Emee Vida Estacio

Health literacy and community empowerment: It is more than just reading, writing and counting

The concept of health literacy is evolving. The re-emergence of Freireian-inspired health literacy projects moves the conceptualisation of health literacy from merely the ability to apply functional literacy skills in a health-care context to a wider ability to exert control over the determinants of health. This article presents an example of a community-based project that adopts an empowerment education model in health literacy. Based within a small indigenous community in the Philippines, participants were engaged in critical reflection to gain a better understanding of how health is conceptualised within their socio-economic and political environment and its implications for practice, power relations and subjective experiences. The article concludes with the assertion that although developing health literacy skills is important, we must never lose sight of unbalanced power relations and unfair structures that hinder positive social change.

Health literacy, associated lifestyle and demographic factors in adult population of an English city: a cross-sectional survey

Lower health literacy is a public health issue that follows a social gradient, potentially reinforcing existing health inequalities. However, levels of health literacy in particular populations can be unclear and are a key to identifying effective public health interventions. This research examined health literacy levels in Stoke‐on‐Trent, where 31.2% of the population live in areas classified amongst the 10% most deprived in England.

Who stays, who drops out? Biosocial predictors of longer-term adherence in participants attending an exercise referral scheme in the UK

BackgroundExercise referral schemes are one of the most popular forms of physical activity intervention in primary care in the UK and present an opportunity to better understand the factors related to exercise adherence. But standard schemes tend to be delivered over a short period and so provide information about the factors associated with short-term adherence. This retrospective register-based study of a longer-duration scheme allowed investigation of longer-term adherence.MethodsSocial, physiological and anthropometric data were extracted from records of a cohort of ERS participants who had enrolled between 01 January and 31 December 2007 (n = 701). Characteristics of adherers and non-adherers were compared and potential predictors of longer-term adherence examined using binomial logistic regression.ResultsSignificant adjusted odds ratios predicting longer-term adherence were found for age and medical condition. For every 10 year increase in age, the odds of people continuing exercise increased by 21.8% (OR = 1.02; CI = 1.00 to 1.04; p = 0.03). Participants referred with orthopaedic (OR = 0.25; CI = 0.07-0.94; p = 0.04), cardiovascular (OR = 0.18; CI = 0.05-0.70; p = 0.01) and other (OR = 0.20; CI = 0.04-0.93; p = 0.04) problems had significantly lower odds of adhering than those with metabolic conditions.ConclusionImproved understanding of the factors that influence adherence to exercise referral schemes will enable providers develop better referral guidance and tailor schemes to better meet participants’ needs. Longer-term schemes offer the opportunity to understand participants’ likelihood of maintaining adherence to exercise.

Child labour and the International Labour Organization's Convention 182: a critical perspective.

‘Child labour’ is a worldwide problem that has caused detrimental effects to children’s health and well-being. The ILO Convention 182 aims to address this issue by immediately eliminating its worst forms. This article provides a discourse analysis of this Convention. The analysis suggests that using an organizational discourse, the Convention promotes the maintenance of existing hierarchies of power, primarily through emphasis on legislative structures and consultation with the Organization of Employers and Workers. It has been recommended that the Convention be revised in light of the insights generated by the analysis and that the children be given a more active role in the process.

Health literacy: exploring future directions and potential contributions from health psychology

Health psychology has the potential to contribute meaningfully to our understanding of the concept, processes, and outcomes of health literacy. Three areas for discussion are presented here: (1) health literacy as a multimodal concept; (2) the role of the health-care system, the professional, and tools of the trade; and (3) the relevance of social context, participation, and empowerment. The three levels of health literacy proposed by Nutbeam are mapped onto the four evolving approaches in health psychology proposed by Marks to explore the synergy between these research areas. It is hoped that this Special Section on Health Literacy will generate more discussion and activity among health psychologists into health literacy research and practice.

Health literacy: why it matters to South Asian men with diabetes.

This study aims to explore the health literacy needs of South Asian men with diabetes to generate scoping data to inform culturally appropriate interventions with this group. Health literacy levels were measured using the TOFHLA-UK (n=45) and supplemented by semi-structured interviews with healthcare providers (n=12). Data suggest that the majority of participants from this cohort tend to have marginal to inadequate health literacy levels. A generational gap was also found. Although language is a common barrier, low literacy confounds this issue since some patients are unable to read even in their own language. Thus health communication and care plans need to be simplified to match current health literacy levels of South Asian men with diabetes. Interventions need to work around cultural norms and collaborate with community members. Research and interventions that consider the needs of older generations of South Asian people with diabetes are also needed.

The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information:

This article aims to examine the socio-demographic characteristics associated with access and use of Internet for health-related purposes and its relationship with health literacy. Data were drawn from a health literacy survey (N = 1046) and analysed using logistic regression. Results show a strong association between health literacy, internet access and use. Socio-demographic characteristics particularly age, education, income, perceived health and social isolation also predict internet access. Thus, in addition to widening access, the movement towards digitisation of health information and services should also consider digital skills development to enable people to utilise digital technology more effectively, especially among traditionally hard-to-reach communities.

The World Café: An Innovative Method to Facilitate Reflections on Internationalisation in Higher Education.

This article provides an example of how the World Café method can be used as a platform to encourage reflection on internationalisation in higher education. The World Café is a community engagement method that encourages participants to engage in reflection and dialogue in a relaxed and comfortable atmosphere. It promotes the use of multiple methods in capturing insights that recognise individual and cultural preferences in communication. It values respect for diversity of perspectives, which resonates with the principles of internationalisation. This article focuses primarily on how this method can be used in practice and provides a step-by-step guide on how to organise and facilitate such an event.

Experiences of Racial Microaggression Among Migrant Nurses in the United Kingdom

In this article, we explore the experiences of racial microaggression among migrant nurses in the United Kingdom. Eleven migrant nurses kept a reflective diary for 6 weeks to record and reflect on their experiences of living and working in the United Kingdom. The diary entries were then thematically analyzed. The results suggest that migrant nurses experienced racial microaggression from patients and colleagues through racial preferences and bullying. Institutional racism also hindered their opportunities for further training and promotion. As a result, some experienced feelings of anger, frustration, and even paranoia. Despite the negative consequences of racial microaggression on their emotional well-being, incidents were downplayed as trivial because of their vague and subtle nature. To encourage better multicultural interactions in the workplace, supportive organizational infrastructures need to be in place to enhance diversity awareness and to improve mechanisms for reporting and dealing with cases of racial microaggression.

Going Beyond the Rhetoric The Movement of Critical Health Psychology towards Social Action

Health is a fundamental human right. Unfortunately the pursuit of good health remains a struggle for marginalized individuals/groups because of the rise of new centres of power. Hepworth (this issue) argues that critical health psychologists can contribute to the promotion of public health by moving towards ‘greater practice and action orientation’. Until we learn to become more actively involved in translating our research into practice, our efforts will only end up being done in vain. To pursue our humanitarian aims, CHP needs to move beyond the confines of its academic circle and begin to share its vision with a greater audience—society itself.