Multiple domains of health literacy as reflected in breastfeeding promotion practice: A Canadian case study

Gillis, Doris E.; Gray, Nicola J.; Murphy, Elizabeth A.

doi:10.1177/1359105312454041

Cited by 8 publications

(25 citation statements)

References 21 publications

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“…HPs commonly assume that patients have a higher level of understanding in terms of being able to read and comprehend written information about health 11 despite research documenting the functional gap between level of education and health information that has Over 20 years later, Gillis et al 33 presented a very similar description:…”

Section: What Is Community Engagement?mentioning

confidence: 98%

“…33 Although the smoking example showed some increase in knowledge of risks as evidenced by attempts to quit, the lack of involvement and subsequent lack of engagement reduced participation and ultimately resulted in negative outcomes. The reductionist approach to breastfeeding information was associated with what was described as a 'disconnected presence' and associated with lack of confidence and motivation to change behaviour.…”

Section: Relating Engagement In Intervention Design To Health Literacymentioning

confidence: 99%

“…31,32 With most of the attention focused on the functional model of HL, very little has been published on approaches to promoting critical or interactive HL. Most of the work linking functional with critical and interactive concepts has been done by Doris Gillis, 33 and explores the barriers encountered by HPs in terms of integrating more interactive HL promotion into their daily practice. Gillis 33 explores the dissonance encountered between the clinical orientation of 'doing information to' someone, and the adult learning model of 'creating information with' someone, through which learning is problem based, and emphasises equality and collaboration between teacher and learner.…”

Section: Sorensen Et Al'smentioning

confidence: 99%

“…Most of the work linking functional with critical and interactive concepts has been done by Doris Gillis, 33 and explores the barriers encountered by HPs in terms of integrating more interactive HL promotion into their daily practice. Gillis 33 explores the dissonance encountered between the clinical orientation of 'doing information to' someone, and the adult learning model of 'creating information with' someone, through which learning is problem based, and emphasises equality and collaboration between teacher and learner. Adult learning is based on the premise that information is offered when the individual needs to know; it is tailored to the self-concept and prior experience of the learner; and it is sensitive to the individual's motivation and readiness to learn.…”

Section: Sorensen Et Al'smentioning

confidence: 99%

“…This was evidenced in breastfeeding in terms of challenging norms in public spaces. For example, in the North American study 33 the co-ordinator of a community-based prenatal nutrition programme enabled a breastfeeding mother who was asked not to breastfeed in a local restaurant to discuss her experience with other mothers. Discussion led to organising a protest through letter writing and a boycott of the restaurant, which led the restaurant to respect women's rights to breastfeed in a public place.…”

Section: Relating Engagement In Intervention Design To Health Literacymentioning

confidence: 99%

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Can community-based peer support promote health literacy and reduce inequalities? A realist review

Harris

Springett

Croot

et al. 2015

Public Health Research

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BackgroundCommunity-based peer support (CBPS) has been proposed as a potentially promising approach to improve health literacy (HL) and reduce health inequalities. Peer support, however, is described as a public health intervention in search of a theory, and as yet there are no systematic reviews exploring why or how peer support works to improve HL.ObjectiveTo undertake a participatory realist synthesis to develop a better understanding of the potential for CBPS to promote better HL and reduce health inequalities.Data sourcesQualitative evidence syntheses, conceptual reviews and primary studies evaluating peer-support programmes; related studies that informed theoretical or contextual elements of the studies of interest were included. We conducted searches covering 1975 to October 2011 across Scopus, Global Health (including MEDLINE), ProQuest Dissertations & Theses database (PQDT) [including the Education Resources Information Center (ERIC) and Social Work Abstracts], The King’s Fund Database and Web of Knowledge, and the Institute of Development Studies supplementary strategies were used for the identification of grey literature. We developed a new approach to searching called ‘cluster searching’, which uses a variety of search techniques to identify papers or other research outputs that relate to a single study.Study eligibility criteriaStudies written in English describing CBPS research/evaluation, and related papers describing theory, were included.Study appraisal and synthesis methodsStudies were selected on the basis of relevance in the first instance. We first analysed within-programme articulation of theory and appraised for coherence. Cross-programme analysis was used to configure relationships among context, mechanisms and outcomes. Patterns were then identified and compared with theories relevant to HL and health inequalities to produce a middle-range theory.ResultsThe synthesis indicated that organisations, researchers and health professionals that adopt an authoritarian design for peer-support programmes risk limiting the ability of peer supporters (PSs) to exercise autonomy and use their experiential knowledge to deliver culturally tailored support. Conversely, when organisations take a negotiated approach to codesigning programmes, PSs are enabled to establish meaningful relationships with people in socially vulnerable groups. CBPS is facilitated when organisations prioritise the importance of assessing community needs; investigate root causes of poor health and well-being; allow adequate time for development of relationships and connections; value experiential cultural knowledge; and share power and control during all stages of design and implementation. The theory now needs to be empirically tested via further primary research.LimitationsAnalysis and synthesis were challenged by a lack of explicit links between peer support for marginalised groups and health inequalities; explicitly stated programme theory; inconsistent reporting of context and mechanism; poor reporting of intermediate process outcomes; and the use of theories aimed at individual-level behaviour change for community-based interventions.ConclusionsPeer-support programmes have the potential to improve HL and reduce health inequalities but potential is dependent upon the surrounding equity context. More explicit empirical research is needed, which establishes clearer links between peer-supported HL and health inequalities.Study registrationThis study is registered as PROSPERO CRD42012002297.FundingThe National Institute for Health Research Public Health Research programme.

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Section: What Is Community Engagement?mentioning

confidence: 98%

Section: Relating Engagement In Intervention Design To Health Literacymentioning

confidence: 99%

Section: Sorensen Et Al'smentioning

confidence: 99%

Section: Sorensen Et Al'smentioning

confidence: 99%

Section: Relating Engagement In Intervention Design To Health Literacymentioning

confidence: 99%

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Can community-based peer support promote health literacy and reduce inequalities? A realist review

Harris

Springett

Croot

et al. 2015

Public Health Research

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Breast, Formula and Combination Feeding in Relation to Childhood Obesity in Nova Scotia, Canada

Rossiter

Colapinto

Khan

et al. 2015

Matern Child Health J

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Breastfeeding has been rigorously studied in relation to childhood obesity prevention. Few studies have examined whether combination feeding—breast milk and formula—may also be protective against obesity. This study aimed to investigate the relationship between breastfeeding duration, combination feeding and overweight and obesity among Canadian school children. We analyzed data from a 2011 cross-sectional, population based survey (n = 5,560), which included self-reported infant feeding behaviours, a food frequency questionnaire and measured height and weight. Multilevel regression methods were used to examine the association between breastfeeding duration and overweight and obesity adjusting for socioeconomic status, diet quality and physical activity. Thirty-four percent of children were breastfed for<1 week or never while 32% were breastfed for at least 6 months. In the fully adjusted model, children who were only formula fed or who were combination fed for <6 months were more likely to be overweight or obese relative to children who were only breastfed (OR 1.29, 95% CI 1.04-1.60 and OR 1.35, 95% CI 1.09-1.69, respectively). When examining overweight and obese children separately, those who were only formula fed were more likely obese (OR 1.57, 95% CI 1.10-2.25) relative to their peers who were only breastfed. And those who were combination fed for <6 months relative to those only breastfed were more likely to be overweight (OR 1.29, 95% CI 1.01-1.66). Breastfeeding, in the absence of formula feeding, appears to have a protective effect on childhood obesity. While combination feeding confers less benefit than only breastfeeding, it is more desirable than formula feeding alone. Strategies and social policies are needed to promote exclusive and longer breastfeeding duration and should be integrated with comprehensive efforts to prevent childhood obesity and to reduce the burden of chronic diseases in the long term.

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How stakeholder participation can contribute to systematic reviews of complex interventions

Harris

Croot

Thompson

et al. 2015

J Epidemiol Community Health

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Although patient and public involvement in research is a requirement for research funding in many countries, the knowledge base for how to effectively involve people—and evidence of the effectiveness of involvement—is weak. This article describes how methods used in participatory health research were used to involve patients, clients, providers and community health workers across all stages of a realist review. Sustained involvement enabled better identification of the components of the complex intervention of community-based peer support. It also challenged assumptions of how peer support is constructed, leading the review team to question whether the process of designing and implementing interventions has more influence on effectiveness than previously recognised in empirical studies. We conclude with a discussion on when sustained involvement should be used, and the challenges of incorporating it into the traditional researcher-led approach to systematic reviews.

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Multiple domains of health literacy as reflected in breastfeeding promotion practice: A Canadian case study

Cited by 8 publications

References 21 publications

Can community-based peer support promote health literacy and reduce inequalities? A realist review

Can community-based peer support promote health literacy and reduce inequalities? A realist review

Breast, Formula and Combination Feeding in Relation to Childhood Obesity in Nova Scotia, Canada

How stakeholder participation can contribute to systematic reviews of complex interventions

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