Conversations About Sexual and Reproductive Health and Rights-From a School Nurse Perspective

Students have the right to receive education about sexual and reproductive health and rights (SRHR). The United Nations Agenda 2030 for sustainable development includes goals regarding SRHR, including the right to universal access to sexual and reproductive health care services and gender equality. The study used a qualitative design with an inductive approach. Data were collected through semistructured interviews. The results are presented in three categories and nine subcategories. The categories were "having an open attitude," "organizational prerequisites," and "challenging tasks." An open attitude was required to create confidence for both school nurses and students in SRHR conversations. Organizational prerequisites, such as planning SRHR education with others, were successful. Multicultural meetings and conversations regarding gender identity and sexual orientation were challenging tasks. Increased knowledge of SRHR and national standardized guidelines are suggested to achieve Agenda 2030 SRHR goals and to ensure equity in school health care.

Study of health information needs among adolescents in Croatia shows distinct gender differences in information seeking behaviour

BACKGROUND

Understanding the health information needs of adolescents is the first step towards providing them with relevant information to aid them in their decision making regarding health issues.

OBJECTIVE

The goal of this study is to assess adolescents' needs, perceptions and sources of health information.

METHODS

Four hundred sixty-nine high school students in Osijek, Croatia, participated in this study by answering a questionnaire. The collected data were analysed using basic frequency and non-parametric statistical methods.

RESULTS

The most popular health topics identified by adolescents in our study were nutrition, diseases, depression, relationships, sexual intercourse and alcohol. Adolescents consider their parents the most reliable personal source of health information (72.0%), while they perceive the Internet as the main non-personal source of health information (29.8%). Adolescents wish to get more education about health issues at school (54.4%). Significant gender differences were found in adolescents' needs, perceptions and sources of health information.

CONCLUSIONS

It is important to provide adolescents with systematic institutional health education and improve health advisory services and library/information services to assist adolescents in locating health information and resolving their health related questions.

National culture and trust in online health information

This article contributes to the ever-increasing body of research on online health information-seeking behaviour. Specifically, this study shows that national culture is a determinant of trust in online health information. A questionnaire-based survey collected the data from undergraduate students on the factors influencing their trust formation toward online health information. The cultural comparisons revealed differences between the trust formations of Americans, Chinese and South Koreans in the online health environment. The trust formation of the Chinese group was based on the three factors of information quality, information style and information verification. For the American group, the information quality, information style, ease of use and information verification were the four antecedents of trust. The South Korean group considered more clues during their trust formation process than the Chinese and American groups did. Furthermore, information verification was a stronger predictor of trust for the South Korean group. The findings were discussed in light of national culture theories, and the future research agenda was presented.

Exploring MEST: a new universal teaching strategy for school health services to promote positive mental health literacy and mental wellbeing among Norwegian adolescents

Background

Mental health among adolescents is an important public health challenge. School health services perform central public health functions in Norwegian municipalities, where school nurses are uniquely positioned to educate and promote mental health among adolescents. MEST (MEST is not an acronym; MEST is a short version of the Norwegian word for coping) is a newly developed universal working strategy for school health services that aims to promote positive mental health literacy (MHL) and mental wellbeing in the adolescent population. The aim of this study was to investigate the potential outcome mean differences in positive MHL and mental wellbeing between adolescents who participated and those who did not participate in MEST over a school year.

Methods

This study is based on cohort data collected from 357 adolescents (aged 15–21 years) in five Norwegian upper secondary schools at the beginning and end of the 2016/2017 school year. The data were analyzed by describing mean scores and estimating the average treatment effect (ATE) of MEST on positive MHL and mental wellbeing.

Results

Positive MHL increased significantly more among the MEST participants compared to the non-MEST participants (p = .02). No significant change in mental wellbeing was found between MEST and non-MEST participants (p = .98). Estimating the ATE of MEST on positive MHL, the MEST participants showed a significant 2.1% increase (p = .04) in the potential outcome mean of positive MHL compared to the nonparticipants. Estimating the ATE of MEST on mental wellbeing, the girls who attended MEST exhibited a significant 9.7% increase (p = .03) in the potential outcome mean of mental wellbeing compared with the girls who did not attend MEST, while no significant change (p = .99) was detected among boys or the entire sample of both genders combined (p = .12).

Conclusion

This study found a significant ATE of MEST on positive MHL and on mental wellbeing among girls. The results support further investments in studying MEST as a promising work strategy for school health services to promote adolescent mental health. This initial study of MEST may be used as a foundation for investing in future evaluations of MEST.

Youth Speak Out on School Food Environments

In Philadelphia, over 40% of youth are overweight or obese. The objective in this assessment was to learn about urban residents' perspectives regarding the local food environment and its impact on eating behaviors. Using photo-elicitation, 20 adolescents reflected on their food environments through photographs and corresponding interviews. Without specific prompting from interviewers, every participant raised concerns about their school food environments, which they commonly found to be unhealthy and unappealing. Participants' responses reflected four themes: (1) mixed reviews regarding the healthfulness of school vending machines, (2) lunch from home versus lunch from school, (3) factors that influenced food choice at school, and (4) critiques of school food environments. Students embraced the photo-elicitation approach as a way to convey their concerns and to suggest opportunities for improvements. School nurses, who are trusted by students and school personnel, are well-positioned to solicit student input and advocate for healthier school food environments.

The Relationship Between Positive Mental Health Literacy and Mental Well-Being Among Adolescents: Implications for School Health Services

Mental health education is a central part of school nurses’ practice. Mental health literacy is an asset for health that educational initiatives can strengthen, and a significant determinant of mental health. This study was intended to examine the relationship between positive mental health literacy (PMeHL) and mental well-being to discuss its implications for school health services’ mental health education. The relationship was assessed using a multiple linear regression model controlling for relevant covariates. Data were derived from a cross-sectional school-based survey including 1,888 adolescents aged 15–21 years (response rate 97.3%). A weak gender difference was found in PMeHL. The regression model accounted for 41% of the variance in adolescents’ mental well-being; PMeHL was a significant explanatory variable of mental well-being. Accordingly, the current study found support for including PMeHL, or knowledge of how to obtain and maintain good mental health, as an integral component of school health services’ mental health education among adolescents.

A review of theory-driven models of trust in the online health context

Generally speaking, theory-driven studies are more successful in producing a desired result than those missing the theoretical grounds. This paper aims to provide an informal assessment of theoretical foundations of trust models in online health context. After a review of literature, 12 theory-driven models were analysed in detail. The findings showed that previous models benefited from different theories within different disciplines (mostly from psychology). The technology acceptance model, the elaboration likelihood model, the theory of reasoned action and the health belief model were the most frequently used theoretical frameworks. The reviewed models were able to account for 23–69% of variance in dependent variables. In conclusion, although the health studies are very open to interdisciplinary theories, the inclusion of institutional and national cultural theories in future researches may enrich the current individualistic perspective with a broader context of society that jointly form trust behaviour and credibility judgements of health consumers in digital health environments.

Comprehensibility of Health-Related Documents for Older Adults with Different Levels of Health Literacy: A Systematic Review

A systematic review was conducted to assess the available evidence for the effectiveness of interventions aiming to improve the comprehensibility of health-related documents in older adults (≥50) with different levels of health literacy. Seven databases were searched (2005 forward), and references in relevant reviews were checked. The selection procedure was conducted by 2 independent reviewers. Data extraction and assessment of the quality of the resulting studies were conducted by 1 reviewer and checked for accuracy by a 2nd reviewer. A total of 38 intervention studies had a study population of older adults (n = 35) or made an explicit comparison between age groups, including older adults (n = 3). Inconsistent evidence was found for the importance of design features to enhance the comprehensibility of health-related documents. Only for narratives and multiple-feature revisions (e.g., combining revisions in textual and visual characteristics) did the included studies provide evidence that they may be effective for older adults. Using narrative formats and/or multiple-feature revisions of health-related documents seem to be promising strategies for enhancing the comprehensibility of health-related documents for older adults. The lack of consistent evidence for effective interventions stresses the importance of (a) replication and (b) the use of standardized research methodologies.

Protagonismo de adolescentes na prevenção de doenças sexualmente transmissíveis

Resumo Objetivo Analisar o protagonismo de adolescentes escolares na prevenção de doenças sexualmente transmissíveis. Métodos Estudo qualitativo do tipo pesquisa-ação desenvolvido com dez adolescentes, com idade entre 15 e 16 anos, de uma escola pública. Os dados foram coletados em grupos focais, entrevistas e observação e analisados na técnica de análise do discurso. Resultados Os depoimentos revelaram que os adolescentes protagonizaram suas participações no planejamento da intervenção educativa, definindo e organizando o espaço educativo escolar, e confeccionando materiais e temas a serem utilizados nas ações de prevenção às doenças sexualmente transmissíveis, gerando um sentimento de domínio sobre o assunto. Conclusão Os participantes do estudo apresentaram protagonismo na elaboração de atividades de prevenção de doenças sexualmente transmissíveis no ambiente escolar.

Bit by bit: using design-based research to improve the health literacy of adolescents

BACKGROUND

Although a low health literacy level has been found to be among the most powerful predictors of poor health outcomes, there is very little research focused on assessing and improving the health literacy skills of adolescents, particularly those from socioeconomically disadvantaged backgrounds. The vast majority of existing research focuses solely on reading comprehension, despite the fact that health literacy is actually a multifaceted concept, which entails many different types of skills.

OBJECTIVE

The aim of this paper is to first mine existing literature to identify the many different skills that have been posited to constitute health literacy, and then, using this collection of skills as an overarching structure, to highlight the challenges that disadvantaged youth participating in our HackHealth after-school program encounter as they identify and articulate their health-related information needs, search for health-related information online, assess the relevance and credibility of this information, and manage and make use of it.

METHODS

We utilized the design-based research method to design, implement, and revise our HackHealth program. To collect data regarding HackHealth participants' health literacy skills and associated challenges, we used a variety of methods, including participant observation, surveys, interviews, focus groups, and logging of Web browser activities. We also collected data through specialized instructional activities and data collection forms that we developed for this purpose. Quantitative and qualitative techniques were used to analyze this data, as well as all of the artifacts that each student produced, including their final projects.

RESULTS

We identified the various challenges that the 30 HackHealth participants faced in completing various health-related information activities during the course of the program. Based on these findings, we describe important implications for working with youth from socioeconomically disadvantaged backgrounds, how to assess and improve their health literacy skills, and offer specific recommendations for health literacy instruction aimed at this population.

CONCLUSIONS

With an increased societal focus on health and a shift from viewing patients as passive recipients of medical care to viewing them as active arbiters of their own health, today's youth need to possess an array of health literacy skills to ensure that they can live long and healthy lives. Working with adolescents to help them develop and practice these skills will also help to break the cycle between poor health literacy and poor health outcomes, thereby reducing health disparities and improving the long-term outlook for the health of our nation.

Forming ideas about health: a qualitative study of Ontario adolescents

Adolescence is a crucial period of child development during which one's ideas about health are formed. However, little is known about the different contexts, experiences, and potential other factors that contribute to shaping the health ideas of adolescent populations, particularly when they are not seeking out the information for a particular purpose. In this Ontario-based qualitative study, grounded theory methods were used to explore ways that health knowledge is obtained in adolescents (age 10–16). A purposeful, criterion-based sampling strategy was used, and data were collected through seven focus groups (n=40). Findings indicate that while young people get their ideas about health through both didactic and organic learning contexts, the significant impact of organic learning is often overlooked. Categories of organic learning that emerged include self-reflective experience, the experience of close contacts, casually observing others, and common discourse. This study suggests that one central way that young people get their ideas about health is from living life: from the people they watch, the conversations that they have, and the experiences they live. Findings support the development of effective health promotion messages and also contribute to considering the place of some aspects of organic learning in the development of health-related resources that target adolescent populations.

Jean B, Follman R, Kodama C, Casciotti D. As simple as that?: tween credibility assessment in a complex online world

Purpose

– The purpose of this paper is to focus on disadvantaged tweens’ (ages 11 through 13) strategies for making predictive and evaluative judgments of the credibility of health information online. More specifically, this paper identifies the features of Google search results pages and web sites that signal credibility (or lack thereof) to this population and the reasons behind their perceptions.

Design/methodology/approach

– The authors employed an ethnographic approach (using various types of data collection methods) targeted to generate in-depth descriptions of tweens making predictive and evaluative judgments of credibility, focussing on the ways in which these tweens naturally assess the credibility of online information.

Findings

– The research has yielded novel findings concerning the types of factors that influence disadvantaged tweens’ credibility assessment strategies, such as limited English-language vocabularies, lack of familiarity with perhaps otherwise well-known sources, and forced reliance on (and/or general preference for) non-textual modalities, such as audio and video.

Practical implications

– The findings indicate a need for implementing digital literacy programs in a naturalized setting, building on tweens’ existing heuristics and thereby resulting in strategies that are simultaneously compatible with their natural inclinations within the online environment and likely to consistently lead them to accurate credibility-related judgments.

Originality/value

– This study provides novel insights into how disadvantaged tweens interact with online health information in a natural context, and offers invaluable information regarding the ways in which credibility assessment processes should be facilitated within formal or informal digital literacy programs.

Striving to Make a Positive Difference

In Sweden, school nurses are part of the School Health Service with the main objective of health promotion to support students’ health and attainment of educational goals. The aim in this phenomenological study was to illuminate the experiences of school nurses in promoting the health and well-being of adolescent girls. Seventeen school nurses were interviewed, both in groups and individually, to facilitate personal disclosure and expressions from their lived experiences. To achieve their goal of improving the health of adolescent girls, school nurses require flexibility in their approach and in endeavoring to make a positive difference they experience many challenges. This study concluded that school nurses can tactfully provide adolescent girls with knowledge and health guidance adjusted to individual needs and empowering the individual girl to participate in her own health process.