Improve Health Literacy Research Articles

AN ANALYSIS OF THE HEALTH LITERACY LEVELS OF STUDENTS IN A PUBLIC UNIVERSITY'S FACULTY OF HEALTH SCIENCES

Aim: This study aimed to assess the health literacy levels of students in the Faculty of Health Sciences at a public university and to investigate the relationships and differences between participants' sociodemographic characteristics and their health literacy levels. Methods: The study employed a quantitative, descriptive, cross-sectional, and correlational research design. Data were gathered through face-to-face surveys, utilizing a socio-demographic data form and the THLS-32 scale. Data analysis was conducted using IBM SPSS 22.00. Descriptive statistics, including frequency distributions, percentages, standard deviations, and arithmetic means, were calculated. The Kolmogorov-Smirnov test was used to evaluate the normality of data distribution, which revealed a non-normal distribution. As a result, non-parametric tests (Mann-Whitney U Test and Kruskal-Wallis H Test) were applied. Correlation analyses were performed using Spearman’s Rho coefficient, and statistical significance was evaluated at a 95% confidence interval with a 5% margin of error. Results: The findings indicated that 66.3% of participants exhibited sufficient or excellent health literacy levels. Female students had significantly higher TS-AI perceptions than male students. Health Management (HM) students demonstrated higher health literacy levels compared to Emergency Aid and Disaster Management (EADM) students. The highest literacy levels were observed among final-year students, and students with social security had higher TS perceptions than those without. Conclusion: The study concluded that the health literacy levels of students in the Faculty of Health Sciences were generally high, with significant differences based on gender, department, academic year, and social security status. These findings suggest a need for targeted strategies to improve health literacy, particularly among students in certain departments and those without social security

Revealing the Implementation of the Child-Friendly Healthy School Program and its Effectiveness on Health Literacy and Psychological Well-Being to Achieve the SDGs

Objective: This study aims to describe implementing the child-friendly healthy school program and its effectiveness in improving elementary school students' health literacy and psychological well-being to promote health and well-being in achieving the SDGs. Theoretical Framework: Health education provides learning experiences that influence thoughts, feelings, and actions to achieve life goals and become better, healthier, and more productive, leading to improved health literacy and psychological well-being. Method: Quantitative descriptive research is used to describe implementing a child-friendly, healthy school and calculate its effectiveness test. Respondents, including ten elementary school teachers and 360 elementary school students from various schools in Jakarta Province in Indonesia, tested it. Results and Discussion: The results showed a significant increase in knowledge about health literacy (36.5% before training; 68.7% after training; p <.05) and students' psychological well-being (49.8% before training; 86.05% after training. The responses of teachers and students showed that the child-friendly healthy school program was very good and succeeded in stimulating the Health Literacy and Psychological well-being of elementary school students. Research Implications: This child-friendly healthy school program can be a recommendation for teachers to instil self-awareness of physical and mental health in students and input for other educators to realize a comfortable and enjoyable child-friendly healthy school to achieve the SDGs. Originality/Value: The originality of this research is that the child-friendly healthy school program to achieve SDGs has yet to be done at elementary schools surrounding Jakarta Province in Indonesia.

Inclusive practice: a study exploring community pharmacists' perspectives, knowledge, and training of Neurodiversity (ND) and the effects on their practice

Abstract Introduction An estimated 1 in 7 people in the UK are neurodivergent, a term encompassing conditions such as autism, attention deficit hyperactivity disorder (ADHD), and other learning differences.1 Neurodivergent individuals have poorer health outcomes, increased risk of premature mortality and reduced access to healthcare.2 The Oliver McGowan case highlighted the need for raising awareness of neurodiversity and mandatory training.2 CPs are uniquely positioned to implement simple adjustments, e.g., adapting communication methods and inclusive pharmacy spaces, consequently reducing health inequalities. CPs’ knowledge, cultural perspectives and current accommodations in their practice for neurodiverse patients must be determined. Aim To explore community pharmacists' perspectives, knowledge and training of neurodiversity and the effects on their practice. Methods A mixed-methods approach was used following ethical approval from Kingston University Ethics Committee. After a pilot study, using random sampling, paper questionnaires comprising 26 mixed-style questions were distributed and collected in person to community pharmacists in East London boroughs within a two-month period. Survey participants were invited for an optional in-person or remote semi-structured interview, conducted using a validated interview guide. The minimum sample size was 129 pharmacists (Raosoft online calculator; 95% confidence interval). Data was analysed using descriptive and inferential statistics, using Microsoft Excel alongside thematic analysis for interview responses. Results Response rate was 80% (n=103/129) and 6 pharmacists participated in interviews. 53% (n=55) were Asian, 21% (n=22) Black, and 19% (n=20) White ethnicity. 52% (n=54) identified as male and 47% (n=48) as female. There was a statistically significant correlation between ethnicity and perception of neurodiversity, with conditions taken less seriously in Asian and Black cultures compared to White culture (p<0.001). White participants were statistically more likely to rate their knowledge as good or above in comparison to Asian or Black participants (p=0.01), with 70% (n=14/20) White participants rating their knowledge as good in comparison to 18% (n=4/22) Black and 29% (n=16/55) Asian participants. 100% (n=103/103) and 94% (n=97/103) participants were able to identify autism and ADHD respectively as neurodiverse conditions but only 20% (n=21/103) and 21% (n=22/103) respectively identified dyspraxia and dyscalculia. 94% (n=97/103) stated no changes were made to accommodate neurodiverse patients with only 3% (n=3/103) offering large-print labels or poster formats and 2% (n=2/103) offering quiet areas. Thematic analysis demonstrated the absence of interventions and awareness was commonly due to systemic barriers and lack of specific training. Participants described diverse cultural attitudes and attached stigma to neurodiversity. Discussion/Conclusion There are significant gaps in knowledge about neurodiversity, possibly linked to a lack of formal training opportunities for CPs. Consequently, minimal adjustments are made to accommodate neurodiverse patients. Changes to pharmacy education and training are needed to develop general understanding, with tools that can be incorporated in pharmacies to aid neurodiverse patients and improve health literacy.2 Simple measures such as ‘quiet hours’ or large-text labels can greatly impact a person’s healthcare experience. However, improvements are required in infrastructure and resources within pharmacies, as well as shifts in cultural attitudes to encourage patients to share their status.3 Study limitations included time constraints and a small but diverse geographical area.

Improving health literacy and stakeholder-directed knowledge of One Health through analysis of readability: A cross sectional infodemiology study

BackgroundThe One Health approach involves collaboration across several sectors, including public health, veterinary and environmental sectors in an integrated manner. These sectors may be disparate and unrelated, however to succeed, all stakeholders need to understand what the other stakeholders are communicating. Likewise, it is important that there is public acceptance and support of One Health approaches, which requires effective communication between professional and institutional organisations and the public. To help aid and facilitate such communication, written materials need to be readable by all stakeholders, in order to communicate effectively. There has been an exponential increase in the publication of papers involving One Health, with <5 per year, in the 2000s, to nearly 500 published in 2023. To date, readability of One Health information has not been scrutinised, nor has it been considered as an integral intervention of One Health policy communication. The aim of this study was therefore to examine readability of public-facing One Health information prepared by 24 global organisations. MethodsReadability was calculated using Readable software, to obtain four readability scores [(ⅰ) Flesch Reading Ease (FRE), (ⅱ) Flesch-Kinkaid Grade Level (FKGL), (ⅲ) Gunning Fog Index and (ⅳ) SMOG Index] and two text metrics [words/sentence, syllables/word] for 100 sources of One Health information, from four categories [One Health public information, PubMed abstracts; Science in One Health (SOH) abstracts (articles); SOH abstracts (reviews)]. ResultsReadability of One Health information for the public is poor, not reaching readability reference standards. No information was found that had a readability of less than 9th grade (around 14 years old). Mean values for the Flesch Reading Ease and Flesch Kincaid Grade Level were (19.4 ​± ​1.4) (target >60) and (15.6 ​± ​0.3) (target <8), respectively, with mean words per sentence and syllables per word of 20.5 and 2.0, respectively. Abstracts with “One Health” in the title were more difficult to read than those without “One Health” in the title (FRE: P ​= ​0.0337; FKGL: P ​= ​0.0087). Comparison of FRE and FKGL readability scores for the four categories of One Health information [One Health public information, PubMed abstracts; SOH abstracts (articles); SOH abstracts (reviews)] showed that SOH abstracts from articles were easier to read than those from SOH reviews. No One Health public-facing information from the 100 sources examined met the Flesch Kincaid Grade Level target of ≤8. The most easily read One Health information required a Grade Level of 9th grade (14–15 year old), with a mean Grade Level of 15.5 (university/college level). ConclusionConsiderable work is required in making One Health written materials more readable, particularly for children and adolescents (<14 years of age). It is important that any interventions or mitigations taken to support better public understanding of the One Health approach are not ephemeral, but have longer lasting and legacy value. Authors of One Health information should consider using readability calculators when preparing One Health information for their stakeholders, to check the readability of their work, so that the final material is within recommended readability reference parameters, to support the health literacy and stakeholder-directed knowledge of their readers.

Understanding of Health literacy among Healthcare students in Saudi Arabia: a cross-sectional study

Background and objectiveHealth literacy is the cognitive and social abilities that influence a person’s motivation and capacity to learn, comprehend, and use information to improve and maintain good health. We aimed to investigate Healthcare Students’ knowledge, attitudes, and practices regarding Health Literacy in the Riyadh Province of Saudi Arabia.MethodsThis study used prevalidated electronic questionnaires among healthcare undergraduates from colleges affiliated with Saudi University in Riyadh, Saudi Arabia, from December to April 2024. Healthcare students were asked to answer a self-designed online questionnaire sent to them through social media platforms.ResultsThe response rate was 560 out of 600 (93.3%); 293 of the 560 students (52.3%) were aged between 23 and 24 years (mean age was 21.29 SD = 1.852). The mean GPA among the students was 4.31(± 0.682). The average overall score for health literacy among healthcare students was 100.92 ± 11.80. The mean scores for knowledge were 24.17 ± 4.67, attitudes were 38.65 ± 4.20, and practice in health literacy was 38.09 ± 5.09. Among all healthcare students, 50.2% reported good knowledge, 54.1% had good attitudes, and 50.1% exhibited good practices in health literacy. However, students’ knowledge (p = 0.019) and training (p = 0.024) in health literacy were significantly associated with smoking cigarettes. Additionally, smoking shisha was significantly associated with students’ knowledge (p = 0.022), attitudes (p = 0.001), and practices (p = 0.001) in health literacy.ConclusionOur study highlights that half of the healthcare students reported limited knowledge, attitude, and practice in health literacy. Age, gender, and course of study did not show significant differences. Rather, students who did not smoke cigarettes or shisha were found to have higher knowledge, attitudes, and practice in health literacy compared to smokers. However, to improve health literacy, additional education and increased awareness are needed. Further investigation is warranted to address the factors related to poor health literacy.

Interventions for improving health literacy among older people: a systematic review

BackgroundHealth literacy(HL) is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions. Effective interventions to improve older people’s HL have become increasingly important. The purpose of this study is to conduct a review of interventions aimed at enhancing the HL of older people.MethodologyRelevant information was gathered from various databases including PubMed, Scopus, Cochrane Library, Science Direct, and Web of Science. Additionally, a manual search of related journals and Google Scholar, a search of the reference lists of selected articles, and a search of unpublished sources were also conducted up to 30 August 2024. Reporting quality assessment was performed using CONSORT: 2010, JBI Critical Appraisal Checklist for Quasi-Experimental Studies, and “Quality Assessment Criteria for Survey Research Reports”.ResultsA total of 21 articles were included in this study. The interventions conducted in high-income countries were found to be more effective compared to those conducted in middle and low-income countries. Furthermore, interventions carried out at the community level were more effective than those performed in nursing homes. Educational interventions were more effective than lifestyle modification interventions, and interventions carried out in a single dimension were more effective than multidimensional interventions. Additionally, interventions that utilized technology were found to be more effective.ConclusionBased on the findings, community-based interventions that encompass a one-dimensional approach, incorporating the use of technology and considering the duration of the intervention, are more recommended.

Enhancing Access to Orthopedic Education: Exploring the Potential of Generative Artificial Intelligence (AI) in Improving Health Literacy on Rotator Cuff Injuries

Enhancing Access to Orthopedic Education: Exploring the Potential of Generative Artificial Intelligence (AI) in Improving Health Literacy on Rotator Cuff Injuries

Health Literacy in Africa—A Scoping Review of Scientific Publications

Africa’s health landscape is rapidly changing, requiring new solutions such as a focus on health literacy. However, there is currently a limited overview of the development and application of health literacy in African countries and societies. This scoping review aims to analyze scientific publications on health literacy in Africa with regards to research approaches, historical developments, geographic origins, target populations and settings, and topical interests. The research followed Arksey and O’Malley six steps of scoping reviews and employed the Joanna Briggs Institute’s PCC method for search string formulation and the PRISMA-SCR checklist for reporting. On 11 July 2022, the following six databases were searched for scientific articles including included reports, policy briefs, book chapters, and research publications: PubMed, PsycINFO, Cochrane Library, ERIC, African Journals Online, and African Index Medicus. A total of 336 articles were identified. The research team co-developed a codebook and three researchers independently extracted data. The analysis provided the most comprehensive overview of the current scope and scale of health literacy in Africa to date. The publications represented 37 of the 54 African Union countries and dated back to 2001, although most were published in the last decade. The content analysis identified 13 broad themes, including mental health, communicable diseases, non-communicable diseases, maternal health, digital health, information and communication, health care, prevention and health promotion, conceptual perspectives, cultural perspectives, and outcomes and measurement. The analysis of target groups revealed a wide range of actors involved in different settings, mostly in health care or community settings. These comprehensive and novel findings can be used to prioritize future actions for public and professional capacity building, policy development, and improved practice to improve health literacy for all in Africa.

Innovative healthcare solutions for resource-limited settings expanding pharmaceutical care to remote populations

Access to essential healthcare and pharmaceutical services remains a significant challenge in resource-limited settings. This paper explores innovative strategies for expanding pharmaceutical care to remote populations, focusing on the integration of mobile health technologies and community-based interventions. Mobile health (mHealth) technologies, including telemedicine and mobile pharmacies, offer a cost-effective means of delivering healthcare services, enhancing access, and improving real-time monitoring. Community-based interventions, such as the deployment of community health workers, health education campaigns, and peer support groups, play a critical role in addressing healthcare disparities and improving health literacy and medication adherence. The paper also discusses the integration of pharmaceutical care models, emphasizing the importance of collaboration among healthcare providers, pharmacists, and community health workers. Future directions highlight emerging innovations like AI and blockchain technology, while policy recommendations emphasize the need for investment in healthcare infrastructure, professional training, and regulatory support. By leveraging these strategies and innovations, healthcare outcomes and equity in resource-limited settings can significantly improve.

A SIMBA CoMICs Initiative to Cocreating and Disseminating Evidence-Based, Peer-Reviewed Short Videos on Social Media: Mixed Methods Prospective Study.

Social media is a powerful platform for disseminating health information, yet it is often riddled with misinformation. Further, few guidelines exist for producing reliable, peer-reviewed content. This study describes a framework for creating and disseminating evidence-based videos on polycystic ovary syndrome (PCOS) and thyroid conditions to improve health literacy and tackle misinformation. The study aims to evaluate the creation, dissemination, and impact of evidence-based, peer-reviewed short videos on PCOS and thyroid disorders across social media. It also explores the experiences of content creators and assesses audience engagement. This mixed methods prospective study was conducted between December 2022 and May 2023 and comprised five phases: (1) script generation, (2) video creation, (3) cross-platform publication, (4) process evaluation, and (5) impact evaluation. The SIMBA-CoMICs (Simulation via Instant Messaging for Bedside Application-Combined Medical Information Cines) initiative provides a structured process where medical concepts are simplified and converted to visually engaging videos. The initiative recruited medical students interested in making visually appealing and scientifically accurate videos for social media. The students were then guided to create video scripts based on frequently searched PCOS- and thyroid-related topics. Once experts confirmed the accuracy of the scripts, the medical students produced the videos. The videos were checked by clinical experts and experts with lived experience to ensure clarity and engagement. The SIMBA-CoMICs team then guided the students in editing these videos to fit platform requirements before posting them on TikTok, Instagram, YouTube, and Twitter. Engagement metrics were tracked over 2 months. Content creators were interviewed, and thematic analysis was performed to explore their experiences. The 20 videos received 718 likes, 120 shares, and 54,686 views across all platforms, with TikTok (19,458 views) and Twitter (19,678 views) being the most popular. Engagement increased significantly, with follower growth ranging from 5% on Twitter to 89% on TikTok. Thematic analysis of interviews with 8 out of 38 participants revealed 4 key themes: views on social media, advice for using social media, reasons for participating, and reflections on the project. Content creators highlighted the advantages of social media, such as large outreach (12 references), convenience (10 references), and accessibility to opportunities (7 references). Participants appreciated the nonrestrictive participation criteria, convenience (8 references), and the ability to record from home using prewritten scripts (6 references). Further recommendations to improve the content creation experience included awareness of audience demographics (9 references), sharing content on multiple platforms (5 references), and collaborating with organizations (3 references). This study demonstrates the effectiveness of the SIMBA CoMICs initiative in training medical students to create accurate medical information on PCOS and thyroid disorders for social media dissemination. The model offers a scalable solution to combat misinformation and improve health literacy.

3.D. Round table: Improving equity in health: Understanding and responding to health literacy as a social determinant

Abstract Evidence of a social gradient in health literacy has been found in all reported national population surveys in Europe. This workshop will examine the explanations for this social gradient and explore ways to optimise the contribution that health literacy makes in mediating the causes and effects of established social determinants of health. This will include consideration of practical approaches to improving health literacy in socially disadvantaged populations as a contribution to reducing health inequities within and across European countries. The workshop will explore the concept of critical health literacy and the potential to improve public awareness of and capacity to act on the wider social determinants of health. It will also draw upon existing evidence from interventions that demonstrate the feasibility of improving health literacy among higher-risk and diverse populations. This will include consideration of approaches to improving frontline professional skills and support; approaches to organizational and systems health literacy, working directly with people to develop critical skills in accessing, understanding and applying health information; and ensuring that in public health policy, priority is proportionate to need - reaching and engaging the population groups disproportionately affected by low health literacy. Recognising that research remains underdeveloped and the effects of interventions on health inequity are largely untested, the workshop will also consider where the most important research gaps exist and where future health literacy research should be prioritised. The workshop chair will provide introductory and summary remarks to the workshop. The co-chair will manage the panel discussion and audience participation in the workshop. The individual panel members will make 3-minute introductions to key issues from different perspectives examining the mediating and moderating role of health literacy in addressing the social determinants of health. The panel is made up of individuals from academic and policy roles and at different career stages who can offer complementary perspectives on these issues. Following the presentations, the co-chair will present some follow-up questions to the panel before engaging directly with the workshop participants for an open discussion scheduled to last for 30 minutes of the workshop. Key messages • Improving health literacy is not a panacea for entrenched inequities in health but can help moderate the impact on health of other social determinants and provide an important practical response. • Public health policy and practice intended to improve health literacy should prioritise reaching and engaging the population groups disproportionately affected by low health literacy. Speakers/Panelists Gill Rowlands Newcastle University, Newcastle, UK Stephan Van den Broucke Université Catholique de Louvain, Louvain-la-Neuve, Belgium Ana Rita Pedro NOVA National School of Public Health, Lisbon, Portugal Christina Dietscher Austrian Ministry of Health, Vienna, Austria Susie Sykes London South Bank University, London, UK

Development and Implementation of Health Education Tools for Excluded Areas in the Czech Republic

Abstract Background Reducing health inequalities among population groups is imperative, however, health communication strategies tailored to ethnic minorities remain under-researched. To address this issue, various health communication strategies were developed and tested within the 3 year Saste Roma project, focused on improving health literacy and disease prevention in the excluded Czech Roma population. Methods A planning group comprising of doctors, sociologists, psychologists, NGOs and community health workers was established to create tailored health communication tools. The tools were developed with consideration of the sociocultural specifics of the Roma community, using focus groups, in-depth interviews, and the Delphi method. A PR agency was hired to implement the tools. Reach, engagement and Price Per Click = PPC were measured for online tools; feedback on offline tools was collected via surveys and interviews. Results From April 2021 to March 2024, 12 online and offline tools addressing 10 diseases were developed for various age groups and implemented. These tools, such as health literacy brochures and leaflets (78,500 pcs distributed), music videoclips (viewed 150,000 times), a mobile application (with over 500 users), social media profiles dedicated to health (with 140 followers), preventative events, school-based e-learning modules (implemented in 86 elementary schools in excluded areas), online campaigns (reaching 556,337 people; PPC of 0.85 EUR in case of in-house campaign Vs. PPC of 3.21 EUR by PR agency) or poster campaigns (engaging 3,046 individuals) focusing on excluded areas. Lessons This project represents the first extensive use of diverse communication tools targeting the Roma population. The involvement of community representatives (patients, artists, actors, and residents) in tool development is crucial. Training and support for health community workers are essential to achieve effective engagement with the community. Key messages • Tools must be delivered in a culturally sensitive and comprehensible manner by members of the communities. • Commercial PR agencies failed with this specific campaign. Cooperation with Roma artists and influencers is essential.

Cancer Prevention in People Experiencing Mental Ill-Health: A co-designed Patient Navigation Concept

Abstract Introduction People experiencing mental ill-health have greater disparities in cancer specific morbidity and mortality. Factors influencing cancer prevention include increased risk behaviours and frequent encounters with barriers to health care utilization. The Patient Navigation Model (PNM) has been proven to reduce barriers in accessing cancer preventive care in vulnerable populations. To facilitate successful implementation, the conceptual features of the PNM were co-designed with patients and other relevant stakeholders. Methods Twelve focus groups were conducted in January 2024 at four pilot sites in Austria, Greece, Poland, and Spain. Iterative focus group discussions were carried out following key considerations for the PNM as outlined by DeGroff et al., audio recorded and transcribed verbatim. Transcripts were analysed deductively using a directed content analysis while allowing for potential inductive emergence of codes and topics. A total of 50 participants attended, representing five groups (individuals with mental ill-health, care givers, care team members, representatives of mental health organizations, and representatives of service managers). Results The co-design focus groups allowed for the PNM to be contextually adapted to each pilot site, but similarities in the approach emerged within the following four themes: 1) the requirement for a person-centred approach, 2) consideration of both person-specific and context-specific needs, 3) flexibility and competencies of navigators and 4) variation of navigation services (e.g., improving health literacy, promoting a healthy lifestyle, and providing practical support). Conclusions Participatory approaches in co-designing interventions allow for context specific development of interventions to meet the requirements of people with complex needs. Co-designing the PNM is part of activities of the CO-CAPTAIN project funded by the European Union’s Horizon Europe Programme (GA 101104784). Key messages • The Patient Navigation Model for Primary Cancer Prevention is a tailored intervention aiming to meet the needs of individuals experiencing mental ill-health. • The conceptual features of the Patient Navigation Model for Primary Cancer Prevention were co-designed with patients and other relevant stakeholders.

Scaling up joint efforts to tackle cardiovascular diseases and diabetes in Europe

Abstract JACARDI, a Joint Action on cardiovascular diseases (CVD) and diabetes (DM), aims to support EU countries in reducing the burden of CVD and DM and related risk factors, both at individual and societal levels, while ensuring health systems sustainability and equity. In particular, JACARDI aims to implement best practices and pilot testing of innovative practices throughout the entire patient journey. Commencing by improving health literacy and raising awareness among general and target populations, moving through primary prevention and screening of CVD and DM among high-risk populations, and then address people living with CVD and DM and their health service providers, through the improvement of service paths and (self) management, including through digital tools, and completing the path by supporting and encouraging the labour participation of people living with these diseases. With 21 European countries and 76 partners engaged, JACARDI undertakes 142 pilot projects, promising to advance CVD and DM care for millions across Europe. In particular, through an innovative Work Package on methodology, JACARDI will develop and implement a methodological framework to guide all the pilot projects in the design, preparation, implementation, monitoring, reporting, and assessment processes. This framework will encompass transversal and intersectional aspects, ensuring a harmonized and efficient approach for all JA activities. Through rigorous and multidimensional evaluation, JACARDI aims to uncover new approaches to enhance healthcare systems, grounded in evidence-based practices and current needs, while adopting the lens of equity and sustainability throughout the entire methodological and implementation process.

Predictors of infectious disease-related behaviors among adolescents in Armenia

Abstract Background We explored the behaviors related to infectious diseases (ID) and its predictors among 15-17 years old adolescents in Armenia. Methods We surveyed adolescents from public and private high schools in Yerevan and one province in 2023. The instrument explored ID-related behaviors, health literacy (HL), interest in health, and socio-demographics. ID-related behaviors were measured with five Yes/No questions about sharing a toothbrush, covering their mouth when coughing or sneezing, and washing hands with soap and water - before eating, after using the bathroom, and when coming home. HL was assessed with ten questions on a scale from ‘Strongly disagree’ to ‘Strongly agree’. Summative scores were calculated for ID-related behaviors and HL. Multivariable regression analysis explored factors associated with ID-related behaviors. Results Overall, 366 students completed the survey, most of them being females (64.4%). The majority were interested in health issues (80.7%). Almost all respondents reported not sharing a toothbrush with other persons (97.9%) and usually covering their mouth when coughing or sneezing in public places (94.1%). Somewhat lower percentages reported washing hands with soap and water before eating (82.0%), after using the bathroom (89.2%), and when coming home (86.6%). The mean behavior score was 4.52 out of 5 (SD = 0.92) and the percent score was 90.4%. The average HL score was 17.41 out of 30 (SD = 4.47). In the regression analysis, being female vs. male, being interested in health vs. not, studying in private vs. public schools, and having higher HL were independent significant predictors for higher score of ID-related behaviors. Conclusions Armenian adolescents reported high levels of compliance with ID-related behaviors. Improving health literacy and fostering interest in health can help further enhance the performance of preventive behaviors. Interventions targeting public schools and male adolescents are particularly pertinent. Key messages • Being female, studying in private schools, having higher interest in health issues, and better health literacy independently positively influence infectious disease-related behaviors. • Promoting health literacy and fostering interest in health in high schools have the potential to further enhance infectious disease prevention behaviors among adolescents.

5.B. Round table: Improving digital health literacy in the era of generative artificial intelligence

Abstract Improved access to generative Artificial Intelligence (AI) platforms and technologies has prompted greater awareness of their potential application in health communication. This workshop will examine this potential alongside the practical challenges and risks of using generative AI in health communication in the broader context of the European Union AI Act. The workshop will explore the implications for the concept of digital health literacy in ways that reduce or mitigate existing digital health inequities across and within Europe. Chatbots and conversational AI platforms such as ChatGPT have opened opportunities for people to find, understand and use health information in significantly different ways. Public health professionals are already using these technologies to simplify health and medical information and to make it available in different languages. AI assisted technologies are also being used to create interactive and engaging learning experiences that provide the public with real-time feedback and insights about their health as well as prompting and reinforcing actions they can take to improve health. These developments have fundamental implications for our understanding of digital health literacy and the methods we use to support people in optimising the potential benefits of AI. Different communities in Europe vary considerably in their - access to digital technology, - skills to discriminate the accuracy and reliability of information, and - trust and responsiveness to what digital technologies have to offer. Building these fundamental digital health literacy skills is a critical priority if we are to ensure that all people benefit equitably from the potential offered by AI. Those of us engaged in improving health literacy have an important role to play in influencing the future direction of AI in health communication, including and especially by engaging in research and development activities that build evidence of effectiveness and support the development of digital health literacy skills in parallel with the expansion of access to AI-assisted digital technologies. The workshop chairs will provide introductory and summary remarks, moderate the panel discussion, and facilitate audience participation in the workshop. The individual panel members will make 3-minute introductions to key issues from different perspectives on the emerging practical applications of generative AI in health communication as well as the implications for strategies to improve digital health literacy in different population groups. The panel is made up of individuals in different roles and at different career stages who can offer complementary perspectives on these issues. Following the presentations, the co-chair will present some follow-up questions to the Panel before engaging directly with the workshop attendees for an open but structured discussion scheduled to last for 30 minutes of the Workshop. Key messages • We will examine how generative artificial intelligence has opened new both new opportunities and risks in the ways people find, understand and use health information. • We will consider how we can optimise the benefits of generative AI in a way that is equitable through the development of digital health literacy within and between communities in Europe. Speakers/panelists Catherine Jenkins London South Bank University, London, UK Diane Levin-Zamir Tel Aviv University, Tel Aviv, Israel Christopher Le Inland Norway University of Applied Sciences, Innlandet, Norway Miguel Telo de Arriaga Direção-Geral da Saúde, Lisbon, Portugal

Food and nutrition literacy in Austria - results of a representative study

Abstract Background A healthy diet is a key factor in people’s long-term health. The nutritional health literacy and food literacy of the population play a crucial role in this. In 2021, comprehensive data on these competences were collected for the first time in Austria. Methods Almost 3,000 people were surveyed online. Nutrition health literacy was assessed with the newly developed Nutrition Health Literacy Scale (NHLS) and food literacy with the Self-Perceived Food Literacy Scale Short-Form (SPFL-SF). Scores and subscores were calculated. Associations between socio-demographic and socio-economic factors and the competences surveyed were assessed using t-tests, variance analysis, correlations, and multivariate regression models. Results In terms of nutritional health literacy, respondents score an average of 60 out of 100 points, with judging (51 points) and applying (60 points) nutritional information being the most difficult. In the area of food literacy, respondents score an average of 62 out of 100 points. The most challenging areas are ‘healthier choices’ (44 points), ‘healthy snacking’ (52 points) and ‘healthy eating in exceptional circumstances’ (54 points). In both areas, men and people with less formal education score lower. In the case of nutritional health literacy, people aged 65 and over have greater difficulties. Conversely, this group performs better in the area of food literacy. Differences by income can only be seen for nutritional health literacy, to the detriment of low-income groups. Conclusions Possible options for action include the provision of quality-assured and target-group-specific information, the implementation of appropriate tools to facilitate the assessment of foods, and measures to strengthen assessment skills, digital health literacy, food and nutrition skills. Key messages • The survey showed that there is potential for improvement in both nutritional health literacy and food literacy. • The biggest challenge is to evaluate and use nutritional information and to stick to a healthy diet without making exceptions.

The relationship between health literacy level and quality of life in bariatric surgery patients

Abstract Background Today, obesity is an important public health problem. In addition to the intervention programmes developed to prevent obesity, the necessity of medical and surgical treatment is increasing with the growing population. This study was conducted to determine the relationship between health literacy and quality of life in patients undergoing bariatric surgery. Methods This cross-sectional study was conducted with the participation of 136 patients aged 18 years and older who underwent bariatric surgery in a general surgery service between January 2021 and December 2023 and whose contact information was available. The survey participation rate was 75.1%. The questionnaire used for data collection consisted of questions about the sociodemographic information of the participants, The European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the Postbariatric Surgery Quality of Life Scale items. Descriptive statistics, Mann Whitney U, Kruskal Wallis H test and Spearman correlation analysis were used to analyze the data. A value of p &amp;lt; 0.05 was considered statistically significant. Results The mean age of the patients who participated in the study was 38.2 ± 10.8 years; mean BMI was 42.3 ± 6.4 before surgery and 29.0 ± 6.2 after surgery. In the study, 44.1% of the patients who underwent bariatric surgery were found to have inadequate/problematic health literacy level. Participants who had less than a bachelor’s degree (p = 0.009) and low income (p &amp;lt; 0.001) had significantly lower health literacy levels. In addition, a moderate positive correlation was found between overall health literacy score and quality of life score (r = 0.252; p = 0.003). Conclusions In conclusion, this study shows that improved health literacy positively affects quality of life in patients undergoing bariatric surgery and that health literacy education should be emphasized in this context. Key messages • The level of health literacy of bariatric surgery patients is a determining factor on quality of life, and therefore health literacy education is important, especially in identified risk groups. • Increased health literacy can have positive results in terms of psychosocial and physical health and improve quality of life after bariatric surgery.

Dialogue between researchers and older immigrant women in Norway post COVID-19: A qualitative study

Abstract Background In the wake of the COVID-19 pandemic, marginalized groups, particularly older immigrant women, have faced new challenges, prompting an urgent need for research to understand their post-pandemic needs and foster inclusive healthcare systems. In view of this, older immigrant women and researchers developed a project based on dialogue, holding monthly meetings for a year, with the aim of improving health literacy for the women, and enlightening the researchers on the women’s challenges. This study has sought to understand the experiences of the dialogue between older immigrant women and researchers. Methods We utilized participant observation in five dialogical meetings between older immigrant women and researchers, followed by semi-structured interviews with 8 older immigrant women and 7 researchers in Bergen. Data was analyzed using thematic analysis, supported by audio-recorded and transcribed interviews, alongside notes from participant observations. Results Analysis yielded three main themes of health knowledge, collaboration, and power dynamics. The dialogue was seen as a positive experience by both older immigrant women and researchers, with a view to establishing collaboration and trust. It also encouraged user participation in research, for the women, and carrying out research that was relevant to this otherwise ‘invisible’ population to the health system, for researchers, whilst empowering the women with knowledge to improve and maintain their own health. Conclusions This study sheds light on the crucial role of dialogue between older immigrant women and researchers in understanding post-COVID-19 needs. The findings underscore the importance of fostering collaboration, trust, and user participation in research, empowering marginalized populations while addressing gaps in the healthcare system. By amplifying the older immigrant women voices’ and promoting inclusive research practices, we can foster responsive and equitable healthcare systems. Key messages • Dialogue between older immigrant women and researchers is essential for understanding post-COVID-19 needs, fostering collaboration and trust. • User participation empowers marginalized groups, while relevant research improves healthcare inclusivity and outcomes for all.

Can ChatGPT affect health literacy?

Abstract Background ChatGPT is a large language model based on artificial intelligence, which nowadays finds application in various fields, including medicine. Objectives To investigate the usefulness of ChatGPT related to health literacy and to highlight its potential limitations. Methods We searched PubMed/MEDLINE for published research and articles that reviewed ChatGPT in the context of health literacy, written in English over the past five years with free full text access. All original articles were screened. Results A total of 53 publications were found. Twenty-five publications met the inclusion criteria and were included in the review. Most of the works presented a positive opinion towards the use of ChatGPT. The authors of six articles believe that ChatGPT generates more readable papers, while four of them believe the opposite. In four articles authors found out possibility to simplify text. The negative sides relate to the possibly insufficient education of users, the accuracy of the information, potential bias, dependence on the outdated data, and the ethical problem of the real authors not being cited, and therefore not recognized for their work. Conclusions According to the conducted research, ChatGPT represents an opportunity to improve health literacy by generating accessible and comprehensible information about health. It has also been shown to improve the readability and accessibility of public education materials on selected health topics. Furthermore, while AI models like ChatGPT can serve as a reliable source of health information, they should be used as an addition to professional medical consultation, and not as a standalone advice service. Key messages • ChatGPT represents an opportunity to improve health literacy. • AI models like ChatGPT can serve as a reliable source of health information, but they should be used as an addition to professional medical consultation, and not as a standalone advice service.