Health Promotion Outcomes Research Articles

60 Sustainable impact of an outdoor exercise program on health outcomes of older adults: a quasi-randomized controlled trial with a 3-month follow-up

Abstract Older people benefit in several health-promoting outcomes from needs-oriented exercise programs in their immediate living environment. For a low-threshold, and thus sustainable and cost-effective design of exercise programs a transfer to self-organisation is favourable. The aim of our study is to examine the health-promoting impacts of an outdoor exercise program developed for older persons, as well as its sustainability after 3 months. Ninety-five persons aged 60+ were randomized according to their residence (IG: n = 40, mean age = 72.35 years, 24 female; KG: n = 55, mean age = 75.05 years, 34 female). An age-adjusted exercise program was carried out over 12 weeks (2x/week á 45-60min; adherence: 90.9%) by professional exercise instructors in urban parks. During this instructor-led exercise phase, seven participants were trained as mentors, and thus, enabled to continue the exercise program for further 12 weeks (1-2x/week á 45-60min; adherence: 2-3x/month = 11.5%, 1-2x/week = 88.5%). Before (T1) and after the instructor-led exercise phase (T2) as well as after the mentor-led exercise phase (T3), health outcomes (e.g., walking distance/6MWT, neurocognitive performance/DSST) of IG and CG (no intervention) were assessed and analysed using paired t-Tests. 75.1% of IG participants completed both phases of the exercise program. Neurocognitive performance improved significantly for IG between T1 and T2 (+2.32 correct number-symbol matches; p = .003; d = -.509) and remained stable between T2 and T3 (+0.15 correct matches; p = .863; d = -.028) while for CG the opposite development was observed (T1-T2: -0.6 correct matches; p = .451; d = .102; T2-T3: +2.18 correct matches; p = .004; d = -.423). IG improved their walking distance for T1-T2 by 21.39m (p = .172; d = -.223), which could be maintained for T2-T3 (+5,1m; p = .648; d = -.074). Improvements in CG for walking distance were smaller (T1-T2: +2.8m; p = .690; d = -.055; T2-T3: +14.26m, p = .315; d = -.147). The mentoring of the exercise groups proved to be very successful, as evidenced by the maintained effects in the mentor-led phase, ensuring sustainability of health-promoting interventions. (Funded by the Free State of Saxony, “Demographics” #100535625)

Impacts of early psychological changes on correlates of weight-loss maintenance: Seeking increased precision for sustained behavioural obesity treatment effects.

Obesity is an increasing worldwide health issue. In affluent English-speaking countries, obesity ranges from ~28% (Australia) to ~42% (United States) of the adult population. Enabling weight loss beyond an initial 6 months is an unresolved challenge. Women with obesity participated in community-based obesity treatments incorporating either cognitive-behavioural methods emphasizing self-regulatory skills development (n = 106) or typical information/education processes (n = 47). Psychosocial, behavioural, and weight changes were measured. Significant overall improvements in exercise-related self-regulation and self-efficacy, mood, physical activity/exercise (PA/exercise), diet, and weight were found from baseline-month 6 (weight-loss phase) and baseline-month 12, but not from months 6-12 (weight-loss maintenance phase). Significantly greater improvements were found in the cognitive-behavioural group. Within the weight-loss phase, changes in both PA/exercise and diet significantly contributed to the explained variance in weight loss, whereas within the weight-loss maintenance phase, only change in PA/exercise was a significant predictor. There was no significant relationship of weight loss across phases. Months 6-12 change in PA/exercise significantly mediated relationships of changes in self-regulation→weight, mood→weight, and self-efficacy→weight. Earlier scores and score changes in mood and self-efficacy significantly impacted the subsequent parallel relationships. Cognitive-behavioural methods affect psychosocial changes leading to initial changes in diet, PA/exercise, and weight. Those changes then impact subsequent changes in PA/exercise-a primary malleable correlate of maintained weight loss. SO WHAT?: This research extended previous findings to better-inform behavioural obesity-treatment foci to address the pervasive public health problem of attaining and sustaining weight loss. Findings related to PA/exercise will help impact health-promotion outcomes.

Review of Physical Education Curriculum Design for Primary and Secondary School Students in Malaysia for the Purpose of Health Promotion in the Past Ten Years

Among both primary and secondary school students, physical education (PE) plays a critical role in encouraging pupils to take responsibility for their own health on multiple levels. This narrative literature review focuses on examining the design of the PE curriculum for health promotion within the Malaysian context over the past decade. Employing a narrative literature review approach, a total of 118 articles were scrutinized from an initial pool of 157. This comprehensive analysis aimed to uncover key variables influencing PE curriculum design and its role in health promotion. The review identified critical variables shaping health promotion through PE. Curriculum content, teaching methods, teacher training, professional development, stakeholder involvement, and health promotion outcomes were all included. The evaluation emphasized how important it is to have curriculums that are based on evidence, to use effective teaching methods, and to give teachers chances to improve their skills. These factors emerged as essential contributors to promoting health among students. Furthermore, the study highlighted the importance of involving various stakeholders in the curriculum design process and emphasized the necessity of evaluating health promotion outcomes. There is a clear need for further investigations into the intricate relationships between these variables and health promotion outcomes. Additionally, it suggests the formulation of comprehensive policy guidelines and standards for PE within the Malaysian educational system. In conclusion, this literature evaluation may help practice and policymakers create effective PE programs. Malaysia may improve student health through physical education by using evidence-based curriculum design, teacher training, and stakeholder interaction.

Promoting men's health through sports clubs: a rapid realist review

Abstract Background Traditional health promotion interventions have failed to engage men. Sports clubs offer male-friendly health promotion settings for men, but little is known about implementable intervention strategies and subsequent effects. This rapid realist review (RRR) aims to identify context, mechanisms and effects of health promotion interventions targeting men by or in collaboration with sports clubs. Methods The RRR methodology was developed in collaboration with a panel of Danish practice and policy representatives and international academics. A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SportDiscus databases and through grey literature sources. Included studies: 1) targeted men aged 18+ years, 2) reported health promotion outcomes, and 3) were delivered primarily by or in collaboration with sports clubs. Results Fifty-two studies were included. Preliminary analyses indicate that interventions delivered through sports clubs show promise for engaging men with high cardiometabolic risk and producing favorable health outcomes. Preliminary findings from the realist synthesis show that if men felt a strong attachment to the sports club (context), it resonated with their feelings of social identity which outweighed a former reluctance to attend health programs (mechanism), and thus increased the men's likelihood for program engagement and health behavior change (outcome). Conclusions Our study indicates that men's health promotion through sports clubs is emergent. While great strides have been made to increase men's involvement in health promoting activities by delivering interventions through sports clubs, research has predominantly focused on select behaviours (e.g., physical activity), sub-groups (e.g., sports fans) and predominantly Caucasian, overweight, middle-aged men.

Contents, Methods, and Outcomes of Adolescent Sexual Health Promotion in School Environments: A Scoping Review.

Schools play a significant role in adolescent sexual health (SH) promotion. Although adolescents' SH has improved, growing challenges still exist in some areas. Previous studies have noted a lack of knowledge about SH promotion implementation in school environments. The purpose of this review is to describe the contents, methods, and outcomes of adolescent SH promotion in school environments. Three databases (Cinahl, ERIC, Medline) were searched for peer-reviewed articles published in 2011 to 2022, to identify SH promotion in school environments for adolescents aged 12 to 19 years old. After critical appraisal, inductive content analysis was conducted. After screening, 25 studies from 8 countries were included. Sexually transmitted diseases and contraception were emphasized in the contents of the methods. Five SH promotion methods were identified: traditional, virtual, interactive, practical skills supporting, and creative. The outcomes were advancement in SH abilities, changes in sexual behavior, and the strengthening of sexual identity. The contents mostly considered negative consequences of sexual behavior, whereas positive aspects were less discussed. Traditional methods were emphasized, yet positive outcomes were identified regardless of the method. SH promotion should aim to better support adolescents' sexual identity reinforcement.

O.4.4-8 Promoting men’s health through sports clubs: a rapid realist review

Abstract Purpose Traditional health promotion interventions have failed to engage men. Sports clubs offer male-friendly environments that have been identified as an attractive setting for men’s health promotion, but little is known about implementable intervention strategies and subsequent effects. This rapid realist review (RRR) aims to close this gap by assessing context, mechanisms and effects of health promotion interventions targeting men by or in collaboration with sports clubs. Methods The RRR methodology was developed in collaboration with a panel of Danish practice and policy representatives and international academics. A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE, Embase, and SportDiscus databases. Included studies: 1) targeted men aged 18+ years, 2) reported health promotion outcomes, and 3) were delivered primarily by or in collaboration with sports clubs. A grey literature search of National Sports Associations and Federations and non-government men’s health organizations was also performed. Dalkin’s conceptualization of mechanisms in realist methodology was used to identify context- mechanism-outcome configurations (CMOc) and develop a program theory. The study follows Cochrane’s guidance for rapid reviews and is registered in Research Registry (ID: reviewregistry1556). Results We identified 2.720 studies after duplicates removal. Preliminary analyses indicate that interventions delivered through sports clubs show promise for engaging men and producing favorable health outcomes (e.g., weight loss, increased physical activity and improved social support). The realist synthesis suggests that health interventions delivered through sports clubs (resource mechanism) targeted at men who have high attachment to the sport or club (context), may align with their interests and identities (mechanism), to increase the potential for engagement and health behavior change (outcome). The analysis will be finalised by August. Conclusions Our study indicates that men’s health promotion through sports clubs is emergent. While great strides have been made to increase men’s involvement in health promoting activities by delivering interventions through sports clubs, research has predominantly focused on select behaviours (e.g., physical activity) and sub-groups (e.g., sports fans). Support/Funding Source This work was funded by the five Steno Diabetes Centers in Denmark, which are partly funded by the Novo Nordisk Foundation.

Psychological Resilience in Children and Adolescents: The Power of Self-Recovery

Many children in the world grow up without good enough opportunities under challenging conditions such as poverty, violence, neglect, abuse, family discord and diseases. These conditions hinder the mental, emotional and social development of children and young people, making it difficult for them to reach their potential to become healthy adults. In addition to all these, there are children who can survive even in the most severe conditions and continue their development with health and functionality. Psychological resilience is a resource that protects and develops the psychological well-being of children and adolescents, rather than an invariable, innate feature, it is a dynamic process that can be developed, continuous and shaped by the interaction of the individual with his own internal factors and environmental factors. The aim of this study is to present a review of the literature on resilience research from past to present. The article includes the definition of resilience, the history of resilience research, components of resilience, models, measurement, interventions, and future directions in resilience research. Investments in the development of resilience in children and adolescents will produce health-promoting outcomes that balance individual and community-based psychological well-being throughout life, including positive outcomes and potential improvements.

Non-familial intergenerational interventions and their impact on social and mental wellbeing of both younger and older people-A mapping review and evidence and gap map.

Non-familial intergenerational interventions and their impact on social and mental wellbeing of both younger and older people-A mapping review and evidence and gap map.

Effects of Medicare wellness visits on health promotion outcomes

The American older adult population has the highest historical prevalence of chronic disease and underuses wellness visit benefits. Little is known about how Medicare wellness visits (MWVs) affect health outcomes. The aim of this retrospective case-control study was to examine how MWVs affect health outcomes by measuring two kinds of data for case and control groups at baseline versus 15 months: (1) the differences in blood pressure, fasting lipids, and glucose levels and (2) the completion frequencies for seven screenings and vaccinations. Informed by Pender's Health Promotion Model, this design used purposively matched samples from a large American Midwestern Medicare population active between January 2013 and January 2016, with a total sample size of 252, consisting of the case group ( N = 120) and control group ( N = 132). The case and control group samples were matched according to gender, age, marital status, Charlson index scores, smoking status, and pharmaceutical classes. The two groups, case (MWV recipients) and matched control (MWV nonrecipients), were compared at different time points using a doubly multivariate repeated-measures analysis procedure. Descriptive statistics were computed to compare completion frequencies between groups. A doubly repeated multivariate analysis of variance (MANOVA) and descriptive statistics revealed significant differences between the case and control group for three of the four health outcomes. The case group had increased completion frequencies in pneumococcal vaccination. Additional research controlling for more variables is warranted to better understand MWV efficacy on health outcomes. Primary care providers need to study how MWVs affect longitudinal health outcomes.

Outcomes of Peer-Provided Individual Placement and Support Services in a Mental Health Peer-Run Vocational Program.

The authors sought to determine whether staff at a peer-run agency could deliver supported employment services with high fidelity to the individual placement and support (IPS) model and whether employment outcomes of peer-delivered IPS plus work-specific health promotion were superior to usual supported employment services. Two teams from a vocational program of a large peer-run agency were studied from July 2015 to July 2017. One team received training and supervision in delivering IPS plus employment-focused physical wellness support and mentoring. The other team continued providing usual supported employment services. Study data included vocational outcomes from 348 clients served by the two teams (IPS, N=184; comparison condition, N=164) and the results of IPS fidelity reviews of the IPS team at study baseline, midpoint, and end. The authors modeled the primary outcome of competitive employment with random-effects logistic regression and adjusted propensity scores for age, gender, race, ethnicity, education, and months of service receipt. Following training, the IPS team demonstrated acceptable and increasing fidelity to the IPS model, achieving "good fidelity" by the end of the 25-month observation period. Among IPS recipients, 43% achieved competitive employment versus 21% of comparison recipients (p<0.001). Multivariable analysis indicated that IPS recipients were significantly more likely to achieve competitive employment than individuals in the comparison group (OR=4.06, p<0.001). Providing training in IPS along with health promotion to the behavioral health peer workforce may help address the severe shortage of IPS services and enhance the competitive employment outcomes of people served by peer-run programs.

Effectiveness of educational intervention on Attitude regarding care of geriatric among Nursing Students at a selected nursing colleges, Kolar

Background: By 2050, 80% of the world's elderly will reside in low- and middle-income countries. Nurses play an important role in addressing challenges by encouraging people to lead independent lives with favourable health promotion outcomes. Objectives: To examine the relationship between attitude scores and selected demographic variables of nursing students. Effectiveness of educational intervention on attitude of nursing students regarding care of geriatric. Settings and Design: Quantitative approach-one group pre-test, post-test-Experimental research design developed by establishing sample frame using simple random sampling technique among 60 nursing students from III and IV years of BSc (N). Data was collected using a 5-point likert scale and evaluated using descriptive and inferential statistics after obtaining IEC. Results: Pre-test, 37 (61.7%) had an unfavourable attitude, after the post-test, 54 participants (90%) had a fairly good attitude, whereas 6 people (10%) had a pleasant attitude. With a pre-test mean score of 48.1, SD 5.25, and a post-test mean score of 63.5, SD 9.183, significant at p0.05. Hence intervention was effective &amp; research hypothesis has been accepted. Conclusion: requires emphasis on competency caring for older persons and to address concerns. Key words: educational intervention, Attitude, care of geriatric.

Gender, ethnicity differences in mental health status and COVID-19 vaccine intention among U.S. College students during COVID-19 pandemic

Objective: To examine mental health status, COVID-19 vaccine intention and barriers among college students in the U.S. Participants: Students (n = 337) registered at a large public university in 2021. Methods: Cross-sectional survey data were collected online and analyzed using independent samples t test, chi-square test, and one-way ANOVA. Results: Compared to male students, females reported greater anxiety (p < .05) and fear (p < .01). Hispanic participants reported increased anxiety level and the least positive pandemic coping strategies (both p < .05) across the ethnic groups. Black students were the racial group with the lowest trust in the safety and effectiveness of COVID-19 vaccine (p < .05). Vaccine intention was positively correlated with factors such as vaccine safety measures, and perceptions toward vaccination (both p < .001). Conclusions: These gender- and ethnicity- based mental health struggles should be addressed immediately for better health and vaccine promotion outcomes amid the COVID-19 pandemic.

Adverse childhood experiences and college student health promotion outcomes: Another perspective on the trauma‐health relationship

AbstractMost research to date has focused on negative health outcomes associated with adverse childhood experience (ACE) exposure. The goal of the present study was to examine the relationship between ACE exposure and health information seeking, health promoting behaviours and health screening among US college students. Supplemental ACE items were added to the cross‐sectional National College Health Assessment survey administered between 2017 and 2018 with young adult (ages 18–29) college students in California (n = 3862) and Texas (n = 451). Approximately 41.9 per cent of participants reported ACE. ACE‐exposed participants were consistently and significantly less likely to receive health information from their university (p &lt; 0.01). Using multivariable logistic regression models, reporting four or more ACE was associated with significantly lower odds of past year seatbelt use (AOR = 0.62, 95% CI = 0.44–0.89) and past 30‐day condom use during oral sex (AOR = 0.51, 95% CI = 0.27–0.97). Increases in ACE exposure were significantly associated with an increase in the odds of ever testing for HIV (AORs:1.26–2.49). Longitudinal research is needed to uncover the complex interplay between ACE, mental health, negative health behaviours and health promotion activities among young adults. Interventions to improve health promotion activities in ACE‐exposed populations could improve health and quality of life for this vulnerable population.Key Practitioner Messages ACE exposure has a potentially harmful impact on health education efforts and health promotion outcomes including healthy behaviours and obtaining regular health screenings. Young adults with a history of ACE exposure are more likely to report HIV screenings and more work is needed to uncover the reason for this association. College campus health education and promotion programs should target ACE affected young adults.

Health ambassadors in the workplace: a health promotion intervention mobilizing middle managers and RE-AIM evaluation of outcomes

BackgroundThe workplace provides an ideal setting for health promotion, as adults spend most of their day at work. Middle managers hold a strategic position to lead workplace health promotion. This study evaluates the outcomes of an intensive intervention training middle managers to promote health in the workplace.MethodsA workshop was designed and conducted to train female middle management employees to construct, implement, and evaluate a health promotion program in their workplace. Semi-structured interviews were carried out post-intervention to assess workplace health promotion outcomes according to the RE-AIM framework, and identify variables contributing to success. Additionally, questionnaires were distributed pre and post-program assessing personal health and self-efficacy changes.ResultsEighteen participants from 13 government offices, who serve 19,560 employees, completed the training course. Nine workplaces had workplace health promotion programs in progress 12 months after the course had ended, of which 8 made health promotion changes in organizational policy. Workplace RE-AIM scores showed that 8 workplaces were high or partial performers, and 5 were low or non-performers. Factors that increased the likelihood of successful interventions included management support, steering committee, comprehensive programming, conducting a needs assessment and flexibility in program implementation in the presence of challenges. Post course, participants reported increased health knowledge related to workplace health promotion (p < 0.001), and increased health promotion self-efficacy (p < 0.05).ConclusionsTraining and continued guidance of middle managers resulted in the design and successful implementation of workplace health promotion interventions. A RE-AIM based assessment was found to be an effective method for evaluating multi-content workplace health promotion programs.Registered at ClinicalTrials.gov, https://www.clinicaltrials.gov, registration number:NCT03295136, registration date: 24/09/2017.

A meta-analysis of the impact of point of view on narrative processing and persuasion in health messaging

Objective To synthesize experimental research on the impact of narrative point of view (POV) on message processing and persuasion outcomes in health promotion. Moderators examined included characteristics of study design, participants, and experimental stimuli. Design and Main Outcome Measures Random effects model meta-analysis of 16 health promotion experiments, using the metafor package in R. Studies included compared the effects of first- and third-person POV on risk perceptions, attitudes, behavioral intention, identification and transportation. Results There was no evidence of publication bias. Narratives told in the first-person POV led to higher levels of perceived susceptibility (d = 0.10, 95% CI [0.01, 0.20]) and identification feelings (d = 0.10, 95% CI [0.10, 0.21]) than third-person narratives. The effects of first-person POV narratives were significantly stronger for stories that were written in the past-tense and that depicted the protagonist as being similar to message recipients. Conclusion Findings support a theoretical model of POV impact in which a first-person perspective increases identification with the character, thereby leading to higher levels of perceived susceptibility to the health threat. The practical implication is that the effectiveness of narrative persuasion is enhanced by using the first-person point of view, emphasizing target audience-protagonist similarities, and telling stories in the past tense.

Building a Prevention System: Infrastructure to Strengthen Health Promotion Outcomes.

Prevention systems improve the performance of health promotion interventions. This research describes the establishment of the Australian state government initiative, Healthy Together Victoria’s (HTV) macro infrastructure for the delivery of large-scale prevention interventions. Methods: This paper reports on findings of 31 semi-structured interviews about participants’ understanding of systems thinking and their reflections of the strengths and weaknesses of the HTV prevention system. A chronic disease prevention framework informed the coding that was used to create a causal loop diagram and a core feedback loop to illustrate the results. Results: Findings highlighted that HTV created a highly connected prevention system that included a sizeable workforce, significant funding and supportive leadership. Operating guidelines, additional professional development and real-time evaluation were significant gaps, which hindered systems practice. For inexperienced systems thinkers, these limitations encouraged them to implement programs, rather than interact with the seemingly ambiguous systems methods. Conclusions: HTV was an innovative attempt to strengthen health promotion infrastructure, creating a common language and shared understanding of prevention system requirements. However, the model was inadequate for HTV to achieve population-level reductions in chronic disease as system oversight was missing, as was an intervention delivery focus. Clarity was needed to define the systems practice that HTV was seeking to achieve. Importantly, the HTV prevention system needed to be understood as complex and adaptive, and not prioritized as individual parts.

Abstract 16044: Association of Area Deprivation Index With Recurrent Cardiovascular Outcomes: Does Cardiac Rehabilitation Participation Mitigate Effects?

Introduction: Neighborhood location impacts access to health-promoting resources and outcomes. Cardiac rehabilitation (CR) provides a multidisciplinary approach that improves cardiovascular outcomes. We evaluated the association of Area Deprivation Index (ADI) and cardiovascular events in individuals with incident Heart Failure (HF) or myocardial infarction (MI) and the modifying effect of CR. Methods: We identified an observational cohort admitted with primary diagnosis of 1) MI with percutaneous coronary intervention or 2) a primary diagnosis of incident HF from 2010-2018 at a multi-site regional center. We derived ADI from patient home address and then categorized into quartiles. Demographics, clinical covariates, and CR participation post-hospitalization were obtained from the electronic medical record. We compared rates of readmission for a cardiovascular primary diagnosis and mortality across ADI quartiles. Analyses were then stratified by CR participation. Results: In a cohort of 6957 (38.2% women, 88.7% white) with adjustment for covariates, increasing ADI was significantly associated with higher rates of cardiovascular rehospitalization (p&lt;0.01), Acute Coronary Syndrome (ACS) rehospitalization (p=0.01), HF rehospitalization (p&lt;0.01), and all-cause mortality (p=0.04), Table. When we stratified across CR participation, those with participation had significantly lower rehospitalizations (p&lt;0.01) and mortality (p&lt;0.01) when compared to the no CR group. There was no significant effect of ADI on outcomes in the CR group. Discussion: We found increased ADI was adversely associated with mortality and rehospitalizations in cardiac patients. For those participating in CR, there was 1) no significant effect of ADI and 2) decreased incidence of adverse outcomes vs. those who did not participate in CR. Given the benefit of CR participation on ADI’s adverse effect on outcomes, future interventions should focus on increasing CR participation.

Learning Processes as Key for Success in Workplace Health Promotion Interventions in Health Care.

There is limited previous research on how learning processes contribute to the outcomes of workplace health promotion (WHP) leadership interventions. The aim of this study was to identify the outcomes of a system-based WPH education program for managers and investigated what impact the intervention program had on health-oriented leadership, improvement work, and employee well-being, as well as what factors (i.e., how manager's active work following the intervention and organizational learning climate) contributed to these outcomes. A mixed-methods approach was applied, including qualitative interviews with 23 managers and process leaders, as well as questionnaires to employees and managers representing 17 public health care units in Sweden. The results showed that health-oriented leadership, improvement work, work satisfaction, and vitality increased at workplaces that worked actively to implement WHP following the program. Working actively with WHP and health-oriented leadership was of central importance for success and was a covariate with improved social learning climate, improved developmental leadership, and increased degree of improvement work. All included factors of learning during the intervention were associated with improved job satisfaction, while the increase in vitality seemed unrelated to program implementation. In conclusion, successful outcomes of WHP interventions interact with dimensions of organizational learning climate in the workplace.

A pilot study of adolescent health literacy research in Melbourne: Implementation and reflections.

While adolescent health literacy research has gained momentum, there is little evidence regarding its implementation and data collection in school settings. This study explored the feasibility of collecting health literacy data from Australian secondary schools and piloted three health literacy instruments. A cross-sectional study was designed to recruit four government secondary schools in Melbourne. Active, opt-in consent was obtained from parents and students in Years 7-9, and an online survey was conducted. Three health literacy instruments were used: the 8-item Health Literacy Assessment Tool (HLAT-8), the Newest Vital Sign (NVS), and the 47-item Health Literacy Survey (HLS-47). A total of 120 students (age 12-15years) were finally recruited from one school, whereas the other three schools declined due to busy educational commitment or no interest in research. Learnings and reflections on data collection included: a shared perspective of health literacy evaluation between school and researchers; the feasibility of online data collection; and the possibility of obtaining passive, opt-out consent. About one-quarter (23.7%-32.2%) of students were likely to have poor health literacy. Although the recruitment was challenging, this pilot study indicates the feasibility of large-scale online health literacy survey in future school-based research. SO WHAT?: Measuring and monitoring adolescent health literacy is essential to achieve the aim of the Australian Curriculum of Health and Physical Education. More implementation research is needed with representative samples to validate health literacy instruments and examine the impact of health literacy on health promotion outcomes in Australian adolescents.

Correlates of mental health in occupations at risk for traumatization: a cross-sectional study

BackgroundHospitals, police stations, and fire departments are highly demanding workplaces. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate three health-promoting factors simultaneously among three different, highly demanding occupations.MethodsThe present cross-sectional survey investigated health-promoting factors (sense of coherence – SOC, trait-resilience, locus of control – LOC) and mental health outcomes (general psychopathological symptom burden, posttraumatic stress, burnout) in medical staff (n = 223), police officers (n = 257), and firefighters (n = 100).ResultsAmong all occupations, SOC, trait-resilience, and an internal LOC were negatively associated with general psychopathological symptoms, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-promoting factors explained 56% of the variance in general psychopathological symptoms and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general psychopathological symptom burden and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers.ConclusionAcross all occupations, SOC was identified as the most important health-promoting factor. Future longitudinal studies should further examine the causal link between health-promoting factors and mental distress in different workplaces. Such studies will also allow for further development and evaluation of resilience promoting programs.