Making a Case for "Education for Health Literacy": An International Perspective.

Vamos S, Okan O, Sentell T, Rootman I. Making a Case for "Education for Health Literacy": An International Perspective. International journal of environmental research and public health. 2020;17(4): 1436.In many countries, health literacy research, practice, and policy have been moving away from a focus only on medical care and health-care settings to a much broader conceptualization. In this broader perspective, health literacy can be obtained and used across many other settings (e.g., school, home, workplaces, government) towards achieving health and wellness goals across the life-course for individuals, families, and communities. The education sector is a critical domain towards these achievements and education for health literacy is a fundamental process and outcome. This can help towards important public health goals, including critical health literacy, as oriented not only towards individual actions, but also towards supporting effective social and political action. This Perspective Article describes the importance and utility of the education for health literacy perspective, which, follows a view that health literacy is a key outcome of health education from which improved population health, health promotion and disease prevention could be achieved across diverse contexts. We first describe different educational paradigms to address health literacy and clarify the education for health literacy perspective as a supportive, instructional and capacity-building global resource across the life-course. Then, using specific examples from Canada, America, and Germany, we provide a snapshot of the diverse ways in which the education for health literacy perspective can be found in national policies. These include broad national goals and standards (Germany and Canada) and major health care reform (America). We next consider the tensions and gaps that can arise in the translation and implementation of these policies relative to the ideal education for health literacy perspective, especially related to equity. These include the need for funding, goals of the educational system, and limited evaluation of policy in practice. Finally, we highlight strategic opportunities to achieve education for health literacy and equity especially offering examples from innovative practice in Canada across the lifespan

Preventive check-up programme for strengthening people-centred primary health care services in Albania: Case study and lessons learnt

Non-communicable Diseases (NCDs) in Albania are increasing, yet the country has a low number of outpatient visits per inhabitant per year. A primary health care (PHC) based programme of medical check-ups, with a focus on prevention, was set up in the country in 2015 aiming to address this issue, among others. This manuscript describes the development and status of the programme at key time points after its implementation, and considers some of its outcomes.The current analysis was based on data gathered from the check-up programme information system and the registry of diseases at PHC centres, and guided by the European Framework for Action on Integrated Health Services Delivery.Based on PHC registered cases, a 13% and 34% increase in the prevalence of elevated blood pres-sure and diabetes were observed in 2015 respectively, following the introduction of the check-up programme compared to the previous year. Three years after implementation, about 60% of the population aged 35–70 years old had used the programme at least once, with 61% of the total 954 667 visits provided to women.Overall, the check-up programme in Albania has identified a substantial number of new cases of NCD as well as their associated risk factors in its population. The early detection of NCDs is expected to contribute to the prevention of complications, premature mortality and their associated costs. Albanian politicians and decision-makers should regularly revise and introduce appropriate changes to the check-up programme in the future. In particular, the issue of sustainability and long-term resource mobilization is of particular concern and warrants careful consideration.   Conflict of interests: None declared

Preventive check-up programme for strengthening people-centred primary health care services in Albania: Case study and lessons learnt

Non-communicable Diseases (NCDs) in Albania are increasing, yet the country has a low number of outpatient visits per inhabitant per year. A primary health care (PHC) based programme of medical check-ups, with a focus on prevention, was set up in the country in 2015 aiming to address this issue, among others. This manuscript describes the development and status of the programme at key time points after its implementation, and considers some of its outcomes.The current analysis was based on data gathered from the check-up programme information system and the registry of diseases at PHC centres, and guided by the European Framework for Action on Integrated Health Services Delivery.Based on PHC registered cases, a 13% and 34% increase in the prevalence of elevated blood pres-sure and diabetes were observed in 2015 respectively, following the introduction of the check-up programme compared to the previous year. Three years after implementation, about 60% of the population aged 35–70 years old had used the programme at least once, with 61% of the total 954 667 visits provided to women.Overall, the check-up programme in Albania has identified a substantial number of new cases of NCD as well as their associated risk factors in its population. The early detection of NCDs is expected to contribute to the prevention of complications, premature mortality and their associated costs. Albanian politicians and decision-makers should regularly revise and introduce appropriate changes to the check-up programme in the future. In particular, the issue of sustainability and long-term resource mobilization is of particular concern and warrants careful consideration.   Conflict of interests: None declared

Socioecological Factors Associated with Hypertension Awareness and Control Among Older Adults in Brazil and Colombia: Correlational Analysis from the International Mobility in Aging Study

Background: Hypertension awareness and control are understudied among older adults in middle-income countries, with limited work contextualizing awareness and control across layers of influence (individual to the community). Research on hypertension in Latin America is acknowledged as insufficient. Objectives: This study applies the socioecological model (SEM) to examine individual, interpersonal, institutional, and community factors related to hypertension awareness and control in older adults residing in Brazil and Colombia. It identifies groups of older adults more likely to be unaware of their condition and/or to have challenges achieving hypertension control. Methods: We analyzed International Mobility in Aging Study data of 803 community-dwelling adults 65–74 years from study sites in the two most populous countries in South America. The study framework was the socioecological model. Logistic regression models identified factors associated with hypertension awareness and control. Conclusions: Hypertension was prevalent in both samples (>70%), and awareness was high (>80%). Blood pressure control among diagnosed respondents was low: 30% in Brazil and 51% in Colombia. Factors across the socioecological model were associated with awareness and control, with notable differences across countries. Those with diabetes (OR 4.19, 95%CI 1.64–10.71) and insufficient incomes (OR: 1.85, 95%CI 1.03–3.31) were more likely to be aware of their hypertension. In Colombia, those reporting no community activity engagement were less likely to be aware compared to those reporting community activities. In Brazil, it was the opposite. Women (OR 1.66, 95%CI 1.12–2.46) and those reporting strolling shops and stores (OR 1.80, 95% CI 1.09–3.00) were significantly more likely to have their hypertension under control. In Brazil, those 70–75 were significantly less likely to have their hypertension under control compared to their younger counterparts. In Colombia, this was not observed. This paper highlights the importance of theory-based studies within unique Latin American contexts on hypertension and suggests novel opportunities for intervention

Data gaps in adolescent fertility surveillance in middle-income countries in Latin America and South Eastern Europe: Barriers to evidence-based health promotion

Adolescent health is a major global priority. Yet, as recently described by the World Health Organization (WHO), increased recognition of the importance of adolescent health rarely transforms into action. One challenge is lack of data, particularly on adolescent fertility. Adolescent pregnancy and childbirth are widespread and affect lifetime health and social outcomes of women, men, and families. Other important components of adolescent fertility include abortion, miscarriage, and stillbirth. Access to reliable, consistently-collected data to understand the scope and complexity of adolescent fertility is critical for designing strong research, developing meaningful policies, building effective programs, and evaluating success in these domains. Vital surveillance data can be challenging to obtain in general, and particularly in low- and middle-income countries and other under-resourced settings (including rural and indigenous communities in high-income countries). Definitions also vary, making comparisons over time and across locations challenging. Informed by the Adolescence and Motherhood Research project in Brazil and considering relevance to the Southern Eastern European (SEE) context, this article focuses on challenges in surveillance data for adolescent fertility for middle-income countries. Specifically, we review the literature to: (1) discuss the importance of understanding adolescent fertility generally, and (2) highlight relevant challenges and complexity in collecting adolescent fertility data, then we (3) consider implications of data gaps on this topic for selected middle-income countries in Latin America and SEE, and (4) propose next steps to improve adolescent fertility data for evidence-based health promotion in the middle-income country context

Data gaps in adolescent fertility surveillance in middle-income countries in Latin America and South Eastern Europe: Barriers to evidence-based health promotion

Adolescent health is a major global priority. Yet, as recently described by the World Health Organization (WHO), increased recognition of the importance of adolescent health rarely transforms into action. One challenge is lack of data, particularly on adolescent fertility. Adolescent pregnancy and childbirth are widespread and affect lifetime health and social outcomes of women, men, and families. Other important components of adolescent fertility include abortion, miscarriage, and stillbirth. Access to reliable, consistently-collected data to understand the scope and complexity of adolescent fertility is critical for designing strong research, developing meaningful policies, building effective programs, and evaluating success in these domains. Vital surveillance data can be challenging to obtain in general, and particularly in low- and middle-income countries and other under-resourced settings (including rural and indigenous communities in high-income countries). Definitions also vary, making comparisons over time and across locations challenging. Informed by the Adolescence and Motherhood Research project in Brazil and considering relevance to the Southern Eastern European (SEE) context, this article focuses on challenges in surveillance data for adolescent fertility for middle-income countries. Specifically, we review the literature to: (1) discuss the importance of understanding adolescent fertility generally, and (2) highlight relevant challenges and complexity in collecting adolescent fertility data, then we (3) consider implications of data gaps on this topic for selected middle-income countries in Latin America and SEE, and (4) propose next steps to improve adolescent fertility data for evidence-based health promotion in the middle-income country context.Conflicts of interest: None