Making a Case for "Education for Health Literacy": An International Perspective.

In many countries, health literacy research, practice, and policy have been moving away from a focus only on medical care and health-care settings to a much broader conceptualization. In this broader perspective, health literacy can be obtained and used across many other settings (e.g.

Health literacy in chronic disease management: a matter of interaction.

Health literacy plays a crucial role in chronic disease management. To comprehensively manage chronic conditions on a daily basis, individuals must be able to assess, understand, evaluate, and use health information. Several key publications emphasize that health literacy is not merely a matter of individual skills but that it is highly dependent on the accessibility of health-care systems, the communication skills of health-care professionals, and the level of complexity of the health information.

Health literacy and chronic disease management: drawing from expert knowledge to set an agenda.

Understanding the nature and impact of health literacy is a priority in health promotion and chronic disease prevention and treatment. Health literacy comprises the application of a broad set of skills to access, comprehend, evaluate, communicate and act on health information for improved health and well-being. A complex concept, it involves multiple participants and is enacted across a wide variety of contexts.

Effectiveness of educational interventions on asthma self-management in Punjabi and Chinese asthma patients: a randomized controlled trial.

Background: Asthma tends to be less well controlled among ethnic minority groups, and its prevalence in new immigrants increases significantly the longer they are in Canada; mainly due to their lack of familiarity with English and difficulty understanding information regarding the disease, health literacy, cultural issues, housing conditions, and lack of access to appropriate care services.

Objective: To explore the effectiveness of different formats of culturally relevant information and its impact on asthma patients' self-management within the Punjabi, Mandarin, and Cantonese communities.

Methods: Using a participatory approach, we developed and tested knowledge and community educational videos (with similar information, but used a different approach, i.

Canada's health promotion survey as a milestone in public health research.

This commentary describes the contribution of the 1985 Canadian National Health Promotion Survey to the development of public health research and policy-making in Canada and argues that on the basis of that contribution, it should be considered to be a public health research milestone. In terms of research, among its contributions which subsequently have been adopted in other survey studies were: going beyond risk factors to operationalize concepts implicit in the Ottawa Charter for Health Promotion; empowering users to participate in knowledge translation, sharing and transfer; ensuring sufficient sample sizes for each jurisdiction to be able to confidently generalize to its population; establishing a model as well as questions for subsequent health surveys; encouraging widespread use of data through making them available early; and developing and using an explicit social marketing strategy to reach target audiences, including the general public. With regard to policy-making, among its contributions which have been adopted were: using survey data to develop and enhance healthy public policy initiatives; encouraging researchers to work with policy-makers in developing policies; using survey data to contribute to the evaluation of public health initiatives; engaging policy-makers in the development of surveys; and encouraging the use of survey data for advocacy.

Health literacy, language, and ethnicity-related factors in newcomer asthma patients to Canada: a qualitative study.

The objectives of this study were to investigate how asthma patients from new immigrant groups are being informed and educated about asthma and its management, and to identify barriers to knowledge transfer. Four focus groups (n = 29) from Latino, Chinese, Iranian and Punjabi cultural communities were conducted with asthmatic patients in the Greater Vancouver Area. Our results from the focus group discussions can be summarized in four broad areas (a) perceptions of and ways of coping with asthma, (b) perceptions of whether the healthcare system is culturally competent, (c) perceptions of language barriers in regards to accessing the healthcare system, and (d) perceptions of how to access reliable asthma information.

Lifelong educational practices and resources in enabling health literacy among older adults.

Objective: The goal of this study is to examine the role of lifelong educational and learning practices and resources in enabling health literacy.

Method: A subsample of older adults (n = 2,979) derived from the 2003 seven country IALSS (Canadian survey) was used. An expanded Andersen-Newman model that included lifelong learning enabling factors was used to develop predictors of health literacy.

Developing and evaluating a relevant and feasible instrument for measuring health literacy of Canadian high school students.

Health literacy has come to play a critical role in health education and promotion, yet it is poorly understood in adolescents and few measurement tools exist. Standardized instruments to measure health literacy in adults assume it to be a derivative of general literacy. This paper reports on the development and the early-stage validation of a health literacy tool for high school students that measured skills to understand and evaluate health information.

Development and evaluation of an oral health literacy instrument for adults.

Objectives: To develop and validate an instrument to measure the functional oral health literacy of adults.

Methods: For the generation of items different dental patient educational materials and text types were selected that had reading levels similar to materials used for the Test of Functional Health Literacy in Adults (TOFHLA) which was the model for our Oral Health Literacy Instrument (OHLI). The OHLI contains reading comprehension and numeracy sections.

A systematic review of asthma and health literacy: a cultural-ethnic perspective in Canada.

Background: Asthma is one of the most common inflammatory lung diseases and its prevalence and incidence have increased in many developed and developing countries. Asthma places a heavy burden on healthcare expenditures and productivity, which in turn diminishes the quality of life of the individuals involved as well as their families. The goal of improving a patient's knowledge about asthma management should include the enhancement of the individual's skills with the hopeful outcome of improving how the individual manages the condition.

Assessing the effectiveness of informational video clips on Iranian immigrants' attitudes toward and intention to use the BC HealthGuide Program in the greater Vancouver area.

Background: Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources.

Effective components for nutrition interventions: a review and application of the literature.

A review of the nutrition intervention literature was conducted for Cancer Care Ontario (CCO) to develop a provincial nutrition and healthy body weight strategy. Controlled trials that were conducted between 1994 and 2000 in North America, Europe, Australia, and New Zealand were included. Fifteen interventions were included, 10 of which showed significant intervention effect and 5 reporting negative effect.

General literacy and health resources.

Unlabelled: This concluding article comments on what we learned from the conference, what we still need to know, and what we need to do now. It describes what participants said about the impact of the conference and the follow-up steps that have been taken so far. In terms of what we learned, there was agreement on the importance of culture in understanding literacy and health literacy; the importance of context; the integral relationship between literacy and health literacy and the concept of “empowerment;” the value of efforts to improve health through literacy and health literacy; and the need for collaboration.

As the ship sails forth.

This concluding article comments on what we learned from the conference, what we still need to know, and what we need to do now. It describes what participants said about the impact of the conference and the follow-up steps that have been taken so far. In terms of what we learned, there was agreement on the importance of culture in understanding literacy and health literacy; the importance of context; the integral relationship between literacy and health literacy and the concept of "empowerment;" the value of efforts to improve health through literacy and health literacy; and the need for collaboration.

Staying the course: the Captain's Log continues.

This paper introduces the reader to the context for the papers in this journal supplement by describing the background and task assigned to the authors, a short history of the development of the field of literacy and health in Canada, some recent developments and opportunities, some information on the nature and magnitude of the issue, and an overview of the supplement. The publication results from the Second Canadian Conference on Literacy and Health. Authors were asked to summarize what was learned at the conference, what we need to know, and what we need to do to move the field forward in relation to the themes of the conference.

International School Health Network: an informal network for advocacy and knowledge exchange.

In Canada, researchers, policy-makers and non-governmental organisations have re-conceptualized the school setting as being an ecological entity, linked to parallel ecologies of the homes and the community it serves. The school, public health and other systems that seek to deliver programs in that setting are open, loosely coupled and bureaucratic. This reconceived view of the school as a setting for health promotion leads to an emphasis on building organizational, system, professional and community capacity.

Determinants of health-service use by low-income people.

Poverty influences health status, life expectancy, health behaviours, and use of health services. This study examined factors influencing the use of health-related services by people living in poverty. In the first phase, 199 impoverished users of health-related services in 2 large Canadian cities were interviewed by their peers.

Literacy and health research in Canada: where have we been and where should we go?

This article reviews current literature and research on literacy and health and identifies priorities for research on this topic in Canada. Information sources included documents found through an environmental scan, the Alpha Plus collection and a computer search of recent documents. The information was analyzed using a conceptual framework.

Low-income Canadians' experiences with health-related services: implications for health care reform.

This study investigated the use of health-related services by low-income Canadians living in two large cities, Edmonton and Toronto. Interview data collected from low-income people, service providers and managers, advocacy group representatives, and senior-level public servants were analyzed using thematic content analysis. Findings indicate that, in addition to health care policies and programs, a broad range of policies, programs, and services relating to income security, recreation, and housing influence the ability of low-income Canadians to attain, maintain, and enhance their health.