Involving Children in Health Literacy Research

Despite the volume and breadth of health literacy research related to children, children’s involvement in that research is rare. Research with children is challenging, but the principles of involvement and engagement underpin all health promotion work, including health literacy. This commentary reflects on the process of setting up a Children’s Advisory Group to consult on an institutional ethnography study of health literacy work from children’s standpoint. The Children’s Advisory Group contributed feedback on the study ethics and design and piloted methods for rapport-building and data collection, including livestreamed draw-and-describe and modified Interview to the Double. Consulting with the Children’s Advisory Group highlighted the importance of listening to children and recognizing and valuing children’s imaginative contributions to methods for involving children in health literacy research. Insights from this commentary can be used to foreground equity-focused approaches to future research and practice with children in the field of health literacy

Settings for the development of health literacy: A conceptual review

Advances in conceptualizing settings in health promotion include understanding settings as complex and interlinked systems with a core commitment to health and related outcomes such as health literacy. Traditional settings for the development of health literacy include health care environments and schools. There is a need to identify and conceptualize non-traditional and emerging settings of twenty-first-century everyday life. The aim of this conceptual review is to inform a conceptual model of a “non-traditional” setting for the development of health literacy. The model uses the example of the public library to propose four equity-focused antecedents required in a setting for the development of health literacy: the setting acknowledges the wider determinants of health, is open access, involves local communities in how it is run, and facilitates informed action for health. The review concludes that a settings approach to the development of health literacy can be conceptualized as part of a coordinated “supersetting approach,” where multiple settings work in synergy with each other

Public Libraries as Supportive Environments for Children’s Development of Critical Health Literacy

Critical health literacy enables individuals to use cognitive and social resources for informed action on the wider determinants of health. Promoting critical health literacy early in the life-course may contribute to improved health outcomes in the long term, but children’s opportunities to develop critical health literacy are limited and tend to be school-based. This study applies a settings-based approach to analyse the potential of public libraries in England to be supportive environments for children’s development of critical health literacy. The study adopted institutional ethnography as a framework to explore the public library as an everyday setting for children. A children’s advisory group informed the study design. Thirteen children and 19 public library staff and community stakeholders were interviewed. The study results indicated that the public library was not seen by children, staff, or community stakeholders as a setting for health. Its policies and structure purport to develop health literacy, but the political nature of critical health literacy was seen as outside its remit. A supersetting approach in which children’s everyday settings work together is proposed and a conceptual model of the public library role is presented

What works in advocating for food advertising policy change across an english region - a realist evaluation.

With increasing recognition of the role of commercial determinants of health, local areas in England have sought to restrict the advertising of products high in fat, salt and sugar (HFSS) on council-owned spaces, as part of wider strategies to reduce obesity. While there is some evidence of the impact of such policy change on behaviour, little is known about what works in the process of implementing this policy change. Guided by a realist evaluation framework that explores the interaction between context, mechanism and outcomes, this study aims to investigate the factors that influence the restriction of outdoor advertising of HFSS products in one region in England. It refines a programme theory co-produced with stakeholders from 14 local authorities within a region and uses multiple data sources from each area with an in-depth examination of four case study sites. Data sources include longitudinal realist interviews, focus groups and surveys with policy advocates and policy stakeholders. Data were analysed retroductively to understand the causal link between context, mechanism and outcomes. Outcomes were driven by five dominant mechanisms: a strategic and staggered approach to stakeholder engagement, gathering intelligence, identifying policy champions, building relationships, reframing the issue; and two secondary mechanisms of amplifying the issue and increasing public will. These led to varied outcomes with no changes in formal policy position within the evaluation period but draft policy guidance in place and changes in political will demonstrated. Dominant context factors influencing change included having a named and resourced policy advocate in place supported by an external Community of Improvement and having existing aligned local objectives. Organisational complexity and change, financial concerns, lack of local examples, ideological positions and the pandemic were also influencing contextual factors. Effecting policy change in this area requires the commitment of an extended period and the valuing of short-term policy outcomes, such as increasing political will. The importance of a resourced and well-supported policy advocate to lead this work is fundamental and the commercially sensitive nature of this policy change means that a complex interplay of mechanisms is required which may be dominated by a strategically staggered approach to stakeholder engagement. [Abstract copyright: © 2023. BioMed Central Ltd., part of Springer Nature.

Involving Lived Experience in regional efforts to address gambling-related harms: going beyond ‘window dressing’ and ‘tick box exercises’

Background Lived Experience (LE) involvement has been shown to improve interventions across diverse sectors. Yet LE contributions to public health approaches to address gambling-related harms remain underexplored, despite notable detrimental health and social outcomes linked to gambling. This paper analyses the potential of LE involvement in public health strategy to address gambling-related harms. It focuses on the example of a UK city-region gambling harms reduction intervention that presented multiple opportunities for LE input. Methods Three focus groups and 33 semi-structured interviews were conducted to hear from people with and without LE who were involved in the gambling harms reduction intervention, or who had previous experience of LE-informed efforts for addressing gambling-related harms. People without LE provided reflections on the value and contributions of others’ LE to their work. Data analysis combined the Framework Method with themes developed inductively (from people’s accounts) and deductively (from the literature, including grey literature). Results Four themes were identified: (1) personal journeys to LE involvement; (2) the value added by LE to interventions for addressing gambling-related harms; (3) emotional impacts on people with LE; and (4) collective LE and diverse lived experiences. Two figures outlining LE involvement specific to gambling harms reduction in the UK, where public health efforts aimed at addressing gambling-related harms coexist with industry-funded programmes, are proposed. Conclusions Integrating a range of LE perspectives in a public health approach to gambling harms reduction requires local access to involvement for people with LE via diverse routes that are free from stigma and present people with LE with options in how they can engage and be heard in decision-making, and how they operate in relation to industry influence. Involving LE in gambling harms reduction requires enabling people to develop the affective and critical skills necessary to navigate complex emotional journeys and a challenging commercial and policy environment

Complex-Temperature Singularities in the d=2d=2 Ising Model. III. Honeycomb Lattice

We study complex-temperature properties of the uniform and staggered susceptibilities $\chi$ and $\chi^{(a)}$ of the Ising model on the honeycomb lattice. From an analysis of low-temperature series expansions, we find evidence that $\chi$ and $\chi^{(a)}$ both have divergent singularities at the point $z=-1 \equiv z_{\ell}$ (where $z=e^{-2K}$), with exponents $\gamma_{\ell}'= \gamma_{\ell,a}'=5/2$. The critical amplitudes at this singularity are calculated. Using exact results, we extract the behaviour of the magnetisation $M$ and specific heat $C$ at complex-temperature singularities. We find that, in addition to its zero at the physical critical point, $M$ diverges at $z=-1$ with exponent $\beta_{\ell}=-1/4$, vanishes continuously at $z=\pm i$ with exponent $\beta_s=3/8$, and vanishes discontinuously elsewhere along the boundary of the complex-temperature ferromagnetic phase. $C$ diverges at $z=-1$ with exponent $\alpha_{\ell}'=2$ and at $v=\pm i/\sqrt{3}$ (where $v = \tanh K$) with exponent $\alpha_e=1$, and diverges logarithmically at $z=\pm i$. We find that the exponent relation $\alpha'+2\beta+\gamma'=2$ is violated at $z=-1$; the right-hand side is 4 rather than 2. The connections of these results with complex-temperature properties of the Ising model on the triangular lattice are discussed.Comment: 22 pages, latex, figures appended after the end of the text as a compressed, uuencoded postscript fil

Simulation and Measurement of Transient Fluid Phenomena within Diesel Injection

Rail pressures of modern diesel fuel injection systems have increased significantly over recent years, greatly improving atomisation of the main fuel injection event and air utilisation of the combustion process. Continued improvement in controlling the process of introducing fuel into the cylinder has led to focussing on fluid phenomena related to transient response. High-speed microscopy has been employed to visualise the detailed fluid dynamics around the near nozzle region of an automotive diesel fuel injector, during the opening, closing and post injection events. Complementary computational fluid dynamic (CFD) simulations have been undertaken to elucidate the interaction of the liquid and gas phases during these highly transient events, including an assessment of close-coupled injections. Microscopic imaging shows the development of a plug flow in the initial stages of injection, with rapid transition into a primary breakup regime, transitioning to a finely atomised spray and subsequent vaporisation of the fuel. During closuring of the injector the spray collapses, with evidence of swirling breakup structures together with unstable ligaments of fuel breaking into large slow-moving droplets. This leads to sub-optimal combustion in the developing flame fronts established by the earlier, more fully-developed spray. The simulation results predict these observed phenomena, including injector surface wetting as a result of large slow-moving droplets and post-injection discharge of liquid fuel. This work suggests that post-injection discharges of fuel play a part in the mechanism of the initial formation, and subsequent accumulation of deposits on the exterior surface of the injector. For multiple injections, opening events are influenced by the dynamics of the previous injection closure; these phenomena have been investigated within the simulations