bluuebunny/crossref_metadata_2025 huggingface dataset:
A lifestyle program for socially vulnerable community-dwelling elderly
Authors: Lambers S , Verschelden P , Es E , Vanderlinden J
Published: October 2024

Problem

Socially vulnerable older adults often face lower health literacy and limited access to health care.

Description of the problem

Current lifestyle programs are often insufficiently adapted to this socially vulnerable target group. As a result, these older adults are underrepresented in lifestyle programs. From a public health perspective, lifestyle programs that improve the poorer physical and mental health of these older adults, should be made more accessible by involving the expertise, participation and needs of this group. The aim of this study was to develop and implement a lifestyle program adapted to the expectations and needs of socially vulnerable older adults.

Results

Both the target group and the local community (health) centers were involved during the co-creative phase of development. A neighborhood analysis was used to identify and reach out to the target group. Motivators and barriers for a healthy lifestyle were identified through focus groups. The developed program consisted of 10 weekly group sessions. Various health aspects were integrated, including exercise, nutrition, stress, sleep, positive psychology, meaningful living, and motivation. Nine centers for community dwelling older adults in Flanders and Brussels were included. In total, 93 older adults were recruited out of which 76 completed the full program. In the final phase, the program was evaluated by means of objective and subjective measuring methods. Finally, the local community (health) centers are currently involved in the program’s sustainability through a trainers’ program.

Lessons

The belongingness, the catering, the empowering attitude of the trainer and the ‘fun’ factor turned out to be success factors for the adherence to the program. The participating centres experienced an increase in numbers of older adults that were attracted to their activities that are focused on healthy lifestyle behaviors. The continuity of the program is currently being examined.

Key messages

• A neighbourhood analysis in collaboration with local partners helped to reach the target group.

• The program was made attractive by the involvement of the older adults, the fun-factor and the small groups.
Development of the health literacy responsiveness (HLR) evaluation framework for HLR interventions
Authors: Meldgaard M , Aaby A , Østergaard L S , Heuck I R
Published: October 2024

Background

Health literacy responsiveness (HLR) interventions include actions at different levels of an organization to provoke change and improve environments ensuring equitable access to and use of information and services (1). However, generic instruments measuring the effect of HLR at intervention level are inconsistent, making evidence on HLR intervention effects difficult to compare (2). The objective of this study was to develop an evaluation framework based on core outcome domains of HLR to facilitate higher consistency in future evaluations of HLR interventions.

Methods

HLR outcomes were identified through a narrative literature review and categorized into domains through a content mapping process. Expert consensus on core outcome domains was reached through a Delphi process. Experts within the field of HLR were invited to participate and answer three questionnaires designed to rank and clarify potential core outcome domains. Quantitative and qualitative analysis was performed to select and complete the final core outcome domains in the HLR evaluation framework (HLR-EF).

Results

The literature search resulted in identification of nine reviews. A total of 383 outcomes were identified from these reviews and included in the content mapping process, which resulted in a total of 26 core outcome domains. Experts (n = 15) participated in the three-round Delphi process, which resulted in consensus on 15 core outcome domains in HLR-EF allocated under five headings.

Conclusions

The study has successfully managed to identify a set of core outcome domains applicable in future evaluations of HLR interventions based on systematic methodologies and expert consensus. Context-sensitive manuals for the use of the HLR-EF is under development and the instrument is ready to be applied in future evaluation of HLR interventions, potentially making future measuring, reporting and comparison of results significantly easier.

Key messages

• Instruments facilitating evaluation of HLR interventions are non-generic and inconsistent.

• HLR-EF has been developed using a narrative literature review, content mapping, and a Delphi process, and defines 15 core outcome domains for evaluation of HLR interventions.
A process evaluation of a LifeLab Dublin; an interactive health literacy intervention
Authors: Smith C , Belton S , Issartel J , Meegan S , Goss H R
Published: October 2024

The argument for targeting adolescent health has been made strongly, with poor lifestyle behaviours often emerging during this life stage. Furthermore, there is consistent evidence of a widening socioeconomic gap in health indicators. Developing health literacy (HL) in youth populations to improve lifelong health behaviours has garnered increased interest in recent years. This process evaluation examines the acceptability, fidelity and dose delivered of the pilot of LifeLab Dublin: a nine-week, school-based HL intervention for low socioeconomic adolescents. The intervention, which comprised of two out-of-school, interactive HL experiences in conjunction with seven school-based lessons, took place between September and December in 2021 and involved students aged 11 - 13. The health issues targeted were previously identified by the teachers and students of the target population, and the learning activities within the out-of-school experiences were co-designed by adolescents of a similar demographic. Overall, the intervention was perceived positively by the students and teachers, particularly the two interactive out-of-school experiences. The teachers, however, highlighted issues with the volume and content of the school-based lessons, resulting in a reduced number of lessons being delivered. The fidelity of the two LifeLab experiences was high, demonstrating that the students engaged well with the learning activities and that the experience aligned with LifeLab’s core principles and underpinning theoretical constructs. The findings from this study highlight the value in implementing experiential style learning in school-based HL education and the benefit of involving participants in the design of intervention. The evaluation provided valuable insight into the refinements required to enhance the efficacy of the intervention, as well as providing an evidence-base to inform future school-based HL interventions for low socioeconomic adolescents.

Key messages

• The benefit of adopting experiential style health literacy education with young people.

• The benefit of including young people in the design of a health literacy intervention.
An update on the concept and importance of health literacy in young people
Authors: Smith C , Belton S , Meegan S , Behan S , Goss H R
Published: October 2024

The burden of non-communicable diseases is a growing public health crisis that requires immediate action. As health literacy (HL) has been strongly linked with health behaviours and health outcomes, it has many potential implications for health care and health education. Although recent research has emphasised the importance of developing HL early in life, much of the research has focused on understanding and improving HL in adult populations. As young people socialise in different contexts and are exposed to different health-related situations, they require different HL competencies. As part of a wider project, this study aims to gather the perceptions of international academics and community-based practitioners on the concept and importance of HL in and for young people. Specifically, the study aims to (i) explore current understandings of the concept of HL in young people; (ii) examine the importance of HL for young people; (iii) identify those at risk of having low levels of HL; and (iv) determine the specific health behaviours that young people are currently struggling with. A stakeholder mapping exercise was used to recruit academic and community-based practitioners to take part in a one-to-one interview (n = 29). Reflexive thematic analysis was used to analyse the data. The preliminary findings suggest that HL is a very broad yet individualised concept that is critical to develop at an early age given the difficulty young people face in adopting healthy behaviours in their social and physical environment. Furthermore, the participants highlighted that minority groups, such as members of the travelling community and refugees, and those from low socioeconomic populations, are at greatest risk of low HL. Finally, the health issues that appeared to be of most concern in young people were vaping, social media use and poor mental health. These findings can be used to inform appropriate interventions and policies to target the HL of young people.

Key messages

• Health literacy is a very, yet individualised, concept that is critical to develop given the difficulty young people face in adopting healthy behaviours in their social and physical environment.

• Minority groups, such as members of the travelling community, refugees, and those from low socioeconomic populations are at greatest risk of low levels of health literacy.
Beyond the like button: how european public health institutions use social media in 2024?
Authors: Vital Brito D , Garcia A
Published: October 2024

Background

In 2024, 62% of world’s population actively use social media (SM), with people aged 16 to 64 spending an average of 2 hours and 23 minutes daily across 6,7 SM platforms - most people use Facebook but spend more time on TikTok. While these platforms are essential for disseminating public health information, this study aims to explore their use by public health institutions in European countries.

Methods

We analysed the SM engagement of 32 health institutions recognized by ECDC across 29 European countries. Data collected focused on Facebook, Instagram, X, LinkedIn, TikTok, and YouTube, including SM presence on official websites, number of followers, and posts from January to March 2024. Additional data included followers per 100.000 residents, with population statistics from Worldometer and SM usage from DataReportal.

Results

Most institutions (30) are active on SM, particularly on Facebook (28), X (23), Instagram (22), YouTube (22), and LinkedIn (21). Spain and Slovenia’s institutions are active on all analysed platforms, while only four institutions are on TikTok. The most used platforms were Facebook and X, with averages of 59,7 and 58,1 publications, respectively. There are disparities in engagement across platforms, with Facebook having the highest average followers (177.241) and TikTok the lowest (1.961) among all platforms. Notably, the most followed platform within ten institutions did not match country’s most popular platform, indicating a misalignment in SM platforms’ strategy. There was an average of 2.756 followers per 100.000 residents among analysed countries.

Conclusions

Public health institutions in Europe are actively using SM platforms to disseminate health information, mainly Facebook, X, LinkedIn, and Instagram. Despite high engagement on Facebook and X, there is a need for strategic alignment with audience’s preferences, particularly in underutilized platforms like TikTok, to optimize the effectiveness of public health communication.

Key messages

• The majority of European public health institutions actively use social media, with Facebook leading; however, newer platforms like TikTok are underutilized.

• There is a need for public health institutions to realign their social media strategies to better match the platforms preferred by their audiences to maximize the effectiveness of their communication.
Defining digital health literacy profiles in Spanish adults: a latent class analysis
Authors: Hernández Encuentra E , Bas-Sarmiento P , Fernández-Gutiérrez M , González-Caballero J L , Montagni I
Published: October 2024

Background

According to different reports, Spain is among the European countries that use digital health technologies the most. However, to develop inclusive and fair digital health services, there is the need to feature digital health knowledge, skills, confidence, and a positive attitude about their significance. This work aims to draw a picture of digital health literacy levels in Spain.

Methods

A stratified sample of the Spanish population regarding gender, age group and area of residence was used. Participants were recruited from an online panel and by direct approach to balance quotas. Between May 2021- May 2022, participants filled a self-administered online survey, including the Spanish version of the eHealth Literacy Questionnaire (eHLQ) and the eHealth Literacy Scale (eHEALS).

Results

Digital health literacy showed similar mean scores, between 2.6-2.7 out of 5 with similar SD on each of the 7 dimensions of the eHLQ. The highest scores were related to knowledge about filling data in digital health services and knowledge about health and how the body works, and feelings about the usefulness of digital technology for health. In contrast, lower scores were related to sharing health information by technology, thinking that using technology gives access to better health services, and the possibility to contact usual health professionals with technology. Latent profile analysis identified 5 user profiles. Significant differences were found according to age, inhabitants per municipality, technology use, self-perceived health status, educational level, socioeconomic index and eHEALS scores; not by gender.

Conclusions

As the scores are similar in the different subscales, competencies, attitudes and confidence in digital health that they measure are balanced. However, the main challenge appears in granting users access to digital services that work, which involves the definition and monitoring of strategies until the final implementation.

Key messages

• Digital Health literacy in Spain differs according to different aspects, not only age, educational or socioeconomic level.

• Confidence in usefulness is a common denominator among the five digital health service user profiles identified.
The empowering role of health literacy in combatting fake news, misinformation and infodemics
Authors: Beese A-S , Guggiari E , Jaks R , De Gani S M
Published: October 2024

Background

In times of the rapid digital transformation, people need to acquire specific knowledge, skills and attitudes to deal with data, digital information and technology. Such skills are particularly important in times of crisis, as the COVID-19 pandemic has shown. Alongside the pandemic, a so called “infodemic” has emerged, i.e., an overabundance of information, accompanied by misinformation, which impedes sound decision-making processes, affects health literacy (HL) and impacts public health. However, while misinformation poses a well-known threat to our health and well-being, we still lack viable concepts and approaches to satisfactorily solving this issue. Thus, we aimed at reviewing the concept of HL in view of the infodemic and health-related challenges.

Methods

In a 12-month participatory process in Switzerland in 2023, we investigated the empowering role of HL in light of the polycrisis. On behalf of the Swiss Federal Office of Public Health, we conducted a literature review on existing HL definitions. Then, we conducted 6 expert interviews and 2 focus group interviews with other 10 experts in HL and associated domains, which guided and informed the review process.

Results

As a result, HL can be understood as a bundle of competencies to proactively deal with health-related information, services, and challenges and thereby empowers people to manage their and other’s health and well-being. Thus, HL empowers people to better manage digital information and services and promotes critical thinking. This in turn is necessary to assess information quality, uncover misinformation and to adequately manage health data and information.

Conclusions

HL represents a crucial prerequisite for individuals, professionals, and decision-makers to find trustworthy health information, to reflect upon the quality and credibility of sources and content, and to understand the complex interrelations of the determinants of health and is therefore crucial for public health.

Key messages

• Health literacy empowers people to adequately deal with fake news, misinformation and infodemics.

• Strengthening health literacy offers great potential for public health to promote critical thinking and to rebuild trust.
Development and validation of a tool for assessing breast cancer health literacy among Chinese women
Authors: Chenyang P , Yuanli L
Published: October 2024

Background

Breast cancer (BC) is a major malignancy that seriously threatens women’s health. No unified, evidence-based, standardized assessment tools for BC literacy are available in China yet.

Objectives

We sought to develop an assessment tool to measure BC health literacy among Chinese women and to test the tool’s reliability, validity, and feasibility.

Methods

Group discussion, expert consultation, and small-sample pilot investigation were conducted to develop an initial assessment tool. A multi-stage stratified random-sampling process was used to select women aged 18-64 years in Yichang City, Hubei Province, China, for an onsite survey. Project analysis and exploratory factor analysis were used to screen the questions to create a formal assessment tool, which was further evaluated by feasibility analysis and the measurement of reliability and validity.

Results

The official version of the assessment tool for Chinese female BC health literacy includes 32 items. Nine common factors (policy knowledge, uncorrectable risk factors, modifiable risk factors, identification of early warning signs #1 and #2, screening methods, breast self-awareness and examination behaviors, timely seeking of medical help and standardized treatment, and rehabilitation) were extracted through exploratory factor analysis with factor loadings of 0.511-0.873 and a cumulative explained variance of 65.989%. Confirmatory factor analysis revealed χ2/df = 1.61, CFI = 0.91, TLI = 0.90, RMSEA = 0.04, and SRMR = 0.06. The overall Cronbach’s α coefficient was 0.875, and the split-half reliability was 0.770 (both >0.700).

Conclusions

An assessment tool for Chinese female BC health literacy was developed with acceptable feasibility, reliability, and validity. The application of this tool can help to promote BC prevention and control in China and may also benefit other countries.

Key messages

• An assessment tool for Chinese female BC health literacy was developed with acceptable feasibility, reliability, and validity.

• The application of this tool can help to promote BC prevention and control in China and may also benefit other countries.
Factors Influencing Health Literacy among South Korean Adults: A Nationwide Study
Authors: Kim J E , Bae Y , Song I H
Published: October 2024

Background

Health literacy is crucial for health knowledge, behaviors, and outcomes, but research on health literacy has been limited to specific populations and settings in South Korea. This study aimed to identify factors influencing health literacy in a nationally representative sample of South Korean adults to inform public policies.

Methods

This cross-sectional study utilized data from the 2020 Korea Health Panel survey (10,262 adults aged 18-84 years). Sociodemographic factors (age, gender, education level, monthly household income, employment status, marital status, household characteristics, and region) and health (subjective health status, presence of chronic diseases, depression, and health insurance status) factors were examined. Health literacy was assessed using the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16). Linear regression analysis was performed to identify factors associated with health literacy.

Results

The mean health literacy score was 9.1 (SD 1.60), with significant differences across age groups (p < 0.001). Linear regression analysis (adjusted R2=0.287, F = 322.83, P < 0.001) revealed that higher age, female gender, lower education, lower household income, being single, living outside a metropolitan area, having chronic diseases, lower subjective health, depression, and being uninsured or receiving medical aid were significantly associated with lower health literacy (all p < 0.001).

Conclusions

This study identified several socio-economic and health-related factors significantly associated with health literacy among South Korean adults. The findings suggest that older individuals, who may require more time to understand and use health information, are particularly vulnerable to low health literacy. These results provide valuable insights for developing targeted interventions and public health policies aimed at promoting health literacy and successful aging in the context of a rapidly aging society.

Key messages

• Various socio-economic and health-related factors significantly influence health literacy among South Korean adults.

• Older individuals are particularly vulnerable to low health literacy, which has implications for successful aging in a rapidly aging society.
How to measure Organizational Vaccine Literacy: an exploratory cross-country survey
Authors: Bellini A , Russo M L , Aloise I , Marchetti G , Scarso S , De Marchi C , Bartolucci C , Tosti M E , Declich S , Marceca M
Published: October 2024

Background

The project AcToVax4NAM (Grant No. 101018349-3° EU Health Programme) aims to ensure equal and guaranteed access to vaccination services for Newly Arrived Migrants (NAMs). The working group developed a tool that measured the level of Organizational Vaccine Literacy (OVL), defined as an organizational effort to make the Health System easier to access and navigate, thereby facilitating informed decision-making regarding vaccinations for individuals, families and communities.

Methods

A systematic literature review was undertaken to identify validated tools for measuring OVL, but none was found. Consequently, the review was broadened to include tools for assessing Organizational Health Literacy, which were then adapted to define OVL. A questionnaire consisting of 22 questions divided into 7 sections was developed, utilizing a scale of 1 to 5 to gauge OVL. The survey was then distributed among healthcare services in 8 countries of the AcToVax4NAM consortium.

Results

We received 88 responses, mainly from Italy (26%), Spain (23%) and Greece (12%), encompassing 17 facilities, primarily vaccination centers and health prevention departments. Questions about the clarity and easy access to vaccination information provided by organizations had high mean scores, except the questions on the navigability of websites for foreign patients (mean scores < 3). Notably, responses related to the issue of cross-sectoral collaboration between health services and other partners (e.g., patient associations, NGOs), had a mean score of 2.56. Low scores were observed in the area related to the perception of possible individual contribution to systemic organizational efforts.

Conclusions

Shifting to an approach in which organizations prioritize equity and address complex needs, rather than leaving it to individuals to navigate the complex world of healthcare providers, could bring benefits to population groups, particularly those at risk of not accessing prevention services, such as NAMs.

Key messages

• After conducting a systematic review to identify validated instruments for the measure of Organizational Vaccine Literacy (OVL), a tool consisting of 22 questions was developed to measure OVL.

• Shifting to an approach where organizations prioritize equity and address complex needs, rather than leaving it to individual responsibility, could significantly benefit vulnerable population.
Project Health Resilience: a health literacy programme for 16–19-year-olds delivered by doctors
Authors: Grindlay A , Marks D , Zuriaga Alvaro A , Rau C , Lewis C , Landy G , Cross A , Dillon C , Mortlock M , Weil L
Published: October 2024

Background

Project Health Resilience is an education-setting based health literacy pilot for Londoners aged 16-19. This is a transitional age when young people independently engage with health services. Greater health literacy levels improve use of preventive services, successful management of long-term health conditions and reduce emergency service use. Research during the COVID pandemic also demonstrated the importance of building trust with health professionals to reduce health inequalities. The impact of poor health literacy is observed universally. This intervention was developed to empower young people at a critical time.

Methods

3 bespoke modules (healthcare access; medical emergencies; mental health resilience) were co-produced with young people and delivered by doctors. During 2023, 46 sessions were carried out with 712 attendances across 8 London settings. A mixed-methods approach, including questionnaires and interviews, was used for the evaluation. The study explored whether taking part resulted in increased awareness of services, knowledge, confidence and trust in health professionals.

Results

Participants reported that topics filled a crucial gap in their learning. Awareness and confidence increased for: awareness of different health services (increase of 18%) and mental health services (38%), confidence calling emergency services (13%), confidence dealing with medical (34%) or mental health emergencies (40%). Knowledge questions answered correctly increased across the 3 modules (46% pre vs 60% post). Trust levels increased and findings suggest that doctors delivering sessions was a key component.

Conclusions

Findings add to the evidence base around education-setting based health interventions improving health literacy. Providing a unique opportunity for adolescents to engage with health professionals can increase trust levels. Doctors delivering health education at this critical age is a pioneering model which can be replicated in other settings.

Key messages

• Health literacy education is particularly impactful at this critical age of transition; this can contribute to reducing health inequities across the life course.

• Trust, collaboration, and co-production were core principles upon which this pilot thrived. Without input from young people, it is difficult to design appropriate and impactful interventions.
Co-designed Health Literacy Activities for Children in Primary Schools
Authors: van Boxtel W , Jerković-Ćosić K , Chin A Paw M
Published: October 2024

Early exposure to health literacy (HL) and fostering children’s HL development for health promotion purposes is believed to positively influence their ability to lead healthier lives during adulthood (WHO, 2021). Our qualitative study on children’s perspectives on health and HL showed that children perceive health in a broader context emphasizing aspects of everyday life. When engaging with health information, they often encounter irrelevant information and struggle to discern its trustworthiness (van Boxtel et al., in preparation). In this study, we aim to co-design HL activities with children in primary school for the context of health promotion. Children, aged 9-12 years, formed co-design teams and participated in six 1-hour sessions. Initially, they discussed what HL is and selected the most relevant HL skills to address. Through activities like body mapping, they explored ways to learn these skills. Subsequent sessions involved brainstorming ideas for the designing, and prototyping activities. A larger group of children tested these prototypes, followed by evaluations and improvements by the design team. Preliminary results indicate that children prefer designing HL activities that resonate with their everyday experiences. However, they often relied on familiar ideas unless aided to think creatively, therefore we used AI tools for ideation. The final designs, such as life-sized board game about healthy food, show potential to learn HL in schools. Results of the learning outcomes from these activities are pending and will be presented at the conference. Co-designing with children leads to meaningful HL activities that encourage active engagement with health information. This study inspired us to build a toolbox for learning HL skills for children aged 9-12-years-old in primary schools or childcare settings. We also aim to co-design other identified HL skills and competencies from our Delphi study (Van Boxtel et al., in preparation).

Key messages

• HL activities co-designed by children reflect daily life relevance, fostering deeper engagement and learning.

• Using co-design, we enable children to actively engage with health information and learn specific HL skills.
Systematic review of the Health Literacy Questionnaire (HLQ) for global health literacy development
Authors: Hawkins M , Cartner S , Cheng C , Osborne R H
Published: October 2024

Background

The Health Literacy Questionnaire (HLQ) is used to inform programs and policies in more than 80 countries. It is a key needs assessment in the Ophelia (Optimising Health Literacy and Access) process, a codesign process to build effective interventions. Ophelia is applied in the European Commission Joint Action on Cardiovascular Diseases and Diabetes initiative (25 projects/13 countries). Given growing demand, an Ophelia digital platform is being developed, and confirmation of robust HLQ psychometric evidence is needed for user confidence in the interpretation and use of HLQ scores in their contexts. This study is a review of the HLQ.

Methods

Developed in Australia in 2013, the HLQ measures nine health literacy domains and is translated to 40 languages. A March 2024 PRISMA systematic search (PROSPERO CRD42022361966) identified 257 articles, which were screened for evidence about internal structure and reliability.

Results

Across 15 countries/languages, 22 articles were included. Study samples included diverse groups, settings and contexts. Out of the 18 studies that used factor analysis, three used the Bayesian approach. All 15 classical factor analysis studies reported satisfactory fit indices in restricted 9-factor models (range CFI=0.841 to 0.995, TLI=0.826 to 0.969, RMSEA=0.048 to 0.084), except two required correlated residuals for acceptable fit indices. Factor loadings were significant except for five items across five studies (range .20 to .99). Three studies used Rasch modelling and found all domains had unidimensionality except for Domain 9 in one study. Most studies reported Cronbach’s alpha (range .57 to .95) across all domains, with only three studies reporting α<.7.

Conclusions

The HLQ has exceptional robust psychometric properties across cultures and languages, paving the way for users to have confidence in HLQ psychometric validity evidence on the upcoming Digital Ophelia platform to support scaling up of health literacy development.

Key messages

• The HLQ has robust psychometric properties across countries and languages.

• The HLQ 9-domain profiles can inform intervention development for equitable health outcomes.
Associations between maternal health literacy and prenatal micronutrient intake in Hungarian women
Authors: Sisák A , Szabó A , Máté Z S , Molnár R , Németh G , Orvos H , Paulik E
Published: October 2024

Background

Adequate level of health literacy (HL) is an important factor in pregnancy. Low HL may increase the risk of maternal and fetal complications (e.g., gestational diabetes mellitus, low birth weight). This study aimed to measure the levels of maternal HL and its associations with the consumption of folic acid (FoA), vitamin D (VD), and omega-3 fatty acids (FAs) during pregnancy in Hungarian women.

Methods

The questionnaire-based study was conducted at the Department of Obstetrics and Gynecology, University of Szeged among women who gave birth between June and September 2023 (N = 294). Sociodemographic, lifestyle, conception and pregnancy related questions were asked. HL was measured by the Maternal Health Literacy Inventory in Pregnancy (MHELIP) questionnaire (after the Hungarian adaptation); it contains 48 items representing four subscales (maternal health knowledge, search for maternal health information, assessment of maternal health information, and maternal health decision making and behavior). Data analysis was performed by SPSS 29.0. (Ethical permission: 5351)

Results

The mean age of women was 31.53 +-4.75 years. During pregnancy 84.5% of women consumed FoA, 61.8% VD and 41.8% omega-3 FAs. The total mean score of MHELIP on a scale 0-100 was 78.93 (95%CI: 77.77-80.08); the score of “search for maternal health information” subscale was the lowest [57.68 (95%CI: 56.20-59.16)], and the score of “maternal health decision making and behavior” was the highest [86.75 (95%CI: 85.62-87.87)]. Omega-3 FAs and VD consumption was significantly higher in women with higher total and subscales mean scores (except “search for maternal health information”), while FoA consumption was significant in case of “assessment of maternal health information”. (The results are preliminary.)

Conclusions

The association between micronutrient consumption and HL supports that using this tool during pregnancy the mothers who needs more support and health information can be identified.

Key messages

• The Maternal Health Literacy Inventory in Pregnancy questionnaire is a reliable tool for measuring health literacy in Hungarian pregnant women.

• Maternal health literacy plays an important role in the healthier lifestyle, including prenatal vitamin/micronutrient consumption.
Association between family empowerment and health literacy among parents with preschool children
Authors: Yanagi N , Satoh H , Sawada Y
Published: October 2024

Background

For parents raising children, obtaining information and working together to solve problems in a family, including those related to the child’s health, is vital (family empowerment). Communicative and critical health literacy is the ability to acquire and utilize information through communication and to critically analyze and use it to manage one’s life. This may enhance family empowerment. We aimed to examine the association between family empowerment and health literacy among Japanese parents.

Methods

Data from parents of preschool children aged 3-6 years were collected through an online survey in September 2023. Family empowerment was measured using the Family Empowerment Scale for Parents (FES-P) with five sub-factors (26 items in total) using a 7-point Likert scale. Communicative and critical health literacy was measured using the Communicative and Critical Health Literacy (CCHL) scale, which includes five items on a 5-point Likert scale. Multivariable regression analysis was used to examine this association. Age, sex, education, income, employment status, number and age of children, and family members were used as covariates.

Results

Participants included 600 fathers and 600 mothers. The mean FES-P score was 116.5 (SD 23.0) and the mean CCHL score was 3.50 (SD 0.69). In the crude model, CCHL was statistically significantly associated with FES-P and all five sub-factors, such as ‘relationship within the family’. After adjustment for all covariates, the association remained significant for FES-P (beta=0.28, p < 0.001) and sub-factors such as ‘relationship with the community’. However, ‘recognition and combined use of services’ was not statistically significant (beta=0.05, p = 0.078). The income level showed a significant association with family empowerment and all sub-factors, independent of health literacy.

Conclusions

Health literacy was associated with family empowerment. Improving health literacy could contribute to strengthening family empowerment.

Key messages

• Improving health literacy could contribute to strengthening family empowerment.

• Financial support may be needed to strengthen family empowerment since income level was associated with it.
Knowledge and perspectives about medicinal cannabis in nurses and nursing students in Portugal
Authors: Cunha-Oliveira A , Paiva C , Santos T , Rosendo I , Rui Pita J
Published: October 2024

Background

The opening up of legislation on medicinal cannabis in recent years has been a determining factor in the growth of this therapy. In Europe, regulation of medicinal use is a reality in several countries. Nurses can play a leading role in its administration, helping to ensure that it is carried out more effectively and assuming a fundamental role in the success of the therapy. It is therefore pertinent to analyze the knowledge of nurses and nursing students in Portugal about medicinal cannabis.

Methods

Quantitative descriptive study. A self-completion questionnaire was drawn up and made available on the google forms platform. It was face-validated, content-validated and approved by the Ethics Committee. The instrument included sociodemographic data, questions about cannabis knowledge and perspectives. Descriptive statistics were analyzed.

Results

Out of a total of 610 responses, 318 were nurses and 292 nursing students. Medical cannabis is considered legitimate by 79.6% of nurses and 84.3% of students. When asked about the functions of the endocannabinoid system, 71.7% of nurses and 79.5% of students said they had no knowledge. 88.7% of nurses and 79.5% of students disagreed that they had sufficient knowledge to advise users on the use of medicinal cannabis. Also, 38.4% believe that their patients use cannabis illegally to manage the symptoms of illnesses.

Conclusions

There is a need for continuing training for nurses and for the undergraduate and postgraduate nursing curricula to include this emerging area.

Key messages

• The results show that this issue is a public health problem. It reinforces the need to formulate public policies in this area and to implement training for nurses and nursing students.

• These measures will be fundamental in preventing the use of illegal cannabis and promoting the safe use of medicinal cannabis.
Prevalence of Tooth Decay and Related Factors Among Primary School Children
Authors: Ghali H , Bhiri S , Souai S , Khouya F , Maatoug A , Selmi H , Youssef K , Ben Rejeb M , Latiri H , Ben Cheikh A
Published: October 2024

Introduction

Tooth decay is considered the fourth most important public health problem in the world. According to the latest studies, the prevalence of this disease is also important in school children. The interest of this work is to study the prevalence of dental caries and its influencing factors in primary school children in the city of Sousse (Tunisia) and to formulate recommendations for the prevention of this phenomenon.

Methods

It is a cross-sectional study conducted among pupils enrolled from 1st and 3rd grade of 3 primary schools in the city of Sousse in April 2022 through a questionnaire filled out by the pupils.

Results

A total of 376 participated in the study. Among them, 52,4% were male. The mean age was 7.4 ± 1.2 years. The prevalence of dental caries in our population was 43.9%. Many factors were associated with dental caries including pupils from public schools (p = 0.000), poor oral hygiene: [lack of tooth brushing (p = 0.000), tooth brushing only 1 time per day (p = 0.000), eating in the evening after brushing the teeth (p = 0.000), lack of changing the toothbrush (p = 0.000)] and unhealthy eating habits (p ≤ 0.05). Consequently, dental caries was significantly higher among children with overweight body mass index (BMI) (90.9%; p = 0.016).

Conclusions

The organization of awareness and information days in schools, the integration of an education program on preventive measures against this phenomenon and the generalization of screening campaigns to detect this disease are necessary measures that should be carried out according to a well determined strategy.

Key messages

• Dental caries prevalence among primary school children in Sousse is significant, highlighting the urgent need for preventive measures.

• Factors such as poor oral hygiene, unhealthy eating habits, and attending public schools contribute to the prevalence of dental caries.
What does international evidence tell us about the health of people with childhood social care (CSC) experiences?
Authors: Allik M , Bradford D
Published: October 2024

International research into the health of people with childhood social care (CSC) experiences has found evidence of worse mental health and emotional-behavioural wellbeing, higher rates of substance use, neurodevelopmental conditions, and avoidable mortality. Lower vaccination rates and worse dental health among those in care has also been reported in few countries. However, research results have been more mixed with regard to some physical health conditions, with higher prevalence of asthma and respiratory ill health among foster children reported in the US but no obvious differences found in the UK. Are there countries where these inequalities are less pronounced, and can we draw such conclusions based on available evidence? When making international comparisons or aiming to give policy advice, we also need to consider the quality of our evidence. Has this been based on small sample sizes or without comparison to other children and adjusting for relevant (socioeconomic) confounders? Most of our current knowledge is also cross-sectional and we do not know if some health conditions precede entry to care and may even be risk-factors for entering social care. Recent longitudinal and cross-sectoral data linkage programmes in many nations (Australia, UK, Canada) have a potential to change this and provide a foundation for evidence-based recommendations for policy and practice.
Light Physical Activity Throughout the Day and Physical Function in Older Adults
Authors: Kim D , Lai T , Liao Y , Park J , Sung M , Jang M , Shin Y , Park H
Published: October 2024

Background

Light physical activity (LPA) plays a crucial role in preventing muscle loss and disability in older adults. Since LPA makes up a significant portion of daily activity, understanding how the timing of LPA influences physical function is important for designing effective health interventions.

Methods

This cross-sectional study investigated the association between the timing of LPA and physical function among 200 older adults (mean age 76.3, 55.5% female) attending the geriatric outpatient clinic at National Taiwan University Hospital. LPA was objectively measured using wrist-worn accelerometers for seven consecutive days. Principal component analysis (PCA) was used to identify distinct patterns of LPA timing. Participants underwent assessments of grip strength, basic mobility, walking speed, and lower limb muscle strength. Multivariable linear regression models were adjusted for potential confounders, including gender, age, moderate-to-vigorous physical activity (MVPA), and accelerometer wear time.

Results

Our findings revealed that higher levels of LPA during the morning to noon period were positively associated with better performance across all four physical function tests. Moreover, after controlling for relevant confounders, increased LPA in the late afternoon and evening was positively associated with enhanced basic mobility, walking speed, and lower limb muscle strength.

Conclusions

This study highlights the importance of considering LPA timing when promoting physical function in older adults, independent of MVPA participation. Encouraging LPA, particularly during the morning to noon period, could be a valuable strategy for maintaining and improving physical capabilities in this population. These findings provide actionable insights for clinicians and health professionals when tailoring physical activity recommendations for older adults within geriatric care settings.

Key messages

• Morning LPA boosts physical function in seniors, enhancing grip, mobility, walking speed, and muscle strength.

• Timing of light activity crucial for older adults’ physical health, with morning to noon activity showing most benefits.
Lesson from the Covid-19 pandemic: do fear and anxiety lower vaccination hesitancy?
Authors: Crnkovič N , Selak Š
Published: October 2024

Background

The prevalence of vaccination hesitancy has become one of the top ten global health problems. During the Covid-19 pandemic several studies reported negative correlation of vaccination hesitancy with fear of Covid-19 and anxiety. Therefore, the study aimed to explore how fear and anxiety can impact one’s intent to get vaccinated.

Methods

In 2021, data from 5999 post-secondary Slovenian students was gathered using a cross-sectional online survey. Binary logistic regression and the Sprearman correlation coefficient was used to explore the relation between Fear of Covid-19 Scale (FCOV), Generalized Anxiety Disorder Questionnaire (ANX) and a question regarding participants’ intentions to get vaccinated.

Results

Results showed that only 39.7% of students expressed intention to get vaccinated as soon as possible and 29.2% exhibited no intentions to do so. Logistic regression indicated that only FCOV had a mild and significant (p < 0.001) impact on students’ intentions to get vaccinated, whereas ANX was found to have only a weak significant (p < 0.01) effect on students’ intentions to do so. Similarly, ANOVA test showed significant differences with small to medium effect of FCOV on intentions to get vaccinated, but no significant differences were found for ANX.

Conclusions

A low percentage of Slovenian tertiary students expressed intentions to get vaccinated as soon as possible for Covid-19, with only fear having been found to have a small to mild effect on students’ intentions to do so. Anxiety, on the other hand, was found to have a small positively predictive effect on vaccination hesitancy, which could reflect affective forecasting error (i.e. believing that the negative consequences of getting vaccinated would be greater than they really are). Therefore, when considering strategies to address the increasing problem of vaccination hesitancy, one must keep in mind that the loss-framed messages might not be sufficient to prompt people to get vaccinated.

Key messages

• Fear of Covid-19 had only a small to medium significant positive effect on students’ expressed intentions to get vaccinated as soon as possible.

• The loss-framed messages might not be sufficient to prompt people to get vaccinated.