Information and health literacy policies during pandemics: A narrative review.

BACKGROUND: The COVID-19 pandemic has compelled governments globally to formulate policies addressing the unique needs of their populations. These policies are critical in disseminating accurate information and enhancing health literacy during crises. OBJECTIVE: This narrative review aims to identify and assess effective information and health literacy policies implemented during pandemics. METHODS: A comprehensive literature search was performed across five electronic information sources (PubMed, Science Direct, ProQuest, Emerald Insight, Scopus), supplemented by Google Scholar. The analysis employed Walt and Gilson's health policy triangle framework to categorize and evaluate the findings. RESULTS: The review revealed that the policies could be grouped into several key categories: educational programs, laws and regulations, knowledge sharing, national programs, and different information sources. The development of these policies involved multifaceted processes influenced by political, scientific, economic, cultural and social factors, as well as the involvement of multiple stakeholders. CONCLUSIONS: This review offers significant insights and actionable recommendations for policymakers and stakeholders. By understanding the dimensions and components of effective information and health literacy policies, stakeholders can better prepare for and respond to future pandemics and similar health crises.

Superusers of Self-Paced Online Learning on OpenWHO.

INTRODUCTION: OpenWHO provides open-access, online, free and real-time learning responses to health emergencies, which includes capacitating healthcare providers, first liners, medical students and even the general public. During the pandemic and to date, an additional 40 courses for COVID-19 response have led to a massive increase in the number of learners and a change in user's trends. This paper presents initial findings on enrollment trends, use and completion rates of health emergency courses offered on OpenWHO. METHODS: The enrolment data statistics were drawn from OpenWHO's built-in reporting system, which tracks learners' enrolments, completion rates, demographics and other key course-related data, This information was collected from the beginning of the OpenWHO launch in 2017 up until October 2021. RESULTS: Average course completion rate on OpenWHO including all courses and languages was equal to 45.9%. Nearly half (46.4%) of all OpenWHO learners have enrolled in at least 2 courses and 71 000 superusers have completed at least 10 courses on the platform. CONCLUSION: WHO's learning platform during the pandemic registered record high completion rates and repeat learners enrollment. This highlights the massive impact of the OpenWHO online learning platform for health emergencies and the tangible knowledge transfer and access to health literacy.

Health literacy: The role of NHS library and knowledge services.

Health literacy is key to person-centred, preventative healthcare and is both a societal and individual responsibility. This feature describes work undertaken by Health Education England, the Community Health and Learning Foundation and NHS Library and Knowledge Services to raise awareness among NHS staff and other key partners of the impact of low health literacy. It highlights a range of health literacy resources and ideas for developing and adapting these tools for remote delivery during and post-pandemic. D.I.

(Mis)informed about what? What it means to be a science-literate citizen in a digital world.

Science literacy is often held up as crucial for avoiding science-related misinformation and enabling more informed individual and collective decision-making. But research has not yet examined whether science literacy actually enables this, nor what skills it would need to encompass to do so. In this report, we address three questions to outline what it should mean to be science literate in today's world: 1) How should we conceptualize science literacy? 2) How can we achieve this science literacy? and 3) What can we expect science literacy's most important outcomes to be? If science literacy is to truly enable people to become and stay informed (and avoid being misinformed) on complex science issues, it requires skills that span the "lifecycle" of science information. This includes how the scientific community produces science information, how media repackage and share the information, and how individuals encounter and form opinions on this information. Science literacy, then, is best conceptualized as encompassing three dimensions of literacy spanning the lifecycle: Civic science literacy, digital media science literacy, and cognitive science literacy. Achieving such science literacy, particularly for adults, poses many challenges and will likely require a structural perspective. Digital divides, in particular, are a major structural barrier, and community literacy and building science literacy into media and science communication are promising opportunities. We end with a discussion of what some of the beneficial outcomes could be-and, as importantly, will likely not be-of science literacy that furthers informed and critical engagement with science in democratic society.

Patient-Reported Outcomes and Experiences with Population Genetic Testing Offered Through a Primary Care Network.

Aims: To explore patient experiences in a large-scale primary care-based, preemptive genetic testing program. Methods: Patients who received genetic results from the initiative were invited to participate in an online survey 3 weeks postresult disclosure. A 6-month follow-up survey was sent to assess changes over time. Results: The initial survey was completed by 1646 patients, with 544 completing the 6-month follow-up survey. The following outcomes were high overall: patient-reported understanding of results (cancer: 87%; cardiac: 86%); perceived utility (75%); positive emotions (relieved: 66.8%; happy: 62.0%); family result sharing (67.6%); and satisfaction (87%), although analysis by demographic factors identified groups who may benefit from additional education and emotional support. Results-related health behaviors and discussions with providers increased over time (screening procedures 6.1% to 14.2% p < 0.001; provider discussion 10.3% to 25.3%, p < 0.001), and were more likely to take place for patients with positive cancer and/or cardiac results (39.8% vs. 7.6%, p < 0.001). Forty-seven percent of patients reported insurance discrimination concerns, and most (79.4%) were not familiar with privacy and nondiscrimination laws. Concerns regarding discrimination and negative emotions decreased between the two survey time points (privacy issues 44.6% to 35.1% p < 0.001; life insurance discrimination concerns 35.5% to 29.6%, p = 0.001; anxiety 8.1% to 3.3%, p < 0.001; and uncertainty 19.8% to 12.8%, p < 0.001). These findings led to the development and integration of additional patient resources to improve program implementation. Conclusion: Our findings highlight patient experiences with and areas of need in a community-based genomic screening pilot initiative using a mixed primary care/genetics provider model to deliver precision medicine.

Health literacy, preventive COVID 19 behaviour and adherence to chronic disease treatment during lockdown among patients registered at primary health facility in urban Jodhpur, Rajasthan.

BACKGROUND AND AIMS: Potential role of health literacy in determining adherence to COVID-19 preventive behavior, pharmacological, and lifestyle management among diagnosed patients of chronic diseases during nationwide lockdown is inadequately investigated. METHODS: A cross-sectional study was conducted from May-August 2020 among diagnosed patients of chronic diseases residing in a COVID-19 hotspot of urban Jodhpur, Rajasthan, and availing health services from primary care facility. Telephonic interviews of participants were conducted to determine their health literacy using HLS-EU-Q47 questionnaire, adherence to COVID-19 preventive behaviour as per World Health Organization recommendations, and compliance to prescribed pharmacological and physical activity recommendations for chronic disease. RESULTS: All the 605 diagnosed patients of chronic diseases availing services from primary care facility were contacted for the study, yielding response rate of 68% with 412 agreeing to participate. Insufficient health literacy was observed for 65.8% participants. Only about half of participants had scored above median for COVID-19 awareness (55.1%) and preventive behavior (45.1%). Health literacy was observed to be significant predictor of COVID-19 awareness [aOR: 3.53 (95% CI: 1.81-6.88)]; COVID-19 preventive behavior [aOR: 2.06, 95%CI; 1.14-3.69] and compliance to pharmacological management [aOR: 3.05; 95% CI: 1.47-6.35] but not for physical activity. CONCLUSION: COVID-19 awareness, preventive behavior, and compliance to pharmacological management is associated with health literacy among patients of chronic disease availing services from primary health facility. Focusing on health literacy could thus be an essential strategic intervention yielding long term benefits.

Building on Evidence to Improve eHealth Literacy in Older Adults: A Systematic Review.

This review aimed to provide information on ways to improve eHealth literacy in older adults by assessing current studies examining eHealth literacy. To achieve the aim, this review focused on what theories or theoretical frameworks were used in the studies, what factors were related to eHealth literacy, and what outcome variables were used in eHealth literacy interventions for older adults. Five electronic databases were searched to identify eligible studies. The Cochrane Handbook for Systematic Reviews of Interventions was followed to select relevant studies, and narrative synthesis was performed. Among a total of 27 studies, 13 described theories or theoretical frameworks. Credibility in Internet health information, knowledge, and experience were identified as modifiable factors related to eHealth literacy. The most frequently used outcome variable was eHealth literacy efficacy. Nurses who are interested in improving eHealth literacy in older adults should consider appropriate theoretical frameworks and multiple factors influencing eHealth literacy.

Concordância entre dois instrumentos para avaliação do letramento em saúde / Concordancia entre dos instrumentos para evaluación de la alfabetización en salud / Concordance between two instruments for health literacy assessment

Objetivo: Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos: Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados: Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA, respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); e a concordância de acertos encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão: Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e desenvolvimento de instrumentos específicos às condições de saúde que permitam obter resultado próximo ao real contexto dos indivíduos.

Objetivo: Determinar la concordancia entre instrumentos de medición psicométrica short test of functional health literacy in adults (S-TOFHLA) y short assessment of health literacy for portuguese-speaking adults (SAHLPA-18) como estrategia para estimar la validez concurrente. Métodos: estudio transversal realizado con usuarios del Sistema Único de Salud. Para testear la validez concurrente se aplicó un enfoque de concordancia con una prueba ponderada de Kappa para datos cualitativos. Resultados: participaron 372 individuos. Se encontró que 66% y 62% de estos no tenía un nivel adecuado de letramiento según SAHLPA-18 y S-TOFHLA, respectivamente. Hubo una fuerte correlación entre los instrumentos (p<0.001; r=0.60), sin embargo 65.3% de concordancia, se consideró débil (Kappa=0.35; p<0.001). Conclusión: Los instrumentos SAHLPA-18 y S-TOFHLA tienen diferentes construcciones y escasa concordancia. En la investigación se indica el uso de diferentes instrumentos para medir el nivel de letramiento y el desarrollo de instrumentos específicos a las condiciones de salud que permitan obtener resultados cercanos al contexto real de los individuos.

Objetivo: To determine agreement between the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) measurement instruments as a strategy for estimating concurrent validity. Methods: This was a cross-sectional study conducted with users of the Brazilian National Health System. An agreement approach using a weighted Kappa test for qualitative data was applied in order to test for concurrent validity. Results: 372 individuals participated. It was found that 66% and 62% of them did not have an adequate level of literacy according to SAHLPA-18 and S-TOFHLA, respectively. There was strong correlation between the instruments (p<0.001; r=0.60), although the 65.3% agreement of correct answers found was considered weak (Kappa=0.35; p<0.001). Conclusion: The SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. Use of different instruments is indicated in research intended to measure level of literacy, as is the development of instruments specific to health conditions that allow results close to the real context of individuals to be obtained.

Library Jargon Creates Barriers for Potential Users of Health Library and Information Services.

This paper is based on Helen Kiely's Masters dissertation on MA in Library and Information Service Management, successfully completed at the University of Sheffield in 2018. The aim of the study was to explore the extent to which users of a health care library service understood common terminology used by clinical librarians/information professionals. A survey was developed based on the terminology used for common services and was distributed to staff and students at an acute NHS Foundation Trust. One hundred and eight people participated over a four week period and were asked to provide definitions to the terms. Analysis of the responses for accuracy and common themes indicates that jargon can be a barrier to user access and recommendations are made with respect to the need for outreach to users and the language used in this practice for creating better accessibility. F.J.

Enhancing global health communication during a crisis: lessons from the COVID-19 pandemic.

BACKGROUND/OBJECTIVE: The understanding and practice of public health crisis communication are improved through the study of responses to past crises, but require retooling for present challenges. The 'Addressing Ebola and other outbreaks' checklist contains guiding principles built upon maxims developed from a World Health Organization consultation in response to the mad cow (bovine spongiform encephalopathy) crisis that were later adopted for Ebola. The purpose of this article is to adapt the checklist for the health communication challenges and public health practices that have emerged during the coronavirus disease 2019 (COVID-19) pandemic. The communication challenges of promoting vaccine acceptance are used to illustrate a key area that requires strengthened communication. Type of program or service: Effective communication principles for application during the COVID-19 pandemic. RESULTS: The COVID-19 pandemic has introduced unique challenges for public health practitioners and health communicators that warrant an expansion of existing health communication principles to take into consideration: the new infodemic (or mis/disinfodemic) challenge - particularly as treatments and vaccines are being developed; communication of risk and uncertainty; health-information behaviours and the instantaneous nature of social media, and the relationship between media literacy and health literacy; the effects of the pandemic on other health issues; and the need for a flexible communication strategy that adapts to the different stages of the pandemic. LESSONS LEARNT: Principles discussed in this article will help build preparedness capacity and offer communication strategies for moving from the acute phase to the 'next normal' with likely prevention (e.g. herd immunity achieved through vaccination) and societal COVID-19 resilience.

Epilepsy through the eyes of the media: A paradox of positive reporting and challenges of access to advanced neurotechnology.

OBJECTIVE: Media coverage of disorders and medical advancements can impact public perception regarding the riskiness, effectiveness, and accessibility of treatment options. We studied that coverage for epilepsy with a focus on surgical interventions and emerging neurotechnologies. METHODS: Epilepsy-related English language articles published through 2019 were retrieved from online International news media with a circulation of 80,000 or above. We used directed content analysis of news articles to code content into a priori categories both to identify salient themes and to characterize their valence. RESULTS: One hundred forty-six unique articles matched our search terms. Overall, there was a steady increase in epilepsy reporting over time, with a majority of articles published with a positive tone. Neuromodulation was the focus of over 50% of all the articles in the time points analyzed. Vagus nerve stimulation (VNS) and deep-brain stimulation (DBS) were discussed more prominently than other types of neurotechnological interventions; VNS was the neurotechnological focus in 39% of the pediatric articles; resective surgery was the focus in 34% of adult articles. Access, support, and epilepsy literacy were the central themes in the context of ethical, legal, and social issues. SIGNIFICANCE: News media can influence the trust that the public places in science and medicine, and by extension, influences health policy. As innovations in neurotechnology for epilepsy emerge, understanding of individual and societal values is essential to their beneficial evolution and translation to care.

Health Literacy and Health Behaviors Among Adults With Prediabetes, 2016 Behavioral Risk Factor Surveillance System.

OBJECTIVES: Evidence is needed for designing interventions to address health literacy-related issues among adults with prediabetes to reduce their risk of developing type 2 diabetes. This study assessed health literacy and behaviors among US adults with prediabetes and the mediating role of health literacy on health behaviors. METHODS: We used data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) (N = 54 344 adults). The BRFSS health literacy module included 3 questions on levels of difficulty in obtaining information, understanding health care providers, and comprehending written information. We defined low health literacy as a response of "somewhat difficult" or "very difficult" to at least 1 of these 3 questions. Respondents self-reported their prediabetes status. We included 3 health behavior indicators available in the BRFSS survey-current smoking, physical inactivity, and inadequate sleep, all measured as binary outcomes (yes/no). We used a path analysis to examine pathways among prediabetes, health literacy, and health behaviors. RESULTS: About 1 in 5 (19.0%) adults with prediabetes had low health literacy. The rates of physical inactivity (31.0% vs 24.6%, P < .001) and inadequate sleep (38.8% vs 33.5%, P < .001) among adults with prediabetes were significantly higher than among adults without prediabetes. The path analysis showed a significant direct effect of prediabetes and health literacy on health behaviors. The indirect effect of prediabetes through health literacy on health behaviors was also significant. CONCLUSION: BRFSS data from 2016 showed that rates of low health literacy and unhealthy behaviors were higher among adults with prediabetes than among adults without prediabetes. Interventions are needed to assist adults with prediabetes in comprehending, communicating about, and managing health issues to reduce the risk of type 2 diabetes.

Effects of a Universal School-Based Mental Health Program on the Self-concept, Coping Skills, and Perceptions of Social Support of Students with Developmental Disabilities.

In a cluster randomized control trial, a school-based mental health program combining mental health literacy and dialectical behavior skills was implemented by teachers to determine effects on protective factors related to resilience for students in 3rd-12th grade. As part of a larger study, a subsample of 113 students with developmental disabilities attending 37 classrooms participated. Student-reported measures of self-concept, coping skills, and social support were collected three times in the year. Results indicated large effect sizes for the program on all measures, which pertain to time × group interactions (g = 1.53, 1.91, and 0.86 for self-concept, coping, and social support respectively). Follow-up analyses indicated that gains for the intervention schools primarily occurred between the first two assessment periods when the majority of program content was delivered. Implications for universal school-based mental health programming for students with developmental disabilities are discussed.

Epidemiological characteristics of hepatic echinococcosis, concurrent cerebral echinococcosis, and pulmonary echinococcosis in Ganzi County, Sichuan Province, China.

Human echinococcosis has become a major public health problem in most parts of the world. The objective of this article was to study the demographics of patients with hepatic echinococcosis in Ganzi County to elucidate the main risk factors, as well as to report the concurrent prevalence of cerebral echinococcosis and pulmonary echinococcosis.We recruited 195 patients with hepatic echinococcosis from the Datongma area of Ganzi County from January 2018 to November 2018. The patients' demographics, living environments, supported medical resources, knowledge of echinococcosis prevention and control, and hygienic practices were investigated and analyzed. The prevalence of cerebral echinococcosis and pulmonary echinococcosis were also investigated.The data were analyzed to identify risk factors for human echinococcosis. Our analysis showed that the herding Tibetan population within the 20 to 60 age group, and females, in particular, were at the highest risk of human echinococcosis infection. Having stray dogs around habitations and intimate activities with dogs and livestock were also behavioral risk factors. People with poor health literacy and low educational qualifications had possible risks of infection. In terms of hygiene, not using tap water as the drinking water source and lack of medical staff were significantly correlated with echinococcosis prevalence. Four patients were diagnosed with cerebral echinococcosis. Among them, 1 patient had both cerebral echinococcosis and pulmonary echinococcosis.Possible high-risk factors for echinococcosis were being female, herding population, in the 20 to 60 age group, having stray dogs around habitations, having activities with dogs and livestock, having poor health literacy, having low educational qualifications, and not using tap water as a drinking water source. The detection rate for brain echinococcosis in patients with hepatic echinococcosis was high (2.05%). Effective preventive strategies should be implemented in epidemic areas. Head CT scans should be applied for early detection of cerebral echinococcosis to carry out the treatment.

Limited Ability of Three Health Literacy Screening Items to Identify Adult English- and Spanish-Speaking Emergency Department Patients With Lower Health Literacy.

STUDY OBJECTIVE: Brief, easily administered, and valid health literacy assessment tools are needed to optimize health care delivery in the emergency medicine setting. Three health literacy screening items have been proposed to assess health literacy in outpatient settings. We investigated their ability to identify English- and Spanish-speaking adult emergency department (ED) patients with lower health literacy. METHODS: Participants were Spanish- or English-speaking adult patients randomly selected from 4 geographically spread, US, urban, safety-net EDs. Participants completed the 3 health literacy screening items, as well as the Short Assessment of Health Literacy-Spanish and English (SAHL-S&E). Test performance characteristics, including receiver operating characteristics area under the curve, of the 3 health literacy screening items were estimated, as compared with the SAHL-S&E. RESULTS: According to the SAHL-S&E, 36% of the 1,165 English speakers and 35% of the 1,605 Spanish speakers had lower health literacy. Areas under the curve for each health literacy screening item individually were: needing others to help read materials (English 0.59, 95% confidence interval [CI] 0.56 to 0.62; Spanish 0.58, 95% CI 0.56 to 0.61), problems learning because of difficulty reading (English 0.63, 95% CI 0.60 to 0.66; Spanish 0.59, 95% CI 0.56 to 0.62), and confidence with completing forms (English 0.62, 95% CI 0.59 to 0.65; Spanish 0.60, 95% CI 0.57 to 0.63). Areas under the curve for the 3 screening items combined were: English 0.66 (95% CI 0.63 to 0.70) and Spanish 0.62 (95% CI 0.59 to 0.64). CONCLUSION: The 3 health literacy screening items performed poorly in identifying adult ED patients with lower health literacy. Higher-validity screening measures are needed to better serve the health care needs of this vulnerable population in the ED setting.