Health Literacy Concepts, Themes, and Research Trends Globally and in Latin America and the Caribbean: A Bibliometric Review.

(1) Background: Health literacy (HL) debates have increased significantly in the last two decades. HL concepts/themes and models have achieved substantial development in the US and Europe. Although there have been some efforts to develop HL in Latin America and the Caribbean (LAC), these seem to be few and scattered. This paper reviews and discusses developments of HL concepts and themes globally and in LAC over the last two decades. (2) Purpose: This study aimed to identify the prevalent health literacy concepts/themes deployed globally and in LAC as reported in academic journals from 2005 to 2022. We looked into which fields of knowledge have been informing HL research over the last decades. (3) Methods: We conducted a structured search on the Web of Science (WoS), Scopus, PubMed, and SciELO databases to extract the textual data for bibliometric analysis. We analyzed the textual data with VOSviewer and Biblioshiny to better understand health literacy themes and strands currently being researched in the LAC region. We conducted the searches in two periods: the first in May 2023 and the second in October 2023. (4) Results: The bibliometric study highlighted five WoS categories informing most HL global studies: (i) public environmental occupational health; (ii) environmental sciences; (iii) health policy services; (iv) health care science services; and (v) communication. The two predominant categories in LAC are public environmental occupation health and health policy services. Journals hosting HL publications come from these WoS categories. Themes in HL publications can be organized into four thematic clusters: (i) analytical (research designs, analytic techniques, and criteria for examining HL data); (ii) psychometric (measurement properties of data collection tools); (iii) pragmatic (practical issues related to implementing HL programs); and (iv) well-being (effectiveness of HL programs on mental health and illness treatment). (5) Conclusions: There is expanding interest in health literacy among scholars. The number of publications has increased substantially, particularly over the last five years. These are dominated by the Global North. The metrics show that LAC and Africa are trailing in publications. There is an emerging focus on adult literacy, functional/low health literacy, and their effect on improving capabilities, comprehension, and communication regarding health-related topics.

Planetary Health and Health Education in Brazil: Towards Better Trained Future Health Professionals.

Brazil is Latin America's largest country and has a strong economy, but it is also characterised by many inequalities. These are very conspicuous in the health sector, particularly in health education, which is expected to modernise according to the planetary health (PH) perspective. This paper describes the health education scenario in Brazil and undertakes an analysis of the postgraduate health programmes and policies in place, identifying the extent to which these support the cause of PH. To achieve this goal, this paper deploys a bibliometric analysis to gain a better understanding of the research streams related to higher education and PH. In addition, it presents and discusses selected case studies in the field and cross-checks documents from the Brazilian Ministry of Education against five domains of PH in education. The results indicate that despite some progress to date and the fact that some programmes are in place, there is a perceived need for policies and efforts from education organisations towards connecting PH principles in the education of current and future health professionals.

Stability and change in public health studies in Colombia and Mexico: an exploratory approach based on co-word analysis

[ABSTRACT]. Objective. To determine the level of stability or change in topic areas published by public health journals in Latin America and the Caribbean, using keywords and co-word analysis, in order to support evidence-based research planning. Methods. Keywords were extracted from papers indexed in Scopus® that were published by the Revista de Salud Pública (RSP; Colombia), the Salud Pública de México (SPM; Mexico), and the Revista Peruana de Medicina Experimental y Salud Pública (RPMESP; Peru) for three periods: 2005 – 2007, 2008 – 2010, and 2011 – 2013. Co-word analysis was used to examine keywords extracted. Textual information was analyzed using centrality measures (inbetweenness and closeness). The hypothesis of stability/change of thematic coverage was tested using the Spearman’s rho correlation coefficient. VOSviewer was used to visualize the co-word maps. Results. A moderate level of change in thematic coverage was observed in 2005 – 2010, as evidenced by the correlation coefficients for two of the 3-year periods, 2005 – 2007 and 2008 – 2010: 0.545 for RSP and 0.593 for SPM. However, in 2008 – 2013, more keywords remained constant from one period to the next, given the size of the correlation coefficients for the last 3-year periods: 2008 – 2010 and 2011 – 2013: 0.727 for RSP and 0.605 for SPM. Conclusion. The research hypothesis was partially accepted given that just two consecutive 3-year periods showed a statistically-significant degree of stability in thematic coverage in public health studies. In that sense, this study provides compelling evidence of the effectiveness of using a combined approach for examining the dynamics of thematic coverage: centrality measures for identifying the main keywords and visual inspection for detecting the structure of textual information.

[RESUMEN]. Objetivo. Determinar el grado de estabilidad o cambio en los temas que se publican en las revistas de salud pública de América Latina y el Caribe, por medio del análisis de palabras clave y copalabras, a fin de sustentar la planificación de investigaciones basadas en la evidencia. Métodos. Se extrajeron las palabras clave de los artículos indizados en Scopus® publicados por tres revistas —Revista de la Salud Pública (RSP; Colombia), Salud Pública de México (SPM; México) y Revista Peruana de la Salud y de Medicina Experimental Pública (RPMESP; Perú)— en tres períodos: 2005-2007, 2008-2010 y 2011-2013. Se usó el análisis de copalabras para examinar las palabras clave extraídas. Se analizó la información textual aplicando diversas medidas de centralidad (intermediación y proximidad). Se puso a prueba la hipótesis de estabilidad o cambio de la cobertura temática usando el coeficiente de correlación rho de Spearman. Se usó VOSviewer para visualizar los mapas de copalabras. Resultados. En el período 2005‑2010 se observó un nivel moderado de cambios en la cobertura temática, como lo demuestran los coeficientes de correlación correspondientes a dos períodos trianuales (2005‑2007 y 2008‑2010): 0,545 en RSP y 0,593 en SPM. En cambio, en el período 2008-2013 un mayor número de palabras clave se mantuvo constante de un período al siguiente, considerando la magnitud de los coeficientes de correlación de los últimos períodos trianuales: 2008‑2010 y 2011‑2013: 0,727 en RSP y 0,605 en SPM. Conclusiones. La hipótesis de investigación fue aceptada parcialmente considerando que solo en dos períodos trianuales consecutivos se observó una estabilidad estadísticamente significativa en la cobertura temática de los artículos sobre salud pública. En ese sentido, el presente estudio aporta datos convincentes sobre la eficacia de usar un enfoque combinado para examinar la dinámica de la cobertura temática: medidas de centralidad para determinar las principales palabras clave e inspección visual para determinar la estructura de la información textual.

[RESUMO]. Objetivo. Determinar o nível de estabilidade ou mudança em áreas de tópicos publicadas por periódicos de saúde pública na América Latina e no Caribe, com o uso de palavras-chave e da análise da coocorrência das palavras, para apoiar o planejamento de pesquisas com fundamentação científica. Métodos. As palavras-chave foram extraídas de artigos indexados na Scopus® publicados na Revista de Salud Pública (RSP, Colômbia), Salud Pública de México (SPM, México) e Revista Peruana de Medicina Experimental y Salud Pública (RPMESP, Peru) em três triênios distintos: 2005–2007, 2008–2010 e 2011–2013. Foi usada a análise da coocorrência das palavras para analisar as palavras-chave extraídas. Informação textual foi analisada com o uso de medidas de centralidade (intermediação e proximidade). A hipótese de estabilidade/mudança da cobertura temática foi testada com o uso do coeficiente de correlação (rho) de Spearman e o programa VOSviewer foi usado para visualizar os mapas de coocorrência das palavras. Resultados. Um nível moderado de mudança na cobertura temática foi observado no período de 2005–2010, como evidenciado pelos coeficientes de correlação em dois dos triênios estudados (2005–2007 e 2008–2010): 0,545 para RSP e 0,593 para SPM. Porém, no triênio de 2008–2013, verificou-se que um número maior de palavras-chave continuou constante de um período ao outro, como demonstrado pelos coeficientes de correlação para os últimos triênios (2008–2010 e 2011–2013): 0,727 para RSP e 0,605 para SPM. Conclusões. A hipótese de pesquisa foi parcialmente aceita visto que somente dois triênios consecutivos apresentaram um nível estatisticamente significativo de estabilidade na cobertura temática em estudos de saúde pública. O presente estudo fornece evidências convincentes da efetividade de usar um enfoque combinado para examinar a dinâmica da cobertura temática: medidas de centralidade para identificar as principais palavras-chave e inspeção visual para detectar a estrutura da informação textual.

Stability and change in public health studies in Colombia and Mexico: an exploratory approach based on co-word analysis.

OBJECTIVE: To determine the level of stability or change in topic areas published by public health journals in Latin America and the Caribbean, using keywords and co-word analysis, in order to support evidence-based research planning. METHODS: Keywords were extracted from papers indexed in Scopus® that were published by the Revista de Salud Pública (RSP; Colombia), the Salud Pública de México (SPM; Mexico), and the Revista Peruana de Medicina Experimental y Salud Pública (RPMESP; Peru) for three periods: 2005 - 2007, 2008 - 2010, and 2011 - 2013. Co-word analysis was used to examine keywords extracted. Textual information was analyzed using centrality measures (inbetweenness and closeness). The hypothesis of stability/change of thematic coverage was tested using the Spearman's rho correlation coefficient. VOSviewer was used to visualize the co-word maps. RESULTS: A moderate level of change in thematic coverage was observed in 2005 - 2010, as evidenced by the correlation coefficients for two of the 3-year periods, 2005 - 2007 and 2008 - 2010: 0.545 for RSP and 0.593 for SPM. However, in 2008 - 2013, more keywords remained constant from one period to the next, given the size of the correlation coefficients for the last 3-year periods: 2008 - 2010 and 2011 - 2013: 0.727 for RSP and 0.605 for SPM. CONCLUSION: The research hypothesis was partially accepted given that just two consecutive 3-year periods showed a statistically-significant degree of stability in thematic coverage in public health studies. In that sense, this study provides compelling evidence of the effectiveness of using a combined approach for examining the dynamics of thematic coverage: centrality measures for identifying the main keywords and visual inspection for detecting the structure of textual information.

Stability and change in public health studies in Colombia and Mexico: an exploratory approach based on co-word analysis / Estabilidad y cambio en los estudios sobre salud pública realizados en Colombia y México: método exploratorio basado en el análisis de copalabras / Estabilidade e mudança nos estudos de saúde pública na Colômbia e no México: um enfoque exploratório com o uso de análise da coocorrência das palavras

ABSTRACT Objective To determine the level of stability or change in topic areas published by public health journals in Latin America and the Caribbean, using keywords and co-word analysis, in order to support evidence-based research planning. Methods Keywords were extracted from papers indexed in Scopus® that were published by the Revista de Salud Pública (RSP; Colombia), the Salud Pública de México (SPM; Mexico), and the Revista Peruana de Medicina Experimental y Salud Pública (RPMESP; Peru) for three periods: 2005 - 2007, 2008 - 2010, and 2011 - 2013. Co-word analysis was used to examine keywords extracted. Textual information was analyzed using centrality measures (inbetweenness and closeness). The hypothesis of stability/change of thematic coverage was tested using the Spearman's rho correlation coefficient. VOSviewer was used to visualize the co-word maps. Results A moderate level of change in thematic coverage was observed in 2005 - 2010, as evidenced by the correlation coefficients for two of the 3-year periods, 2005 - 2007 and 2008 - 2010: 0.545 for RSP and 0.593 for SPM. However, in 2008 - 2013, more keywords remained constant from one period to the next, given the size of the correlation coefficients for the last 3-year periods: 2008 - 2010 and 2011 - 2013: 0.727 for RSP and 0.605 for SPM. Conclusion The research hypothesis was partially accepted given that just two consecutive 3-year periods showed a statistically-significant degree of stability in thematic coverage in public health studies. In that sense, this study provides compelling evidence of the effectiveness of using a combined approach for examining the dynamics of thematic coverage: centrality measures for identifying the main keywords and visual inspection for detecting the structure of textual information.

RESUMEN Objetivo Determinar el grado de estabilidad o cambio en los temas que se publican en las revistas de salud pública de América Latina y el Caribe, por medio del análisis de palabras clave y copalabras, a fin de sustentar la planificación de investigaciones basadas en la evidencia. Métodos Se extrajeron las palabras clave de los artículos indizados en Scopus® publicados por tres revistas —Revista de la Salud Pública (RSP; Colombia), Salud Pública de México (SPM; México) y Revista Peruana de la Salud y de Medicina Experimental Pública (RPMESP; Perú)— en tres períodos: 2005-2007, 2008-2010 y 2011-2013. Se usó el análisis de copalabras para examinar las palabras clave extraídas. Se analizó la información textual aplicando diversas medidas de centralidad (intermediación y proximidad). Se puso a prueba la hipótesis de estabilidad o cambio de la cobertura temática usando el coeficiente de correlación rho de Spearman. Se usó VOSviewer para visualizar los mapas de copalabras. Resultados En el período 2005-2010 se observó un nivel moderado de cambios en la cobertura temática, como lo demuestran los coeficientes de correlación correspondientes a dos períodos trianuales (2005-2007 y 2008-2010): 0,545 en RSP y 0,593 en SPM. En cambio, en el período 2008-2013 un mayor número de palabras clave se mantuvo constante de un período al siguiente, considerando la magnitud de los coeficientes de correlación de los últimos períodos trianuales: 2008-2010 y 2011-2013: 0,727 en RSP y 0,605 en SPM. Conclusiones La hipótesis de investigación fue aceptada parcialmente considerando que solo en dos períodos trianuales consecutivos se observó una estabilidad estadísticamente significativa en la cobertura temática de los artículos sobre salud pública. En ese sentido, el presente estudio aporta datos convincentes sobre la eficacia de usar un enfoque combinado para examinar la dinámica de la cobertura temática: medidas de centralidad para determinar las principales palabras clave e inspección visual para determinar la estructura de la información textual.

RESUMO Objetivo Determinar o nível de estabilidade ou mudança em áreas de tópicos publicadas por periódicos de saúde pública na América Latina e no Caribe, com o uso de palavras-chave e da análise da coocorrência das palavras, para apoiar o planejamento de pesquisas com fundamentação científica. Métodos As palavras-chave foram extraídas de artigos indexados na Scopus® publicados na Revista de Salud Pública (RSP, Colômbia), Salud Pública de México (SPM, México) e Revista Peruana de Medicina Experimental y Salud Pública (RPMESP, Peru) em três triênios distintos: 2005-2007, 2008-2010 e 2011-2013. Foi usada a análise da coocorrência das palavras para analisar as palavras-chave extraídas. Informação textual foi analisada com o uso de medidas de centralidade (intermediação e proximidade). A hipótese de estabilidade/mudança da cobertura temática foi testada com o uso do coeficiente de correlação (rho) de Spearman e o programa VOSviewer foi usado para visualizar os mapas de coocorrência das palavras. Resultados Um nível moderado de mudança na cobertura temática foi observado no período de 2005-2010, como evidenciado pelos coeficientes de correlação em dois dos triênios estudados (2005-2007 e 2008-2010): 0,545 para RSP e 0,593 para SPM. Porém, no triênio de 2008-2013, verificou-se que um número maior de palavras-chave continuou constante de um período ao outro, como demonstrado pelos coeficientes de correlação para os últimos triênios (2008-2010 e 2011-2013): 0,727 para RSP e 0,605 para SPM. Conclusões A hipótese de pesquisa foi parcialmente aceita visto que somente dois triênios consecutivos apresentaram um nível estatisticamente significativo de estabilidade na cobertura temática em estudos de saúde pública. O presente estudo fornece evidências convincentes da efetividade de usar um enfoque combinado para examinar a dinâmica da cobertura temática: medidas de centralidade para identificar as principais palavras-chave e inspeção visual para detectar a estrutura da informação textual.

Factores demográficos asociados con el conocimiento sobre salud en una muestra de mujeres de la ciudad de Lima (Perú) en 2008: resultados del cuestionario SAHLSA-50 / Demographic factors associated with health literacy in a sample of females residing in Lima, Peru in 2008: results from the SAHLSA-50 test

Objetivo: identificar el porcentaje de sujetos con un adecuado conocimiento sobre la salud y determinar las variables demográficas que predicen un apropiado conocimiento de la misma. Metodología: estudio de cohorte transversal en el que se aplicó la prueba SAHLSA-50 en una muestra de 49 mujeres en edad fértil, usuarias del servicio ginecológico del Hospital Dos de Mayo de la ciudad de Lima (Perú). Para someter a prueba la hipótesis se empleó el coeficiente de correlación de Pearson y el análisis de regresión lineal. Resultados: de acuerdo con lo obtenido, el rango de valores del puntaje de la prueba SAHLSA estuvo entre 22 y 50 puntos con un promedio de 37 ±7, 15 puntos. Dichos resultados se vieron reflejados en 43% de las encuestadas, las cuales consiguieron un puntaje inferior al promedio en la prueba de conocimiento sobre salud (n=21). Igualmente, se encontró que la escolaridad es predictora del nivel de conocimiento sobre la salud (p < 0,05). Conclusiones: los resultados muestran que las pacientes con menor grado de instrucción podrían tener pocas oportunidades de entender los mensajes escritos que provengan de sus servicios de salud.

Objective: the objectives were to identify the percentage of subjects having appropriate health literacy and determine the demographic variables predicting appropriate health literacy in females. Methodology: this was a cross-sectional study in which the short assessment of health literacy for Spanish adults (SAHLSA-50) test was given to a sample of 49 reproductive-aged females who were attending the gynaecological service at Dos de Mayo Hospital in Lima, Peru. Linear regression analysis and Pearson’s coefficient of correlation were used to test the hypothesis. Results: SAHLSA test scores ranged from 22 to 50 points, averaging 37 + 7.15 points; 43% of the females surveyed obtained a score lower than the average on the health literacy test (n=21). It was found that the level of schooling was a predictor for health literacy level (p<0.05). Conclusions: these findings showed that patients who have had lower levels of schooling would have little opportunity of understanding written messages/instructions issued by local or state health services.

[Unwanted pregnancy and access to printed media in Peruvian women]. / Embarazo no deseado y fuentes de información impresas y audiovisuales, en mujeres peruanas (2004-2005).

BACKGROUND: It is possible that there is a relationship between reading newspapers and magazines, watching television and inverted exclamation listening to the radio and unwanted pregnancies. AIM: To assess the relationship between the access to printed and audiovisual information resources and unwanted pregnancy in Peruvian women. MATERIAL AND METHODS: A sample of 5,071 women, aged between 18 and 30 years was selected from a database of a Demographics and Health survey performed between 2004 and 2005. Using the information obtained in the survey, the association between unwanted pregnancies and reading newspapers and magazines, was analyzed. RESULTS: Twenty six percent of women had at least an unwanted child (n =1,327). Radio and television were the media mostly used by these women. Seventy five percent of women almost never read newspapers and magazines. The lack of reading and the reliance in television and radio as sources of information were all associated with unwanted pregnancy (p < 0.001). CONCLUSIONS: In this sample of women, there is a negligible interest for reading and a high preference for radio and television. This explains the poor knowledge on sexual and reproductive health and the lack of impact of printed materials used in educational campaigns.

Embarazo no deseado y fuentes de información impresas y audiovisuales, en mujeres peruanas (2004-2005) / Unwanted pregnancy and access to printed media in Peruvian women

Background: It is possible that there is a relationship between reading newspapers and magazines, watching televisión and ¡istening to the radio and unwanted pregnancies. Aim: To assess the relationship between the access to printed and audiovisual information resources and unwanted pregnancy in Peruvian women. Material and methods: A sample of 5,071 women, aged between 18 and 30 years was selected from a datábase of a Demographics and Health survey performed between 2004 and 2005. Using the information obtained in the survey, the association between unwanted pregnancies and reading newspapers and magazines, was analyzed. Results: Twenty six percent of women had at least an unwanted child (n =1,327). Radio and televisión were the media mostly used by these women. Seventy five percent of women almost never read newspapers and magazines. The lack of reading and the reliance in televisión and radio as sources of information were all associated with unwanted pregnancy (p <0.001). Conclusions: In this sample of women, there is a negligible interest for reading and a high preference for radio and televisión. This explains the poor knowledge on sexual and reproductive health and the lack of impact of printed materials used in educational campaigns.

Usabilidad de un sistema de recuperación de información a texto completo: el caso del portal Cybertesis Perú / Usability of a full text information retrieval system: the case of Cybertesis Peru

Se revisaron los programas de recuperación de la información para países en vías de desarrollo; así como las técnicas de evaluación empleadas en el área de la usabilidad, y propias de la interacción humano-computadora, con énfasis en las pruebas empíricas. Se describió la forma de trabajo de un sistema de recuperación de la información a texto completo, distribuido bajo el modelo de software libre, y que ha logrado una importante difusión en el interior de la comunidad académica peruana: la plataforma Cybertesis. Posteriormente, a partir del desempeño logrado por los usuarios que participaron en el estudio, se identificaron los problemas de usabilidad de la interfaz de búsqueda de dicha plataforma. El análisis de los datos revela un exceso de información en la presentación de los resultados y omisiones en los rótulos y etiquetas empleadas; así como la ausencia de opciones necesarias para la búsqueda como, por ejemplo, la búsqueda cronológica. Finalmente, se recomendaron cambios a la interfaz de búsqueda de la plataforma de Cybertesis con vistas a mejorar la efectividad y eficiencia de su sistema de recuperación de la información.

The programs of information retrieval for developing countries were analyzed, as well as the evaluation techniques applied to the usability, and those applied to the human-computer interaction, making emphasis on the empirical tests. A description was made of the work style of a full text information retrieval system distributed as a free software model, which has achieved an important diffusion level within the Peruvian academic community: the Cybertesis site. Subsequently, the usability problems of the search interface of the mentioned site reveals an excess of information in the presentation of the results, as well as omissions in the signs and labels used, and the absence of necessary search options as, for example, chronologic search. Finally, changes to the search interface of Cybertesis were recommended aimed at improving the effectiveness and efficiency of its information recovery system.