Health Promotion International[JOURNAL]
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200 papers
Scalability and scaling-up strategy of a physical activity policy intervention in Australian childcare centres.
Christian H, Mclaughlin M, Nathan A … +7 more , Adams E, Bauman A, Naylor PJ, Shilton T, Maher C, Trost SG, Schipperijn J
Health Promot Int · 2025 Sep · PMID 40898429 · Full text
There is an urgent need for scalable interventions to promote physical activity in early childhood. An early childhood education and care (ECEC) physical activity policy intervention with implementation support strategie...
There is an urgent need for scalable interventions to promote physical activity in early childhood. An early childhood education and care (ECEC) physical activity policy intervention with implementation support strategies (Play Active) has been proposed for scale-up in Australia. This study sought to assess the scalability of Play Active and describe the Play Active scaling-up strategy. The Intervention Scalability Assessment Tool was used to assess scalability. The PRACTical planning for Implementation and Scale-up (PRACTIS) guided the scaling-up strategy and involved: (i) characterizing the implementation setting; (ii) identifying existing/new partnerships; (iii) identifying barriers and facilitators to implementation; (iv) addressing barriers through adaptations. The Play Active scalability assessment domains with the highest scores (>2.5/3) were for the problem, intervention, reach and acceptability. Four additional domains scored highly (>2/3): fidelity and adaptation, delivery settings and workforce, implementation infrastructure, and strategic/political context. The lowest scores (<2/3) were the evidence of effectiveness, intervention costs and benefits, and sustainability domains. The PRACTIS guide showed that the implementation setting and existing and new partnerships were appropriate for scaling-up Play Active. The PRACTIS guide also identified key barriers (e.g. staff time) and enablers (e.g. staff professional development) to implementation at scale. Adaptations were identified to address these barriers (e.g. intervention delivery via a customised website). Overall, the scalability assessment revealed gaps in some scalability domains to be addressed through further research and adaptation of Play Active. The proposed scale-up trial evaluation is crucial to support decision-makers to fund, scale and institutionalize Play Active in the real world.
Mixed methods systematic review of consumer engagement in rural health practice, research, and education.
Broadhurst T, Cha YJ, Bartlett C … +8 more , Van Heerden J, Smith L, Lizarondo L, McGrail M, Nasir B, Hulme A, Kondalsamy-Chennakesavan S, Martin P
Health Promot Int · 2025 Jul · PMID 40878441 · Full text
This systematic review aimed to synthesize evidence on consumer engagement in rural health practice, research, and education. It was conducted using the JBI mixed methods methodology, specifically the convergent integrat...
This systematic review aimed to synthesize evidence on consumer engagement in rural health practice, research, and education. It was conducted using the JBI mixed methods methodology, specifically the convergent integrated approach. PubMed, PsychINFO, Cochrane Library, SCOPUS, Web of Science, EMBASE, and CINAHL were searched, along with gray literature sources-Google, ProQuest Dissertation, and Theses Global. Primary research studies published globally in English, from 2011 to 2024 were included. Dual reviewer screening occurred in two stages, title and abstract, then followed by full text. Critical appraisals of included studies were undertaken using McMaster Critical Appraisal Tool for quantitative and qualitative studies, respectively, and the Mixed Methods Appraisal Tool. Extracted data was synthesized to develop themes for reporting per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review identified 25 studies that explored the top three levels of consumer involvement in rural healthcare settings, namely Partnership, Involving, and Consumer-led, adapted from the 2011 National Framework for Consumer Involvement in Cancer Control. Five key themes were developed from the data: positive impacts of co-design, importance of relationship building, sustainability of interventions, power issues in co-design, and the importance of context. Findings showed that interventions utilizing the top three partnership levels (consumer-led, partnership, and involving) consistently lead to positive impacts on health outcomes of rural communities with higher levels of sustained engagement. Enablers and barriers were identified and categorized into a macro, micro, and meso framework for direct comparison between studies. Rural healthcare initiatives involving consumer engagement appear to have several benefits including strengthening community-researcher relationships, enhanced sustainability, and enriching local contexts while addressing power imbalances to enhance healthcare outcomes.
Alcohol lobbying in Canada: a quantitative analysis of the federal registry of lobbyists.
Grinberg A, Vallance K, Farkouh EK … +3 more , Giesbrecht N, Wettlaufer A, Naimi TS
Health Promot Int · 2025 Jul · PMID 40879083 · Full text
Although alcohol is a leading cause of health and social harms in Canada, policies directed at alleviating the public health burden created by alcohol are rarely adopted and often reversed. This study analyses alcohol-re...
Although alcohol is a leading cause of health and social harms in Canada, policies directed at alleviating the public health burden created by alcohol are rarely adopted and often reversed. This study analyses alcohol-related policy lobbying activity to better understand how lobbying might impact policy development in Canada. This was deemed not human subjects research. A cross-sectional analysis was conducted using data from the federal Canadian Registry of Lobbyists to characterize the frequency and nature of alcohol industry and public health lobbying activities between May 2022 and May 2023. In this period, there was substantially more lobbying activity by alcohol industry representatives compared to public health stakeholders. Over three-quarters of lobby groups represented alcohol industry organizations (n = 13) compared to public health organizations (n = 4), with industry recording a majority of registered lobbyists (81.3%), meetings reported (66.2%), and number of officials lobbied (71.2%). Alcohol industry organizations predominantly lobbied bureaucrats in policy making/governance roles (54.2% of industry meetings), while public health stakeholders mainly lobbied legislators (60.4% of public health meetings). The alcohol industry's dominance in federal lobbying activities may enable corporate influence over alcohol policy development and undermine public health approaches. The nature of lobbying in Canada has international implications for the regulation of a product that is an important commercial determinant of health, showing the potential role lobbying may play in weakening alcohol regulation.
Capacity to address determinants of health among a social justice coalition in the United States.
Clawson AH, Du R, Jones DM … +7 more , Baker S, Taylor E, Orloff M, Prewitt E, Donald K, Cornell CE, Fagan P
Health Promot Int · 2025 Jul · PMID 40856209 · Full text
This study describes the Arkansas Social Justice Coalition and early pre-post changes in the capacity of participating community-based organizations to address social and structural determinants of health during the form...
This study describes the Arkansas Social Justice Coalition and early pre-post changes in the capacity of participating community-based organizations to address social and structural determinants of health during the formative stage of this coalition. We utilized population-level data to understand the coalition's reach to counties experiencing health inequities. Community-based organizations (N = 29) involved in this coalition all served rural counties and counties with greater burden from COVID-19 hospitalizations, heart disease mortality, and cancer mortality. Food quality and access, economic stability, and education were identified by coalition members as the primary determinants of health impacting their communities. Coalition members completed a baseline survey, participated in coalition activities focused on addressing these primary determinants of health, and then completed a follow-up survey 3-months later. Coalition members reported significant increases in several domains of their community-based organizations' capacity to address select determinants of health across assessments. Specifically, there were significant increases in the average number of partnerships facilitated and the average number of educational sessions offered by the community-based organization that addressed economic stability, education, and food access and quality. The Arkansas Social Justice Coalition effectively created a network of 29 community-based organizations dedicated to addressing determinants of health to reduce the disproportionate burden of COVID-19, cardiovascular disease, and cancer affecting their communities. Engagement in the coalition resulted in early improvements in several capacity domains during our coalition's formative stage, which may translate to improvements in long-term outcomes related to promoting health equity at the community level.
Culturally relevant physical activity in Hawai'i: outrigger canoeing across an adapted social-ecological model.
Schmid SM, Soo Hoo C, Pirkle CM … +7 more , Phillips MM, Thompson M, Yoshida A, Hansen Smith H, Ching L, Finn J, Sentell T
Health Promot Int · 2025 Jul · PMID 40855632 · Full text
Outrigger canoe paddling ("paddling") is a culturally and regionally relevant physical activity (PA) in Hawai'i and the Pacific with potential for public health promotion and disease prevention, yet paddling remains unde...
Outrigger canoe paddling ("paddling") is a culturally and regionally relevant physical activity (PA) in Hawai'i and the Pacific with potential for public health promotion and disease prevention, yet paddling remains understudied from a public health perspective. This study explored the meaning of paddling across levels of the social-ecological model (SEM) using qualitative methods. The study goal was to develop a research base and inform scholarship about participation in paddling for public health. A total of 1066 Hawai'i residents (18 + years) completed an online or phone survey about culturally relevant PA. Among them, 362 self-identified as current or former paddlers and responded to the open-ended question: 'What does outrigger canoe paddling mean to you?'. Qualitative analysis was conducted using a deductive-inductive approach. Findings revealed themes spanning an adapted SEM: (i) intrapersonal-fun, relaxation, PA; (ii) proximal connections-relationships with people past and present; (iii) distal connections-teams, canoe(s), and the ocean "humanized" as part of the community; (iv) environmental-immersion in the natural world; (v) macrosocial-culture, traditions, ancestral knowledge; and (vi) spiritual-life symbolism and spirituality. Many respondents reported multiple levels of the SEM in their responses, which can be seen in this illustrative quote, sharing that padding meant: '…physical health, emotional balance, spiritual connection with ocean and self, building trust and communication with a team.' Paddling fosters health, well-being, and community across SEM levels, making it a strong candidate for PA interventions aligned with best-practice public health guidelines.
Mitigating child health inequalities through equity, diversity, inclusion, and accessibility school practices in Canada.
Maximova K, Honorato C, Matheson FI … +2 more , Dabravolskaj J, Veugelers PJ
Health Promot Int · 2025 Jul · PMID 40855631 · Full text
Unhealthy lifestyle behaviours and mental disorders disproportionately affect children living in deprived neighbourhoods. In Canada, schools are encouraged to adopt equity, diversity, inclusion, and accessibility (EDIA)...
Unhealthy lifestyle behaviours and mental disorders disproportionately affect children living in deprived neighbourhoods. In Canada, schools are encouraged to adopt equity, diversity, inclusion, and accessibility (EDIA) practices to tackle these inequalities. We examined whether integrating EDIA school practices into curriculum and programming mitigates the impact of neighbourhood deprivation on children's lifestyle behaviours and mental health. In 2023/2024, we surveyed 1970 students in grades 4-6 (aged 9-12) from 28 elementary schools in Alberta. Students self-reported diet, physical activity, screen time, and mental health and wellbeing. School principals reported on the extent (full vs. partial) of integrating EDIA school practices into curriculum and programming. The Canadian Index of Multiple Deprivation (i.e. residential instability, economic dependency, ethno-cultural composition, situational vulnerability) was used to capture neighbourhood deprivation. Over half (54%) of schools had fully integrated EDIA school practices into curriculum and programming, and were located primarily in areas with greater residential instability (50%), ethno-cultural diversity (57%), economic dependency and situational vulnerability (46%). In highly deprived neighbourhoods, students attending schools with fully integrated EDIA practices were less likely to have poor diets (0.9 vs. 1.6) and consume excessive intake of free sugar (1.3 vs. 1.8) and saturated fat (0.6 vs. 0.8). EDIA school practices did not appear to moderate the relationship of neighbourhood deprivation with physical activity, screen time, or mental health and wellbeing. These findings suggest that integrating EDIA school practices into curriculum and programming may help buffer some adverse effects of neighbourhood deprivation on children's health and diets in particular.
Insights into organizational health literacy in Italian hospitals: findings from the M-POHL network project.
Lorini C, Palmieri L, Unim B … +14 more , Zimmitti S, Lunetta C, Biagi C, Toccafondi F, Zanobini P, Iadevaia S, Cacciuttolo MG, Lombardo C, Marcozzi B, Ancona A, Paladini A, Galeone D, Specchia ML, Bonaccorsi G
Health Promot Int · 2025 Jul · PMID 40852979 · Full text
Hospitals are recognized as settings for health promotion, serving as a process that empowers individuals to gain greater control over and improve their health. Health-literate organizations play a crucial role in health...
Hospitals are recognized as settings for health promotion, serving as a process that empowers individuals to gain greater control over and improve their health. Health-literate organizations play a crucial role in health promotion by creating supportive environments that ensure equitable access to health information and services, empowering individuals to engage with, understand, evaluate, and apply health information through diverse communication channels and social resources. The International Self-Assessment Tool for Organizational Health Literacy of Hospitals (OHL-Hos) was used for the first time in Italy to evaluate the implementation of OHL principles in two local hospitals and one academic hospital. The OHL-Hos is organized into 8 standards, 21 substandards, and 155 items. The degree of fulfillment with the OHL principles was calculated for substandards and standards to assess their accomplishment within the organization, along with an overall score. In each hospital, the self-assessment was carried out by an interdisciplinary team; the team members initially conducted the assessment individually, and then a joint assessment was performed to reach a consensus. The two local hospitals presented similar results and an overall level of OHL responsiveness (41.62% and 39.15%, respectively) lower than the academic hospital (63.22%). The OHL principles were found to be only partially addressed and fulfilled. The OHL-Hos tool proved valuable in identifying the most critical areas that require targeted interventions, aimed at enhancing both the OHL of the organizations and the health of individuals as a result.
Health literacy research on the island of Ireland: a systematic review.
Murray M, Behan S, Smith C … +1 more , Goss H
Health Promot Int · 2025 Jul · PMID 40852978 · Full text
Consistently, low health literacy has been found to lead to poorer health outcomes, both internationally, and in Ireland. Given this knowledge, there is a need to understand key thematic trends, methodological approaches...
Consistently, low health literacy has been found to lead to poorer health outcomes, both internationally, and in Ireland. Given this knowledge, there is a need to understand key thematic trends, methodological approaches and evidence gaps in policy and practice. Seven electronic databases (Science Direct, MEDLINE, CINAHL Complete, Web of Science, Scopus, PsychoINFO, and SPORTDiscus) were searched between October and December 2023 focusing on studies published in English between 2013 and 2023. Initial peer reviewed records (N = 551) were screened resulting in 37 studies included in this review. Narrative analysis indicated that across the island of Ireland many studies had narrow populations of focus (e.g. Dublin based, adults, chronic illness populations), limited research design and methodologies (e.g. cross-sectional, narrative, and primary research with short time frames), and lacked rigorous monitoring and evaluation of health literacy as a primary or secondary outcome. Future health literacy research in Ireland should consider: (i) contextual and sociodemographic factors (age, sex, ethnicity, socioeconomic status) when aiming to improve health literacy in different populations, (ii) exploring health literacy beyond the clinical domain, (iii) advocating for sustainability of effective programmes, and (iv) rigorous, longitudinal evaluation of health literacy. Quality research in these areas will support the meaningful and sustainable development of health literacy in Ireland, with findings that can be transferred internationally.
Learning from community narratives about the COVID-19 pandemic in Papua New Guinea.
Schuele E, Toloube O, Anea K … +3 more , Wohemani R, MacDougall C, Giduthuri JG
Health Promot Int · 2025 Jul · PMID 40847836 · Publisher ↗
In this paper we use constructivism to explore community members' accounts of how socio-cultural and behavioral factors provided meaning to the COVID-19 pandemic in Papua New Guinea, adherence to "niupela pasin" (new nor...
In this paper we use constructivism to explore community members' accounts of how socio-cultural and behavioral factors provided meaning to the COVID-19 pandemic in Papua New Guinea, adherence to "niupela pasin" (new normal), and vaccination acceptance. We purposively selected 50 participants including community members, leaders, and church representatives for semi-structured interviews from urban and rural areas of Madang and Eastern Highlands Provinces. Data were analyzed using inductive thematic analysis. The findings showed how people applied risk prevention strategies and actively sought localized solutions to deal with the pandemic. The pandemic also disrupted socio-cultural norms, such as communal gatherings, care for the sick, and attending funerals, leading to distress and interruptions of interpersonal relationships and extended family structures. Economic hardship, particularly during lockdowns, disproportionately affected those people from lower socioeconomic levels. Strong Christian faith and prayer played a key role in either adhering to "niupela pasin" and COVID-19 vaccine acceptance or rejection of the vaccine. Conspiracy theories and misinformation often propagated through social media, fueled fears and doubts about vaccine efficacy. By articulating and understanding these culturally informed findings, the paper demonstrates how people undertook ordinary theorizing about their worlds to contextualize, modify, or significantly change the policies and strategies developed by experts using conventional science. Preparation for future pandemics can be enhanced by adding to public health policies and guidelines community perspectives and health promotion principles from the Ottawa Charter for Health Promotion.
40 years of the Ottawa Charter for Health Promotion-Reaffirming Health for All.
Thomas SL, Kickbusch I, Kökény M … +1 more , Okan O
Health Promot Int · 2025 Jul · PMID 40836494 · Publisher ↗
Abstract loading — click title to view on PubMed.
An analysis of submissions on regulations to implement Aotearoa New Zealand's tobacco endgame policies.
Hoek J, Ozarka E, Gartner C
Health Promot Int · 2025 Jul · PMID 40832956 · Full text
In late 2022, Aotearoa New Zealand passed legislation to introduce three commercial 'tobacco endgame' policies designed to reduce smoking prevalence rapidly and equitably; however, a newly elected coalition government re...
In late 2022, Aotearoa New Zealand passed legislation to introduce three commercial 'tobacco endgame' policies designed to reduce smoking prevalence rapidly and equitably; however, a newly elected coalition government repealed these measures in early 2024. Although Aotearoa is a Party to the Framework Convention on Tobacco Control, tobacco companies could participate in policy consultation processes and lobbied strongly against the endgame policies. Using an Official Information Act request, we obtained submissions made during the final consultation phase (on regulations that would have implemented the policies). We focused on 13 submissions made by tobacco companies, groups or individuals understood to have received industry funding (directly or indirectly), and groups that have roles within the nicotine product supply chain. We analysed arguments opposing the retail outlet reduction measure, which aimed to make smoked tobacco products substantially less accessible. Using the Policy Dystopia Model as a framework, we identified arguments that mapped to the PDM's economic, legal and political domains. Submitters stated the policy would impose serious costs, particularly on retailers; they anticipated illicit tobacco trade escalating, a consequence they predicted would harm communities and reduce public safety. We identified two over-arching themes: unfairness and promoting self-interest. Tobacco companies' ability to participate in consultation processes questions whether Aotearoa's implementation of Article 5.3 of the World Health Organization Framework Convention on Tobacco Control adequately protects public health policy-making from tobacco companies' influence. Stronger regulation of lobbying should set greater transparency requirements, monitor and critique industry activity, and implement a robust code of conduct.
Addressing social isolation among older people in Danish senior centres: staff acceptability of intervention delivery.
Langergaard S, Evans R, Andreasen J … +2 more , Petersen KS, Overgaard C
Health Promot Int · 2025 Jul · PMID 40810299 · Publisher ↗
Social isolation is a significant challenge among the aging population. A newly developed intervention was implemented in municipal senior centres to support new users to become part of the social community, with the int...
Social isolation is a significant challenge among the aging population. A newly developed intervention was implemented in municipal senior centres to support new users to become part of the social community, with the intention of reducing social isolation. The intervention consisted of a starting conversation with staff members, a 'buddy' from existing users and monthly follow-up conversations. This study aims to explore the acceptability of the intervention among senior centre staff members as part of a process evaluation, drawing upon the Theoretical Framework of Acceptability by Sekhon et al. Data were collected through observation and interviews with senior centre staff members (N = 10) involved in the implementation and delivery of the intervention. Data analysis was inspired by thematic analysis. The results indicated a decline in acceptability during the intervention period. Underlying reasons were organized in three main themes: 'Why do it this way, when I can do it my way'; 'I don't like to place these demands on the user'; and 'We just had to prioritise'. Overall, participants suggested a preference for a noninstitutional approach to welcoming new users and felt the intervention misaligned with the organizational goals to improve health. High staff turnover and workload further negatively affected intervention acceptability. This study highlights the complexities of implementing interventions in senior centres, where staff hesitance and a misalignment with values can affect intervention acceptability.
Paramedics' role in healthcare delivery in short-term police custody in Queensland, Australia: a preliminary report.
Brandenburg C, Daley N, Wilson D … +10 more , Thomas S, Lincoln C, Somerville A, Heffernan E, Kinner SA, Byrnes J, Gardiner P, Davidson P, Green D, Crilly J
Health Promot Int · 2025 Jul · PMID 40810298 · Publisher ↗
Provision of healthcare within short-term custody settings such as police watch-houses presents a complex public health challenge. This area has received limited attention in the literature, particularly the viewpoints o...
Provision of healthcare within short-term custody settings such as police watch-houses presents a complex public health challenge. This area has received limited attention in the literature, particularly the viewpoints of paramedics, who are a key link in the chain of healthcare. This study aimed to describe paramedics' decision-making practices and procedures regarding the transport of patients from the watch-house to the emergency department. A qualitative descriptive study was undertaken utilizing semi-structured interviews with paramedics in Queensland, Australia. A full thematic analysis was not completed due to the small sample and limited data sufficiency. However, interview data were grouped into similar categories with the goal of reporting these novel findings. Six paramedics from five metropolitan, regional, and rural/remote regions participated. Interviews were analysed into four main categories: paramedic's role, challenges, enablers, and suggestions. Paramedics described their role as being autonomous with decision-making, especially regarding transport to hospital. Reported challenges revolved around the complexity of the patient, environment, and competing health/security needs. A key issue identified by paramedics was perceived dissatisfaction from police when their assessment resulted in a recommendation to transport the patient to hospital. Enablers included the controlled environment of the watch-house and access to watch-house embedded healthcare providers. Suggestions related to improving structures (e.g. paperwork, education, hours of on-site healthcare providers) and processes (e.g. communication, transport). This study provides a unique perspective on the key role that paramedics have in the delivery of the healthcare to patients in short-term custody and accords with findings from previous studies with emergency doctors.
An analysis of social media strategies used to promote the e-cigarette brand Vuse.
Hardie L, Watts C, Freeman B … +1 more , McCool J
Health Promot Int · 2025 Jul · PMID 40795924 · Full text
Social media has been instrumental in the promotion of electronic cigarette (e-cigarette) brands globally. As a result of concerns around these types of promotions, many countries have introduced policies to restrict asp...
Social media has been instrumental in the promotion of electronic cigarette (e-cigarette) brands globally. As a result of concerns around these types of promotions, many countries have introduced policies to restrict aspects of digital e-cigarette marketing, along with some restrictions introduced by social media platforms. This paper critiques the Instagram account of the leading global e-cigarette brand 'Vuse', owned by British American Tobacco. Focusing on the Instagram account @Vuse.Worldwide, this study explores the strategies and techniques used in this account to promote the Vuse brand in an international context. Using content analysis methods, we extracted images, videos, and metadata for the posts made by the Vuse account between 1 August 2023 and 31 July 2024. We identified the most viewed and liked content, associated social media influencers, and brand collaborations and assessed the potential reach of these strategies. We identified 405 posts for the study period: 128 images and 277 Reels (short-form videos). We found that content that tagged Formula 1 race team McLaren had the most views and likes. Other popular content linked to music festivals, DJs, art, and designers (n = 65) who were frequently tagged in the study sample. The Vuse Worldwide Instagram account used brand collaborations, such as a 'principal partnership' with Formula 1 team McLaren, to extend its brand reach and capitalize on the racing team's extensive global audience. Other collaborations with music festivals and influencers show that the company continues to deploy its product marketing strategies to position products within youth culture.
Demystifying the commercial determinants of health in antimicrobial resistance through complex system dynamics.
Smith C, Hitch J, Savic L
Health Promot Int · 2025 Jul · PMID 40795186 · Full text
Antimicrobial resistance (AMR) poses a significant threat to public health. The commercial determinants of health (CDoH) play a key role in shaping the development and growth of AMR. It is important to recognise these co...
Antimicrobial resistance (AMR) poses a significant threat to public health. The commercial determinants of health (CDoH) play a key role in shaping the development and growth of AMR. It is important to recognise these commercial factors and situate them within the complex system which describes the emergence and transmission of AMR, so that we can begin to evaluate their impact. There are several feedback loops in the AMR system that prevent a linear 'cause and effect' solution presenting itself to policymakers. These factors are all complexly interdependent and a solution requires recognition of this complexity. We take it for granted that one solution alone cannot tackle the issue of the growing threat of AMR. For this reason, we propose the use of complex system dynamics to visualize key interdependencies within the system. By building on existing systems maps of AMR, we propose to explore and highlight the relationships between the CDoH and AMR in order to demonstrate how commercial factors have consequences for and knock-on effects on other elements (and potential policy suggestions) within the system. In short, the proposed systems map is a tool that can be used to (i) represent some of the ways that commercial factors impact on AMR and (ii) visually simplify the complexity of the issue at hand. We provide a map that could act as a starting point to demonstrate our argument and act as a baseline to be developed going forward in collaboration with other research and non-research actors within the system.
Frameworks for process evaluations of diabetes self-management programs: a systematic review.
Nsobundu C, Nmadu YW, Wagle NS … +5 more , Mwintshi ND, Salis MO, Foster MJ, Smith ML, Ory MG
Health Promot Int · 2025 Jul · PMID 40795185 · Publisher ↗
This systematic review investigates the utilization and reporting of frameworks to guide process evaluations (PE) of diabetes self-management programmes (DSMPs). Constituting a subset of articles from a previously publis...
This systematic review investigates the utilization and reporting of frameworks to guide process evaluations (PE) of diabetes self-management programmes (DSMPs). Constituting a subset of articles from a previously published systematic review, seven studies, comprising nine articles, met the inclusion criteria. The different approaches to manage diabetes were reflected in the study's characteristics and types of interventions. The quality of reporting differed even with the inclusion of evaluation frameworks, which affected the evidence's transferability and comparability. All studies cited their frameworks; yet, only a few gave thorough explanations and used the frameworks consistently throughout their research. A critical appraisal for reporting quality revealed a need for standardized guidelines to assess the thoroughness of framework utilization. Implications for practice include adopting a checklist of indicators to enhance reporting quality and encouraging uniformity in PE methodologies.
Physical activity in urban green spaces: a systematic review of participatory approaches.
Abdala SA, Belabbes S, Oliveira FC … +2 more , Griba N, Mouwafaq S
Health Promot Int · 2025 Jul · PMID 40795184 · Publisher ↗
Urban green spaces (UGSs) are most effective in promoting physical activity (PA) when they are designed to align with the needs of the communities they serve, and participatory approaches address this need by capturing l...
Urban green spaces (UGSs) are most effective in promoting physical activity (PA) when they are designed to align with the needs of the communities they serve, and participatory approaches address this need by capturing local knowledge and driving meaningful action. This systematic review aims to synthesize evidence on how participatory approaches address PA in UGS, analyzing variations in their context, process, output, outcome, and impact. A systematic search was conducted in Scopus, Web of Science, PubMed, and ScienceDirect for literature from January 2000 to January 2025. Studies were included if they employed participatory approaches for assessing or promoting PA in UGS. Data extraction followed the comparison of the participatory processes framework, and study quality was assessed using the Mixed Methods Appraisal Tool 2018. Of 1926 records, 13 studies met the inclusion criteria. The results show that most approaches were researcher-led and operated at the local and regional levels. Despite being labeled participatory, several studies had a limited degree of participation, focusing mostly on (co-)data collection. Most studies had also limited spatial, social, and temporal reach, often confined to the study area and participant group. However, some approaches successfully increased PA in UGS and demonstrated positive social and individual benefits, with (co-)design and citizen science projects standing out for their strong participation and broader social impacts. Future studies and interventions should involve participants throughout all stages, establish clear participatory frameworks, enhance scalability, and incorporate strategies for long-term sustainability to optimize outcomes.
Factor structure of self-reported health literacy scales: a large-scale cross-sectional study among Japanese-speaking adults.
Moriishi C, Takano K, Oba T … +3 more , Konishi N, Katahira K, Kimura K
Health Promot Int · 2025 Jul · PMID 40795183 · Publisher ↗
The importance of health literacy has become widely recognized in the fields of psychology and public health over past decades, during which more than 100 health-literacy scales have been developed. These scales typicall...
The importance of health literacy has become widely recognized in the fields of psychology and public health over past decades, during which more than 100 health-literacy scales have been developed. These scales typically have unique targets (or subscales), leading to an enormous number of factors proposed across scales. However, conceptual overlaps and redundancy are left unresolved. This study therefore explored the factor structure of 219 items extracted from 11 existing scales assessing subjective health literacy, each of which was administered to Japanese-speaking online panels (N = 16 097; 7722 women; mean age = 54.9 years). Exploratory factor analysis suggested seven factors, three of which represented general health literacy and the other four pertained to social health literacy, mental health literacy, digital literacy, and numeracy. The three factors of general health literacy cover slightly different constructs (e.g. ability vs. motivation to find health information) and may reflect differences in the rating scales (easy to difficult vs. agree to disagree). Confirmatory factor analysis on independent testing data supported this seven-factor structure with selected items. Each factor showed, overall, small correlations with mental and physical health and healthy lifestyles, which leaves the discriminant validity open for future research. These results suggest that subjective health literacy scales can be reduced to a smaller, more parsimonious number of factors. Some of the administered scales were combined as a single latent factor, whereas scales targeting specific aspects (social, mental, digital, and numeracy) were recognized as independent factors. Recommendations for assessment and battery designs are discussed.
Restricting outdoor advertising of unhealthy food: can Australia's food category-based classification system be applied consistently?
Whitton C, Klug F, Bivoltsis A … +2 more , Trapp GSA, Pulker CE
Health Promot Int · 2025 Jul · PMID 40758525 · Full text
Most outdoor food advertising (e.g. billboards and bus stops) features foods that are considered unhealthy. The most important technical challenge when designing policies to restrict unhealthy outdoor food advertising is...
Most outdoor food advertising (e.g. billboards and bus stops) features foods that are considered unhealthy. The most important technical challenge when designing policies to restrict unhealthy outdoor food advertising is defining 'unhealthy food'. To date, most restriction policies have used nutrient profiling models (i.e. foods are classified according to their nutritional composition) to determine which foods and beverages may be advertised. In Australia, state governments have endorsed a food category-based classification system, with no prescribed nutrient limits, which may create ambiguity when multiple users are identifying food advertisements to be restricted. This study aimed to assess the consistency of decisions (inter-rater reliability) using a food category-based system to assess outdoor advertisements. Three coders independently assessed outdoor food advertisements (n 550) around 64 schools in metropolitan Perth, Western Australia, using the Council of Australian Governments 'National interim guide to reduce children's exposure to unhealthy food and drink promotion'. Overall, 78.7% of outdoor advertisements were restricted by at least one of three coders and 25.5% by all three; inter-rater reliability was fair [0.29; 95% confidence interval (CI) 0.24, 0.34]. The strongest agreement was for confectionery (κ = 0.94; 95% CI 0.89, 0.99) and desserts, ice cream, and ice confections (κ = 0.99; 95% CI 0.94, 1.04) while the poorest agreement was for brand advertising (κ = 0.04; 95% CI -0.01, 0.09). This study found that the Australian-government-endorsed model could not be consistently applied to assess outdoor food advertising, apart from the narrowly defined categories of confectionery and desserts. Recommendations to reduce ambiguity and policy implications are discussed.
Organizational health literacy of schools in Germany: results of a cross-sectional study.
Kirchhoff S, Krudewig C, Okan O
Health Promot Int · 2025 Jul · PMID 40754692 · Full text
A social gradient in health literacy is prevalent in children and adolescents, with those from lower socioeconomic backgrounds often having lower levels. Interventions aiming at an entire setting, such as the organizatio...
A social gradient in health literacy is prevalent in children and adolescents, with those from lower socioeconomic backgrounds often having lower levels. Interventions aiming at an entire setting, such as the organizational health literacy approach, seem promising to tackle these inequities. Schools represent unique environments to implement such interventions. The HeLit-Schools project aimed at developing an organizational health literacy framework for schools. The framework contains eight quality standards, each underpinned by six indicators, and was translated into a self-assessment tool (OHLS-Q). In this cross-sectional study, the German version of the OHLS-Q was used to assess the implementation status of organizational health literacy in schools in Germany for the first time. School management members completed the questionnaire via an online survey, including sociodemographic, personal, and school information. Descriptive statistics were reported. The n = 598 participants from five federal states were Ø 52.3 years old and mainly female (73.6%). 49.1% worked in primary, 37% in secondary, and 13.9% in special education schools. Overall, respondents reported that 65.1% of the standards and indicators of the framework were (rather) highly implemented. A great variance can be found between the individual standards and indicators. Schools already participating in school health promotion programs or networks showed a higher percentage of implementation across all standards. A lack of resources (financial, time, and personnel) is reported. The results reveal important insights into barriers and facilitators for the implementation of organizational health literacy in schools. Future studies should focus on interventions that overcome identified barriers, targeting specific standards and indicators.
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