Health literacy in Europe. comparative results of the European health literacy survey (HLS-EU)

Sørensen K, Pelikan JM, Röthlin F, et al. Health literacy in Europe. comparative results of the European health literacy survey (HLS-EU). The European Journal of Public Health. 2015;25(6):1053-1058

Die Republik ausstellen – zur Idee des „Hauses der Geschichte der Republik Österreich“

Österreich gehört zu den Ländern mit der höchsten Museumsdichte in Europa, doch unter den vielen Museen findet sich kein nationalgeschichtliches Museum, das der österreichischen Zeitgeschichte gewidmet wäre. Zwar wurde bereits öfter über ein solches Museum nachgedacht, doch umgesetzt wurden die Ideen entweder nur ansatzweise oder gar nicht. Die aktuelle Debatte, die im Fokus dieser Arbeit steht, begann vor fast zwei Jahrzehnten, als die Idee geboren wurde, das Palais Epstein für ein Museum der österreichischen Zeitgeschichte zu nutzen. Aus dieser Debatte heraus stellt sich die Frage, warum es in Österreich kein nationalgeschichtliches Museum gibt und warum Projekte zu einem Museum der österreichischen Zeitgeschichte, wie etwa der Idee zu einem Haus der Geschichte der Republik Österreich (HGÖ), zu scheitern scheinen. Im Zuge dieser Fragestellungen wird eine soziologische Perspektive auf die Institution Museum eingenommen und die gesellschaftlichen Prozesse, die mit der Entstehung einer solchen Institution verbunden sind, herausgearbeitet, sowie die gesellschaftlichen Funktionen des Museums erörtert. Die aktuelle Debatte um das Haus der Geschichte der Republik Österreich wird aus zwei Perspektiven heraus beleuchtet, zum einen durch die Analyse der öffentlichen Debatten in den Medien als auch durch 6 Gruppendiskussionen, die in Vorarlberg und Wien durchgeführt wurden. Warum es in Österreich kein nationalgeschichtliches Museum gibt, liegt zum einen daran, dass es bereits eines gibt. Zwar ist dieses auf den ersten Blick nicht ersichtlich, da es geographisch zersplittert ist und durch die Summer aller Landesmuseen repräsentiert wird. Zum anderen konnte in dieser Arbeit gezeigt werden, dass die Debatte um das HGÖ im Idee-Stadium verhaftet bleibt, da die Bevölkerung in keinem Schritt miteinbezogen wurde und es weder zu einer Interpretation der Werte noch zu einer Konkretisierung der Leitidee für ein solches Museum kommen konnte.Austria is one of the countries with the greatest concentration of museum in Europe, but among all these different museums, there is no National Museum, that deals with Austria‘s contemporary history. Throughout Austria’s History there have been many attempts to establish such am museum. But none of them were realized. This thesis focuses on the latest debate that started about two decades ago when the idea emerged to use the Palais Epstein as museum for Austria’s contemporary history. Against this background this thesis deals with the research question why Austria doesn’t have a National Museum and why the latest debate seems to come to nothing. In a first step a sociological perspective was drawn on the institution museum and the social processes that are bound to the development of such an institution. The latest debate on the „Haus der Geschichte der Republik Österreich” was looked at from two different perspectives, firstly from the public debate that took place in the media and secondly from the perspective of students that took part in 6 group discussions, in Vorarlberg und Vienna. The resulting outcomes of this thesis are that the reason why Austria does not have a National museum is on the one hand, that it already has one. This finding might seem to be a contradiction to the research question, but looking closely it means that the National museum in Austria can be seen as geographically fragmented and cannot be found under one roof but is more the sum of all regional museums in Austria’s federal states. And on the other side the debate on the „Haus der Geschichte der Republik Österreich“ remains just an idea because the public was not involved in the conception process and therefore the legitimization for the museum is missing

Health literacy in the domain of healthcare among older migrants in Germany (North Rhine-Westphalia). Findings from a cross-sectional-survey

Berens E-M, Ganahl K, Vogt D, Schaeffer D. Health literacy in the domain of healthcare among older migrants in Germany (North Rhine-Westphalia). Findings from a cross-sectional-survey. International Journal of Migration, Health and Social Care. 2021;17(1):62-74.Purpose - Health literacy (HL) is considered an important prerequisite for informed, self-determined health decisions. HL research among older migrants is scarce, but especially important, as older people face great challenges regarding management of chronic illnesses and, therefore, are in need of adequate healthcare. Therefore, this paper aims to report HL in the domain of healthcare (HL-HC) among older migrants in Germany stratified by different countries of origin. Design/methodology/approach - Data were collected by a quota sample in North Rhine-Westphalia, Germany. Computer-assisted personal face-to-face interviews were conducted in German, Russian and Turkish. For this analysis, a subsample of 192 first-generation migrants aged 65-80 years from Turkey, Poland, Greece or Italy was drawn from the main sample (n = 1,000). HL-HC was assessed using a sub-index of health literacy survey European questionnaire 47. Data analyses comprised descriptive statistics, bivariate and multivariate analyses. Findings - Overall, 68.6% of the older migrants have limited HL-HC, and mean HL-HC scores vary significantly among different countries of origin. There is great variation in reported difficulties for the single HL-HC tasks by migrant groups. In multiple regressions, country of origin, not German as main language, low functional HL and low social status are significantly associated with lower HL-HC. Practical implications - Interventions should be aimed at smaller target groups and should consider language issues and possible differences related to countries of origin into account. Both individual skills and system-related aspects need to be addressed. Originality/value - This paper presents first data on HL-HC among older migrants in Germany and its determinants, stratified by different countries of origin

Health Literacy and preferred information resources among immigrants in older age in Germany. Findings from a cross-sectional survey

Berens E-M, Gille S, Vogt D, Ganahl K, Schaeffer D. Health Literacy and preferred information resources among immigrants in older age in Germany. Findings from a cross-sectional survey. Presented at the 4th European Health Literacy Conference, Dublin

Der Einfluss von Gesundheitskompetenz auf die Häufigkeit von Arztkontakten – Ergebnisse des deutschen Health Literacy Surveys

Berens E-M, Ganahl K, Vogt D, Pelikan J, Schaeffer D. Der Einfluss von Gesundheitskompetenz auf die Häufigkeit von Arztkontakten – Ergebnisse des deutschen Health Literacy Surveys. Gesundheitswesen. 2017;79(08/09):656

Health Literacy and Health Service Use in Germany

Berens E-M, Vogt D, Ganahl K, Weishaar H, Pelikan J, Schaeffer D. Health Literacy and Health Service Use in Germany. HLRP: Health Literacy Research and Practice. 2018;2(2):e115-e122

Effects on engagement and health literacy outcomes of Web-based materials promoting physical activity in people with diabetes: an international randomized trial

Background: Developing accessible Web-based materials to support diabetes self-management in people with lower levels of health literacy is a continuing challenge.Objective: The objective of this international study was to develop a Web-based intervention promoting physical activity among people with type 2 diabetes to determine whether audiovisual presentation and interactivity (quizzes, planners, tailoring) could help to overcome the digital divide by making digital interventions accessible and effective for people with all levels of health literacy. This study also aimed to determine whether these materials can improve health literacy outcomes for people with lower levels of health literacy and also be effective for people with higher levels of health literacy.Methods: To assess the impact of interactivity and audiovisual features on usage, engagement, and health literacy outcomes, we designed two versions of a Web-based intervention (one interactive and one plain-text version of the same content) to promote physical activity in people with type 2 diabetes. We randomly assigned participants from the United Kingdom, Austria, Germany, Ireland, and Taiwan to either an interactive or plain-text version of the intervention in English, German, or Mandarin. Intervention usage was objectively recorded by the intervention software. Self-report measures were taken at baseline and follow-up (immediately after participants viewed the intervention) and included measures of health literacy, engagement (website satisfaction and willingness to recommend the intervention to others), and health literacy outcomes (diabetes knowledge, enablement, attitude, perceived behavioral control, and intention to undertake physical activity).Results: In total, 1041 people took part in this study. Of the 1005 who completed health literacy information, 268 (26.67%) had intermediate or low levels of health literacy. The interactive intervention overall did not produce better outcomes than did the plain-text version. Participants in the plain-text intervention group looked at significantly more sections of the intervention (mean difference –0.47, 95% CI –0.64 to –0.30, P&lt;.001), but this did not lead to better outcomes. Health literacy outcomes, including attitudes and intentions to engage in physical activity, significantly improved following the intervention for participants in both intervention groups. These improvements were similar across higher and lower health literacy levels and in all countries. Participants in the interactive intervention group had acquired more diabetes knowledge (mean difference 0.80, 95% CI 0.65-0.94, P&lt;.001). Participants from both groups reported high levels of website satisfaction and would recommend the website to others.Conclusions: Following established practice for simple, clear design and presentation and using a person-based approach to intervention development, with in-depth iterative feedback from users, may be more important than interactivity and audiovisual presentations when developing accessible digital health interventions to improve health literacy outcomes.ClinicalTrial: International Standard Randomized Controlled Trial Number (ISRCTN): 43587048; http://www.isrctn.com/ISRCTN43587048. (Archived by WebCite at http://www.webcitation.org/6nGhaP9bv)</p

Empfehlungen für eine international vergleichbare Erhebung von Gesundheitskompetenz (HLS-Neu) in Österreich

Eine neuerliche Gesundheitskompetenzerhebung (HLS neu) in Österreich hat die wesentliche Aufgabe, die kontinuierliche Entwicklung von Gesundheitskompetenz in der allgemeinen Bevölkerung beobachtbar zu machen und Entwicklungsbedarf zu identifizieren. Damit schließt HLS neu sowohl an nationale (Zielsteuerung, Rahmen-Gesundheitsziele) als auch an internationale (EU: EU-Gesundheitsstrategie; WHO-Europa: Gesundheit 2020, WHO: Schanghai-Deklaration) gesundheitspolitische Zielsetzungen an

Patient level cost of diabetes self-management education programmes: an international evaluation

Objectives The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study.Setting Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel.Participants Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes.Primary and secondary measures Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes.Results We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded.Conclusions This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME