Health literacy: where are the Canadian doctors?
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Biomedical subjects
Publications and source records attributed to Irving Rootman.
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A review of the nutrition intervention literature was conducted for Cancer Care Ontario (CCO) to develop a provincial nutrition and healthy body weight strategy. Controlled trials that were conducted between 1994 and 2000 in North America, Europe, Australia, and New Zealand were included. Fifteen interventions were included, 10 of which showed significant intervention effect and 5 reporting negative effect. Elements of effective interventions included theoretical basis, family involvement, participatory planning and implementation models, clear messages, and adequate training and ongoing support for intervenors. CCO applied these practices to design a pilot intervention. Stakeholders participated in the intervention design and tested for clear messaging. Consistent with social cognitive theory, the intervention included activities for children and parents and provided environmental supports such as transportation and child care. Training and support for implementers and evaluators was provided by CCO.
This study investigated the use of health-related services by low-income Canadians living in two large cities, Edmonton and Toronto. Interview data collected from low-income people, service providers and managers, advocacy group representatives, and senior-level public servants were analyzed using thematic content analysis. Findings indicate that, in addition to health care policies and programs, a broad range of policies, programs, and services relating to income security, recreation, and housing influence the ability of low-income Canadians to attain, maintain, and enhance their health. Furthermore, the manner in which health-related services are delivered plays a key role in low-income people's service-use decisions. We conclude the paper with a discussion of the health and social policy implications of the findings, which are particularly relevant within the context of recent health care reform discussions in Canada.
In Canada, researchers, policy-makers and non-governmental organisations have re-conceptualized the school setting as being an ecological entity, linked to parallel ecologies of the homes and the community it serves. The school, public health and other systems that seek to deliver programs in that setting are open, loosely coupled and bureaucratic. This reconceived view of the school as a setting for health promotion leads to an emphasis on building organizational, system, professional and community capacity. One of the most effective ways of building such capacities when resources are scarce is to invest in a variety of formal and informal networks that can sustain themselves with little or no external resources. A number of recognised researchers from the health and education sectors have emphasized this systems-based approach and the need to build supportive, small-scale networks or learning communities. In recent health promotion research, networking at various levels, across sectors and within communities is viewed as a key strategy within new, more effective health promotion strategies. In education, the notion of networking for educational change has been described as "learning communities" for continuous school improvement. The authors suggest that this strategy of networking be used at the international level to address several global challenges: There is no single, convenient way to obtain basic information about the status and nature of national and state/provincial school health programs around the world. There is no global research agenda in school health promotion, despite the obvious value of sharing such research and knowledge. There is no global mechanism to facilitate the development of common or shared tools for surveillance of child/youth health and monitoring of school health policies and programs, despite the excellent work being done in individual countries and by the European Network of Health Promoting Schools. There is no international mechanism with a focus on school health that brings together the following stakeholders: educational organisations with public health organisations; researchers with government officials and practitioners; those who work in Spanish, English, French and other languages; issue-specific networks with health generalists. An invitation is given to government officials, researchers and national school health associations to join an informal International School Health Network (ISHN) (soon available at: www.internationalschoolhealt.org). Discussions about the formation of the ISHN have been held with a number of participants at several international meetings and have culminated in a fledgling network that will focus on electronic and web-based exchanges of information, developing a global school health research agenda, exchanging effective materials and tools, informing policy-makers about effective practices, policies and programs. This network would build on and not duplicate the work of existing networks and include participation from WHO, OECD, UNESCO, the IUHPE and the World Bank. The next large meeting of the ISHN will occur at the IUHPE 2007 Conference in Vancouver, Canada (www.iuhpe conference.org). Before then the ISHN will organise several on-line projects and teleconferences. For more information, contact dmccall@jcsh-cces.ca.
Poverty influences health status, life expectancy, health behaviours, and use of health services. This study examined factors influencing the use of health-related services by people living in poverty. In the first phase, 199 impoverished users of health-related services in 2 large Canadian cities were interviewed by their peers. In the second phase, group interviews with people living in poverty (n = 52) were conducted. Data were analyzed using thematic content analysis. Diverse health-related services were used to meet basic and health needs, to maintain human contact, and to cope with life's challenges. Use of services depended on proximity, affordability, convenience, information, and providers' attitudes and behaviours. Use was impeded by inequities based on income status. To promote the health of people living in poverty, nurses and other health professionals can enhance the accessibility and quality of services, improve their interactions with people living in poverty, provide information about available programs, offer coordinated community-based services, collaborate with other sectors, and advocate for more equitable services and policies.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
This article reviews current literature and research on literacy and health and identifies priorities for research on this topic in Canada. Information sources included documents found through an environmental scan, the Alpha Plus collection and a computer search of recent documents. The information was analyzed using a conceptual framework. The review found that low literacy has direct and indirect impacts on health. Families are at risk due to difficulty reading medication prescriptions, baby formula instructions and health and safety education materials. People with lower levels of literacy tend to live and work in less healthy environments. They have more difficulties obtaining employment and income security. Determinants of literacy include: education, early childhood development, aging, living and working conditions, personal capacity/genetics, gender and culture. Action is needed to improve literacy and health through a combination of health communication, education and training, community development, organizational development, and policy development. There is some evidence that such interventions can have a positive effect on health, particularly when combined with one another. Further program and policy development requires greater evidence and evaluation of existing initiatives, more cost/benefit analyses, more culturally specific studies, and greater attention to current social trends and needs.
This paper introduces the reader to the context for the papers in this journal supplement by describing the background and task assigned to the authors, a short history of the development of the field of literacy and health in Canada, some recent developments and opportunities, some information on the nature and magnitude of the issue, and an overview of the supplement. The publication results from the Second Canadian Conference on Literacy and Health. Authors were asked to summarize what was learned at the conference, what we need to know, and what we need to do to move the field forward in relation to the themes of the conference. The four themes were: Building Best Practices in Literacy and Health; Focusing on Language and Culture; Building Knowledge in Literacy and Health; and Building Healthy Public Policy.
This concluding article comments on what we learned from the conference, what we still need to know, and what we need to do now. It describes what participants said about the impact of the conference and the follow-up steps that have been taken so far. In terms of what we learned, there was agreement on the importance of culture in understanding literacy and health literacy; the importance of context; the integral relationship between literacy and health literacy and the concept of "empowerment;" the value of efforts to improve health through literacy and health literacy; and the need for collaboration. We need more and better information on how our various efforts are working; the cost of low literacy; the links between health, education, and lifelong learning; the needs and strengths of Aboriginal people, and the perspectives of Francophone and ethnocultural groups. Specific topics worthy of pursuit are suggested. They are followed by a list of recommendations from the conference related to focussing on language and culture, and to building best practices, knowledge, and healthy public policy. The paper presents some findings from the conference evaluation, which suggests that the conference met its goals. It concludes by reporting on actions that have been taken to implement the conference recommendations, including the establishment of a Health Literacy Expert Committee and the submission of several funding proposals.