Multidimensional eHealth Literacy for Infertility

Acquisition, application, and distribution of health literacy from culturally sensitive type 2 diabetes education among Arabic-Speaking migrants in Denmark: A longitudinal qualitative analysis

BACKGROUND

Effective self-management of type 2 diabetes requires adequate health literacy (HL) and a supportive network. Diabetes self-management education and support programmes play a crucial role in improving these factors. However, limited research exists on how such programmes can support health literacy among migrants and facilitate the dissemination of knowledge within their social networks.

AIM

This study aimed to investigate the perspectives of Arabic-speaking informants with a migrant background in relation to how their type 2 diabetes-related health literacy was acquired, applied and distributed within social networks through participation in a culturally sensitive diabetes self-management education and support (DSMES) programme.

METHODS

Semi-structured interviews were conducted with 12 informants during the programme and three to 7 months later, from September 2019 to May 2020. Abductive analysis was applied using HL and distributed health literacy (DHL) theory as frameworks.

RESULTS

The analysis generated three themes: (1) sources of health information and the development of health literacy; (2) changes towards active self-management; and (3) distributed health literacy. Prior to programme participation, informants faced challenges in navigating conflicting information from family, friends and social media. After participating in the programme, they reported improvements in HL, particularly in knowledge acquisition. Many became more actively engaged in decision-making and exhibited improved health behaviours, such as dietary choices. Nonetheless, some informants continued to struggle with choosing appropriate prevention and treatment strategies. Notably, certain informants acted as HL mediators, sharing their newly acquired knowledge within their social networks in Denmark and abroad.

CONCLUSION

Culturally sensitive diabetes self-management education programmes have the potential to enhance HL among migrants, leading to the distribution of relevant diabetes knowledge within their social networks. Future studies should explore how members of migrants' social networks perceive their supportive role in type 2 diabetes management. Programmes can benefit from emphasising critical HL and exploring how participant-informants effectively communicate diabetes-related knowledge within their networks to address misinformation and conflicting information.

Doing public health differently: How can public health departments engage with local communities through social media interventions?

Objectives

This paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic.

Study design

A qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis?

Methods

Fourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis.

Results

Collaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community.

Conclusions

Social media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues.

Health Literacy, General Health, and Lifestyle among Infertile Men and Women in the Southeastern Iran

Background

Infertility is a growing social problem, and health literacy is one of the factors that affects infertility, thereby affecting life quality. On the other hand, lifestyle factors exert a considerable impact on reproductive capacity and general health. Against this backdrop, this study aims to determine health literacy, general health, and lifestyle in infertile people in Zahedan, Iran.

Methods

In this descriptive cross-sectional study, 86 male and 181 female participants who referred to Molod Infertility center (AliIbnAbiTalib Hospital) in Zahedan were randomly selected. Health Literacy Standard Questionnaires (HELIA), the General Health Questionnaire (GHQ), and the Miller-Smith Lifestyle Assessment Inventory (LSI) were used to collect data. In addition, data were analyzed by SPSS V.22.

Results

The participants' mean age was 30.87±7.5. Besides, 39% and 70% of the participations did not have enough health literacy and had a moderate lifestyle, respectively. In addition, the general health of 68.9% was exposed to damage. Moreover, there was a significant relationship between the three aforementioned factors, with the participants of higher levels of health literacy having had higher levels of general health and lifestyle.

Conclusion

According to the findings of this study, the infertile people's health literacy was not enough, and most of them had a moderate lifestyle. In addition, their general health was exposed to damage in most cases. Thus, it is necessary to pay attention to providing proper education and health services to infertile men and women to improve their level of health literacy and healthy fertility in order to support childbearing in the society.

Supporting Women Undergoing IVF Treatment With Timely Patient Information Through an App: Randomized Controlled Trial

BACKGROUND

Since the introduction of assisted reproductive technologies in 1978, over 2 million in vitro fertilization (IVF) babies have been born worldwide. Patients play a vital role in the success of this treatment. They are required to take fertility medication (hormone injections) to activate the ovaries to produce a sufficient number of oocytes. Later, they need to take medication to increase the chance of the embryo surviving inside the uterus. Patients are educated during an intake consultation at the start of the treatment to minimize the emotional burden and reduce noncompliance. The consultation lasts about 30 to 45 minutes and covers all essential subjects. Even though ample time and energy is spent on patient education, patients still feel anxious, unknowledgeable, and unsupported. As such, electronic health utilizing a smartphone or tablet app can offer additional support, as it allows health care professionals to provide their patients with the correct information at the right time by using push notifications.

OBJECTIVE

This randomized controlled trial aimed to evaluate the capacity of an app to support IVF patients throughout the different phases of their treatment and assess its effectiveness. The study's primary outcome was to determine the patients' level of satisfaction with the information provided. The secondary outcomes included their level of knowledge, ability to administer the medication, overall experienced quality of the treatment, health care consumption, and app usage.

METHODS

This study was performed at a specialized fertility clinic of the nonacademic teaching hospital Elisabeth-TweeSteden Ziekenhuis in Tilburg, the Netherlands. Patients who were scheduled for IVF or intracytoplasmic sperm injection treatments between April 2018 and August 2019 were invited to participate in a physician-blinded, randomized controlled trial.

RESULTS

In total, 54 patients participated (intervention group: n=29). Patients in the intervention group demonstrated a higher level of satisfaction on a 0 to 10 scale (mean 8.43, SD 1.03 vs mean 7.70, SD 0.66; P=.004). In addition, they were more knowledgeable about the different elements of the treatment on a 7 to 35 scale (mean 27.29, SD 2.94 vs mean 23.05, SD 2.76; P<.001). However, the difference disappeared over time. There were no differences between the two patient groups on the other outcomes. In total, 25 patients in the intervention group used the app 1425 times, an average of 57 times per patient.

CONCLUSIONS

Our study demonstrates that, in comparison with standard patient education, using an app to provide patients with timely information increases their level of satisfaction. Furthermore, using the app leads to a higher level of knowledge about the steps and procedures of IVF treatment. Finally, the app's usage statistics demonstrate patients' informational needs and their willingness to use an electronic health application as part of their treatment.

TRIAL REGISTRATION

Netherlands Trial Register (NTR) 6959; https://www.trialregister.nl/trial/6959.

eHealth literacy during the COVID-19 pandemic: seeking, sharing, suspicion amongst older and younger UK populations

The containment of infectious diseases is most successful when at-risk populations have a high level of relevant health literacy (HL). To achieve this both literacy needs and patterns of knowledge sharing must be understood within the context of the disease being studied. It is also important to understand these processes from both offline (HL) and online (eHL) perspectives and amongst demographics with access to different types of information and social capital, and who have different levels of vulnerability. This paper discusses the insights gained over a series of 30 interviews with the UK residents aged either 19 − 30 years of age or older than 70 years—focussing on how they seek, understand, evaluate and convey information about COVID-19 during the current pandemic. Using thematic analysis, we identified themes around motivations to seek information, the information journey, digital choice and engagement, dilemmas and challenges of managing and appraising information, and sharing information. There was little difference in the eHL between the two age groups who both had high levels of education and were sophisticated digital citizens. The COVID-19 pandemic highlights three dominant processes in managing complex and uncertain information: some individuals may suffer from information fatigue but there was no evidence of any impact on their behaviours; others seek and share information across many networks; and there were strikingly high levels of distrust leading to complex processes of meaning-making demanding critical health literacy skills.

Reproductive Health Literacy and Fertility Awareness Among Polish Female Students

The falling fertility indicators and high prevalence of infertility in Poland make it important for people of reproductive age to have good knowledge of their own fertility in order to be able to take care of their reproductive health. This paper examines reproductive health literacy and fertility awareness among Polish female students. It can help identify gaps in reproductive health education in Poland. The study group included 456 women aged 18–29, who were students of 6 public universities located in Poznan, Poland. The method used was a survey using a self-developed questionnaire assessing the students' knowledge of female and male fertility-related physiology and fertility patterns. The respondents' knowledge was assessed on the basis of the percentage of correct answers. Regression analysis and univariate analysis of variance were used to explore relationships between the students' knowledge and their age, year of study, university and source(s) of information. The average score of correct answers was 55.8%. Older students and medical university students were the most knowledgeable. 93.4% of the respondents correctly identified the optimum age for a woman to have the first child from the point of view of achieving pregnancy fast. Over 90% of the respondents knew such fertility-compromising risks as smoking, diseases and psychological distress. There was much poorer awareness of the adverse effect of unbalanced diet, irregular sleep, and long-lasting physical effort. 47.1% of the students reported gaining information from a number of sources, but as many as 28.3% said their only source was primary or middle school classes. Reproductive health knowledge among the young female students is incomplete, especially as regards lifestyle-related risks. They should be encouraged to supplement it by consulting reliable sources such as health professionals. It is advisable to ensure that the curricula of medical university students provide thorough knowledge in this area, and to arrange suitable electives for students from other universities. As primary and secondary school classes remain an important source of information, quality teaching at these levels should be offered with a focus on making the knowledge as practical and operational as possible. Relevant graduate, postgraduate and in-service courses should be available to professionals responsible for spreading reproductive health knowledge.

Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

As we write our editorial for a health literacy special issue in the midst of the international COVID-19 crisis, we take this opportunity to highlight the importance of individual, community, and population health literacy. We are not only in a "pandemic" but also an "infodemic". Health literacy is more important than ever in the face of these global health threats, which have impacted outcomes across the levels of the socio-ecological model (SEM), including individual health behaviors, family relationships, organizational behavior, state policy-making, national mortality statistics, and the international economy in the span of weeks. Our special issue sought to pull together interdisciplinary threads guided by two principles. The first was defining health literacy as essential skills and situational resources needed for people to find, understand, evaluate, communicate, and use information and services in a variety of forms across various settings throughout their life course to promote health and wellbeing. The second was the idea that enhancing health literacy in populations and systems is critical to achieving health equity. In this time of public health need across traditional borders, the inter-sectoral and international perspectives of special issue articles are more urgent than ever. A greater understanding, appreciation, and application of health literacy can support policy action on multiple levels to address major public health challenges. Health literacy should be built deliberately as a population-level resource and community asset. We have summarized the set of articles in this special issue across the levels of the SEM, hoping their thoughtful considerations and interesting findings will help to support global health and wellness and inspire future research, policy, and practice in this global public health emergency and beyond.