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Blankart CR, De Gani SM, Crimlisk H, Desmedt M, Bauer B, Doyle G. Health literacy, governance and systems leadership contribute to the implementation of the One Health approach: a virtuous circle. Health Policy 2024; 143:105042. [PMID: 38518391 DOI: 10.1016/j.healthpol.2024.105042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/12/2024] [Accepted: 03/11/2024] [Indexed: 03/24/2024]
Abstract
One Health is an important approach to addressing health threats and promoting health through interdisciplinary health, policy, legislation and leadership research to achieve better human and animal health and better outcomes for the planet. The Covid-19 pandemic has triggered an urgent awareness of the need to develop innovative integrative solutions to address root causes of such threats to health, which requires collaboration across disciplines and amongst different sectors and communities. We explore how achieving the Quadripartite Organizations' One Health Joint Plan of Action can be supported by the concepts of 'One Health literacy' and 'One Health governance' and promote both academic and policy dialogue. We show how One Health literacy and One Health governance influence and reinforce each other, while an interdisciplinary systems leadership approach acts as a catalyst and mechanism for understanding and enacting change. Based on our understanding of how these elements influence the implementation of the One Health approach, we describe a model for considering how external triggering events such as the Covid-19 pandemic may prompt a virtuous circle whereby exposure to and exploration of One Health issues may lead to improved One Health literacy and to better governance. We close with recommendations to international organisations, national governments and to leaders in policy, research and practice to enhance their influence on society, the planetary environment, health and well-being.
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Affiliation(s)
- Carl Rudolf Blankart
- KPM Center for Public Management, University of Bern, Freiburgstr. 3, 3010 Bern, Switzerland; Swiss Institute for Translational and Entrepreneurial Medicine (sitem-insel), Freiburgstr. 3, 3010 Bern, Switzerland; Multidisciplinary Center for Infectious Diseases (MCID), University of Bern, Hallerstrasse 6, 3012 Bern, Switzerland.
| | - Saskia Maria De Gani
- Careum Center for Health Literacy, Careum Foundation, 8032 Zürich, Switzerland; Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zürich, Switzerland
| | - Helen Crimlisk
- Sheffield Health and Social Care NHS Foundation Trust, Centre Court, Atlas Way, Sheffield S47QQ, United Kingdom; Faculty of Medicine and Population Health, University of Sheffield, Beech Hill Rd, Sheffield S102RX, United Kingdom; Royal College of Psychiatrists, 21 Prescot St, London E18BB, United Kingdom
| | - Mario Desmedt
- Swiss Nurse Leaders, Haus der Akademien, Laupenstrasse 7, P.O. Box, 3001 Bern, Switzerland
| | - Birgit Bauer
- Data Saves Lives Germany, c/o european digital health academy gGmbH, Mohnblumenweg 1, 93326 Abensberg, Germany
| | - Gerardine Doyle
- UCD College of Business, University College Dublin, Belfield, Dublin 4, Ireland; UCD Geary Institute for Public Policy, University College Dublin, Belfield, Dublin 4, Ireland
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Jaks R, Guggiari E, De Gani SM, Nicca D. Patients' Perspectives on the Use of a Newly Developed "Patients' Guide for Doctor's Visit": DocVISITguide. Int J Environ Res Public Health 2023; 20:6414. [PMID: 37510646 PMCID: PMC10379287 DOI: 10.3390/ijerph20146414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
During doctor's visits, fundamental decisions regarding a patient's diagnosis and therapy are taken. However, consultations often take place within a limited time frame and are characterized by an asymmetric interaction. Therefore, patients' questions can remain unanswered and concerns unspoken. A "Patients' Guide for Doctor's Visit" (DocVISITguide) was developed to prepare patients for their visits, supporting them to take an active role in the communication and leave the consultation well-informed. This paper describes the development of the DocVISITguide and its first small-scale evaluation based on a sequential explanatory mixed methods design from the patients' perspective. For this purpose, a small sample of patients completed a pre- and post-questionnaire, and two in-depth interviews were conducted. Most participants found the DocVISITguide easy to understand. The guide helped them to take a closer look at their own health situation and be better prepared for the visit. More than three-quarters (82%) of the participants would probably use the guide again, and all (100%) would recommend it to family and friends. However, some patients felt unsure about using the guide within the consultation and showing it to their physician. To counteract this uncertainty, physicians should be actively involved in the use of such guides in the future.
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Affiliation(s)
- Rebecca Jaks
- Careum Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
| | - Elena Guggiari
- Careum Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
- Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zurich, Switzerland
| | - Saskia Maria De Gani
- Careum Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
- Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zurich, Switzerland
| | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
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Rachamin Y, Nerlich SE, Jäger L, De Gani SM, Favre O, Senn O. Adolescents' self-reported health status, behaviours and health issues addressed during routine school doctor consultations in Switzerland: an observational study. Swiss Med Wkly 2023; 153:40078. [PMID: 37243976 DOI: 10.57187/smw.2023.40078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND We aimed to investigate the self-reported health status and behaviours of 7th-grade adolescents, associations with gender and educational track, as well as health issues addressed during routine school doctor consultations in Switzerland. METHODS Data on health status and behaviours, specifically general well-being, stimulant and addictive substance use, bullying/violence, exercise, nutrition and health protection, and puberty/sexuality, were drawn from routinely collected self-assessment questionnaires from 1076 (of a total of 1126) students from 14 schools in the Swiss canton of Zug in 2020. Data on health issues addressed in school doctor consultations were collected by nine school doctors (for 595 individual consultations). Multilevel logistic regression analyses were used to investigate the association of gender and educational track with unfavourable health status or behaviours. RESULTS Although 92% (n = 989) of the students reported being happy or satisfied overall, 21% (n = 215) often or almost always felt sad, and 5-10% had repeatedly been seriously physically hurt (n = 67), sexually harassed with words (n = 88) or experienced uncomfortable physical contact (n = 60). Female gender and a lower educational track were associated with unfavourable health status. In 90% (n = 533) of the school doctor consultations, at least one topic of disease prevention or health promotion was addressed, whereby the topics addressed depended strongly on the individual school doctors. CONCLUSIONS Our findings revealed that unfavourable health status and behaviours were prevalent among adolescents but the health topics addressed in school doctor consultations were not tailored to students' self-reported health issues. A school-based approach that strengthens adolescents' health literacy and provides opportunities for patient-centred counselling has the potential to improve the current and future health of adolescents and, ultimately, adults. To realise this potential, it is essential for school doctors to be sensitised and trained to address students' health concerns. Emphasis should be placed on the importance of patient-centred counselling, the high prevalence of bullying, and gender and educational differences.
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Affiliation(s)
- Yael Rachamin
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Campus Stiftung Lindenhof Bern (SLB), Bern, Switzerland
| | - Sofia Elena Nerlich
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Levy Jäger
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | | | - Olivier Favre
- Department of Child and Adolescent Health, Office of Public Health, Canton of Zug, Zug, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Beese AS, Nicca D, Jaks R, Stuermer N, De Gani SM. How Do Primary Care Organizations Rate Their Level of Organizational Health Literacy? Results of a Swiss Pilot-Study. Int J Environ Res Public Health 2022; 19:16139. [PMID: 36498209 PMCID: PMC9738898 DOI: 10.3390/ijerph192316139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Primary care organizations offer a suitable setting to promote organizational health literacy (OHL) since they are a crucial interface for patients and clients. However, a clear picture on the OHL situation in primary care is lacking. The aim of this study was to assess OHL in Swiss primary care organizations by evaluating (i) how they rate their level of OHL and which improvement measures they accordingly plan (organizational level), (ii) what knowledge and attitudes among health professionals in primary care regarding OHL exist (individual level) and (iii) how teams working in general practitioners' practices and a home care service organization differ regarding OHL (organizational and individual level). The research design included an online survey (N = 74, health professionals) on the individual level and a checklist and intervention documentation (N = 10, primary care teams) on the organizational level. The study reveals a crucial demand regarding organizationally embedded OHL practices in the participating primary care teams, despite a rather comprehensive understanding of the concept. The greatest need for action was identified in strengthening health literacy of staff members, which underlines the necessity to develop interventions to systematically strengthen the health literacy of health professionals.
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Affiliation(s)
- Anna-Sophia Beese
- Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
| | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Rebecca Jaks
- Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
| | - Natascha Stuermer
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Saskia Maria De Gani
- Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
- Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zurich, Switzerland
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Stuermer N, De Gani SM, Beese AS, Giovanoli Evack J, Jaks R, Nicca D. Health Professionals' Experience with the First Implementation of the Organizational Health Literacy Self-Assessment Tool for Primary Care (OHL Self-AsseT)-A Qualitative Reflexive Thematic Analysis. Int J Environ Res Public Health 2022; 19:15916. [PMID: 36497990 PMCID: PMC9735722 DOI: 10.3390/ijerph192315916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Organizational health literacy (OHL) is crucial for public health, in turn health care organizations play vital roles in improving populations' health literacy. Therefore, the aim of this qualitative study was to explore how the organizational health literacy self-assessment tool (OHL Self-AsseT) was implemented, used, and understood by primary care teams from a network of general practices and a Home Care Service Organization in Zurich, Switzerland. Reflexive thematic analysis with a constructivist orientation was used to analyze data from 19 interviews pre- and post-OHL Self-AsseT use. Normalization Process Theory supported structuring of inductively developed themes. Findings show that the participants experienced working with the OHL Self-AsseT meaningful, as it helped with "Addressing OHL construction sites" so that they could "build momentum for change". The experience of "Succeeding together in construction" led to a "feeling of team-efficacy during change". Practical use of the tool and/or discussions about OHL led to a growing conceptual understanding, which was described as "Using a construction plan-making sense of ongoing OHL activities". To conclude, the OHL Self-AsseT encouraged teams to initiate change, led to greater team-efficacy and supported the construction of OHL. Improved implementation strategies will support this intervention's scale-up as a base for effectiveness testing.
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Affiliation(s)
- Natascha Stuermer
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Saskia Maria De Gani
- Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
- Careum School of Health, Kalaidos University of Applied Sciences, 8006 Zurich, Switzerland
| | - Anna-Sophia Beese
- Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
| | - Jennifer Giovanoli Evack
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Rebecca Jaks
- Center for Health Literacy, Careum Foundation, 8032 Zurich, Switzerland
| | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
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Guggiari E, Jaks R, Berger FMP, Nicca D, De Gani SM. Health Literacy in the Canton of Zurich: First Results of a Representative Study. Int J Environ Res Public Health 2021; 18:ijerph182312755. [PMID: 34886479 PMCID: PMC8657543 DOI: 10.3390/ijerph182312755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022]
Abstract
Managing health information and services is difficult for nearly half of the population in Switzerland. Low health literacy has been shown to result in poorer health and health outcomes as well as a higher utilization of health services. To date, studies on health literacy in Switzerland have focused on a national level. However, Switzerland is a federal state with 26 cantons and a strongly decentralized health system. Therefore, the aim of this study is to understand how health literacy is distributed within the population of the canton of Zurich specifically, and to develop methods to determine whether an individual has a higher or lower level of health literacy. There were a total of 1000 participants in this representative study. Data was collected by an adapted version of the HLS-EU-Q47 and additional sociodemographic questions. The majority (56%) of the reported difficulties concerned accessing, understanding, appraising, and applying health information. The findings confirm that health literacy follows a social gradient, whereby financially deprived individuals and those with a low educational level report lower health literacy. The need for action to strengthen the health literacy of these population groups is therefore urgent. Interventions should pay particular attention to these vulnerable groups and tailor resolutions to their needs and preferences.
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Affiliation(s)
- Elena Guggiari
- Careum Foundation, Health Literacy Department, Pestalozzistrasse 3, 8032 Zurich, Switzerland; (E.G.); (R.J.); (F.M.P.B.)
- Research Department, Careum School of Health, Gloriastrasse 18a, 8006 Zurich, Switzerland
| | - Rebecca Jaks
- Careum Foundation, Health Literacy Department, Pestalozzistrasse 3, 8032 Zurich, Switzerland; (E.G.); (R.J.); (F.M.P.B.)
| | - Fabian Marc Pascal Berger
- Careum Foundation, Health Literacy Department, Pestalozzistrasse 3, 8032 Zurich, Switzerland; (E.G.); (R.J.); (F.M.P.B.)
- Research Department, Careum School of Health, Gloriastrasse 18a, 8006 Zurich, Switzerland
| | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland;
| | - Saskia Maria De Gani
- Careum Foundation, Health Literacy Department, Pestalozzistrasse 3, 8032 Zurich, Switzerland; (E.G.); (R.J.); (F.M.P.B.)
- Correspondence: ; Tel.: +41-4-3222-6429
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Schneider M, Jaks R, Nowak-Flück D, Nicca D, De Gani SM. Mental Health Literacy in Zurich: A First Measurement Attempt Using the General HLS-EU-Q47. Front Public Health 2021; 9:723900. [PMID: 34589463 PMCID: PMC8473678 DOI: 10.3389/fpubh.2021.723900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mental health literacy (MHL) promises to be an important factor for public health by enabling people to take responsibility for their own mental health. To date, there is no measurement tool that allows the assessment of a comprehensive understanding of MHL as part of health literacy (HL). Nonetheless, the widely used Health Literacy Survey European Questionnaire 47 (HLS-EU-Q47) includes items assessing at least some MHL-aspects in the context of HL. The present study aimed at investigating how these MHL-aspects are related to HL, health behavior and health outcome and how they differ between sociodemographic groups. Methods: Data from the Health Literacy Survey Zurich 2018, collected by an adapted version of the HLS-EU-Q47, served to investigate these relationships. Results: MHL-aspects were related to HL, health behavior and health outcome. Nearly half of all respondents (45%; N = 904) showed low MHL levels, particularly those with higher age and higher financial deprivation. Conclusions: Relations of MHL-aspects with HL, health behavior, and health outcome indicate their potential importance for future interventions in public health, addressing mental health and MHL. A specific MHL tool is needed to comprehensively investigate these relations, which could be developed by extending the present measurement approach.
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Affiliation(s)
- Michael Schneider
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland.,Health Literacy Division, Careum Foundation, Zurich, Switzerland
| | - Rebecca Jaks
- Health Literacy Division, Careum Foundation, Zurich, Switzerland
| | | | - Dunja Nicca
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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