Examining the relationship between demographic variables and perceived health literacy challenges in Tasmania, Australia.

ISSUE ADDRESSED: Whilst there is a relationship between health literacy and health outcomes, the importance of social and personal demographic characteristics remains understudied., Identifying the factors responsible for creating health literacy challenges would help ensure that responses are tailored to individual or community needs. METHODS: This survey included questions from five domains from the Health Literacy Questionnaire. Descriptive analyses and hierarchical regression were used to explore the relationship between the demographic characteristics and health literacy. Qualitative questions were subjected to thematic analysis, to identify the current barriers and proposed solutions. RESULTS: A total of 255 participants completed the survey. Demographic characteristics that significantly predicted lower Health Literacy Questionnaire scores were having one or more chronic health conditions and living in an area of more socioeconomic disadvantage. Participants found 'navigating the health care system' the most difficult of the five elements measured. A total of 276 individual barriers to health literacy were identified and 162 solutions proposed. CONCLUSIONS: This study provides an overview of our sample's health literacy and how their social demographic characteristics may predict their health literacy challenges. Findings from this study can be used to develop targeted interventions to respond to specific health literacy challenges identified within this population. SO WHAT?: Distinct from other research, whereby solutions are proposed by researchers, the participants in this study were encouraged to share their health literacy challenges and outline potential solutions to address these in their local context.

The curriculum took a back seat to huff and puff: Teaching high school health and physical education during Covid-19.

This study examined secondary (high) school teachers' experiences of online delivery of health and physical education (HPE) during Covid-19 suppression measures in one Australian state in 2020. Research has noted the use of blended learning and flipped classrooms in HPE, yet little is known about the delivery of fully online school HPE. Semi-structured interviews occurred with eight high school HPE specialist teachers, providing qualitative data for analysis. The analysis of teachers' experiences indicated that in most cases HPE did not happen; rather, physical activity provision was initiated, or HPE was marginalised to a movement break between subjects with perceived higher status and priority. Additionally, teachers found that providing HPE online was challenging, and struggled to connect with, engage and provide equitable opportunities for their students online. The results showed that the move to online provision of HPE resulted in diminished educative purpose.

Peer champions responses to nudge-based strategies designed to reduce prolonged sitting behaviour: Lessons learnt and implications from lived experiences of non-compliant participants.

Occupational sedentariness is problematic for office-based workers because of their prolonged sitting periods and the advent of technology which reduces work-based movement. A common workplace strategy to deal with this preventable health risk is to have workers engage in brief movement breaks throughout the workday. To date, the use of interventions underpinned by individual self-regulation has had less than optimal impact on changing workers sedentary work behaviours. An alternative design for workplace interventions is the use of nudge theory. Nudge theory incorporates strategies that are delivered at the point of choice designed to influence individual decision making regarding alternative behaviour options. In this study, desk-based workers were exposed to two nudge strategies which suggested alternative behaviours of regular standing and taking movement breaks during work periods to the default behaviours of prolonged sitting and sedentary work behaviour. A small group of women managers who served as peer champions (n = 6), withdrew early from the study, and then took part in an exit interview to gain an understanding of their experiences of being exposed to the two nudge strategies. Verbatim transcripts were analysed using inductive, reflexive thematic analysis. Two major themes with seven second order themes central to their experiences were extracted: facilitative behaviour and feelings (advocacy, acceptance & facilitative burden) and dysfunctional behaviours and feelings (dysfunctional behaviour & feelings, control, reactance & presenteeism). Participants initially perceived a positive exchange associated with exposure to nudge strategies. Yet, participants' emotional connection to their work roles and behaviour were perceived as a negative exchange. Participants cited numerous maladaptive feelings because of a perception of incongruency with the established work normative behaviour. These findings reveal that nudge strategies of reduced choice and social norms are viable, but perceptions of monitoring can moderate adherence.

An International Review to Characterize the Role, Responsibilities, and Optimal Setting for Health Literacy Mediators.

Health literacy is a critically important determinant of health and is influenced by access to supportive social networks and services. Global investment in education throughout the life course is required to support health literacy development. The aim of this review is to characterize the role, responsibilities, and the optimal setting for the emergent role of a Health Literacy Mediator (HLM). A scoping review of recent literature was conducted. The review revealed a lack of consensus on who should be teaching health literacy, and variability in confidence when teaching health literacy. Professionals reported facing barriers such as a lack of time, a lack of knowledge, and recognized that the health literacy needs of children worldwide are not being met. Further research into the role of HLM is required to determine who is best suited to this role and what their responsibilities will be to ensure consistent health literacy education.

How Did Parents View the Impact of the Curriculum-Based HealthLit4Kids Program Beyond the Classroom?

The HealthLit4Kids program aims to build health literacy in a participatory and contextually relevant way. Whole-of-school and curriculum strategies aim to empower and build capacity to make informed health choices amongst students, teachers, parents, and their local community. The aim of this study was to evaluate the HealthLit4Kids program from the perspective of parents, using a Self-Determination Theory framework. This is one component within a larger evaluation of the program. Parents at four Australian primary schools were interviewed post-program. Qualitative data collected through parent interviews were analyzed thematically to identify themes, and coding checks were completed by experienced qualitative researchers. The three key themes identified were student engagement, behaviour change, and parent engagement. Findings also indicated that parents placed a high value on effective communication from schools and raised a range of health areas such as food and nutrition, physical activity, and mental health with the interviewer. Parent opinions of the HealthLit4Kids program were positive, with many reporting a perceived increase in their children's ability to understand, communicate and act on health-related knowledge at home. The HealthLit4Kids program requires further research to determine its viability as an optimal pedagogical strategy for the health literacy development of primary school-aged children.