Tobacco still a major killer-will we achieve the end game?

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Health Literacy, Diabetes Prevention, and Self-Management

International audienceOBJECTIVE:To identify the factors that can predict physicians' use of electronic prescribing.DESIGN:All primary care physicians who practised in a single geographic region in Quebec were invited to use a free, advanced, research-based electronic prescribing and drug management system. This natural experiment was studied with an expansion of the Technology Acceptance Model (TAM), which was used to explain early adopters' use of this electronic prescribing technology.SETTING:Quebec city region.PARTICIPANTS:A total of 61 primary care physicians who practised in a single geographic region where there was no electronic prescribing.MAIN OUTCOME MEASURES:Actual use of electronic prescribing; physicians' perceptions of and intentions to use electronic prescribing; physician and practice characteristics.RESULTS:During the 9-month study period, 61 primary care physicians located in 26 practice sites used electronic prescribing to write 15 160 electronic prescriptions for 18 604 patients. Physician electronic prescribing rates varied considerably, from a low of 0 to a high of 75 per 100 patient visits, with a mean utilization rate of 30 per 100 patient visits. Overall, 34% of the variance in the use of electronic prescribing was explained by the expanded TAM. Computer experience (P=.001), physicians' information-acquisition style (P=.01), and mean medication use in the practice (P=.02) were significant predictors. Other TAM factors that generally predict new technology adoption (eg, intention to use, perceived ease of use, and perceived usefulness) were not predictive in this study.CONCLUSION:The adoption of electronic prescribing was a highly challenging task, even among early adopters. The insight that this pilot study provides into the determinants of the adoption of electronic prescribing suggests that novel physician-related factors (eg, information-acquisition style) and practice-related variables (eg, prevalence of medication use) influence the adoption of electronic prescribing

Health Literacy in Context—Settings, Media, and Populations

To date, most published health literacy research has focused on assessing and improving personal skills and abilities. More recently, a better understanding has emerged of the extent to which these skills and abilities are mediated by environmental demands and situational complexities — the context in which health literacy is developed and applied. This has led to much greater attention being given to ways of reducing the situational demands and complexity in which an individual makes a health decision. This collection of papers examines current progress in understanding health literacy "in context", by improving our understanding of the mutual impact of a range of social, economic, environmental, and organisational influences on health literacy. These papers provide unique and original perspectives on the concept, distribution, and application of health literacy in very diverse populations, offering cultural insights and a clear indication of the impact of social and environmental context on health literacy. These perspectives include an examination of differing national policy responses to health literacy illustrating how policy and practice can (and should) respond to this more complete but complex understanding of health literacy. Other papers look at the application of new digital media and the creative harnessing of popular culture as routes to extend the reach and customisation of communications. These papers also illustrate good progress in the evolution of research in the contexts in which health literacy is developed and applied, as well as signaling some areas in which more research would be useful

International Handbook of Health Literacy : Research, practice and policy across the lifespan

Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International Handbook of Health Literacy : Research, practice and policy across the lifespan. Bristol: Policy Press, University of Bristol; 2019

Measuring children’s health literacy. Current approaches and challenges

Bollweg TM, Okan O. Measuring children’s health literacy. Current approaches and challenges. In: Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International handbook of health literacy. Research, practice and policy across the life-span. Bristol: Policy Press; 2019: 83-97

Anatomical and functional visual network patterns in progressive multiple sclerosis

The gradual accrual of disability over time in progressive multiple sclerosis is believed to be driven by widespread degeneration. Yet another facet of the problem may reside in the loss of the brain's ability to adapt to the damage incurred as the disease progresses. In this study, we attempted to examine whether changes associated with optic neuritis in the structural and functional visual networks can still be discerned in progressive patients even years after the acute insult. Forty-eight progressive multiple sclerosis patients, 21 with and 27 without prior optic neuritis, underwent structural and functional MRI, including DTI and resting state fMRI. Anatomical and functional visual networks were analyzed using graph theory-based methods. While no functional metrics were significantly different between the two groups, anatomical global efficiency and density were significantly lower in the optic neuritis group, despite no significant difference in lesion load between the groups. We conclude that long-standing distal damage to the optic nerve causes trans-synaptic effects and the early ability of the cortex to adapt may be altered, or possibly nullified. We suggest that this limited ability of the brain to compensate should be considered when attempting to explain the accumulation of disability in progressive multiple sclerosis patients

Assessing organizational health literacy in hospitals and primary health care services-experiences from the M-POHL project

The WHO-Action Network on Measuring Population and Organizational Health Literacy (M-POHL) initiated in 2022 in cooperation with the Health Promoting Hospitals and Health Literate Health Care Organizations working group a project with two main tasks: (1) to translate, culturally adapt and pilot the “International Self-Assessment Tool for Organizational Health Literacy of Hospitals” in as many countries as possible, an instrument which was developed by the “International Working Group Health Promoting Hospitals and Health Literate Health Care Organizations” in 2019, and (2) to develop a self- assessment tool for organizational health literacy (OHL) in primary health care services, building on existing tools and thereafter translate it into further languages, culturally adapt, and subsequently pilot it in different countries. Many countries in the European region have joined the M-POHL OHL project. The objective of the workshop is to inform on the above-mentioned tools and the study protocol used and to present and discuss national experiences regarding the process and results of translation, cultural adaption, and piloting of the tools with a focus on the feasibility and acceptability of the tools, on possible improvements and suggestions to facilitate a broad uptake of the tools in practice. Key message/Impact: The tools for assessing OHL in hospitals and in primary health care services are designed to support management and staff of hospitals and primary health care services to consider, systematically assess, and improve the health literacy responsiveness of their organization to better serve their patients, their local population, and support to their staff to integrate health literacy in their roles in the healthcare system. The expected impact of the proposed session is to increase the awareness of OHL and disseminate the respective tools that facilitate the assessment of OHL. Workshop participants can benefit from the experiences gained in the M- POHL project

Navigational health literacy

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