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Van Boxtel W, Jerković-Ćosić K, Schoonmade LJ, Chinapaw MJM. Health literacy in the context of child health promotion: a scoping review of conceptualizations and descriptions. BMC Public Health 2024; 24:808. [PMID: 38486202 PMCID: PMC10941366 DOI: 10.1186/s12889-024-17955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Increasing health literacy (HL) in children could be an opportunity for a more health literate future generation. The aim of this scoping review is to provide an overview of how HL is conceptualized and described in the context of health promotion in 9-12-year-old children. METHODS A systematic and comprehensive search for 'health literacy' and 'children' and 'measure' was performed in accordance with PRISMA ScR in PubMed, Embase.com and via Ebsco in CINAHL, APA PsycInfo and ERIC. Two reviewers independently screened titles and abstracts and evaluated full-text publications regarding eligibility. Data was extracted systematically, and the extracted descriptions of HL were analyzed qualitatively using deductive analysis based on previously published HL definitions. RESULTS The search provided 5,401 original titles, of which 26 eligible publications were included. We found a wide variation of descriptions of learning outcomes as well as competencies for HL. Most HL descriptions could be linked to commonly used definitions of HL in the literature, and some combined several HL dimensions. The descriptions varied between HL dimensions and were not always relevant to health promotion. The educational setting plays a prominent role in HL regarding health promotion. CONCLUSION The description of HL is truly diverse and complex encompassing a wide range of topics. We recommend adopting a comprehensive and integrated approach to describe HL dimensions, particularly in the context of health promotion for children. By considering the diverse dimensions of HL and its integration within educational programs, children can learn HL skills and competencies from an early age.
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Affiliation(s)
- Wieke Van Boxtel
- Research group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands.
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.
- Health Behaviour and Chronic Diseases, Methodology, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Katarina Jerković-Ćosić
- Research group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands
| | - Linda J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, 1007 MB, The Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviour and Chronic Diseases, Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
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Doré A, Kalo K, Schwab L, Reichel JL, Eisenbarth L, Strepp T, Jacob R, Enders K, Letzel S, Simon P, Dietz P, Kubiak T, Heller S. Videos using different message strategies to promote the interruption of sedentary behavior in university students during online lectures - A pilot study. Front Public Health 2023; 11:1108154. [PMID: 37575097 PMCID: PMC10412984 DOI: 10.3389/fpubh.2023.1108154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/26/2023] [Indexed: 08/15/2023] Open
Abstract
Background Sedentary behavior (SB) is highly prevalent among university students and has increased during COVID-19 pandemic. As SB is associated with negative health outcomes, appropriate prevention measures in the university setting are needed. Objective This pilot study aimed at investigating the effects of videos using different message strategies to interrupt SB in the collective of university students during online lectures. Methods During online lectures, university students (N = 96) were shown one of three videos on the interruption of SB. The videos differed in their message strategies with regard to evidence type (statistical vs. narrative) and vividness (static vs. animated images). Demographics, health variables (SB intentions, SB attitudes) and selected media reception variables (identification, homophily, counterarguing) were examined as possible influence factors on the interruption of SB evoked by watching the video. Results Approximately half of the students interrupted sedentary behavior during watching the videos and students of the older age group (cut-off: median = 22 years) interrupted SB significantly more often (p = 0.046). The interruption of SB was predicted by SB intentions (p < 0.05). Identification with characters significantly predicted the intentions to reduce SB (p < 0.001), with a large effect of the overall regression model (R2corr = 0.47). Conclusion Considering the increased digitalization in general and restrictions due to COVID-19 pandemic, videos seem to be a useful tool to interrupt SB among university students during online lectures. Narrative formats could facilitate the intention to reduce SB, which in turn could have a positive impact on the interruption of SB. However, further research on effective communication and message strategies is needed.
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Affiliation(s)
- Anastasia Doré
- Department of Health Psychology, Institute of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kristin Kalo
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lisa Schwab
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jennifer L. Reichel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Laura Eisenbarth
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Tilmann Strepp
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Robin Jacob
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Kira Enders
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Perikles Simon
- Department of Sports Medicine, Disease Prevention and Rehabilitation, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Pavel Dietz
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
| | - Thomas Kubiak
- Department of Health Psychology, Institute of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sebastian Heller
- Institute of Occupational, Social and Environmental Medicine, University Medical Centre of the University of Mainz, Mainz, Germany
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Wang T, Pavelko R. Creating persuasive health messages on social media: Effects of humor and perceived efficacy on health attitudes and intentions. Health Mark Q 2023; 40:326-346. [PMID: 35946911 DOI: 10.1080/07359683.2022.2109396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
This study examined how humor (incongruity humor vs. no humor) interacts with individual differences in perceived efficacy to influence health attitudes and behavioral intentions. Results of a controlled experiment (N = 294) revealed that among individuals with lower levels of perceived efficacy, incongruity humor, relative to no humor condition, resulted in greater source liking, which in turn, enhanced their attitudes and intentions to perform preventive health behaviors. However, for individuals higher in perceived efficacy, incongruity humor (vs. no humor) had an indirect negative effect on intentions via decreased attitudes. Theoretical and practical implications of these findings are discussed.
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Affiliation(s)
- Tianjiao Wang
- Department of Communication, Slane College of Communications and Fine Arts, Bradley University, Peoria, IL, USA
| | - Rachelle Pavelko
- Department of Communication, Slane College of Communications and Fine Arts, Bradley University, Peoria, IL, USA
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Bechraki E, Mavrikaki E, Gialamas V, Galanaki E. Development and validation of an instrument for the health literacy assessment of secondary school students (HeLiASeSS). HEALTH EDUCATION 2022. [DOI: 10.1108/he-08-2021-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe development of health literacy skills is of paramount importance especially for students, as it is associated with their wellbeing and academic success. Assessing students' health literacy is necessary for its advancement. This study comes to fill the need for a valid multidimensional health literacy assessment instrument for secondary school students.Design/methodology/approachInitially, the authors defined the conceptual framework within which the items of this instrument were generated. Its final form was obtained through three pilot studies. A test-retest followed and, finally, a nationwide survey was conducted on Greek seventh-, ninth- and tenth-grade students (N = 2,800).FindingsA 37-item instrument, the Health Literacy Assessment for Secondary School Students (HeLiASeSS), was developed which includes the following nine dimensions/skills of health literacy: “access to”, “understand” and “evaluate” (health information), “functional communication”, “interactive communication” and “critical communication”, “relying on health information”, “self-efficacy regarding health matters” and “intention for active citizenship regarding health matters”. HeLiASeSS proved to have good stability (ICC = 0.943) and high internal consistency reliability (a = 0.903).Originality/valueHeLiASeSS offers the possibility of a reliable and valid assessment of secondary school students' health literacy skills providing a multidimensional evaluation of this construct and is expected to be useful in interventions aiming at promoting this type of literacy.
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Guo S, Yu X, Davis E, Armstrong R, Naccarella L. Comparison of Health Literacy Assessment Tools among Beijing School-Aged Children. CHILDREN 2022; 9:children9081128. [PMID: 36010019 PMCID: PMC9406777 DOI: 10.3390/children9081128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022]
Abstract
Health literacy is a broad and multidimensional construct, making its measurement and conclusions inconsistent. This study aims to compare the patterning of health literacy using different assessment tools and examine their impact on children’s developmental outcomes. A cross-sectional study was conducted with 650 students in Years 7–9 from four secondary schools in Beijing. Health literacy was measured by the eight-item health literacy assessment tool (HLAT, score range 0–37), the six-item Newest Vital Sign (NVS, score range 0–6), and the 16-item Health Literacy Survey (HLS, score range 0–16). Based on Manganello’s health literacy framework, information on upstream factors (e.g., gender, ethnicity, socioeconomic status) and developmental outcomes (e.g., health-promoting behaviours, health service use, global health status) was collected. Overall, the average scores for health literacy were 26.34 ± 5.89, 3.64 ± 1.64, and 13.72 ± 2.94, respectively, for HLAT, NVS, and HLS. The distribution of health literacy varied by socio-demographics and individual characteristics except for gender, no matter which health literacy assessment tool was used. The magnitude of associations between health literacy, its upstream factors and developmental outcomes was greater when using three-domain instruments (HLAT and HLS) than using single-domain instruments (NVS). The approach to health literacy measurement will influence the conclusion. Using multidimensional assessment tools may better capture a child’s health literacy and contribute to the maximum efficiency and effectiveness of school-based health literacy interventions.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia; (E.D.); (R.A.); (L.N.)
- Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
- Correspondence: (S.G.); (X.Y.); Tel.: +61-452-110-331 (S.G.); +86-010-8280-2631 (X.Y.)
| | - Xiaoming Yu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
- Correspondence: (S.G.); (X.Y.); Tel.: +61-452-110-331 (S.G.); +86-010-8280-2631 (X.Y.)
| | - Elise Davis
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia; (E.D.); (R.A.); (L.N.)
| | - Rebecca Armstrong
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia; (E.D.); (R.A.); (L.N.)
| | - Lucio Naccarella
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, Australia; (E.D.); (R.A.); (L.N.)
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Loer AKM, Domanska OM, Stock C, Jordan S. Correction: Loer et al. Subjective Generic Health Literacy and Its Associated Factors among Adolescents: Results of a Population-Based Online Survey in Germany. Int. J. Environ. Res. Public Health 2020, 17, 8682. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031848. [PMID: 35162933 PMCID: PMC8835594 DOI: 10.3390/ijerph19031848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 02/01/2023]
Affiliation(s)
- Anne-Kathrin M. Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (S.J.)
- Correspondence:
| | - Olga M. Domanska
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (S.J.)
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Susanne Jordan
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (S.J.)
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GÜR K, DANIŞ R, DERİNSU AC, TURAN A, AKSOY Z, TUNCEL A. Access to Health Services by the Parents of Individuals with Intellectual Disability according to their Health Literacy Levels. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.881581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Park SK, Kim EG. A Study on the Reliability and Validity of the Korean Health Literacy Instrument for Late School-Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910304. [PMID: 34639605 PMCID: PMC8508180 DOI: 10.3390/ijerph181910304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to develop and validate the Korean Health Literacy Instrument, which measures Korean late school-aged children's understanding capacity. The construct's concepts were drawn from the literature review and interviews with school nurses and teachers. A survey was then conducted in 552 fifth and sixth graders in nine elementary schools, from 1 to 9 May 2014. The KR-20 coefficient for reliability, difficulty index, discrimination index, item-total correlation, and known group technique for validity were performed. An exploratory factor analysis was performed to test the construct validity of the instrument and its unidimensionality. The results reveal that a two-factor structure was appropriate for the Korean school-age health literacy tool (root mean square error of approximation = 0.06, Comparative Fit Index = 0.96, and Tucker-Lewis Index = 0.95). From the remaining 16 items, the internal consistency reliability coefficient of this instrument was 0.85, and the criterion-related validity was 0.62 (p < 0.001). The Korean health literacy instrument for late school-aged children was suitable for screening individuals who have limited health literacy. Based on the findings of this study, future studies must continue to conduct empirical investigations on the Korean health literacy instrument for late school-aged children.
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Affiliation(s)
- Sook-Kyoung Park
- College of Nursing, Jeonbuk National University, Jeonju 54896, Korea;
| | - Eun-Gyeong Kim
- Department of Nursing, Kunsan National University, Gunsan 54150, Korea
- Correspondence: ; Tel.:+82-63-469-7429
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Adolescent Health Literacy and Neighbourhood Features: HBSC Findings from Czech Republic, Poland, and Slovakia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147388. [PMID: 34299839 PMCID: PMC8303563 DOI: 10.3390/ijerph18147388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022]
Abstract
The role of supportive environments on health, wellbeing, and longevity has been widely recognized. However, there is no strong empirical evidence on the association between health literacy (HL) as a particular health-related competence and neighbourhoods. Therefore, the aim of the study was to assess the association between the features of neighbourhoods and the level of HL competencies of young people from three countries (Czech Republic, Poland, Slovakia). Self-reported data from an international sample of 11,521 students aged 13–15 years participating in the Health Behaviour in School-aged Children Study (HBSC) in the year 2018 were included in the analyses. The level of HL shows a strong positive relationship with family wealth, and a significant relationship is maintained in all studied countries. Both social and structural features of neighbourhoods turned out to have an impact on students’ HL. However, HL is most clearly explained by the school environment. This study confirms the school effect on higher levels of HL competences in adolescents. This indicates the need to invest in schools located in less affluent areas to generally improve the level of education, implement modern health education combined with HL, and strengthen the social and health competencies of students.
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Bollweg TM, Okan O, Freţian AM, Bröder J, Domanska OM, Jordan S, Bruland D, Pinheiro P, Bauer U. Adapting the European Health Literacy Survey Questionnaire for Fourth-Grade Students in Germany: Validation and Psychometric Analysis. Health Lit Res Pract 2021; 4:e144-e159. [PMID: 32674162 PMCID: PMC7365660 DOI: 10.3928/24748307-20200428-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/26/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Until now, children younger than age 13 years have received little attention in research on health literacy. Although some tools assess children's health literacy, no validated tool is available that assesses self-reported health literacy in a systematic and comparable way. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a valid and reliable measure of adults' self-reported health literacy. It has also been used among adolescents, but it has never been adapted for use with children. We believe it would be worth adapting for younger age groups so that self-reported health literacy could be assessed continuously. OBJECTIVE This study aimed to quantitatively test an adapted scale based on the HLS-EU-Q developed for German-speaking children age 9 and 10 years. METHODS An adapted 26-item HLS-EU-Q scale was given in a paper-and-pencil survey to 907 fourth-grade students in North Rhine-Westphalia, Germany. The psychometric properties of the scale were investigated with item analysis and factor analyses, and both convergent and discriminant validity were assessed. KEY RESULTS Of the 26 tested items, 9 were discarded due to poor performance in terms of missing values, item difficulty, and factor structure. This left a 15-item scale with a high internal consistency (α = .791) that takes only a short time to administer. The scale, called the HLS-Child-Q15, had a low correlation with functional health literacy (r = .107, p < .001), and a moderate correlation with indicators of self-efficacy (ρ = .280 to .306, p < .001). The latter indicates adequate discriminant validity, whereas the former points to a need to further investigate convergent validity. CONCLUSIONS This is the first study to apply an age-adapted version of the HLS-EU-Q to children. Statistical analyses indicated the successful development of a promising instrument, but further research is needed on its factor structure and validity. This study contributes significantly to the comparative assessment of health literacy across the life course by providing a measurement tool for children age 9 and 10 years. [HLRP: Health Literacy Research and Practice. 2020;4(3):e144-e159.] PLAIN LANGUAGE SUMMARY: The European Health Literacy Survey Questionnaire was adapted for German-speaking 9- and 10-year-old children, and 26 adapted items were tested in a written survey of 907 children. Item analysis resulted in a 15-item scale with satisfactory psychometric properties. This scale, the HLS-Child-Q15, shows high internal consistency and can be used to assess self-reported health literacy in German-speaking 9- and 10-year-old children. Nonetheless, further studies are needed to validate these results.
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Affiliation(s)
- Torsten Michael Bollweg
- Address correspondence to Torsten Michael Bollweg, MA, Centre for Prevention and Intervention in Childhood and Adolescence, Faculty of Educational Science, Bielefeld University, Universitaetsstrasse 25, 33615 Bielefeld, Germany;
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Children of Smoking and Non-Smoking Households' Perceptions of Physical Activity, Cardiorespiratory Fitness, and Exercise. CHILDREN-BASEL 2021; 8:children8070552. [PMID: 34206729 PMCID: PMC8307148 DOI: 10.3390/children8070552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/02/2022]
Abstract
Previous research has shown secondhand tobacco smoke to be detrimental to children’s health. This qualitative study aimed to explore children from low socioeconomic status (SES) families and their reasons for being physically active, attitudes towards physical activity (PA), fitness and exercise, perceived barriers and facilitators to PA, self-perceptions of fitness and physical ability, and how these differ for children from smoking and non-smoking households. A total of 38 children (9–11 years; 50% female; 42% smoking households) from the deprived areas of North West England participated in focus groups (n = 8), which were analysed by utilizing thematic analysis. The findings support hypothesised mediators of PA in children including self-efficacy, enjoyment, perceived benefit, and social support. Fewer than a quarter of all children were aware of the PA guidelines with varying explanations, while the majority of children perceived their own fitness to be high. Variances also emerged between important barriers (e.g., sedentary behaviour and environmental factors) and facilitators (e.g., psychological factors and PA opportunity) for children from smoking and non-smoking households. This unique study provided a voice to children from low SES and smoking households and these child perspectives could be used to create relevant and effective strategies for interventions to improve PA, fitness, and health.
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Kanmounye US, Nguembu S, Djiofack D, Zolo Y, Tétinou F, Ghomsi N, Figuim B, Esene I. Patient Attitudes toward Neurosurgery in Low- and Middle-Income Countries: A Systematic Review. Neurol India 2021; 69:12-20. [PMID: 33642264 DOI: 10.4103/0028-3886.310098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Low- and middle-income countries (LMICs) bear the majority of the neurosurgical burden of diseases but lack the resources to meet these needs. Objective As we increase access to neurosurgical care in LMICs, we must understand patient attitudes toward neurosurgery. Methods and Material PubMed, LILACS, and African Journals Online databases were searched systematically from inception to January 4, 2020, for studies on neurosurgical patient perceptions in LMICs. The articles found were blindly reviewed with Rayyan by two authors. The two authors resolved conflicts between themselves, and when this was not possible, a third reviewer was consulted. All the articles included were then appraised, and the results were summarized. Results Six of the 1,175 articles met the inclusion criteria. The studies were set in Brazil, Ethiopia, India, Nigeria, South Korea, and Sub-Saharan Africa. Four of the studies (50%) were phenomenological studies, and the other two were grounded theory and narrative. The studies identified patient attitudes toward neurosurgical practitioners, diseases, and interventions. Ethiopian and Nigerian patients believed cranial diseases to be otherworldly and resorted to traditional medicine or spiritual healing first, whereas Brazilian patients were more comfortable with cranial diseases and even more so if they had had a previous craniotomy. The Indian paper was a recount of a neurosurgeon's experience as a spine patient. Conclusions There are few studies on neurosurgery patient perception in LMICs. LMIC neurosurgeons should be encouraged to study their patient beliefs concerning neurosurgical diseases and interventions, as this can explain health-seeking behaviors.
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Affiliation(s)
- Ulrick S Kanmounye
- Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Department, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo, Cameroon
| | - Stéphane Nguembu
- Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon
| | - Dylan Djiofack
- Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Medicine, Higher Institute of Medical Technology, Nkolondom, Cameroon
| | - Yvan Zolo
- Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Franklin Tétinou
- Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon
| | - Nathalie Ghomsi
- Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Department, Felix Houphouet Boigny University, Abidjan, Côte d'Ivoire, Cameroon
| | - Bello Figuim
- Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Unit, Department of Surgery, Yaounde Central Hospital, Yaounde, Cameroon
| | - Ignatius Esene
- Neurosurgery Unit, Department of Surgery, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
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Nriagu BN, Ako AA, Wang C, De Roos AJ, Wallace R, Allison MA, Seguin RA, Michael YL. Occupations Associated With Poor Cardiovascular Health in Women: The Women's Health Initiative Observational Study. J Occup Environ Med 2021; 63:387-394. [PMID: 33928936 DOI: 10.1097/jom.0000000000002135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Research on the effect of occupation on cardiovascular health (CVH) among older women is limited. METHODS Each of the seven American Heart Association's CVH metrics was scored as ideal (1) or non-ideal (0) and summed. Multivariable logistic regression was used to estimate the odds of poor overall CVH (CVH score of 0 to 2) comparing women employed in each of the top 20 occupational categories to those not employed in that category, adjusting for age, marital status, and race/ethnicity. RESULTS (1) Bookkeeping, accounting, and auditing clerks; (2) first-line supervisors of sales workers; (3) first-line supervisors of office and administrative support workers; and (4) nursing, psychiatric, and home health aides were more likely to have poor overall CVH compared to women who did not work in these occupations. CONCLUSIONS Several commonly held occupations among women were associated with poor CVH.
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Affiliation(s)
- Bede N Nriagu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania (Nriagu, Ako, Wang, Michael); Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania (De Roos); Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa (Wallace); Department of Family Medicine and Public Health University of California, San Diego, La Jolla, California (Allison); Texas A&M AgriLife Research, Texas A&M University System, College Station, Texas (Seguin)
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Fernandes SC, Louceiro A, Lopes LB, Esteves F, Arriaga P. Children's Attitudes and Behaviors about Oral Health and Dental Practices. Healthcare (Basel) 2021; 9:healthcare9040416. [PMID: 33916533 PMCID: PMC8065731 DOI: 10.3390/healthcare9040416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022] Open
Abstract
The present study sought to contribute to a better understanding of children's attitudes and behaviors regarding oral health and dental practices. The sample was composed of 101 children (8-10 years), collected from several schools in the Lisbon metropolitan area. Our main goals were to collect a survey of information about the beliefs, attitudes, habits and knowledge of children about oral and dental issues in order to not only have an overview of them but also to serve as a basis and a starting point for the development of intervention programs to increase positive attitudes and behaviors related to oral health and promote greater knowledge about these subjects. In general, children reported positive behaviors regarding dental habits and oral hygiene practices. Children's opinions and beliefs about dentists were also globally positive; however, the results suggested that younger children reported more positive attitudes, emotions and previous experiences. Regarding children's knowledge about these dental issues, the results were quite negative and worrying, ruled by ignorance and incorrect beliefs and behaviors. In sum, all the results and conclusions of this study may contribute to the development of educational programs within the scope of the promotion of oral health and hygiene practices-"An Adventure about Oral Health."
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Affiliation(s)
- Sara Costa Fernandes
- Centro de Intervenção e Investigação Social (CIS-Iscte), ISCTE-Instituto Universitário de Lisboa, 1649-026 Lisboa, Portugal;
- Correspondence:
| | - Ana Louceiro
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal;
| | - Luísa Bandeira Lopes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Dental Pediatrics Department, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal;
| | - Francisco Esteves
- Department of Psychology and Social Work, MidSweden University, 831 25 Östersund, Sweden;
| | - Patrícia Arriaga
- Centro de Intervenção e Investigação Social (CIS-Iscte), ISCTE-Instituto Universitário de Lisboa, 1649-026 Lisboa, Portugal;
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Knisel E, Rupprich H, Wunram A, Bremer M, Desaive C. Promotion of Elementary School Students' Health Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249560. [PMID: 33371224 PMCID: PMC7766722 DOI: 10.3390/ijerph17249560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 11/16/2022]
Abstract
Health literacy is an important outcome of the discussion of school-related health education and health promotion in the 21st century. Although the improvement of health literacy at an early age is increasingly recognized and few interventions show the development of children´s health literacy, still there is little research in this area. The purpose of the study was to examine the enhancement of health literacy among children in a physical activity-based program at elementary school. In total, 137 students aged 6–12 years participated in the program, which included health knowledge transfer in child-appropriate games and exercises. Participants´ health literacy was assessed using the HLS-Child-Q15-DE at the beginning and the end of the program. The instrument measures the access, understanding, appraisal and application of health-related information on a four-point Likert-type scale. As expected, the Wilcoxon signed-rank test revealed significant increases in self-reported health literacy over time. The results show that the degree of change in health literacy was not associated with gender or age. The results suggest that the physical activity-based program has the potential to improve elementary school children´s health literacy, even though in a single group pilot study.
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Affiliation(s)
- Elke Knisel
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
- Correspondence: ; Tel.: +49-(0)391-6756981
| | - Helge Rupprich
- Faculty of Social Sciences, Media, and Sports, Institute of Sport Science, Johannes Gutenberg University Mainz, 55128 Mainz, Germany;
| | - Annika Wunram
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
| | - Markus Bremer
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
| | - Christiane Desaive
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
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Bollweg TM, Okan O, Freţian A, Janner C, Schulenkorf T, Kirchhoff S, Pinheiro P, Bauer U. Dimensionen der Gesundheitskompetenz von Viertklässler*innen. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2020. [DOI: 10.1007/s11553-020-00822-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Zusammenfassung
Hintergrund
Die Gesundheitskompetenz (GK) junger Menschen wird von Wissenschaft und Politik zunehmend als Ansatzpunkt für Gesundheitsförderung und Prävention anerkannt. Gerade die GK von Kindern wurde jedoch, insbesondere in Deutschland, bisher kaum erforscht. Diese Studie widmet sich dieser Forschungslücke, indem sie die GK von Viertklässler*innen in Nordrhein-Westfalen (NRW) untersucht.
Ziel der Arbeit (Fragestellung)
Die Fragestellung ist die explorative Beschreibung verschiedener Dimensionen der GK von Kindern unter Berücksichtigung sozioökonomischer Merkmale.
Material und Methoden
Es wurde eine schriftliche Klassenraumbefragung durchgeführt. Der Fragebogen, der speziell für 9‑ bis 10-Jährige entwickelt wurde, umfasst drei Dimensionen der GK: selbstberichtete allgemeine GK, funktionale GK (schriftsprachliche und numerische Fähigkeiten) und das Gesundheitswissen.
Ergebnisse
Es wurden 899 Schüler*innen an 32 Schulen befragt. Hierbei wurde eine hohe selbstberichtete GK ermittelt: die Befragten empfinden den Umgang mit Gesundheitsinformationen als einfach. Kinder mit niedrigem Wohlstand schneiden in allen Dimensionen der GK signifikant schlechter ab. Dies gilt mit Ausnahme der selbstberichteten GK auch für Kinder, die zuhause nicht nur Deutsch sprechen.
Schlussfolgerung
Diese Studie untersucht erstmals die GK von Viertklässler*innen in NRW. Wenngleich die selbstberichtete GK hoch ist, zeigt sich schon bei dieser jungen Altersgruppe ein sozialer Gradient hinsichtlich Wohlstand und Sprache. Die Forschungslage ist für das Kindesalter zwar noch lückenhaft und es besteht weiterhin Forschungsbedarf, die Ergebnisse deuten aber auf einen frühen Interventionsbedarf hin, um allen Kindern unabhängig von ihrer Herkunft zu ermöglichen, GK in dem Maß zu entwickeln, wie es der eigenen Gesundheit zuträglich ist.
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Loer AKM, Domanska OM, Stock C, Jordan S. Subjective Generic Health Literacy and Its Associated Factors among Adolescents: Results of a Population-Based Online Survey in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228682. [PMID: 33238456 PMCID: PMC7709029 DOI: 10.3390/ijerph17228682] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/31/2020] [Accepted: 11/17/2020] [Indexed: 01/01/2023]
Abstract
Profound data on adolescent health literacy are needed as a requirement for the development of health literacy promoting interventions. This paper aims to study the level of generic health literacy among adolescents and to explore associations between health literacy and socio-demographic (age, sex, family affluence, migration background), social (social support by family and friends) and personal (self-efficacy) factors. We conducted a representative cross-sectional online survey. Four health literacy dimensions were captured among 14–17 years old adolescents living in Germany (n = 1235) with the “Measurement of Health Literacy Among Adolescents-Questionnaire” (MOHLAA-Q). Descriptive, bivariate and multiple logistic regression analyses were used to analyse the data (n = 1202). We found poor health literacy levels—to varying degrees—in all examined health literacy dimensions: dealing with health-related information (8.41% with many difficulties), health-related communication skills (28.13% with low skills), attitudes toward one’s own health and health information (8.81% with passive attitudes) and health-related knowledge (22.73% with low levels). We identified significant associations between poor health literacy levels and all factors studied except for age. Our results indicate a need for the implementation of evidence-based health literacy-related promoting interventions, preferentially in education and training institutions.
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Affiliation(s)
- Anne-Kathrin M. Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (S.J.)
- Correspondence:
| | - Olga M. Domanska
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (S.J.)
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Susanne Jordan
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (S.J.)
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Teufl L, Vrtis D, Felder-Puig R. QUIGK-K: Quiz zur Erhebung von Gesundheitskompetenz bei Kindern. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2020. [DOI: 10.1007/s11553-019-00749-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bollweg TM, Okan O, Pinheiro P, Bröder J, Bruland D, Freţian AM, Domanska OM, Jordan S, Bauer U. Adapting the European Health Literacy Survey for Fourth-Grade Students in Germany: Questionnaire Development and Qualitative Pretest. Health Lit Res Pract 2020; 4:e119-e128. [PMID: 32392350 PMCID: PMC7213025 DOI: 10.3928/24748307-20200326-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/23/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Promoting health literacy in early life is regarded as an important means of sustaining health literacy and health over the life course. However, little evidence is available on children's health literacy, partly due to a scarcity of suitable measurement tools. Although there are 18 tools to measure specific items of health literacy for people younger than age 13 years, there is a lack of comparable, valid, and age-appropriate measures of generic health literacy. OBJECTIVE This study aimed to develop and qualitatively test an age-adapted version of the European Health Literacy Survey Questionnaire (HLS-EU-Q) for German-speaking children age 9 and 10 years. Although validated for adults and adolescents, the HLS-EU-Q has never been age-adapted or used with children. METHODS The content and language of HLS-EU-Q items were adapted for this age range. The literature was consulted to inform this process, and adaptations were developed and selected based on consensus among authors. From an item pool of 102 adapted items, 37 were given to 30 fourth-grade students in a cognitive pretest, which is a standard procedure in questionnaire development aiming to explore how items are interpreted. Participants (18 girls, 12 boys) were mostly age 9 or 10 years (range, 9-11 years). KEY RESULTS Problems with misinterpretation were identified for some items and participants (e.g., items designed to assess participants' perceived difficulty in accessing and appraising health information were partly answered on the basis of knowledge and experience). A final selection of 26 well-performing items corresponded to the underlying HLS-EU-Q framework. CONCLUSIONS This is the first age-adapted version of the HLS-EU-Q. A preliminary 26-item questionnaire was successfully developed that performed well in a cognitive pretest. However, further research needs to verify its validity and reliability. The present findings help to advance the measurement of generic self-reported health literacy in children and highlight the need for cognitive pretesting as an essential part of questionnaire development. [HLRP: Health Literacy Research and Practice. 2020;4(2):e119-e128.] PLAIN LANGUAGE SUMMARY: The European Health Literacy Survey Questionnaire is used for testing adults' health literacy. It was adapted for German-speaking children age 9 and 10 years. Based on a review of the original items and the literature, 26 questionnaire items were developed and tested in interviews with 30 children. Although problems with understanding could be identified, the questionnaire was mostly well understood.
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Affiliation(s)
- Torsten Michael Bollweg
- Address correspondence to Torsten Michael Bollweg, MA, Centre for Prevention and Intervention in Childhood and Adolescence, Faculty of Educational Science, Bielefeld University, Universitaetsstrasse 25, 33615 Bielefeld, Germany;
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Domanska OM, Bollweg TM, Loer AK, Holmberg C, Schenk L, Jordan S. Development and Psychometric Properties of a Questionnaire Assessing Self-Reported Generic Health Literacy in Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2860. [PMID: 32326285 PMCID: PMC7216216 DOI: 10.3390/ijerph17082860] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 02/04/2023]
Abstract
Health literacy is a promising approach to promoting health and preventing disease among children and adolescents. Promoting health literacy in early stages of life could contribute to reducing health inequalities. However, it is difficult to identify concrete needs for action as there are few age-adjusted measures to assess generic health literacy in young people. Our aim was to develop a multidimensional measure of health literacy in German to assess generic health literacy among 14- to 17-year-old adolescents, namely, the "Measurement of Health Literacy Among Adolescents Questionnaire" (MOHLAA-Q). The development process included two stages. Stage 1 comprised the development and validation using a literature review, two rounds of cognitive interviews, two focus groups and two rounds of expert assessments by health literacy experts. Stage 2 included a standard pretest (n = 625) of the questionnaire draft to examine the psychometric properties, reliability and different validity aspects. The MOHLAA-Q consists of 29 items in four scales: (A) "Dealing with health-related information (HLS-EU-Q12-adolescents-DE)"; (B) "Communication and interaction skills", (C) "Attitudes toward one's own health and health information", and (D) "Health-related knowledge". The confirmatory factor analysis indicated a multidimensional structure of the MOHLAA-Q. The internal consistency coefficients (Cronbach's α) of the scales varied from 0.54 to 0.77. The development of the MOHLAA-Q constitutes a significant step towards the comprehensive measurement of adolescents' health literacy. However, further research is necessary to re-examine its structural validity and to improve the internal consistency of two scales.
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Affiliation(s)
- Olga Maria Domanska
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (A.-K.L.); (S.J.)
| | - Torsten Michael Bollweg
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany;
| | - Anne-Kathrin Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (A.-K.L.); (S.J.)
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, 14770 Brandenburg an der Havel, Germany;
| | - Liane Schenk
- Institute of Medical Sociology and Rehabilitation Science, Charité – Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Susanne Jordan
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany; (A.-K.L.); (S.J.)
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Fretian A, Bollweg TM, Okan O, Pinheiro P, Bauer U. Exploring Associated Factors of Subjective Health Literacy in School-Aged Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1720. [PMID: 32155711 PMCID: PMC7084889 DOI: 10.3390/ijerph17051720] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/27/2020] [Accepted: 03/03/2020] [Indexed: 01/01/2023]
Abstract
Low health literacy is considered to lead to worse health-related outcomes and behaviors and has therefore been recognized as a social determinant of health. While health literacy and its potential determinants have been studied in adults, little research has been conducted with children. This study aims to address this research gap by investigating factors associated with children's subjective health literacy. Cross-sectional data was collected from fourth graders at German schools with a self-report questionnaire. Sociodemographic characteristics, health-related attitudes, and motivation were analyzed. We used hierarchical multivariate linear regression to explain variance in the dependent variable "subjective health literacy". A total of n = 907 fourth graders were surveyed. Regarding health literacy, eight out of ten participants (82.2%) reported that it was "rather easy" or "very easy" to deal with health-related information. Family affluence, but not language spoken at home, was significantly related to subjective health literacy, after controlling for confounding. Moreover, parental health orientation, self-efficacy, and motivation are factors significantly associated with health literacy. Based on the results of this study, it is hypothesized that a general motivation to learn new things about health, as well as an environment promoting health-positive behavior, might foster children's health literacy.
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Affiliation(s)
- Alexandra Fretian
- School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany; (T.M.B.); (O.O.); (P.P.); (U.B.)
| | - Torsten Michael Bollweg
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany; (T.M.B.); (O.O.); (P.P.); (U.B.)
| | - Orkan Okan
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany; (T.M.B.); (O.O.); (P.P.); (U.B.)
| | - Paulo Pinheiro
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany; (T.M.B.); (O.O.); (P.P.); (U.B.)
| | - Ullrich Bauer
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Faculty of Educational Science, Bielefeld University, 33615 Bielefeld, Germany; (T.M.B.); (O.O.); (P.P.); (U.B.)
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Nagy-Pénzes G, Vincze F, Sándor J, Bíró É. Does Better Health-Related Knowledge Predict Favorable Health Behavior in Adolescents? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051680. [PMID: 32143530 PMCID: PMC7084625 DOI: 10.3390/ijerph17051680] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 12/22/2022]
Abstract
The importance of puberty on later health status and behavior is indisputable, which also means that it is worth making intervention efforts during this period of life. However, whether better health-related knowledge is correlated with favorable health behavior in adolescents is an important, still unanswered question. Our objective was to examine this relationship. The participants were ninth-grade secondary school students. Data were collected using anonymous, self-administered questionnaires. The knowledge-related questions were compiled by the authors, while the questions concerning eating habits, physical activity, demographic and socioeconomic data were taken from the Health Behavior in School-Aged Children survey. The relationship between knowledge and behavior was investigated with structural equation modeling adjusted for gender, age, and socioeconomic status. The results demonstrated a good fit to the data, but better knowledge was not related to behavior in our sample. This finding suggests that adolescents’ health behavior is highly influenced by the living context; therefore, appropriate knowledge is necessary but not sufficient to improve adolescents’ behavior. Hence, comprehensive health promotion programs could provide solutions for encouraging healthy behavior.
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Affiliation(s)
- Gabriella Nagy-Pénzes
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 26. Kassai street, 4028 Debrecen, Hungary; (G.N.-P.); (F.V.); (J.S.)
- Doctoral School of Health Sciences, University of Debrecen, 26. Kassai street, 4028 Debrecen, Hungary
| | - Ferenc Vincze
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 26. Kassai street, 4028 Debrecen, Hungary; (G.N.-P.); (F.V.); (J.S.)
| | - János Sándor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 26. Kassai street, 4028 Debrecen, Hungary; (G.N.-P.); (F.V.); (J.S.)
| | - Éva Bíró
- Division of Health Promotion, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 26. Kassai street, 4028 Debrecen, Hungary
- Correspondence: ; Tel.: +36-52-512-765 (ext. 77405)
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Loer AKM, Domanska OM, Kuhnert R, Houben R, Albrecht S, Jordan S. Online Survey for the Assessment of Generic Health Literacy among Adolescents in Germany (GeKoJu): Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1518. [PMID: 32120870 PMCID: PMC7084343 DOI: 10.3390/ijerph17051518] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/13/2022]
Abstract
The promotion of health literacy at a young age can protect, maintain and improve health across the life course. Yet to date, a sound data basis on adolescent health literacy as a requirement for the development of strategies to promote health literacy has not been given. This paper presents a study protocol for the online survey "Health Literacy Among Adolescents" (GeKoJu) that collects the first nation-wide representative data on self-reported generic health among adolescents aged 14-17 years in Germany. The objectives of the survey are (1) to assess the distribution of generic health literacy among adolescents in Germany, (2) to identify socio-demographic and social factors in regard to health literacy and (3) to assess the association of health literacy and health-related outcomes. The cross-sectional survey was conducted from September 2019 through December 2019. A two-stage stratified cluster sampling strategy was applied. Individuals invited to participate in the survey (N = 6608) were randomly selected among German-speaking adolescents aged 14-17 years, with permanent residence in Germany. Generic health literacy is measured with the "Measurement of Health Literacy Among Adolescents-Questionnaire" (MOHLAA-Q). Data collection also covers questions on health behavior, subjective health status, personal and social resources, socio-demographic and social factors and health services use. Results of the GeKoJu survey will provide data for the development of strategies to promote generic health literacy among families, in schools, communities and health care.
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Affiliation(s)
- Anne-Kathrin M. Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101 Berlin, Germany; (O.M.D.); (R.K.); (R.H.); (S.A.); (S.J.)
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Seidel G, Meyer A, Lander J, Dierks ML. Facetten von Gesundheitskompetenz. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2020. [DOI: 10.1007/s11553-019-00736-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kupolati MD, MacIntyre UE, Gericke GJ, Becker P. A Contextual Nutrition Education Program Improves Nutrition Knowledge and Attitudes of South African Teachers and Learners. Front Public Health 2019; 7:258. [PMID: 31620415 PMCID: PMC6759471 DOI: 10.3389/fpubh.2019.00258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 08/27/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Evaluating the impact of a nutrition education program could provide insight into the effectiveness of an intervention. Researchers tested the hypothesis that a theory-based contextual nutrition education program (NEP) would improve the nutrition knowledge, attitudes, and dietary practices (KAP) of teachers and learners. Methods: Twenty three teachers who taught nutrition in Grades 4-7 (treatment school, n = 12) and 681 learners (treatment school, n = 350) participated in the study. In this quasi-experimental study, two primary schools were randomly selected to implement a contextual NEP. The nutrition KAP were assessed using previously validated questionnaires. The treatment school teachers taught nutrition using a developed nutrition education manual, while the control school teachers taught nutrition in the usual manner. Random effects Generalized Least Squares regression estimated the difference in the teachers' and learners' KAP for the treatment and control schools; p = 0.025 for a one-tailed test. Results: At post-implementation, the treatment school teachers' had higher total nutrition knowledge mean score (85.5% ± 8.2, p = 0.003) compared to the control school. Within the treatment school, total nutrition knowledge mean score of the teachers improved by 14.1%, p ≤ 0.001. Learners in the treatment school had higher total nutrition knowledge (53.2% ± 16.9, p = 0.002) and nutrition attitude (63.9% ± 19.7, p = 0.001) scores compared to learners in the control school. Within the treatment school, learners' total nutrition knowledge and nutrition attitudes scores increased by 4.9%, p ≤ 0.001 and 6.9%, p ≤ 0.001, respectively. The dietary practices of the teachers and the learners, and the nutrition attitudes of the teachers in the treatment school showed no significant within school improvement or in comparison with the control school (p > 0.025). Conclusions: The NEP led to the improvement in the teachers' and the learners' nutrition knowledge and the learners' nutrition attitudes. However, no significant improvement in the dietary practices of either teachers or learners was found.
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Affiliation(s)
| | - Una E. MacIntyre
- Human Nutrition Department, University of Pretoria, Pretoria, South Africa
| | - Gerda J. Gericke
- Human Nutrition Department, University of Pretoria, Pretoria, South Africa
| | - Piet Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Ludwig B, Smith SS, Heussler H. How Well Do Children Understand the Vocabulary of Sleep? Health Lit Res Pract 2019; 3:e53-e69. [PMID: 31294308 PMCID: PMC6608919 DOI: 10.3928/24748307-20190122-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/14/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Sleep surveys, such as the Pediatric Daytime Sleepiness Scale (PDSS), are used to determine a variety of concerns associated with sleep, including excessive daytime sleepiness (hypersomnolence), bedtime sleep behaviors, night awakenings, sleep duration, and sleep-disordered breathing. However, the literacy ability of the patient may not be adequate to ensure comprehension of questions and provision of accurate responses. Objective: To assess children's understanding of the sleep-associated vocabulary included in the PDSS. Methods: A cross-sectional, open-response survey was developed for use with students age 4 to 12 years. Prior to completing the instrument, each student was asked the meaning of six key sleep-related words used in the PDSS: drowsy, sleepy, alert, awakened, tired, and awake. The parents/caregivers were requested to record their child's definitions of these key words exactly as stated. Identification of words for “suitable” definitions was undertaken through consultation of three online dictionaries. This enabled the qualitative process associated with open-response surveys to be followed: identification of common themes, chunking of information, and criteria for coding responses. The final sample consisted of word definitions from 325 students (152 boys and 173 girls) from a school enrollment of 727 (45%). Key Results: A high percentage of children provided “suitable” responses for the words sleepy (84%) and tired (75%). The percentage of “suitable” responses for the words drowsy and awakened gradually increased across the age groups. The words alert and awake were challenging for the children to define, with the sleep-associated definition for alert only being provided by 31% of children overall and awake only being provided by 48% overall. In total, 57% of children were able to provide suitable definitions for at least four words. Conclusions: Our findings suggest that the results of many sleep surveys using these terms may not yield results that accurately reflect a child's actual state of daytime sleepiness and sleep/wake behaviors. Prior to administering a sleep survey, physicians need to clearly explain the meanings of sleep-associated words used in the survey and thus gain a more accurate reflection of a child's sleep and daytime behaviors. [HLRP: Health Literacy Research and Practice. 2019;3(1):e53–e69.] Plain Language Summary: Sleep surveys are used to identify problems with sleep. Children with poor health literacy due to age may not understand the questions and may not provide adequate answers. Children's understanding of sleep-associated vocabulary was assessed using six words: drowsy, sleepy, alert, awakened, tired, and awake. Many of these words were found to be difficult for the children to define.
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Affiliation(s)
- Beris Ludwig
- Address correspondence to Beris Ludwig, MEd, BSc (Hons) (Psychology), University of Queensland, 881 Ruthven Street, Toowoomba, QLD, Australia, 4350;
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Domanska OM, Firnges C, Bollweg TM, Sørensen K, Holmberg C, Jordan S. Do adolescents understand the items of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) - German version? Findings from cognitive interviews of the project "Measurement of Health Literacy Among Adolescents" (MOHLAA) in Germany. ACTA ACUST UNITED AC 2018; 76:46. [PMID: 30009022 PMCID: PMC6040081 DOI: 10.1186/s13690-018-0276-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 06/05/2018] [Indexed: 02/02/2023]
Abstract
Background In Germany, there are no measurement tools to assess the general health literacy of adolescents. The aim of the study "Measurement of Health Literacy Among Adolescents" (MOHLAA) is to develop such a tool for use among adolescents aged 14-17. The German version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47-GER) served as a blueprint for the development of the tool. The present study examined the extent to which the HLS-EU-Q47-GER can be applied to the measurement of general health literacy in adolescents. Methods The applicability of the HLS-EU-Q47-GER for adolescents was tested qualitatively using cognitive interviewing (CI). Purposive sampling was used to achieve an equal distribution of participants regarding age groups, educational backgrounds and gender. CI was standardized on the basis of an interview guide. Verbal probing and the retrospective think-aloud technique were applied. The interviews were audio-recorded, transcribed and analyzed using the criteria of theory-based analysis, which were derived from the model of cognitive processes. The analysis focused on identifying terms and questions that were difficult to understand and on scrutinizing the extent to which the content of the items is appropriate for assessing adolescents' health literacy. Results Adolescent respondents were unfamiliar with some terms of the HLS-EU-Q47-GER or provided heterogeneous interpretations of the terms. They had limited or no experience regarding some health-related tasks in health care and disease prevention that are addressed by HLS-EU-Q-items. A few items seemed to be too "difficult" to answer due to a high abstraction level or because they lacked any reference to the everyday lives of youth. Despite comprehension problems with some of the HLS-EU items, the respondents assessed the covered health-related tasks as "very easy" or "fairly easy". CI stressed the importance of interpersonal agents, especially parents, in helping adolescents understand and judge the reliability of health information. Conclusions The results of CI indicated that the applicability of the HLS-EU-Q47-GER to the measurement of general health literacy among adolescents aged 14-17 is limited. In order to prevent biased data, some items of the questionnaire should be adjusted to adolescents' state of development and experiences with health care and disease prevention.
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Affiliation(s)
- Olga Maria Domanska
- 1Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christiane Firnges
- 1Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Torsten Michael Bollweg
- 2Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, Bielefeld, Germany
| | | | - Christine Holmberg
- 4Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,Institute of Social Medicine and Epidemiology, Medical School Brandenburg Theodor Fontane, Brandenburg/Havel, Germany
| | - Susanne Jordan
- 1Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Guo S, Armstrong R, Waters E, Sathish T, Alif SM, Browne GR, Yu X. Quality of health literacy instruments used in children and adolescents: a systematic review. BMJ Open 2018; 8:e020080. [PMID: 29903787 PMCID: PMC6009458 DOI: 10.1136/bmjopen-2017-020080] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Improving health literacy at an early age is crucial to personal health and development. Although health literacy in children and adolescents has gained momentum in the past decade, it remains an under-researched area, particularly health literacy measurement. This study aimed to examine the quality of health literacy instruments used in children and adolescents and to identify the best instrument for field use. DESIGN Systematic review. SETTING A wide range of settings including schools, clinics and communities. PARTICIPANTS Children and/or adolescents aged 6-24 years. PRIMARY AND SECONDARY OUTCOME MEASURES Measurement properties (reliability, validity and responsiveness) and other important characteristics (eg, health topics, components or scoring systems) of health literacy instruments. RESULTS There were 29 health literacy instruments identified from the screening process. When measuring health literacy in children and adolescents, researchers mainly focus on the functional domain (basic skills in reading and writing) and consider participant characteristics of developmental change (of cognitive ability), dependency (on parents) and demographic patterns (eg, racial/ethnic backgrounds), less on differential epidemiology (of health and illness). The methodological quality of included studies as assessed via measurement properties varied from poor to excellent. More than half (62.9%) of measurement properties were unknown, due to either poor methodological quality of included studies or a lack of reporting or assessment. The 8-item Health Literacy Assessment Tool (HLAT-8) showed best evidence on construct validity, and the Health Literacy Measure for Adolescents showed best evidence on reliability. CONCLUSIONS More rigorous and high-quality studies are needed to fill the knowledge gap in measurement properties of health literacy instruments. Although it is challenging to draw a robust conclusion about which instrument is the most reliable and the most valid, this review provides important evidence that supports the use of the HLAT-8 to measure childhood and adolescent health literacy in future school-based research.
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Affiliation(s)
- Shuaijun Guo
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Rebecca Armstrong
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth Waters
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Thirunavukkarasu Sathish
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Sheikh M Alif
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Geoffrey R Browne
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Xiaoming Yu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
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Haney MO. Psychometric testing of the Turkish version of the Health Literacy for School-Aged Children Scale. J Child Health Care 2018; 22:97-107. [PMID: 29110532 DOI: 10.1177/1367493517738124] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the validity and reliability of the Turkish version of the Health Literacy for School-Aged Children (HLSAC-T) scale. This study was a cross-sectional and methodological design. The sample consisted of 563 sixth and ninth grade students in Izmir, Turkey. Data were collected with the socio-demographic characteristics questionnaire, HLSAC-T, and Turkish version of the Adolescent Lifestyle Profile. Cronbach's α for the scale was .77 and item-total correlations were between .49 and .61 ( p < .001). The model fit indices were determined to be the root mean square error of approximation at .035, the goodness of fit index at .99, and the comparative fit index at .99. The concordance validity and convergent validity were supported and the discriminant validity suggested that the scale successfully discriminated students who cared about healthy lifestyle from the students who did not. The HLSAC-T showed an adequate reliability and validity for determining the subjective health literacy of Turkish school-aged children. The results showed promise that the scale could be translated into other languages.
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Affiliation(s)
- Meryem Ozturk Haney
- Public Health Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey
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Okan O, Lopes E, Bollweg TM, Bröder J, Messer M, Bruland D, Bond E, Carvalho GS, Sørensen K, Saboga-Nunes L, Levin-Zamir D, Sahrai D, Bittlingmayer UH, Pelikan JM, Thomas M, Bauer U, Pinheiro P. Generic health literacy measurement instruments for children and adolescents: a systematic review of the literature. BMC Public Health 2018; 18:166. [PMID: 29357867 PMCID: PMC5778701 DOI: 10.1186/s12889-018-5054-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 01/10/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health literacy is an important health promotion concern and recently children and adolescents have been the focus of increased academic attention. To assess the health literacy of this population, researchers have been focussing on developing instruments to measure their health literacy. Compared to the wider availability of instruments for adults, only a few tools are known for younger age groups. The objective of this study is to systematically review the field of generic child and adolescent health literacy measurement instruments that are currently available. METHOD A systematic literature search was undertaken in five databases (PubMed, CINAHL, PsycNET, ERIC, and FIS) on articles published between January 1990 and July 2015, addressing children and adolescents ≤18 years old. Eligible articles were analysed, data was extracted, and synthesised according to review objectives. RESULTS Fifteen generic health literacy measurement instruments for children and adolescents were identified. All, except two, are self-administered instruments. Seven are objective measures (performance-based tests), seven are subjective measures (self-reporting), and one uses a mixed-method measurement. Most instruments applied a broad and multidimensional understanding of health literacy. The instruments were developed in eight different countries, with most tools originating in the United States (n = 6). Among the instruments, 31 different components related to health literacy were identified. Accordingly, the studies exhibit a variety of implicit or explicit conceptual and operational definitions, and most instruments have been used in schools and other educational contexts. While the youngest age group studied was 7-year-old children within a parent-child study, there is only one instrument specifically designed for primary school children and none for early years. CONCLUSIONS Despite the reported paucity of health literacy research involving children and adolescents, an unexpected number of health literacy measurement studies in children's populations was found. Most instruments tend to measure their own specific understanding of health literacy and not all provide sufficient conceptual information. To advance health literacy instruments, a much more standardised approach is necessary including improved reporting on the development and validation processes. Further research is required to improve health literacy instruments for children and adolescents and to provide knowledge to inform effective interventions.
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Affiliation(s)
- Orkan Okan
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
| | - Ester Lopes
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
| | - Torsten Michael Bollweg
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
| | - Janine Bröder
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
| | - Melanie Messer
- School of Public Health, Public Health Nursing & Health Science Research, Bielefeld University, Bielefeld, NRW Germany
| | - Dirk Bruland
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
| | - Emma Bond
- University of Suffolk, Ipswich, England UK
| | | | | | - Luis Saboga-Nunes
- CIESP, National School of Public Health, ISAMB (FMUL), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Diane Levin-Zamir
- School of Public Health, University of Haifa, Haifa, Israel
- Clalit Health Services, Department of Health Education and Promotion, Tel Aviv, Israel
| | - Diana Sahrai
- School of Education, University of Applied Sciences and Arts, Northwestern Switzerland, Basel, Switzerland
| | | | - Jürgen M. Pelikan
- Austria & Institute for Public Health, University of Vienna, Vienna, Austria
| | - Malcolm Thomas
- School of Education, Aberystwyth University, Aberystwyth, Wales
| | - Ullrich Bauer
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
| | - Paulo Pinheiro
- Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescents (CPI), Bielefeld University, Bielefeld, NRW Germany
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Health literacy in childhood and youth: a systematic review of definitions and models. BMC Public Health 2017; 17:361. [PMID: 28441934 PMCID: PMC5405535 DOI: 10.1186/s12889-017-4267-y] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 04/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children and young people constitute a core target group for health literacy research and practice: during childhood and youth, fundamental cognitive, physical and emotional development processes take place and health-related behaviours and skills develop. However, there is limited knowledge and academic consensus regarding the abilities and knowledge a child or young person should possess for making sound health decisions. The research presented in this review addresses this gap by providing an overview and synthesis of current understandings of health literacy in childhood and youth. Furthermore, the authors aim to understand to what extent available models capture the unique needs and characteristics of children and young people. METHOD Six databases were systematically searched with relevant search terms in English and German. Of the n = 1492 publications identified, N = 1021 entered the abstract screening and N = 340 full-texts were screened for eligibility. A total of 30 articles, which defined or conceptualized generic health literacy for a target population of 18 years or younger, were selected for a four-step inductive content analysis. RESULTS The systematic review of the literature identified 12 definitions and 21 models that have been specifically developed for children and young people. In the literature, health literacy in children and young people is described as comprising variable sets of key dimensions, each appearing as a cluster of related abilities, skills, commitments, and knowledge that enable a person to approach health information competently and effectively and to derive at health-promoting decisions and actions. DISCUSSION Identified definitions and models are very heterogeneous, depicting health literacy as multidimensional, complex construct. Moreover, health literacy is conceptualized as an action competence, with a strong focus on personal attributes, while also recognising its interrelatedness with social and contextual determinants. Life phase specificities are mainly considered from a cognitive and developmental perspective, leaving children's and young people's specific needs, vulnerabilities, and social structures poorly incorporated within most models. While a critical number of definitions and models were identified for youth or secondary school students, similar findings are lacking for children under the age of ten or within a primary school context.
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Okan O, Pinheiro P, Zamora P, Bauer U. [Health literacy in childhood and adolescence: An overview and current state of research]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:930-41. [PMID: 26133161 DOI: 10.1007/s00103-015-2199-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Health literacy is multidisciplinary and brings together many concepts, and is of increasing importance for disease protection, health promotion, and prevention, and for health policy within Europe. Although its importance is increasingly recognised, adults are mostly the target audience, whereas children and adolescents, in addition to education and schools, have so far been neglected. OBJECTIVES The aim is to give an overview of the state of the art in childhood and adolescence health literacy research, and to identify any existing gaps. MATERIALS A literature review has been performed to identify the relevant research data. RESULTS Limitations in developmental and age-adjusted conceptual frameworks and a lack of prevalence data, however, significantly impede our understanding of the meaning of health literacy in children and adolescents. School health promotion programmes could serve as a platform for effective health literacy education, beginning in early childhood. CONCLUSIONS In addition to compatibility with a broader literacy perspective, the proximity to several theories of health promotion and defined concepts, and the importance of school health promotion and education, it is vital to focus research on current gaps in the understanding of health literacy determinants, health literacy as a determinant of health, and in terms of the design and systematic implementation of intervention programmes.
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Affiliation(s)
- Orkan Okan
- Fakultät für Erziehungswissenschaft, Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Raum: UHG M7-118, Postfach 10 01 31, 33501, Bielefeld, Deutschland,
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Fairbrother H, Curtis P, Goyder E. Making health information meaningful: Children's health literacy practices. SSM Popul Health 2016; 2:476-484. [PMID: 29349163 PMCID: PMC5757919 DOI: 10.1016/j.ssmph.2016.06.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 11/03/2022] Open
Abstract
Children's health and wellbeing is high on the research and policy agenda of many nations. There is a wealth of epidemiological research linking childhood circumstances and health practices with adult health. However, echoing a broader picture within child health research where children have typically been viewed as objects rather than subjects of enquiry, we know very little of how, in their everyday lives, children make sense of health-relevant information. This paper reports key findings from a qualitative study exploring how children understand food in everyday life and their ideas about the relationship between food and health. 53 children aged 9-10, attending two socio-economically contrasting schools in Northern England, participated during 2010 and 2011. Data were generated in schools through interviews and debates in small friendship groups and in the home through individual interviews. Data were analysed thematically using cross-sectional, categorical indexing. Moving beyond a focus on what children know the paper mobilises the concept of health literacy (Nutbeam, 2000), explored very little in relation to children, to conceptualise how children actively construct meaning from health information through their own embodied experiences. It draws on insights from the Social Studies of Childhood (James and Prout, 2015), which emphasise children's active participation in their everyday lives as well as New Literacy Studies (Pahl and Rowsell, 2012), which focus on literacy as a social practice. Recognising children as active health literacy practitioners has important implications for policy and practice geared towards improving child health.
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Affiliation(s)
- Hannah Fairbrother
- School of Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield S10 2LA, UK
| | - Penny Curtis
- School of Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield S10 2LA, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Sreet, Sheffield S1 4DA, UK
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Shih SF, Liu CH, Liao LL, Osborne RH. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan. BMC Public Health 2016; 16:280. [PMID: 27000035 PMCID: PMC4802836 DOI: 10.1186/s12889-016-2879-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. METHODS Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. RESULTS The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese. CONCLUSIONS This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.
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Affiliation(s)
- Shu-Fang Shih
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Chieh-Hsing Liu
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Li-Ling Liao
- />Department of Health Management, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445 Taiwan
| | - Richard H. Osborne
- />Deakin University Centre for Population Health Research, School of Health and Social Development, Geelong, Victoria Australia
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Ye X, Yao Z, Liu W, Fan Y, Xu Y, Chen S. Path analysis to identify factors influencing health skills and behaviors in adolescents: a cross-sectional survey. PLoS One 2014; 9:e104406. [PMID: 25105974 PMCID: PMC4126710 DOI: 10.1371/journal.pone.0104406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 07/11/2014] [Indexed: 11/25/2022] Open
Abstract
Background Studies conducted in the past mostly rely on models of functional health literacy in adult populations. However, such models do not satisfy the need for health intervention in adolescents. The identification of key factors influencing adolescents' health literacy is essential in developing effective prevention and intervention measures. This study aimed to test a theoretical model of predictors on health skills and health behaviors in adolescents. Methods A cross-sectional survey was conducted in Guangdong using a multi-stage stratified cluster sample design. A representative random sample of 3821 students aged 13–25 years was selected using multi-stage stratified cluster sampling. The path analysis was used to test a hypothesized model of health literacy. Results The path analysis showed that knowledge of infectious disease (β = 0.26), health skills (β = 0.22), health concept (β = 0.20), general health knowledge (β = 0.15), gender (β = 0.12), and school performance (β = 0.06) had positive direct effect on health behaviors in adolescents. The explanatory variables accounted for 43% of the variance in explaining health behaviors. Knowledge of infectious disease (β = 0.30), health concept (β = 0.17), general health knowledge (β = 0.13), and school performance (β = 0.05) had positive indirect effect on health behaviors through the impacts on health skills. Conclusion This study identified several direct and indirect factors influencing health skills and health behaviors in adolescents. These findings will assist health professionals designing effective health interventions that aim to improve health skills and health behaviors in adolescents.
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Affiliation(s)
- Xiaohua Ye
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhenjiang Yao
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Weidong Liu
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Yanping Fan
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Ya Xu
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- * E-mail: (YX); (SDC)
| | - Sidong Chen
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- * E-mail: (YX); (SDC)
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Perry EL. Health literacy in adolescents: an integrative review. J SPEC PEDIATR NURS 2014; 19:210-8. [PMID: 24612548 DOI: 10.1111/jspn.12072] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/22/2014] [Accepted: 01/27/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the state of the science of health literacy instruments and interventions for use in adolescents. CONCLUSIONS There is a scarcity of literature regarding health literacy instruments and interventions for adolescents. Ten studies were included in the final table for analysis. One instrument shows high validity and reliability in English. Most interventions are exploratory, with two studies showing significant outcomes. PRACTICE IMPLICATIONS More research is needed to establish the appropriate evaluation of and effective interventions for health literacy in adolescents.
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Driessnack M, Chung S, Perkhounkova E, Hein M. Using the "Newest Vital Sign" to assess health literacy in children. J Pediatr Health Care 2014; 28:165-71. [PMID: 23910945 DOI: 10.1016/j.pedhc.2013.05.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 05/13/2013] [Accepted: 05/29/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to explore the feasibility, utility, and validity of using the Newest Vital Sign (NVS) tool to assess health literacy in children. METHOD Forty-seven parent-child dyads individually completed the NVS and a Home Literacy Environment single-item screening question (No. of children's books in the home). RESULTS The majority (72%; n = 34) of parent-child dyads had adequate health literacy (NVS scores ≥4), with no significant differences (p = .95) between children's NVS scores (M = 4.8, SD = 1.5) and parents (M = 4.8, SD = 1.6). A moderate, positive correlation was found between children's and parents' NVS scores (rs = .35, p = .017). Of note was that all of the parents (n = 4) and children (n = 6) who reported having only 10 or fewer children's books in their homes had NVS scores less than 4, indicating inadequate health literacy. DISCUSSION The NVS is a quick screening mechanism for identifying households that have adequate health literacy levels. Asking children the Home Literacy Environment single-question screening item (No. of children's books) provided additional insight that confirmed and extended findings from the NVS.
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Abel T, Hofmann K, Ackermann S, Bucher S, Sakarya S. Health literacy among young adults: a short survey tool for public health and health promotion research. Health Promot Int 2014; 30:725-35. [PMID: 24482542 DOI: 10.1093/heapro/dat096] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Health literacy (HL) is context-specific. In public health and health promotion, HL in the private realm refers to individuals' knowledge and skills to prevent disease and to promote health in everyday life. However, there is a scarcity of measurement tools explicitly geared to private realm contexts. Our aim was to develop and test a short survey tool that captures different dimensions of HL in the context of family and friends. We used cross-sectional data from the Swiss Federal Surveys of Adolescents from 2010 to 2011, comprising 7983 males and 366 females between 18 and 25 years. HL was assessed through a set of eight items (self-reports). We used principal component analysis to explore the underlying factor structure among these items in the male sample and confirmatory factor analysis to verify the factor structure in the female sample. The results showed that the tested item set represented dimensions of functional, interactive and critical HL. Two sub-dimensions, understanding versus finding health-relevant information, denoted functional HL. Interactive and critical HL were each represented with two items. A sum score based on all eight items (Cronbach's α: 0.64) showed expected positive associations with own and parental education among males and females (p < 0.05). The short item set appears to be a feasible measurement tool to assess HL in the private realm. Its broader application in survey studies may help to improve our understanding of how this form of HL is distributed in the general population.
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Affiliation(s)
- Thomas Abel
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland
| | - Karen Hofmann
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland
| | - Sabine Ackermann
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland
| | - Sabine Bucher
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland
| | - Sibel Sakarya
- Department of Public Health, Marmara University School of Medicine, Haydarpasa, Istanbul 34668, Turkey
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Ormshaw MJ, Paakkari LT, Kannas LK. Measuring child and adolescent health literacy: a systematic review of literature. HEALTH EDUCATION 2013. [DOI: 10.1108/he-07-2012-0039] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Carvalho JC, Rebelo MAB, Vettore MV. The relationship between oral health education and quality of life in adolescents. Int J Paediatr Dent 2013; 23:286-96. [PMID: 23113917 DOI: 10.1111/ipd.12006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is no study on the association between oral health education and oral health quality of life (OHQoL). AIM To assess the relationship between oral health education activities integrated into primary care services and OHQoL in adolescents. DESIGN A retrospective observational survey was conducted on 300 randomly selected 12-14 years-of-age adolescents living in two publicly funded health service administrative areas in Manaus, Brazil. Between 2006 and 2008, dental treatment and oral health education were offered in one area (DT/OHE group), whereas in the other area, only dental treatment was provided (DT group). Collected data included socio-demographic characteristics, health services use, health-related behaviours, dental pain, dental caries and Child-OIDP. Independent variables were compared between groups by Mann-Whitney and chi-square tests. The association between one or more OIDP (Child-OIDP ≥ 1) and DT group tested using multivariate logistic regression. RESULTS Caries, use of dental services and health-related behaviours did not differ between groups (P > 0.05). Child-OIDP ≥ 1 was higher in DT group (90.0%) compared with DT/OHE group (79.3%) (P = 0.01). Child-OIDP ≥ 1 was independently associated with DT group [OR = 4.4 (1.1; 17.0)]. CONCLUSIONS Adolescents living in an area where OHE and DT were provided had better OHRQoL than those living in an area where only DT was provided.
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Affiliation(s)
- Jefferson Calixto Carvalho
- Faculdade de Odontologia, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brazil
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He C, Breiting S, Perez-Cueto FJ. Effect of organic school meals to promote healthy diet in 11–13 year old children. A mixed methods study in four Danish public schools. Appetite 2012; 59:866-76. [DOI: 10.1016/j.appet.2012.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 08/28/2012] [Accepted: 09/01/2012] [Indexed: 11/27/2022]
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Wallmann B, Gierschner S, Froböse I. Gesundheitskompetenz: was wissen unsere Schüler über Gesundheit? PRAVENTION UND GESUNDHEITSFORDERUNG 2011. [DOI: 10.1007/s11553-011-0322-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Implementation and evaluation of the population-based programme "health literacy in school-aged children" (GeKoKidS). J Public Health (Oxf) 2011. [DOI: 10.1007/s10389-011-0421-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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