Improving health and scientific literacy in disadvantaged groups: A scoping review of interventions.

OBJECTIVE: To explore approaches for developing and implementing interventions aimed at improving health literacy and health-related scientific literacy in disadvantaged groups. METHODS: A scoping review of literature published in 2012-2022 was conducted, followed by quality appraisal of eligible studies. RESULTS: Interventions were conducted mainly in community settings, where the most popular venues were adult education facilities. The primary target groups were those with limited income or education, ethnic minorities, or immigrants. Programs were often held in-person using interactive and culturally appropriate methods. They were predominantly focused on functional and interactive health literacy dimensions rather than on critical and scientific ones. Evaluations measured knowledge, health literacy, behavioral and psychological outcomes using various quantitative and qualitative instruments. CONCLUSIONS: The findings offer a comprehensive overview of the ways to design and evaluate health and scientific literacy interventions tailored to disadvantaged groups. PRACTICE IMPLICATIONS: Future interventions should prioritize participatory designs, culturally appropriate materials, and shift focus to critical and scientific health literacy, as well as to program scalability in less controlled conditions.

Communication inequalities and health disparities among vulnerable groups during the COVID-19 pandemic - a scoping review of qualitative and quantitative evidence.

BACKGROUND: The COVID-19 pandemic has exacerbated health disparities in vulnerable groups (e.g., increased infection, hospitalization, and mortality rates in people with lower income, lower education, or ethnic minorities). Communication inequalities can act as mediating factors in this relationship. Understanding this link is vital to prevent communication inequalities and health disparities in public health crises. This study aims to map and summarize the current literature on communication inequalities linked with health disparities (CIHD) in vulnerable groups during the COVID-19 pandemic and to identify research gaps. METHODS: A scoping review of quantitative and qualitative evidence was conducted. The literature search followed the guidelines of PRISMA extension for scoping reviews and was performed on PubMed and PsycInfo. Findings were summarized using a conceptual framework based on the Structural Influence Model by Viswanath et al. RESULTS: The search yielded 92 studies, mainly assessing low education as a social determinant and knowledge as an indicator for communication inequalities. CIHD in vulnerable groups were identified in 45 studies. The association of low education with insufficient knowledge and inadequate preventive behavior was the most frequently observed. Other studies only found part of the link: communication inequalities (n = 25) or health disparities (n = 5). In 17 studies, neither inequalities nor disparities were found. CONCLUSIONS: This review supports the findings of studies on past public health crises. Public health institutions should specifically target their communication to people with low education to reduce communication inequalities. More research about CIHD is needed on groups with migrant status, financial hardship, not speaking the language in the country of residence, sexual minorities, and living in deprived neighborhoods. Future research should also assess communication input factors to derive specific communication strategies for public health institutions to overcome CIHD in public health crises.

Comparison of Life Satisfaction in Persons With Spinal Cord Injury Living in 22 Countries With Different Economic Status.

OBJECTIVE: To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International Spinal Cord Injury (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries' economic status specified as gross domestic product per capita purchased power parity (GDP-PPP). DESIGN: Cross-sectional survey. SETTING: Community setting (22 countries representing all 6 World Health Organization regions). PARTICIPANTS: Persons (N=12,108) with traumatic or nontraumatic SCI aged at least 18 years, living in the community and able to respond to one of the available language versions of the questionnaire. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: LS measured by 5 items selected from the World Health Organization Quality of Life Assessment-BREF: satisfaction with overall quality of life, health, daily activities, relationships, and living conditions. LS index was calculated as the mean of these 5 items. RESULTS: The highest level of LS was reported by persons with SCI living in the United States, Malaysia, and Switzerland (mean range, 3.76-3.80), and the lowest was reported by persons with SCI living in South Korea, Japan, and Morocco (mean range, 2.81-3.16). There was a significant cubic association between LS index and GDP-PPP. Regression tree analysis revealed the main variables differentiating LS index were GDP-PPP and monthly income, followed by time since injury and education. CONCLUSIONS: Life satisfaction reported by persons with SCI related mainly to their country economic situation expressed by GDP-PPP and monthly income. The results of this study underscore the need for policy dialogues to avoid inequalities and improve the life experience in persons with SCI.

A qualitative exploration of interactional and organizational determinants of collaboration in cancer palliative care settings: Family members', health care professionals' and key informants' perspectives.

As life expectancy has increased, a growing number of people experience conditions, including cancers, that carry complex health and social needs. Palliative care services have the potential to address these needs but face significant obstacles. One major obstacle is suboptimal interprofessional collaboration. This study's goal was an in-depth exploration of interactional and organizational barriers and supports of collaboration in palliative care in Switzerland. We sought the perspectives of health care professionals, patients' family members and leaders and experts in oncology/palliative care delivery (key informants) through interviews and focus groups with fifty HPs and key informants and ten patients' family members. Qualitative analyses of interviews and focus groups used framework analysis. We identified three major themes of interaction: personal characteristics, communication, and connectedness with other health care professionals; and three major organizational themes: service characteristics, standardized communication and processes, and service coordination and promotion. Based on our findings, we recommend that health care professionals consider strategies to increase their collaboration and communication skills and opportunities to interact. We advocate the implementation of methods for coordinating services, standardization of consultation/referral procedures and communication between health care professionals, and the promotion of underutilized services to foster successful, sustainable collaboration.

Information seeking behavior and perceived health literacy of family caregivers of persons living with a chronic condition. The case of spinal cord injury in Switzerland.

OBJECTIVE: To examine the information seeking behavior and health literacy of caregivers of individuals living with spinal cord injury in Switzerland and their impact on the caregiving experience. METHODS: Nationwide survey of family caregivers of people with spinal cord injury (N = 717). Caregivers aged 18+ who assisted with activities of daily living were included. Self-reported information seeking behavior, including topics, preferred sources, and health literacy were assessed and analyzed. RESULTS: Health professionals were the most trusted source of information. Among information-seekers, higher health literacy levels were shown to be associated with lower subjective caregiver burden and, in turn, with higher caregivers' satisfaction with own health. CONCLUSION: Caregivers use information on different topics and coming from different sources. In order for information to improve the caregiving experience, however, caregivers need health literacy skills to make sense of it. PRACTICE IMPLICATIONS: Building health literacy is a promising approach to support caregivers in their activities, reduce their subjective burden, and even to improve their health. Interventions should consider involving health professionals, as the most trusted source of information, and address both health-related and more practical issues.

We need an operationalisation, not a definition of health.

Purpose: To demonstrate the value of the International Classification of Functioning, Disability and Health (ICF) notion of functioning as an operationalisation of health so as to describe, measure, and explain the lived experience of health, which is what matters to people about their health.Methods: Conceptual analysis based on evidence on the need to describe, measure, and compare states of health.Results: The ICF is the ideal framework to operationalise the lived experience of health. Its application in rehabilitation in particular, shows its value for the standardised reporting of outcomes of health interventions, clinical and services quality management, and evidence-informed health policy.Conclusions: The ICF provides both the frame of reference for an operationalisation of health that satisfies the intuitive understanding of what matters to people about their health and the technical tools for both health sciences and practice.Implications for rehabilitationAn operationalisation of health is essential to describe the relative health status of individuals and populations as well as to measure the impact of rehabilitation interventions.An operationalisation of health focuses on the lived experience of health.The International Classification of Health, Functioning and Disability (ICF) is the ideal framework to operationalise the lived experience of health.

Awareness, attitudes, and beliefs about music-induced hearing loss: Towards the development of a health communication strategy to promote safe listening.

OBJECTIVE: Worldwide, 1.1 billion young people are at risk of developing hearing loss due to unsafe listening. The World Health Organization plans a global health campaign to promote behavior change. In an effort to develop effective evidence-based interventions, this study identifies modifiable factors that influence listening habits. METHODS: Online survey among 1019 individuals aged 18-35. The questionnaire was based on theories of behavior change. RESULTS: Individuals not contemplating change showed a lack of knowledge, tended not to feel particularly at risk, and did not see the benefits of preventive measures. Conversely, those considering a change perceived more barriers (e.g., lack of information on how to act,). Self-efficacy was shown to play an ambivalent role. CONCLUSION: Four factors that can be influenced by a health communication intervention were identified: risk perception, perceived safe listening level due to a lack of symptoms, knowledge, and perceived benefits and barriers, in particular perceived loss of pleasure. PRACTICE IMPLICATIONS: The first aspects can be influenced through health communication interventions. Influencing the perceived loss of pleasure additionally requires an analysis of competing pressures. To support and not exceedingly burden the individual, we further suggest to address environmental aspects (e.g., policies).

What Online User Innovation Communities Can Teach Us about Capturing the Experiences of Patients Living with Chronic Health Conditions. A Scoping Review.

BACKGROUND: In order to adapt to societal changes, healthcare systems need to switch from a disease orientation to a patient-centered approach. Virtual patient networks are a promising tool to favor this switch and much can be learned from the open and user innovation literature where the involvement of online user communities in the innovation process is well-documented. OBJECTIVES: The objectives of this study were 1) to describe the use of online communities as a tool to capture and harness innovative ideas of end users or consumers; and 2) to point to the potential value and challenges of these virtual platforms to function as a tool to inform and promote patient-centered care in the context of chronic health conditions. METHODS: A scoping review was conducted. A total of seven databases were searched for scientific articles published in English between 1995 and 2014. The search strategy was refined through an iterative process. RESULTS: A total of 144 studies were included in the review. Studies were coded inductively according to their research focus to identify groupings of papers. The first set of studies focused on the interplay of factors related to user roles, motivations, and behaviors that shape the innovation process within online communities. Studies of the second set examined the role of firms in online user innovation initiatives, identifying different organizational strategies and challenges. The third set of studies focused on the idea selection process and measures of success with respect to online user innovation initiatives. Finally, the findings from the review are presented in the light of the particularities and challenges discussed in current healthcare research. CONCLUSION: The present paper highlights the potential of virtual patient communities to inform and promote patient-centered care, describes the key challenges involved in this process, and makes recommendations on how to address them.

"Save 30% if you buy today". Online pharmacies and the enhancement of peripheral thinking in consumers.

PURPOSE: Online pharmacies (OPs) are recognized as a potential threat to public health. The growth of an unregulated global drugs market risks increasing the spread of counterfeit medicines which are often delivered to consumers without a medical prescription. The aim of the study was to assess the strategies of argumentation that OPs adopt in their marketing. METHODS: A sample of 175 OPs was analyzed using the content-analysis method, and evaluated by relying on the Elaboration Likelihood Model (ELM) of persuasion. RESULTS: Almost 80% of the sample of OPs did not ask for a medical prescription by the consumer's physician. The selling arguments used included privacy policy, economic, quality, and service issues. About one-third of the OPs did not declare any side-effects regarding the drugs offered. CONCLUSION: Our results show that OPs advertise their products in an argumentative fashion that enhances consumers' peripheral reflection: by analogically playing with the selling of other commodities, they magnify aspects of the online trade that consumers might find convenient, but overshadow the nature and risks of the actual products they sell.

The rabbit in the hat: dubious argumentation and the persuasive effects of prescription drug advertising (DTCA).

There is an ongoing global debate over the potential benefits and risks of allowing direct-to-consumer advertising of prescription medicines (DTCA). The core of this debate concerns the identification of DTCA either as a beneficial procedure to be promoted or as a damaging procedure to be abolished. Economic data on DTCA suggest that this form of advertising has an impact on consumers. Based on this premise, we explore the use of argumentation theory to inquire into the reasons for this success. In particular, by combining perspectives from argumentation theory and marketing research this paper aims to test the hypothesis of whether DTCA presents information framed in potentially misleading, but persuasive, argumentative structures. We highlight and discuss the results of two studies designed to assess whether readers perceive DTCA as argumentative and, if so, which explicit and implicit elements provide groundings for the inference that consumers draw from the ads. The analysis highlights the presence in DTCA of dubious arguments (fallacies and distracting claims) that may go unnoticed. Also, it illustrates the nature of readers' wrong assumptions that arise independently from the contents of the ads. These factors seem to influence the level of the self-perceived persuasiveness of DTCA.

Online patient education and risk assessment: project OPERA from Cancerbackup. Putting inherited breast cancer risk information into context using argumentation theory.

OBJECTIVE: Many people are concerned about their family history of breast cancer, and are anxious about the possibility of developing breast cancer themselves. The majority of these people are likely not to be at significantly increased risk of developing inherited breast cancer. All women are at risk of developing sporadic breast cancer, and this risk increases with age. This project aims to aid people's understanding of these issues using an interactive online computer programme. METHODS: The UK National Institute of Health and Clinical Excellence has published guidance for the National Health Service on the management of familial breast cancer. That guidance lays down clear criteria for categorising risk level and the appropriate management options. We have developed a user-friendly computer programme named OPERA (online patient education and risk assessment) which captures the individuality of the user's situation in a comprehensive way, and then produces personalised information packages, building on the theoretical framework of argumentation developed by Toulmin [Toulmin S. The uses of argument. Cambridge, MA: Cambridge University Press; 1958]. We will test this programme in a series of pilot studies commencing in 2007. RESULTS: This paper describes the progress of this project to date and focuses on the design of the programme. CONCLUSION: It is possible to construct a user friendly programme which delivers a personalised information package to individuals who are concerned about their risk of developing breast cancer. PRACTICE IMPLICATIONS: This user friendly programme needs to be tested within a series of carefully thought out pilot studies before it is ready for general release and use by the public.