Sara Champlin

Understanding Health Literacy Measurement Through Eye Tracking

This study used eye-tracking technology to explore how individuals with different levels of health literacy visualize health-related information. The authors recruited 25 university administrative staff (more likely to have adequate health literacy skills) and 25 adults enrolled in an adult literacy program (more likely to have limited health literacy skills). The authors administered the Newest Vital Sign (NVS) health literacy assessment to each participant. The assessment involves having individuals answer questions about a nutrition label while viewing the label. The authors used computerized eye-tracking technology to measure the amount of time each participant spent fixing their view at nutrition label information that was relevant to the questions being asked and the amount of time they spent viewing nonrelevant information. Results showed that lower NVS scores were significantly associated with more time spent on information not relevant for answering the NVS items. This finding suggests that efforts to improve health literacy measurement should include the ability to differentiate not just between individuals who have difficulty interpreting and using health information, but also between those who have difficulty finding relevant information. In addition, this finding suggests that health education material should minimize the inclusion of nonrelevant information.

The Many Health Literacies: Advancing Research or Fragmentation?

Health literacy is the degree to which individuals can obtain, process, understand, and communicate about health-related information needed to make informed health decisions and is an important factor in patient health outcomes and resulting health care costs. Because of its importance across many areas of health, specific attention has been given to studying and measuring health literacy in recent years; however, the field lacks consensus on how health literacy should be defined and measured. As a result, numerous definitions and measures of health literacy exist. This fragmentation and inconsistency creates a barrier to conceptualizing, measuring, and understanding health literacy across health domains and fields. A directed literature search reveals a substantial body of work on health literacy; however, findings from studies often emphasize health literacy within specific health domains, populations, contexts, and languages, which makes the comparison of findings across studies difficult. While there is recognition that the measurement of health literacy should be improved, it is important to take into consideration what can be gained from a general health literacy focus and how this could be applied across domains.

Toward a Better Understanding of Patient Health Literacy: A Focus on the Skills Patients Need to Find Health Information:

While many health literacy assessments exist, this area of research lacks an instrument that isolates and reflects the four components driving this concept (abilities to find, understand, use, and communicate about health information). The purpose of this study was to determine what abilities comprise the first component, how a patient finds health information. Low (n = 13) and adequate (n = 14) health literacy patients, and health professionals (n = 10) described their experiences when looking for health information and the skills they employed to complete these tasks. Major skills/themes elicited included knowing when to search, credibility assessments, finding text and numerical information, interpersonal seeking, technology and online search, and spatial navigation. Findings from this study suggest that each of the dimensions included in the definition of health literacy warrants specific attention and assessment. Given identification of the skills comprising each dimension, interventions targeting deficits across health literacy dimensions could be developed to improve patient health.

“Take time. Save lives. Clean hands protect.” A comparison of two hand hygiene health promotion posters

Two posters were designed to encourage hospital staff hand hygiene. One focused on broad benefits of hand hygiene to patients and staff, and the other highlighted hand hygiene as a long-known measure to infection control. The former was better received in terms of attention, likability, and potential to promote hand hygiene. A third-person effect, the perception of stronger impact of communication messages on others, was observed. Implications on health promotion message design were discussed.

Creating a Screening Measure of Health Literacy for the Health Information National Trends Survey

Purpose: Create a screening measure of health literacy for use with the Health Information National Trends Survey (HINTS). Design: Participants completed a paper-based survey. Items from the survey were used to construct a health literacy screening measure. Setting: A population-based survey conducted in geographic areas of high and low minority frequency and in Central Appalachia. Subjects: Two thousand nine hundred four English-speaking participants were included in this study: 66% white, 93% completed high school, mean age = 52.53 years (SD = 16.24). Measures: A health literacy screening measure was created using four items included in the HINTS survey. Scores could range from 0 (no questions affirmative/correct) to 4 (all questions answered affirmatively/correctly). Analysis: Multiple regression analysis was used to determine whether demographic variables known to predict health literacy were indeed associated with the constructed health literacy screening measure. Results: The weighted average health literacy score was 2.63 (SD = 1.00). Those who were nonwhite (p = .0005), were older (p < .0005), or had not completed high school (p < .0001) tended to have lower health literacy screening measure scores. Conclusion: This study highlights the need to assess health literacy in national surveys, but also serves as evidence that screening measures can be created within existing datasets to give researchers the ability to consider the impact of health literacy.

A Multi-Method Study to Understand How Youth Perceive and Evaluate Food and Beverage Advertisements

As a formal practice, advertising has been in existence for over 100 years, most often with the purpose of creating consumer excitement for, and the voluntary purchase of, company products and goods (Grier & Kumanyika, 2010). While advertising is meant to drive consumption, the purchase of certain products, especially among specific groups, may be problematic. Recent literature suggests that there may be a link between food and beverage advertising and the prevalence of childhood obesity among youth in the USA (IOM, 2006). Because of the dramatic increase in the prevalence of obesity over the past 30 years (Ogden, Carrol, Curtin, Lamb, & Flegal, 2010), investigating factors that may contribute to weight gain among children and adolescents is essential. While overweight and obesity is influenced by many factors, food and beverage advertising, and its resulting influence on the dietary preferences and choices of youth, is thought to be a key factor (Story & French, 2004; IOM, 2006). The amount and type of advertising that is directed toward youth has grown considerably in recent years, with marketers using an increasing number of techniques and outlets to promote their products. Greater media use among youth (Rideout, Foehr, & Roberts, 2010), in combination with advertising that extends to a variety of media channels, has resulted in increased exposure to unhealthy food and beverage products.

Introduction: Childhood Obesity: Media, Advertising, Community, and Advocacy

Childhood obesity is a global public health problem. The prevalence of childhood obesity has reached epidemic proportions in the USA and in other nations around the world, including both developing and developed countries, particularly in regions where the adoption of Westernized food consumption and sedentary lifestyles are evident (World Health Organization (WHO), 2010). About 155 million children worldwide are classified as either overweight or obese (Hossain, Kawar, & El Nahas, 2007). According to the Centers for Disease Control and Prevention (CDC), the proportion of children (ages 2–11) and adolescents (ages 12–17) in the USA who are obese has increased threefold or more during the past three decades (Ogden & Carroll, 2010). Nearly one-third (32 %) of children and adolescents over 2 years of age are either overweight or obese, where approximately 17 % (or 12.5 million) of those are obese (Ogden, Carroll, Kit, et al., 2012). The obesity epidemic is nondiscriminating; it affects both boys and girls, across all states and socioeconomic lines and among all racial and ethnic groups, yet in disproportionate ways (Kumanyika & Grier, 2006; Ogden, Lamb, Carroll, et al., 2010; Singh, Kogan, & van Dyck, 2010; Wang & Zhang, 2006). Four out of 10 African-American and Mexican-American girls between the ages of 12 and 19 are considered overweight or obese (Ogden et al., 2012). Obesity prevalence is exacerbated among youth (ages 2–17) residing in economically distressed urban neighborhoods, in remote, isolated areas such as American-Indian reservations, and in areas of the Deep South and Appalachia, which includes the states of Mississippi, Georgia, Kentucky, and Louisiana, where concentrated poverty exists (Ogden, Lamb, et al., 2010; Singh et al., 2010; Story, Evans, Fabsitz, et al., 1999).

Leave a Comment: Consumer Responses to Advertising Featuring “Real” Women

Advertisements frequently feature models that are considered “ultra-thin.” Modern developments in technology and image production have created ways to make models appear even smaller by altering images in post-production processes. The high prevalence of ads with “impossibly gorgeous” women has an impact at the societal level, by reinforcing the idea that women are primarily defined by their attractiveness to heterosexual men, and on the individual level, where exposure can have detrimental effects on women’s mental health. In response to concerns expressed by some consumers about the overuse of ultra-thin models, a few brands have launched advertising campaigns featuring “real women” who are more diverse in body shape and size. The purpose of this chapter is to explore the mixed reactions consumers have expressed toward two real women campaigns: Dove’s Campaign for Real Beauty and aerie Real by American Eagle. Consumer sentiment was investigated via comments sections of online news articles, YouTube videos, and social media platforms Reddit and Twitter. Four themes were identified encapsulating positive (e.g., featuring more diverse models is better for women and society in general), negative (e.g., the problem of ultra-thin models is fictional, made up in the minds of sensitive women, and therefore these campaigns are completely unnecessary), and skeptical (e.g., the campaigns are not diverse and inclusive enough; the motivation behind real women campaigns is profit-driven and disingenuous, making the efforts less meaningful) reactions. Findings provide insight into how people use online spaces to engage in dialogue about the positive and negative outcomes of real women campaigns.

Health Literacy in Adult Education Centers: Exploring Educator and Staff Needs

Objective. Incorporating health content into adult education courses is promising for increasing health literacy skills among “hard-to-reach” populations. The purpose of this study was to gain previously untapped knowledge of adult education personnel (i.e., educators, staff) about the strategies and programs that would be beneficial for helping students learn about health. Method. Personnel (N = 53) from three literacy coalitions completed an online survey that assessed interest and preferences for developing a health literacy curriculum. Results. Personnel indicated general concepts such as health services and insurance as those of greatest priority. Additionally, tools designed for general use (completion of forms) were favored. Personnel preferred programs that focused on general skills over those designed to address specific health topics, χ2(1) = 11.52, p = .001. Conclusions. Adult education personnel find greatest value in health literacy programs aimed at increasing general skills rather than disease-/topic-specific content. There were several mismatches in topics noted as a “priority” and those for which personnel felt comfortable teaching. A focus on fostering general health skills will help all students—not just those with specific health concerns such as diabetes and asthma. Teaching health literacy through general skill development could make health programs exciting, engaging, and accessible for students.

Promoting Mental Health Resource Use on Campus by “Trying Something New”

Purpose: To design and test a persuasive health promotion campaign that aligns with the qualities of trying something new for the first time. Given that a majority of students have not previously sought/considered professional mental health assistance before, the hypothesis tested in this study asked whether a campaign that takes this into account is effective with this audience. Design: Participants viewed an online informational message (n = 84), information message plus first-time experience banner (n = 99), or 1 of 4 full campaigns, each depicting a student story and photo about a first-time experience (moving from home [n = 48], skydiving [n = 52], acting in a play [n = 48], and exercising with personal trainer [n = 48]). Measures: Visual poster items: appeal (visually pleasing, 7 items, α = .92), support (value of poster, 5 items, α = .86) and behavioral intention items: engagement (participant seek help/pay attention, 3 items, α = .86), relevance (content as relevant, 3 items, α = .84), and judgment (judgment of others for not seeking help, 2 items, α = .87). Participants: College students (N = 380). Results: In comparison to information-only messages, framing mental health help seeking as a first-time experience was linked with increased appeal, support, and engagement (Minformationonly = 2.79 [standard deviation, SD = 1.34], Minformationplusbanner = 3.25 [SD = 1.23], Mfullcampaign = 4.07 [SD = 1.28], P < .001, Minformationonly = 4.38 [SD = 1.47], Minformationplusbanner = 4.92 [SD = 1.21], Mfullcampaign = 4.57 [SD = 1.26], P = .014, and Minformationonly = 3.13 [SD = 1.76], Minformationplusbanner = 3.56 [SD = 1.48], Mfullcampaign = 4.02 [SD = 1.42], P < .001, respectively). As anticipated, the full campaign garnered the highest affect and engagement scores. When comparing the 4 first-time experiences, there were main effects on support and engagement (Mtrain = 5.06 [SD = 1.17], Mplane = 4.27 [SD = 1.28], Mhome = 4.59 [SD = 1.19], Mplay = 4.38 [SD = 1.29], P = .009 and Mtrain = 4.50 [SD = 1.27], Mplane = 3.75 [SD = 1.43], Mhome = 4.01 [SD = 1.49], Mplay = 3.84 [SD = 1.39], P = .042, respectively), with the novel experience of “working with a personal trainer” rated highest. Conclusion: Findings from this study have implications for the design of health promotion materials on college campuses. Specifically, campaigns that frame seeking help for mental health as a new experience potentially increase student engagement in this behavior. A key finding from the present study is that a campaign in which this behavior is linked to a familiar form of interpersonal help seeking (personal training) can create receptivity to the stigmatized issue of mental health help seeking.