The case for integrated health and community literacy to achieve transformational community engagement and improved health outcomes: an inclusive approach to addressing rural and remote health inequities and community healthcare expectations

Abstract Context: Despite the substantial investment by Australian health authorities to improve the health of rural and remote communities, rural residents continue to experience health care access challenges and poorer health outcomes. Health literacy and community engagement are both considered critical in addressing these health inequities. However, the current focus on health literacy can place undue burdens of responsibility for healthcare on individuals from disadvantaged communities whilst not taking due account of broader community needs and healthcare expectations. This can also marginalize the influence of community solidarity and mobilization in effecting healthcare improvements. Objective: The objective is to present a conceptual framework that describes community literacy, its alignment with health literacy, and its relationship to concepts of community engaged healthcare. Findings: Community literacy aims to integrate community knowledge, skills and resources into the design, delivery and adaptation of healthcare policies, and services at regional and local levels, with the provision of primary, secondary, and tertiary healthcare that aligns to individual community contexts. A set of principles is proposed to support the development of community literacy. Three levels of community literacy education for health personnel have been described that align with those applied to health literacy for consumers. It is proposed that community literacy education can facilitate transformational community engagement. Skills acquired by health personnel from senior executives to frontline clinical staff, can also lead to enhanced opportunities to promote health literacy for individuals. Conclusions: The integration of health and community literacy provides a holistic framework that has the potential to effectively respond to the diversity of rural and remote Australian communities and their healthcare needs and expectations. Further research is required to develop, validate, and evaluate the three levels of community literacy education and alignment to health policy, prior to promoting its uptake more widely.

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Quick Guide to Health Literacy: Health Literacy and Health Outcomes

PsycEXTRA Dataset ◽

10.1037/e568202010-001 ◽

2013 ◽

Keyword(s):

Health Literacy ◽

Health Outcomes

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Testing the health literacy of twenty Bangladeshi patients before and 5 months after they begin to access their GP electronic record

British Journal of General Practice ◽

10.3399/bjgp18x697133 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697133

Author(s):

Richard Fitton ◽

Amir Hannan ◽

Ingrid Brindle ◽

Shafia Begum ◽

Sarwar Shah

Keyword(s):

Health Literacy ◽

Health Outcomes ◽

Medical History ◽

Medical Records ◽

Practice Nurse ◽

Electronic Record ◽

Phone Calls ◽

Before And After ◽

Medical Histories ◽

Memory Knowledge

BackgroundPatients with higher health literacy enjoy better health outcomes and are more compliant with treatment. Health literacy is a product of memory, reason and imagination. Patients who can access their records have potentially more memory (knowledge) and make less phone calls to and have less consultations with their GP, practice nurse, HCA and other professionals.AimThe study aims to measure the knowledge that twenty Bangladeshi patients with poor English have of their medical history before and after access to their electronic record.Method55% of patients at Thornley House have access to their medical records. A simple questionnaire was given to 20 Bangladeshi patients before and 5 months after access to their electronic record. The questionnaires recorded the patients’ knowledge of their medical histories. The scores of the completed before and after questionnaires were compared to see if record access had increased patients’ knowledge.ResultsFive patients completed before and after questionnaires. Each achieved a higher score after record access. The differences in scores for the five patients were 2, 5, 1, 10, and 1, respectively.ConclusionHealth literacy for patients is similar to medical literacy for doctors. It requires knowledge, skills and attitudes. We will see whether record access can increase knowledge. Further studies might measure whether that increased knowledge improves skills and attitudes.

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The impact of health literacy on health outcomes in individuals with chronic pain: a cross-sectional study

Physiotherapy ◽

10.1016/j.physio.2018.11.006 ◽

2019 ◽

Vol 105 (3) ◽

pp. 346-353

Author(s):

Laura M. Mackey ◽

Catherine Blake ◽

Maire-Brid Casey ◽

Camillus K. Power ◽

Ray Victory ◽

...

Keyword(s):

Chronic Pain ◽

Health Literacy ◽

Health Outcomes ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Impact

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An International Review to Characterize the Role, Responsibilities, and Optimal Setting for Health Literacy Mediators

Global Pediatric Health ◽

10.1177/2333794x211025401 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110254

Author(s):

Madeline Spencer ◽

Nenagh Kemp ◽

Vaughan Cruickshank ◽

Claire Otten ◽

Rosie Nash

Keyword(s):

Health Literacy ◽

Literacy Development ◽

Recent Literature ◽

Important Determinant ◽

Literacy Education ◽

International Review ◽

Optimal Setting ◽

Role Responsibilities ◽

The Life Course

Health literacy is a critically important determinant of health and is influenced by access to supportive social networks and services. Global investment in education throughout the life course is required to support health literacy development. The aim of this review is to characterize the role, responsibilities, and the optimal setting for the emergent role of a Health Literacy Mediator (HLM). A scoping review of recent literature was conducted. The review revealed a lack of consensus on who should be teaching health literacy, and variability in confidence when teaching health literacy. Professionals reported facing barriers such as a lack of time, a lack of knowledge, and recognized that the health literacy needs of children worldwide are not being met. Further research into the role of HLM is required to determine who is best suited to this role and what their responsibilities will be to ensure consistent health literacy education.

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Art during tough times: reflections from an art-based health promotion initiative during the COVID-19 pandemic

Global Health Promotion ◽

10.1177/1757975921998638 ◽

2021 ◽

pp. 175797592199863

Author(s):

Ilhan Abdullahi ◽

Navneet Kaur Chana ◽

Marco Zenone ◽

Paola Ardiles

Keyword(s):

Health Promotion ◽

Community Engagement ◽

Health Inequities ◽

Well Being ◽

Art Museum ◽

Political Context ◽

The Social ◽

Promotion Strategies ◽

Health Promotion Initiative

With the current COVID-19 pandemic impacting communities across the globe, diverse health promotion strategies are required to address the wide-ranging challenges we face. Art is a highly engaging tool that promotes positive well-being and increases community engagement and participation. The ‘Create Hope Mural’ campaign emerged as an arts-based health promotion response to inspire dialogue on why hope is so important for Canadians during these challenging times. This initiative is a partnership between a health promotion network based in Vancouver and an ‘open air’ art museum based in Toronto. Families were invited to submit artwork online that represents the concept of hope. This paper discusses the reflections of organizers of this arts-based health promotion initiative during the early months of the pandemic in Canada. Our findings reveal the importance of decolonizing practices, centring the voices of those impacted by crisis, while being attentive to the social and political context. These learnings can be adopted by prospective health promoters attempting to use arts-based methods to address social and health inequities.

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What do you mean by engagement? – evaluating the use of community engagement in the design and implementation of chronic disease-based interventions for Indigenous populations – scoping review

International Journal for Equity in Health ◽

10.1186/s12939-020-01346-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sahr Wali ◽

Stefan Superina ◽

Angela Mashford-Pringle ◽

Heather Ross ◽

Joseph A. Cafazzo

Keyword(s):

Chronic Disease ◽

Health Outcomes ◽

Community Engagement ◽

Participatory Research ◽

Scoping Review ◽

Indigenous Health ◽

Well Being ◽

Indigenous Populations ◽

Local Context ◽

Engagement Strategies

Abstract Background Indigenous populations have remained strong and resilient in maintaining their unique culture and values, despite centuries of colonial oppression. Unfortunately, a consequential result of facing years of adversity has led Indigenous populations to experience a disproportionate level of poorer health outcomes compared to non-Indigenous populations. Specifically, the rate of Indigenous chronic disease prevalence has significantly increased in the last decade. Many of the unique issues Indigenous populations experience are deeply rooted in their colonial history and the intergenerational traumas that has subsequently impacted their physical, mental, emotional and spiritual well-being. With this, to better improve Indigenous health outcomes, understanding the local context of their challenges is key. Studies have begun to use modes of community engagement to initiate Indigenous partnerships and design chronic disease-based interventions. However, with the lack of a methodological guideline regarding the appropriate level of community engagement to be used, there is concern that many interventions will continue to fall short in meeting community needs. Objective The objective of this study was to investigate the how various community engagement strategies have been used to design and/or implement interventions for Indigenous populations with chronic disease. Methods A scoping review guided by the methods outlined by Arksey and O’Malley was conducted. A comprehensive search was completed by two reviewers in five electronic databases using keywords related to community engagement, Indigenous health and chronic disease. Studies were reviewed using a descriptive-analytical narrative method and data was categorized into thematic groups reflective of the main findings. Results We identified 23 articles that met the criteria for this scoping review. The majority of the studies included the use a participatory research model and the procurement of study approval. However, despite the claimed use of participatory research methods, only 6 studies had involved community members to identify the area of priority and only five had utilized Indigenous interview styles to promote meaningful feedback. Adapting for the local cultural context and the inclusion of community outreach were identified as the key themes from this review. Conclusion Many studies have begun to adopt community engagement strategies to better meet the needs of Indigenous Peoples. With the lack of a clear guideline to approach Indigenous-based participatory research, we recommend that researchers focus on 1) building partnerships, 2) obtaining study approval and 3) adapting interventions to the local context.

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Health literacy and health outcomes in China’s floating population: mediating effects of health service

BMC Public Health ◽

10.1186/s12889-021-10662-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hai-YanYu ◽

Wei-Ling Wu ◽

Lin-Wei Yu ◽

Lei Wu

Keyword(s):

Health Literacy ◽

Health Service ◽

Health Services ◽

Health Outcomes ◽

Service Utilization ◽

Health Service Utilization ◽

Mediating Effect ◽

Floating Population ◽

Equation Modeling ◽

Mediating Effects

Abstract Background The floating population in China consists primarily of internal immigrants and represents a typical health vulnerable group. Poor health literacy has recently become an obstacle in the accessibility and utilization of health services for the vulnerable population, leading to adverse health outcomes. This study aimed to examine whether health literacy affected health outcomes in China’s floating population and whether health service utilization had a mediating effect between health literacy and health outcomes. Method The current study utilized a cross-sectional stratified, multistage, proportional to scale (PPS) study in Zhejiang Province, China, in November and December 2019. In total, 657 valid self-reported questionnaires were recovered and used for data collection. Questionnaires included questions regarding sociodemographic characteristics, health literacy, health outcomes, and health service utilization. Confirmatory factor analysis was used to test questionnaire validity; descriptive statistics were used to understand the demographic characteristics of the floating population; and structural equation modeling was used to determine whether health service utilization mediated health literacy and health outcomes. Results We report positive correlations between health literacy, health service utilization, and health outcomes. Mediation analysis demonstrated that health service utilization had partial mediating effects between health literacy and health outcomes. In the relationship between health literacy and health outcomes, the indirect effects of health service utilization accounted for 6.6–8.7% of the total effects. Conclusion Complete health literacy, through health care literacy and health promotion literacy, affects the mobile population’s initiative to use health services, which, in turn, affects health outcomes. Thus, improving the health literacy of the floating population will help to improve health outcomes. Furthermore, health service providers should enhance the diversity of health service supply to ensure that the floating population has the external resources to improve personal health literacy.

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