick leave, health literacy, sense of coherence, and health-related quality of life. KEY FINDINGS A pilot study to evaluate an educational programme with study groups conducted in cooperation between primary health care and partners outside the healthcare system showed good feasibility. Sick leave decreased significantly six months after baseline. Health literacy, sense of coherence (subscale sense of meaningfulness), and health-related quality of life (subscale social function) improved significantly 6 months after baseline.

The Impact of Higher Education on Health Literacy: A Comparative Study between Urban and Rural China

Health China 2030 calls for health equity. The strict household registration system, known as Hukou, results in an uneven distribution of social resources between urban and rural China. Higher education can promote social mobility and narrow health inequality. Health literacy is a significant indicator to predict health status. Drawing on national representative data recently collected, this study examines the impact of higher education on health literacy in urban and rural China. Propensity score matching was used to address potential selection bias. Ordinary least squares regressions and Oaxaca–Blinder decomposition techniques were conducted to explore urban-rural disparities in health benefits from higher education. The findings indicate that there are existing gaps in health literacy, higher education attainment, household income, and healthcare coverage between urban and rural China. Higher education attainment can significantly promote health literacy both in urban and rural China, after controlling for a series of demographic, socio-economic, and individual characteristics. Moreover, this study highlights a negative heterogenous treatment effect pattern: those who are less likely to attend college can obtain more health benefits from higher education than those who are more likely to be admitted into college. Public education and health programs, policies, and goals should be further optimized to promote integrated development in urban and rural China.

Förderung der mentalen Gesundheitskompetenz im Jugendalter

HintergrundInternational und national wird der Ruf laut, Gesundheitsförderung in Schulen zu verankern, nicht erst, aber insbesondere im Zusammenhang mit dem Anstieg der Rate psychischer Auffälligkeiten seit dem Beginn der „coronavirus disease 2019“(COVID-19)-Pandemie. Die Förderung mentaler Gesundheitskompetenz (mGeKo) erfährt in den vergangenen Jahren als möglicher Ansatzpunkt zunehmende Aufmerksamkeit.FragestellungWelche Evidenzen gibt es für die Förderung der mGeKo im Jugendalter im schulischen Setting, und wie gestaltet sich die praktische Umsetzung in Deutschland?MethodeLiteraturübersicht, Recherche in Datenbanken zu Programmen zur Förderung der mGeKo im schulischen Kontext (Sekundarstufe I).ErgebnisseDie Förderung der mGeKo erscheint, gerade bei einer Implementierung im Schulkontext, als ein vielversprechender Ansatz: Erste Programme existieren, Metaanalysen weisen auf signifikante Effektstärken im unteren bis mittleren Bereich hin. Es bestehen jedoch ein weiterer Forschungsbedarf (z. B. hinsichtlich distaler Endpunkte) und Schwierigkeiten bei der Umsetzung in die Praxis.SchlussfolgerungenDurch eine theorie- und evidenzbasierte Umsetzung kann Schule als Lern- und Lebensort für das wichtige Thema psychische Gesundheit sensibilisiert und für unterstützende Maßnahmen motiviert werden; eine Berücksichtigung der Hürden im deutschen Schulsystem erscheint für eine erfolgreiche Umsetzung maßgeblich.Zusatzmaterial onlineDie Online-Version dieses Beitrags (10.1007/s00278-022-00622-w) enthält eine Liste mit universellen Programmen zur Förderung der mentalen Gesundheitskompetenz (mGeKo) im Schulkontext.

Automated digital counselling with social network support as a novel intervention for patients with heart failure: protocol for randomised controlled trial

IntroductionHeart failure (HF) symptoms improve through self-care, for which adherence remains low among patients despite the provision of education for these behaviours by clinical teams. Open Access Digital Community Promoting...

Assessment of Health Literacy and Health Promoting Behaviors among the Urban Adult Population.

The main criteria of health determinants are Health Promoting Behaviors (HPBs) and Health Literacy (HL). This study aimed to assess HL and HPBs among the urban population of adults. This study was conducted as a cross-sectional study with 379 adults in Iran. The inclusion criteria was that participants were randomly selected from health centers using health records. Data were collected by demographic information questionnaire, Health Literacy for Iranian Adults (HELIA) and Health Promoting Lifestyle Profile II (HPLP-II). Descriptive statistics, independent samples t-test, and Pearson's r correlation coefficient were used to analyze the data. Also, the hierarchical regression analysis was used to adjust for confounders. There was a significant association between HL and demographic factors, including age, gender and education level. HL dimensions were significantly correlated with HPBs of adults (p <0.05). Decision-making was the strongest HL dimension to predictive HPBs (β=0.606). In this study, 49.7% of the variation in HPBs is predicted by the HL, and the demographic characteristics. It can be advantageous to design programs to promote HL and HPBs in adults, focusing on the aging group, gender, and education level.