Accelerating the health literacy agenda in Europe.

Health literacy can be defined as the knowledge, motivation and competence to access, understand, appraise and apply information to make decisions in terms of healthcare, disease prevention and health promotion. Health literacy is a European public health challenge that has to be taken seriously by policy-makers. It constitutes an emerging field for policy, research and practice. However, recent research has shown that health literacy advancement is still at its infancy in Europe, as reflected in the scarce scientific health literacy literature published by European authors. From a total of 569 articles published until 2011 on this subject, the first author of only 15% of them is from Europe. This article conveys recommendations of different European stakeholders on how to accelerate the health literacy agenda in Europe. A general introduction on the current status of health literacy is provided, followed by two cases applying health literacy in the areas of prevention of communicable diseases and promotion of digital health. The current EU strategies integrating health literacy are listed, followed by examples of challenges threatening the further development of health literacy in Europe. Recommendations as to how European stakeholders involved in research, policy, practice and education can promote health literacy are given. It is vital that the European Commission as well as European Union Member States take the necessary steps to increase health literacy at individual, organizational, community, regional and national levels.

Vaccine hesitancy among healthcare workers in Europe: A qualitative study.

Healthcare workers (HCWs) are often referred to as the most trusted source of vaccine-related information for their patients. However, the evidence suggests that a number of HCWs are vaccine-hesitant. This study consists of 65 semi-structured interviews with vaccine providers in Croatia, France, Greece, and Romania to investigate concerns HCWs might have about vaccination. The results revealed that vaccine hesitancy is present in all four countries among vaccine providers. The most important concern across all countries was the fear of vaccine side effects. New vaccines were singled out due to perceived lack of testing for vaccine safety and efficacy. Furthermore, while high trust in health authorities was expressed by HCWs, there was also strong mistrust of pharmaceutical companies due to perceived financial interests and lack of communication about side effects. The notion that it is a doctor's responsibility to respond to hesitant patients was reported in all countries. Concerns were also seen to be country- and context-specific. Strategies to improve confidence in vaccines should be adapted to the specific political, social, cultural and economic context of countries. Furthermore, while most interventions focus on education and improving information about vaccine safety, effectiveness, or the need for vaccines, concerns raised in this study identify other determinants of hesitancy that need addressing. The representativeness of the views of the interviewed HCWs must be interpreted with caution. This a qualitative study with a small sample size that included geographical areas where vaccination uptake was lower or where hesitancy was more prevalent and it reflects individual participants' beliefs and attitudes toward the topic. As HCWs have the potential of influencing patient vaccination uptake, it is crucial to improve their confidence in vaccination and engage them in activities targeting vaccine hesitancy among their patients.

The Transferability of Health Promotion and Education Approaches Between Non-communicable Diseases and Communicable Diseases-an Analysis of Evidence.

BACKGROUND: There is a seeming lack within the public health fields of both research and practice of information sharing across so-called "silos of work". Many professionals in the public health fields dealing with infectious diseases (IDs) are unaware of the programs and approaches taken by their colleagues in the non-communicable diseases (NCDs) arena, and vice versa. A particular instance of this is in the understanding and application of health promotion approaches. This is a problem that needs to be addressed with the goal of producing the most efficient and effective health promotion approaches to the prevention and control of diseases in general. OBJECTIVES: This project examined health promotion approaches to the prevention of NCDs that could be used in the prevention of IDs. METHODS: A knowledge synthesis and translation perspective was undertaken. We screened and analyzed a wide range of sources that were considered relevant, with particular emphasis on systematic reviews, published articles and the grey literature. RESULTS: The analysis revealed a diverse health promotion knowledge base for application to IDs. Comprehensive health promotion models were found to be useful. Findings suggest that there are profound similarities for health promotion approaches in both NCDs and IDs. Conclusions: This study revealed gaps in knowledge synthesis to translation. The need for development of intervention and implementation research is considered.