Health literacy promotion among young adults: a web-based intervention in German vocational schools

Community health literacy outcome measurement practices: A scoping review of recent interventions

Introduction

Evidence suggests that, while a preference for functional Health Literacy (HL) outcome measurement exists, researchers are converging towards more all-encompassing instruments. While this claim is present in the HL field, minimal research has comprehensively explored the state of community HL measurement practices at the direct and proxy level. The almost exclusive focus on direct, as opposed to proxy, community HL measurement indicates a review of progress is needed.

Objective

To identify HL outcome measurement practices for community HL interventions at the direct and proxy level of measurement.

Search Strategy

Medline, PsycINFO, Web of Science, ERIC, Embase, Scopus, CINAHL, ProQuest Dissertations and Theses, Google Scholar and targeted websites were searched.

Inclusion Criteria

Studies were sampled from the general population, included HL as an outcome of interest, involved an intervention aiming to improve HL, were English-text publications and were published ≥2010.

Data Extraction and Synthesis

Study author(s) and publication years, sample characteristics, intervention profiles and direct and proxy instrument and outcome measurement information were extracted. Full-text review retrieved 25 eligible studies.

Main Results

In total, 21 unique direct and 38 unique proxy instruments were extracted. The majority of interventions assessed functional compared to communicative, critical, and other HL domains, with objective instruments more frequently used than subjective or combined objective-subjective types, though more unique subjective HL instruments were extracted overall. The Test of Functional HL in Adults was the most popular instrument, and perceived health, knowledge, behaviors and health intentions were the most frequent proxy outcome measures, with only the Healthy Lifestyle Behavior Scale-II and Patient Activation Measure used across multiple interventions.

Discussion and Conclusions

Direct HL outcome practices endured a unidimensional profile, despite previous suggestions of a convergence towards holistic instruments. This review provides the first overview of proxy HL measurement across community HL interventions, identifying substantial variation in proxy outcome practices.

Patient or Public Contribution

A University-based senior librarian contributed to the development of the search strategy, and reviewed iterations of the strategy until refinement was complete. No further public or patient contribution was made given the review-based nature of the research.

Teacher Trainees’ Well-Being—The Role of Personal Resources

Teacher well-being is intrinsically associated with their personal resources, including health literacy and occupational self-regulation. However, there are few empirical findings on teacher trainees’ health literacy. Furthermore, occupational self-regulation has so far only been associated with indicators of occupational well-being. From a public health perspective, research on teacher trainees’ general well-being will benefit from taking both research aspects into account. In this study, we analysed data from 407 teacher trainees in Germany. Latent profile analysis confirmed the four occupational self-regulatory types (healthy-ambitious, unambitious, excessively ambitious, and resigned), which differed significantly on the health literacy dimensions self-regulation, self-control, self-perception, proactive approach to health, communication and cooperation, and dealing with health information. The health literacy dimensions of self-regulation and self-control were mainly related to occupational self-regulation. Independently of each other, the self-regulatory types and the health literacy dimensions of self-regulation, self-control, and proactive approach to health predicted teacher trainees’ general well-being. If both constructs are considered together, the health literacy dimensions explain more variance in teacher trainees’ general well-being than the self-regulatory types. Research and practical implications are discussed.

Gesundheitskompetenz und Gesundheit von Studierenden unter besonderer Betrachtung der Lehramtsstudierenden

Hintergrund

Ungefähr die Hälfte der Studierenden weist eine eingeschränkte Gesundheitskompetenz (GK) auf. Bislang werden Lehramtsstudierende in Studien zur GK selten adressiert. Im Kontext von Prävention und Gesundheitsförderung erscheint dies aber ein bedeutsames Thema für die Lehrkräfteausbildung zu sein.

Ziel der Arbeit

Erfassung, Vergleich, Zusammenhänge und deren Analyse bezogen auf die erweiterten Fähigkeiten der GK und des allgemeinen Gesundheitszustands von Lehramtsstudierenden (LS) und Nicht-Lehramtsstudierenden (NLS).

Material und Methode

An der Online-Erhebung haben 303 Masterstudierende (LS = 195/ NLS = 108) teilgenommen, die mittels Fragebogen die GK (nach Lenartz) und den allgemeinen Gesundheitszustand (nach WHO) erfasst hat. Die statische Auswertung berücksichtigte t‑Tests, Produkt-Moment-Korrelationen und multivariate Regressionsanalysen.

Ergebnisse

Mit Ausnahme der Verantwortungsübernahme weisen LS im Vergleich zu NLS signifikant höhere Werte in den übrigen Fähigkeiten der GK auf. Die niedrigsten Ausprägungen sind in beiden Gruppen in den Fähigkeiten zur Selbstregulation (SR) sowie Kommunikation und Kooperation (KUK) zu verzeichnen. LS und NLS unterscheiden sich nicht-signifikant in Bezug auf den allgemeinen Gesundheitszustand. Knapp jeder dritte Studierende weist einen schlechten Gesundheitszustand auf. Bezüglich der Zusammenhänge nimmt die Fähigkeit zur SR eine vorgeordnete Rolle ein und stellt den statistisch stärksten Prädiktor dar.

Schlussfolgerung

Die Ergebnisse verdeutlichen die Bedeutung der GK für den allgemeinen Gesundheitszustand. Es lassen sich Interventionen ableiten, die die Fähigkeiten zur SR und KUK fördern. Im Hochschulsetting sollten Rahmenbedingungen geschaffen werden, die die frühzeitige und stetige Förderung der GK für Studierende ermöglichen, u. a. da die späteren Lehrkräfte wichtige Multiplikatorenfunktionen ausüben.

Assessing the Impact of Online Health Education Interventions From 2010-2020: A Systematic Review of the Evidence

OBJECTIVE

Systematically review the evaluation and impact of online health education interventions: assess approaches used, summarize main findings, and identify knowledge gaps.

DATA SOURCE

We searched the following databases: EMBASE, ERIC, MEDLINE, and Web of Science.

STUDY INCLUSION AND EXCLUSION CRITERIA

Studies were included if (a) published in English between 2010-2020 in a peer-reviewed journal (b) reported an online health education intervention aimed at consumers, caregivers, and the public (c) evaluated implementation OR participant outcomes (d) included ≥ 100 participants per study arm.

DATA EXTRACTION

Two authors extracted data using a standardized form.

DATA SYNTHESIS

Data synthesis was structured around the primary outcomes of the included studies.

RESULTS

26 studies met the inclusion criteria. We found substantial heterogeneity in study population, design, intervention, and primary outcomes, and significant methodological issues that resulted in moderate to high risk of bias. Overall, interventions that were available to all (e.g., on YouTube) consistently attained a large global reach, and knowledge was consistently improved. However, the impact on other outcomes of interest (e.g., health literacy, health behaviors) remains unclear.

CONCLUSION

Evidence around the impacts of the type of online health education interventions assessed in this review is sparse. A greater understanding of who online interventions work for and what outcomes can be achieved is crucial to determine, and potentially expand, their place in health education.

Getting the right message: a content analysis and application of the health literacy INDEX tool to online HIV resources in Australia

Health literacy is considered by some as a determinant of health. Research suggests that different levels of health literacy may be associated with human immunodeficiency virus (HIV) knowledge and behaviour, including willingness to test. This study assessed the health literacy demands of existing Australia HIV prevention resources available online using a health literacy assessment and content analysis. Two reviewers assessed 66 resources using the Health Literacy INDEX. Sixty-one (92%) scored below 50%, with an average score of 35.5%. A coding frame was developed to conduct a content analysis of the resources excluding videos, multiple webpages and booklets (n = 52). We coded for six categories of knowledge: HIV knowledge (100% of resources), transmission (96%), acquired immune deficiency syndrome (AIDS) knowledge (88%), testing (87%), consequence of infection (85%) and prevention (77%). We found that resources required a reading grade above grade 8, and very few resources considered audience appropriateness. There were missed opportunities to encourage HIV prevention or testing. Some resources used incorrect language to refer towards people living with HIV, and transmission and prevention messages were often inconsistent. Guidelines for developing HIV prevention resources are warranted to improve health literacy, accessibility and appropriateness of resources and ensure consistent messages and framing of HIV risk.

Engagement with a Web-Based Health Promotion Intervention among Vocational School Students: A Secondary User and Usage Analysis

Engagement with web-based interventions is both generally low and typically declining. Visits and revisits remain a challenge. Based on log data of a web-based cluster randomized controlled trial conducted in vocational schools, the present secondary analysis aimed to identify influencing factors on initially logging in to a health promotion platform among young adults and to examine the engagement over the course of an eight-week intervention. Data of 336 students (62.2% female, age span 18–25) from two intervention arms (web-based intervention and web-based intervention with an additional initial face-to-face contact) was included. Binary logistic regression and log-data visualization were performed. An additional initial face-to-face contact (odds ratio (OR) = 2.971, p = 0.005), female sex (OR = 2.237, p = 0.046) and the health-related skill “dealing with health information” (OR = 2.179, p = 0.030) significantly increased the likelihood of initially logging in. Other variables showed no influence. 16.6% of all potential users logged in at least once, of which 57.4% revisited the platform. Most logins were tracked at the beginning of the intervention and repeated engagement was low. To increase the engagement with web-based interventions, health-related skills should be fostered. In addition, a strategy could be to interlink comparable interventions in vocational schools more regularly with everyday teaching through multi-component interventions.