WHO Health Promotion Glossary: new terms

The WHO Health Promotion Glossary was written to facilitate understanding, communication and cooperation among those engaged in health promotion at the local, regional, national and global levels. Two editions of the Glossary have been released, the first in 1986 and the second in 1998, and continued revision of the document is necessary to promote consensus regarding meanings and to take account of developments in thinking and practice. In this update 10 new terms that are to be included in the Glossary are presented. Criteria for the inclusion of terms in the Glossary are that they differentiate health promotion from other health concepts, or have a specific application or meaning when used in relation to health promotion. The terms defined here are: burden of disease; capacity building; evidence-based health promotion; global health; health impact assessment; needs assessment; self-efficacy; social marketing; sustainable health promotion strategies, and; wellness. WHO will continue to periodically update the Health Promotion Glossary to ensure its relevance to the international health promotion communit

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

Addressing health literacy in patient decision aids

MethodsWe reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews.ResultsAim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which health literacy needs were addressed.ConclusionLower health literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower health literacy users. The specific effects of PtDAs designed to mitigate the influence of low health literacy are unknown. More attention to the needs of patients with lower health literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher health literacy patients

The Impact of the Chronic Disease Self-Management Program on Health Literacy: A Pre-Post Study Using a Multi-Dimensional Health Literacy Instrument.

This study assessed the impact of the Chronic Disease Self-Management Program (CDSMP) on different domains of health literacy using a pre-post study design. Participants aged over 16 years and with one or more self-reported chronic diseases were recruited for the CDSMP in western Sydney (a highly diverse area of New South Wales, Australia) between October 2014 and September 2018. Health literacy was assessed pre- and immediately post-intervention using the Health Literacy Questionnaire (HLQ), with differences in mean scores for each HLQ domain analysed using paired sample t-tests. A total of 486 participants were recruited into the CDSMP. Of those, 316 (65.0%) completed both pre- and post-intervention surveys and were included in the analysis. The median age of the participants was 68 years, the majority were female (62.5%), and most were born in a country other than Australia (80.6%). There were statistically significant (p < 0.001) improvements across all nine domains of the HLQ. This is the first study evaluating the potential impact of the CDSMP on improving different domains of health literacy amongst a diverse sample of participants with chronic diseases using a multi-dimensional instrument. The absence of a control population in this study warrants caution when interpreting the results

Translating Developmental Origins:Improving the Health of Women and Their Children Using a Sustainable Approach to Behaviour Change

Theories of the developmental origins of health and disease imply that optimising the growth and development of babies is an essential route to improving the health of populations. A key factor in the growth of babies is the nutritional status of their mothers. Since women from more disadvantaged backgrounds have poorer quality diets and the worst pregnancy outcomes, they need to be a particular focus. The behavioural sciences have made a substantial contribution to the development of interventions to support dietary changes in disadvantaged women. Translation of such interventions into routine practice is an ideal that is rarely achieved, however. This paper illustrates how re-orientating health and social care services towards an empowerment approach to behaviour change might underpin a new developmental focus to improving long-term health, using learning from a community-based intervention to improve the diets and lifestyles of disadvantaged women. The Southampton Initiative for Health aimed to improve the diets and lifestyles of women of child-bearing age through training health and social care practitioners in skills to support behaviour change. Analysis illustrates the necessary steps in mounting such an intervention: building trust; matching agendas and changing culture. The Southampton Initiative for Health demonstrates that developing sustainable; workable interventions and effective community partnerships; requires commitment beginning long before intervention delivery but is key to the translation of developmental origins research into improvements in human health

Addressing health literacy in patient decision aids

BackgroundEffective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess:1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations.MethodsWe reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews.ResultsAim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which health literacy needs were addressed.ConclusionLower health literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower health literacy users. The specific effects of PtDAs designed to mitigate the influence of low health literacy are unknown. More attention to the needs of patients with lower health literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher health literacy patients

Mapping Health Literacy Research in the European Union: A Bibliometric Analysis

Background: To examine and compare the research productivity on selected fields related to health literacy of the curren

Hezhen Conversational Text (3)

欧文抄録:P.326Hezhen is a Tungusic language spoken by the Hezhen living in Heilongjiang Province in China. The Hezhen population is currently about 4600. Less than 10 Hezhen can speak their native language. This paper presents the transcript of a conversation between two such native speakers, You Wenlan and He Shuzhen, recorded at Jiejinkou village in Heilongjiang Province in China on August 13, 2013. You Wenlan, a Kilen dialect speaker, was born in 1946 in Qindeli village; and He Shuzhen, also a Kilen dialect speaker, was born in 1937 in Fujin village.The length of their conversation was about 35 minutes, and the topics including: the weather, flood, constructions of the Jijingkou village, if vegetables are growing well or not, rumours of the villagers and the health problems concerning talkers themselves