Research on the health literacy of parents with children with intellectual disability is limited. Understanding parents' healthcare skills and needs is essential for improving children's health and developing effective support. In this study we aimed to (1) explore the health literacy skills of parents that enabled them to support the health needs of their child with intellectual disability and the factors influencing these skills, and (2) identify opportunities to support parent health literacy. A qualitative study was carried out using interviews with 24 parents of children and young people with intellectual disability. A directed content analysis was completed, guided by the nine domains included in the Health Literacy Questionnaire. Participants demonstrated strong health literacy skills; however, there was diversity in their strengths and needs across different domains of health literacy. Navigating healthcare systems was the key area where participants faced challenges and required further support. Participants described factors including educational levels, professional expertise, experiences over time, and relationships with healthcare professionals which influenced their health literacy. Opportunities to improve health literacy were identified, addressing parents, healthcare professionals, and healthcare and disability services. Developing and maintaining health literacy is critical to parents supporting the health of children with intellectual disability. These results provide insight into how health literacy interventions can be designed to support parent health literacy. The study provides participants' recommendations for how healthcare professionals can support parent health literacy. These recommendations relate to the health literacy responsiveness of the professional and service.

Functional health literacy (HL), the ability to read and act on health information, is crucial for making informed decisions. Yet, few studies have specifically examined how it relates to COVID-19 vaccination behavior among older adults, particularly in conjunction with digital access. This study investigates the association between functional HL and COVID-19 vaccination uptake among older adults across Europe and explores whether this association is moderated by internet use. Observational prospective study. Data from 30,801 respondents aged 50 and older were drawn from Wave 8 (2019/2020) and the second COVID-19 questionnaire (2021) of SHARE, covering 27 countries. Functional HL was assessed using the Single-Item Literacy Screener. COVID-19 vaccination status and internet use were self-reported. Probit regression models, adjusted for individual- and country-level factors, tested the association and included HL×internet use interaction terms to assess moderation. Overall, 27% of respondents reported at least sometimes needing help reading health information, 54% reported using the internet, and 80% were vaccinated against COVID-19. Lower HL was significantly associated with a lower likelihood of being vaccinated (AME=-0.02, p<0.001). A significant interaction between HL and internet use (p<0.001) indicated that the association between HL and vaccination was stronger among non-users of the internet. Lower functional HL is associated with decreased COVID-19 vaccination uptake among older adults, particularly among those who do not use the internet. Public health interventions should address both HL and digital access to reduce inequalities in vaccination uptake among older populations.

To describe the development and early implementation of the Digital Health Equity & Literacy Program (D-HELP), a student-led quality improvement initiative to promote digital health engagement in the emergency department (ED). Trained student volunteers at Rush University Medical Center delivered in-person education on Epic MyChart and Rush On Demand telehealth services in English and Spanish. Eligible adult patients were identified through the EHR and engaged when clinically appropriate. Over 4 months, 94 patients were approached, with 64 (68%) patients receiving some level of intervention. Volunteers documented encounter type, interpreter use, and unsolicited patient feedback. MyChart invitations were sent to 27 patients, with 7 registering on-site. D-HELP demonstrated feasibility, flexibility, and strong patient receptiveness in the ED setting. The model's low-resource, student-driven design supports scalability and provides a framework for expanding digital health literacy initiatives across diverse clinical settings while addressing social determinants of digital access.

An Evaluation of Radiation Oncology Patient Education Materials: Readability, Gaps, and Health Literacy Implications.

Vaccine hesitancy (VH) remains a global threat, exacerbated by socio-political uncertainty. We aimed primarily to estimate VH prevalence in Italy, identifying the most susceptible subgroups, and secondarily to assess whether these patterns varied across VH dimensions. Cross-sectional survey (web/telephone) among adults in Italy (September 2024-March 2025). The sample (n = 52,094) was nationally representative by age, gender, education, area, municipality size. The primary outcome was VH (score ≥25, adult Vaccine Hesitancy Scale, aVHS). The secondary outcomes were aVHS subscales "Lack of trust" and "Risk perception". Post-stratification weighting for age, area, and municipality size was applied. VH prevalence was 46.09% (95% CI: 45.65-46.53%). Multivariable models showed several associations with VH, e.g., gender, sexual orientation, ethnicity, health literacy, political and religious orientation, personal experiences, and vaccination support from community figures. Among many subgroups significant after multiple-comparison correction, the strongest differences in VH predicted probability (PP) were estimated among individuals using complementary/alternative medicine (PP = 58.5%), right-aligned (PP = 47.0%) or politically unaffiliated participants (PP = 48.4%), individuals with middle school education (PP = 48.3%), people aged 60-74 (PP = 49.0%), and participants uncertain about healthcare workers' pro-vaccination support (PP = 52.8%). While some groups, e.g., individuals with chronic conditions, inadequate health literacy, or religious participants reported higher perceived risk, others, e.g., non-binary respondents, showed higher lack of trust. This study highlighted the importance of granular data to inform inclusive strategies. Key figures and politics emerged as relevant, deserving further exploration. Future research should evaluate tailored interventions for identified at-risk groups. NextGenerationEU funding within the Italian Ministry of University and Research PNRR Extended Partnership initiative on Emerging Infectious Diseases.

Validation and cross-cultural measurement invariance of the English and French versions of the Decision Regret Scale among people living with chronic noncancer pain: A secondary analysis of the DECIDE-PAIN pan-Canadian survey.

Predictors of gastric cancer screening behavior during the COVID-19 pandemic: A longitudinal study in Japan.

The Independent Effect of Depression on Financial Decision-Making in Older Adults.

To map and critically appraise anticipatory guidance interventions and resources for parents following PICU discharge, examine how they address recovery challenges, and identify gaps to inform parent-centred resource development. Database search across EBSCO (MEDLINE, CINAHL, PsychINFO), Embase, Scopus, Web of Science, and Cochrane Library for studies published January 2000-June 2025. Environmental scan via targeted and Google searches. Five tools assessed delivery, understandability, actionability, quality, and readability. Of 1752 records, four studies and nine digital resources met inclusion criteria (n=271 parents). Formats included phone calls, brochures, in-person conversations, plus websites, webpages, downloadable content, and videos, from university children's hospitals (n=10), and organisations (n=3) across the US (n=9), UK (n=3), and Australia (n=1). Three key findings emerged: (1) support for how parents' access, understand, and use information was inconsistent; (2) resources prioritised functional (reading/comprehension), over interactive (communication, application) or critical health literacy (evaluation, advocacy); (3) system-level health literacy strategies were limited. There is an urgent need to strengthen anticipatory guidance by embedding health literacy principles across design and delivery. This includes addressing organisational barriers to access and equity through co-design, plain language, and culturally responsive approaches. Beyond information provision, a deliberate focus on capability building can empower parents as active partners in care, ultimately improving outcomes for children and families. Anticipatory guidance following PICU discharge must move beyond information provision toward capacity building that supports parents to apply, evaluate, and act on information. Embedding health literacy principles - plain language, readability testing, co-design, and cultural responsiveness - into resource development is critical to ensure accessibility and equity. Clinician education and integration into routine workflows are equally important to optimise resource impact. A universal precautions approach offers a practical strategy for health services to ensure all families, regardless of literacy level, receive clear, actionable, and supportive guidance.

The utility of artificial intelligence in plain language writing: A scoping review.

Is Online Oriented-Centred Information About Dry Mouth Trustworthy? An Infodemiologic Study.

Social Participation and Digital Health Literacy Among Older Adults in the Community: The Mediating Roles of Self-Efficacy and Technophobia.

Speech pathologists work with populations vulnerable to mental illness. Investigating the mental health literacy of speech pathology students in their final year of study is an important first step in identifying their preparedness for this area of professional practice. This study sought to investigate the mental health literacy of speech pathology students in their final year of undergraduate study by comparing their mental health literacy to that of first year students and considering relevant associates. A cross-sectional between-groups study was conducted with speech pathology students in their first and final year of undergraduate study at an Australian university. Participants completed a 56-item online survey. Participants were 46 final year speech pathology students and 32 first year students. Final year students had higher mental health literacy scores than first years. Across the whole sample, previous engagement in treatment for mental health symptoms was the only predictor variable to account for a statistically significant portion of the variance in mental health literacy scores of students. Preliminary findings suggest that mental health literacy develops over the course of the degree and that final-year students appear prepared, from a knowledge perspective, for their role in supporting individuals with mental health needs. The main source of this knowledge appears to be personal experience of treatment. A review of mental health curriculum content might be appropriate to ensure those without personal treatment experience can develop knowledge, and for those with personal experience, this is comprehensive and evidence based.

Abuse in individuals with multiple sclerosis: the SocialMS Italian study.

Background: The growing integration of technology in education has made digital health literacy an essential skill for healthcare students. Academic stress and burnout are widely reported among healthcare undergraduates; however, their relationship with digital health literacy remains insufficiently explored, particularly in developing countries such as Pakistan. Objective: This study examined the association between digital health literacy, academic stress, and burnout among undergraduate healthcare students and assessed whether digital health literacy predicts burnout after controlling for demographic factors. Methodology: A cross-sectional analytical study was conducted from January to June 2025 among 300 undergraduate healthcare students from private universities in Pakistan. Data were collected using a self-administered online questionnaire including demographics, the Digital Health Literacy Instrument, Perceived Stress Scale-10, and Maslach Burnout Inventory-Student Survey. Descriptive statistics, Shapiro–Wilk normality testing, Pearson correlation, and multiple linear regression analyses were performed to identify predictors of burnout after adjusting for demographic variables, with statistical significance set at p&lt;0.05. Results: The mean age of participants was 21.4±1.8 years, with females comprising 62% of the sample. Digital health literacy was significantly negatively correlated with academic stress (r= −0.34, p&lt;0.001) and burnout (r= −0.29, p&lt;0.001). Academic stress showed a strong positive correlation with burnout (r=0.63, p&lt;0.001) and was the strongest predictor of burnout (β=0.56, p=0.001). Digital health literacy independently predicted lower burnout (β= −0.18, p=0.002). The model explained 46% of the variance in burnout. Conclusion: Higher digital health literacy is associated with reduced academic stress and burnout. Integrating digital health literacy training may improve student well-being and academic resilience.

Digital information services open new opportunities for health communication, yet their use remains uneven. While many benefit from quick and low-threshold access to knowledge, others face significant barriers. Barriers arise above all from unequal digital skills, limited trust in online sources, structural inequalities in access and the challenge of information overload. Opportunities, in contrast, lie in promoting health literacy, supporting prevention and self-management, enabling personalization through digital tools and facilitating more informed health-related decisions. The findings are discussed in the context of the Health Belief Model (HBM), the Theory of Planned Behavior (TPB) and the concept of the digital divide. These models show how individual attitudes, social norms and structural conditions interact in shaping digital health behavior. Ethical concerns regarding data protection, algorithmic influence and misinformation underline the need for transparency and user-centered design. In practice, strategies must address three levels: strengthening competences at the individual level, ensuring trustworthy systems at the systemic level and reducing inequalities at the societal level. Only by combining these perspectives can digital health communication fulfill its potential and contribute to inclusive improvements in health literacy.

ABSTRACT This article reports on the overall wellbeing and positive outlook of 106 pupils in a city secondary school in England. The pupils were in Year 7 (n = 38) [age 11–12], Year 8 (n = 31) [age 12–13], and Year 10 (n = 37) [age 14–15]. The demographic experienced high levels of socio-economic challenge with a range of social, emotional, and mental health needs requiring support. The percentage of Free School Meals (FSM) and Pupil Premium (PP) across the year groups ranged from 32.4% to 48.4%. All pupils were involved in school intervention to support their mental health literacy and wellbeing between April and July 2024. The findings demonstrated that in-school intervention supported pupils to understand aspects of poor mental health and maintain a positive wellbeing. In Year 7 and Year 8, 68% and 90% of pupils respectively knew what caused poor mental health which increased by 32% for Year 8 pupils and slightly decreased by 3% for year 7 pupils post-intervention. There was less surety in the causes of poor mental health amongst Year 10s with a decrease of 11% post-intervention. There was an observable statistical difference (determined by Pearson’s Correlation Coefficient) in the outlook of Year 8 pupils with just 22.6% reporting a positive general attitude to life.

Precariousness, which refers to experiencing a high level of insecurity and instability in life, manifests in multiple life dimensions and can give rise to mental health issues. Associations with mental health are potentially influenced by migration background. In this study, we examine the associations between precariousness in different life dimensions and depressed mood among individuals with and without migration background. We included 22,039 participants from the baseline measurement of the HELIUS (HEalthy LIfe in an Urban Setting) study, representing the six largest ethnic groups in Amsterdam. We used 13 indicators of precariousness in five life dimensions (employment, financial, housing, cultural and social), 9 assessed through a self-report questionnaire and 4 from neighborhood-level data. Depressed mood was classified as > 9 on the Patient Health Questionnaire (PHQ-9, Dutch version). Network models were applied, stratified by migration background. In total, 14.6% experienced depressed mood. Among those who experienced precariousness in at least four dimensions, the corresponding number was 22.1% to 46%, depending on the specific dimensions of precariousness that were experienced. Associations between depressed mood and indicators of precariousness were similar for those with and without a migration background. Depressed mood was associated with marginal work or unemployment, social satisfaction, social frequency, income inadequacy, discrimination, and financial difficulties, and additionally with lost friendship and health literacy among those with a migration background. Individuals with and without depressed mood differ markedly in their experience of precariousness, but associations are mostly consistent between those with and without a migration background.

Breast density influences both breast cancer risk and the sensitivity of mammographic screening. Several countries routinely notify women of their breast density in community-based screening programmes and provide guidance directly or through general practitioners. In contrast, BreastScreen Aotearoa (BSA) does not currently notify breast density to women, resulting in limited awareness and raising concerns relating to equitable care, patient autonomy in decision making, trust in health professionals and uncertainty regarding clinical pathways. Although the recent Health New Zealand - Te Whatu Ora technical review provides a comprehensive evidence summary and identifies areas for further investigation, policy progression has not occurred as anticipated. An implementation timeline, governance responsibility, communication planning and culturally responsive approach have not yet been specified. Although emerging evidence suggests that artificial intelligence may offer more consistent and reproducible breast density assessment than radiologists, planning for its integration has not been outlined. Research from the comparable settings suggests that misunderstanding, rather than notification itself, drives anxiety. This highlights the importance of communication design, health literacy considerations and primary care readiness. Ethical considerations around transparency and informed decision making remain relevant for screening equity. Addressing the implementation barriers is now crucial, and a coordinated and equity-driven approach is required to inform future policy on breast density notification.

Oral health literacy (OHL) influences older adults' capacity to obtain, process and apply oral health information for self-care and decision-making. Evidence on OHL in community-dwelling older adults in Chile remains scarce. This study explored the factors shaping OHL among Chilean community-dwelling older adults. A qualitative exploratory study was conducted using the Grounded Theory approach. Older adults (≥ 65 years) were purposively sampled from three municipalities in Santiago, Chile, representing different levels of social vulnerability. Thirteen in-depth, face-to-face, semi-structured interviews were conducted. The interviews were audio-recorded, transcribed verbatim and analysed iteratively using constant comparison and open, axial and selective coding, categorising the answers to identify emerging topics until reaching saturation. Data triangulation included interviews, field observations and document reviews. Findings emerged into two overarching dimensions shaping OHL across the life course: upstream and downstream factors. Upstream factors included contextual factors, provider-related factors and system-related factors. Downstream factors encompassed individual and behavioural aspects that influenced access to dental care and attention. OHL in older adults is shaped by cumulative life-course experiences across structural, social and individual domains. Addressing OHL requires integrated public policies, professional training in patient-centred communication and community-based strategies targeting social determinants to promote equitable oral health in older age.