BackgroundHealth attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement.MethodsHealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children’s health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school.DiscussionHealth promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.
Purpose -This paper describes a service improvement project with two aims: to identify and screen all adults with Down's syndrome aged over 30 years in a defined locality using a standardised instrument to establish functional baselines; and to set up a database to facilitate early diagnosis of dementia in this population.Design/methodology/approach -An assistant psychologist used a standardised instrument to screen participants who were identified through contact with health, social, and third sector, and housing services.Findings -Eligible people were identified and screened using an informant-based measure. Three groups were identified: group 1 showed no significant change; group 2 showed significant change but no signs of dementia; and group 3 showed significant change plus signs of dementia. People with suspected dementia were referred on for further investigation/assessment and supportive services.Practical implications -Terminology is important in engaging families in a screening project, as is the opportunity to provide information. A proactive screening project can be established by employing working partnerships between intellectual disability and older adult services to aid diagnosis.Originality/value -Adults with Down's syndrome aged over 30 years in a defined locality can be identified through contact with health, social, and third sector, and housing services. Those identified can be screened using a standardised instrument and a database of screening results established in order to establish baselines against which future re-screening can be conducted. Partnership working between older adult mental health services and intellectual disability services can improve the diagnostic service to adults with Down's syndrome.
Health literacy research and interventions have provided multiple tools to improve communication between professionals and patients in clinical contexts for many years. Despite the reality that many patients participate in clinical trials in conjunction with standard medical care, only recently have efforts extended to address and improve the health literacy of both clinical trial researchers and participants. To date, the primary focus of health literacy activities in clinical trials has centered on communicating trial results to trial participants. This report describes the opportunities and strategies necessary to layer health literacy activities across the clinical trial process from consent to conclusion.
In the United States, communities at risk of developing lung cancer include rural populations, low socioeconomic status (SES) and the under-insured, immigrants, aged populations, racial and ethnic minority groups, and LGBTQIA communities. Many of these high-risk communities are diagnosed at much later stages than high SES whites. When lung cancer is detected early, survival rates are higher due to the possibility of curative surgery. Lung cancer screening (LCS) using low-density computed tomography (LDCT) has been recommended by the USPSTF since 2013. Guidelines for those who meet the USPSTF LCS criteria were expanded in 2021. A major barrier to accessing screening by vulnerable populations is the lack of health literate LCS education materials that can be used to engage and empower these groups and motivate them to seek screening. Research Question: How do we develop health literate (HL), culturally sensitive, and linguistically appropriate health information about LCS to high-risk communities and make them available through trusted community partners? Methods: A multi-phased approach that included material creation, testing, and dissemination was conceptualized by LUNGevity Foundation in partnership with Health Literacy Media (HLM) and a leading expert in accessible patient education. Using an IRB-approved protocol, the study team identified a representative population of persons (N=40 in 15 states) with online recruitment facilitated by NCI community cancer center outreach leaders in high-risk geographies. The participants gave extensive quantitative and qualitative feedback via virtual focus groups or in-depth interviews to obtain opinions and insights into how easily LUNGevity Foundation's Screening and Early Detection Booklet was understood. Revised materials were created using HL best practices, and re-tested with new community members to ensure acceptability, accessibility, and HL. Then, additional materials with relevant health topics were developed consistent with HL principles for extensive testing with communities. An additional 24 people in 11 states took part in 1 of 4, 1 ½ hour focus groups for final review. New HL lung cancer screening materials were made available to NCI community outreach leaders via LUNGevity Foundation's trusted national community engagement network. Results: The participants raised important insights about eligibility for and accessibility to screening. Based on their insights and recommendations, HLM transformed one large booklet into 4 fact sheets and 6 mini booklets. Final materials were disseminated to vulnerable populations via LUNGevity Foundation's trusted community engagement network. Conclusions: The feasibility of creating patient-centered health literate materials that also incorporate community engagement is established. Using LCS as an example, we were able to successfully create materials that were acceptable to high-risk communities. We recommend offering understandable and accessible information to all communities regardless of their literacy or education levels. Citation Format: Jeanne M. Regnante, Upal Basu Roy, Catina O'Leary, Linda M. Fleisher, Diane W. Webb, Linda Wenger, Andrea Ferris, Robert Winn. Health literacy as a tool to drive equitable action for lung cancer screening in high-risk communities [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-064.
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