Jane Sixsmith

Influence of sociodemographic and neighbourhood factors on self rated health and quality of life in rural communities: findings from the Agriproject in the Republic of Ireland

Objective: To examine the influence of sociodemographic and neighbourhood factors on self rated health, quality of life, and perceived opportunities for change (as one measure of empowerment) in rural Irish communities. Design: Pooled data from cross sectional surveys two years apart. Setting: Respondents in four randomly selected rural district electoral divisions with a population size of between 750 and 2000. Participants: 1738 rural dwellers aged 15–93, 40.5% men, interviewed at two time points. Main outcome measures: Determinants of self rated health (SRH), quality of life (QOL), and perceived opportunities for change, rated on a closed option Likert scale and assessed in multivariate logistic regression models. Main results: Overall 23.8% of the sample reported poor SRH, 22.2% poor QOL, and 50.1% low perceived opportunities for change. Low financial security and dissatisfaction with work were each significantly associated with poor SRH (OR = 1.96 (1.50 to 2.56) and 1.54 (1.11 to 2.14)), with poor QOL (OR = 2.04 (1.56 to 2.68) and 1.87 (1.34 to 2.61). Concern about access to public services was significantly predictive of SRH (OR = 1.47 (1.11 to 1.94)) rather than access to health care (that is, hospital and GP services). There were distinct sex specific patterns and a generational effect for educational status in men. Variables associated with social networks and social support were less strongly predictive of SRH and QOL when economic measures were accounted for. Conclusion: Inter-relations between indicators of health status, wellbeing, and deprivation are not well studied in rural communities. Material deprivation has a direct influence on both health status and quality of life, although immediate sources of support are relatively well preserved.

Interventions for Improving Population Health Literacy: Insights From a Rapid Review of the Evidence

The promotion of health literacy is critical to active and informed participation in health promotion, disease prevention, and health care. This article reports on a rapid review of the evidence concerning effective strategies for improving health literacy. This review was undertaken as part of a series of evidence reviews commissioned by the European Centre for Disease Prevention and Control through the Translating Health Communications Project. The authors searched a range of electronic databases and identified six evidence reviews published between 2000 and 2011. A narrative synthesis of the findings was then conducted. The majority of the published research originated in the United States, and the studies reviewed mainly focused on functional health literacy interventions that occurred in clinical settings. Considerable gaps in the evidence exist regarding the most effective population-level health literacy interventions, particularly with regard to communicable diseases. There is a paucity of intervention studies conducted on this topic in Europe. Implications of the findings for improving population health literacy on the prevention and control of communicable diseases in Europe are considered.

Health‐promoting school indicators: schematic models from students

Purpose – The purpose of this paper is to outline a three‐stage process for engaging with students to develop school level indicators of health; in sequential class groups students first generated, then categorised indicators and finally developed schematic representations of their analyses. There is a political and practical need to develop appropriate indicators for health‐promoting schools. As key stakeholders in education, students have the right to be fully engaged in this process.Design/methodology/approach – The sample in this paper comprised 164 students aged 16‐17 years in three medium‐sized Dublin schools. In the first classroom, students answered the question “If you moved to a new school, what would it need to have to be a healthy place?” on individual flashcards. In the second classroom students classified the flashcards into groups using a variation of the card game “snap”. In the third classroom, students discussed the relationships between the developed categories and determined how the ca...

Adolescents' Perceptions of the Words "Health" and "Happy".

Purpose – The shared language of youth includes understandings of concepts that can be different from those of adults. Researchers, in their efforts to explore and illuminate the health behaviours and decision‐making processes of young people, use generic terms in their data collecting protocols. This study aims to explore what adolescents understand by the words “healthy” and “happy”.Design/methodology/approach – Semi‐structured interviews were conducted in three post‐primary schools with 31 students aged 12 and 13 years. Drawing on a grounded theory approach, interviews were transcribed and subjected to thematic content analysis.Findings – The students provided a description and explanation of what health and happiness meant to them and how they intended to maintain both as they grew older. Perceptions of these two concepts were found to contain gendered nuances. This was clear in relation to descriptions of how friends were part of well‐being; the girls were more likely to talk about feeling restricted...

Agenda Setting for Health Promotion: Exploring an Adapted Model for the Social Media Era

Background The foundation of best practice in health promotion is a robust theoretical base that informs design, implementation, and evaluation of interventions that promote the public’s health. This study provides a novel contribution to health promotion through the adaptation of the agenda-setting approach in response to the contribution of social media. This exploration and proposed adaptation is derived from a study that examined the effectiveness of Twitter in influencing agenda setting among users in relation to road traffic accidents in Saudi Arabia. Objective The proposed adaptations to the agenda-setting model to be explored reflect two levels of engagement: agenda setting within the social media sphere and the position of social media within classic agenda setting. This exploratory research aims to assess the veracity of the proposed adaptations on the basis of the hypotheses developed to test these two levels of engagement. Methods To validate the hypotheses, we collected and analyzed data from two primary sources: Twitter activities and Saudi national newspapers. Keyword mentions served as indicators of agenda promotion; for Twitter, interactions were used to measure the process of agenda setting within the platform. The Twitter final dataset comprised 59,046 tweets and 38,066 users who contributed by tweeting, replying, or retweeting. Variables were collected for each tweet and user. In addition, 518 keyword mentions were recorded from six popular Saudi national newspapers. Results The results showed significant ratification of the study hypotheses at both levels of engagement that framed the proposed adaptions. The results indicate that social media facilitates the contribution of individuals in influencing agendas (individual users accounted for 76.29%, 67.79%, and 96.16% of retweet impressions, total impressions, and amplification multipliers, respectively), a component missing from traditional constructions of agenda-setting models. The influence of organizations on agenda setting is also highlighted (in the data of user interactions, organizational accounts registered 17% and 14.74% as source and target of interactions, respectively). In addition, 13 striking similarities showed the relationship between newspapers and Twitter on the mentions trends line. Conclusions The effective use of social media platforms in health promotion intervention programs requires new strategies that consider the limitations of traditional communication channels. Conducting research is vital to establishing a strong basis for modifying, designing, and developing new health promotion strategies and approaches.

Developing and pilot testing a comprehensive health literacy communication training for health professionals in three European countries

OBJECTIVE Skills to address different health literacy problems are lacking among health professionals. We sought to develop and pilot test a comprehensive health literacy communication training for various health professionals in Ireland, Italy and the Netherlands. METHODS Thirty health professionals participated in the study. A literature review focused on evidence-informed training-components. Focus group discussions (FGDs) explored perspectives from seventeen professionals on a prototype-program, and feedback from thirteen professionals following pilot-training. Pre-post questionnaires assessed self-rated health literacy communication skills. RESULTS The literature review yielded five training-components to address functional, interactive and critical health literacy: health literacy education, gathering and providing information, shared decision-making, enabling self-management, and supporting behaviour change. In FGDs, professionals endorsed the prototype-program and reported that the pilot-training increased knowledge and patient-centred communication skills in addressing health literacy, as shown by self-rated pre-post questionnaires. CONCLUSION A comprehensive training for health professionals in three European countries enhances perceived skills to address functional, interactive and critical health literacy. PRACTICE IMPLICATIONS This training has potential for wider application in education and practice in Europe.

Identifying Twitter influencer profiles for health promotion in Saudi Arabia

New media platforms, such as Twitter, provide the ideal opportunity to positively influence the health of large audiences. Saudi Arabia has one of the highest number of Twitter users of any country, some of whom are very influential in setting agendas and contributing to the dissemination of ideas. Those opinion leaders, both individuals and organizations, influential in the new media environment have the potential to raise awareness of health issues, advocate for health and potentially instigate change at a social level. To realize the potential of the new media platforms for public health, the function of opinion leaders is key. This study aims to identify and profile the most influential Twitter accounts in Saudi Arabia. Multiple measures, including: number of followers and four influence scores, were used to evaluate Twitter accounts. The data were then filtered and analysed using ratio and percentage calculations to identify the most influential users. In total, 99 Saudi Twitter accounts were classified, resulting in the identification of 25 religious men/women, 16 traditional media, 14 sports related, 10 new media, 6 political, 6 company and 4 health accounts. The methods used to identify the key influential Saudi accounts can be applied to inform profile development of Twitter users in other countries.

The relevance of context in understanding health literacy skills: Findings from a qualitative study

Conceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of peoples health experiences.

Exploring the diffusion of tweets designed to raise the road safety agenda in Saudi Arabia

This study demonstrates the importance of understanding the diffusion process in social media such as Twitter as an example of the relationship between new media platforms and health promotion interventions. Evidence-informed tweets were developed, pilot tested and distributed to all followers of the Ministry of Health’s Twitter account with the aim of influencing the agenda on road safety in Saudi Arabia. The dissemination pattern and influence of this health communication was assessed. We collected 70 tweets into two groups (29 intervention tweets and 41 additional supported tweets) extracted from the Tweetreach data set and then analysed them using Microsoft Excel and SPSS. Using the concept of innovation/imitation as defined in the Bass Model, we classified retweeting by direct followers as innovation and retweeting by users who were not followers as imitation. In the study, we identify an informative indicator of successful diffusion and propose a novel procedure to measure innovation/imitation coefficients (p and q). We also provided a statistical procedure for evaluating tweet adoption by innovators (influentials) and imitators. In addition, we also assessed the use of message design tools for new media messages. The resulting information can be used to improve public health and health promotion interventions at the levels of planning, design, implementation and evaluation.

Evaluating the implementation of an emotional wellbeing programme for primary school children using participatory approaches

Objective: This paper reports on the use of child participatory approaches to evaluate the implementation and impact of the Zippy’s Friends emotional wellbeing programme on children in disadvantaged primary schools in Ireland. Design:  As part of the overall evaluation study, which comprised a clustered randomised controlled trial, qualitative participatory approaches were utilised to explore children’s experiences of the Zippy’s Friends programme. Setting: From the overall sample of 44 primary schools (N = 717 pupils) that participated in the evaluation study, a subsample of 9 classes (n = 161 children) from the intervention and control groups was randomly selected to take part in child participatory workshops at pre-intervention, interim and post-intervention. Method: A semi-structured child participatory workshop consisting of three activities, including draw and write technique, feelings activity and group brainstorming, was used to explore the children’s experiences of the programme and its impact on their coping strategies and emotional literacy skills. Results: The results from the draw and write activity provided evidence of the positive impact of the programme on children’s use of problem-solving and support-seeking strategies in coping with certain problem situations. Findings from the participatory workshop also helped provide insight into how the programme impacted on children’s emotional literacy skills. Children in the intervention group had a broader range of vocabulary and understanding in relation to emotions concerning problem situations. In addition, children identified factors that, from their perspective, supported their engagement with the programme, including the use of narrative through story and the activity-based nature of the programme. Conclusion: The use of participatory approaches generated data that enriched our understanding of how children experienced and benefited from the programme from their own perspective, thereby providing insights that were untapped by other research methods in this study.