BACKGROUND: Health literacy encompasses the social and cognitive skills required to access, comprehend, and use health information to maintain or improve health. This is the first study to assess the health literacy leve...BACKGROUND: Health literacy encompasses the social and cognitive skills required to access, comprehend, and use health information to maintain or improve health. This is the first study to assess the health literacy levels of health science students and adult residents in Singapore using the health literacy questionnaire (HLQ) and compare their levels. METHODS: A cross-sectional survey was conducted in Singapore from December 2019 to January 2023. The 44-item HLQ was administered to (1) entry-level health science students in a local university and (2) adult residents aged 18 and 80 who could understand and respond in English, Mandarin, or Malay. Variables such as demographic data, gender, age, language(s) spoken, education levels, and employment status were collected. HLQ scores were analysed using descriptive statistics, Mann-Whitney U-test, and rank-biserial coefficient. RESULTS: Two hundred and eighty-two surveys were returned (students, = 112; residents, = 170). Overall, the health science students, particularly the female subgroup, obtained higher mean HLQ scores than the residents. Conversely, male residents scored better in 5 of the 9 subscales. Most comparisons lack statistical significance despite the noticeable effect sizes. CONCLUSIONS: Health science students have better health literacy when navigating health information. However, the lack of significant difference between groups for most HLQ scales, especially when comparing within age groups, indicated that the health science students needed to be more confident in their health literacy skills.
Glob Health Promot
· 2026 Mar · PMID 40589231
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The COVID-19 pandemic affected both the behaviour and the mental health of people and made the decision-making process on health subjects a difficult task. Based on the Common-Sense Model, the current study aimed to inve...The COVID-19 pandemic affected both the behaviour and the mental health of people and made the decision-making process on health subjects a difficult task. Based on the Common-Sense Model, the current study aimed to investigate and document the public's perceptions of COVID-19, examine the relationship between health literacy, fear of COVID-19, and illness perceptions and explore their role in the adoption of protective behaviours. Data from 330 adults were collected through an electronic questionnaire, including the Perceived Stress Scale, the Brief Illness Perceptions Questionnaire, the European Health Literacy Questionnaire-16, the Coronavirus Anxiety Scale, the Fear of COVID-19 Scale, and items related to socio-demographic characteristics, protective behaviours and experience of illness. The results show that increased fear was correlated to more dysfunctional perceptions and increased adherence to protective behaviours (mask use and intention to vaccinate). Increased health literacy was correlated to more functional perceptions and higher intention to use masks, but not to get vaccinated. Health literacy was a significant mediator in the relationship between fear and illness perceptions and between fear and protective behaviours. The results could be useful for promoting public health risk prevention. Targeting strategies for managing negative emotions and enhancing health literacy could be an important step toward more functional illness perceptions and health behaviours.
Glob Health Promot
· 2026 Mar · PMID 40589224
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Interventions informed by intergenerational resilience have shown positive effects on youth mental health. In Majority World countries, however, mental health promotion remains constrained by stigmatizing beliefs and lim...Interventions informed by intergenerational resilience have shown positive effects on youth mental health. In Majority World countries, however, mental health promotion remains constrained by stigmatizing beliefs and limited resources. This study explored multiple stakeholder perspectives of how intergenerational learning was incorporated in youth-led mental health promotion in Pakistan. Fourteen youth peer educators co-designed a mental health promotion programme with family advisers and facilitated 11 workshops in two disadvantaged areas of Karachi. Of the 304 workshops participants, a sub-sample of 63 youth, mothers, teachers and peer educators attended 11 focus groups. Established themes related to the process that enabled intergenerational learning, notably participatory activities, and how such learning could be transferred to resilience-enabling systems by mobilizing communities. A multidimensional resilience framework that draws upon intergenerational experiences can usefully inform youth mental health promotion, especially in resource-constrained settings. Co-production with holders of local knowledge can engage and empower communities.
Tézier B, Michaud Q, Rostan F
… +5 more, Lemonnier F, Vuillemin A, Guillemin F, Kévin K, Van Hoye A
Glob Health Promot
· 2026 Mar · PMID 40538111
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Sports clubs have been encouraged by political and health authorities to exploit their health promotion potential. Yet, existing literature highlights a lack of systems thinking and coordination, limiting sports clubs' c...Sports clubs have been encouraged by political and health authorities to exploit their health promotion potential. Yet, existing literature highlights a lack of systems thinking and coordination, limiting sports clubs' capacity to implement sustainable health promotion interventions. The aim of this article is to describe the scaling-up process and the initial systems map of a health promotion intervention in sports clubs - the PROSCeSS intervention - and to discuss the use of the ExpandNet/WHO guide in this context.A participatory research approach using the nine-step guide from the ExpandNet/WHO was used. Five 2-hour meetings, completed with feedback and questionnaires between meetings, involving 36 stakeholders (14 from public health, 7 from sports, 7 academics and 8 political actors, from local to national levels), were recorded. The data (notes, meeting minutes, questionnaires) were analysed using a deductive process based on the nine-step ExpandNet/WHO guide. Results enabled researchers to identify targets of the intervention, as well as challenges and facilitators for implementing health promotion interventions in sports clubs. Fifty political, sports, academic and public health organisations at local and regional levels were identified as being able to support the scaling-up of the intervention, endorsing different roles : 1) methodological support, 2) communication, 3) provision of resources, 4) advocacy and 5) research. Twenty-two actions were identified and prioritised to support organisations in fulfilling the role they can play in the institutionalisation and expansion of health promotion in sports clubs. This work contributes to strengthening the multi-level systems thinking needed for health promotion implementation in sports clubs, enhancing their societal role to support individuals' health.
Djoudalbaye B, Kabanda R, Mavuto T
… +3 more, Njai M, Mhiraf A, Gweh GN
Glob Health Promot
· 2026 Mar · PMID 40509804
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BACKGROUND: The Africa Centres for Disease Control and Prevention established and launched the Public Health Risk Communication and Community Engagement Community of Practice in Africa (PH-RCCE-CoPA) initiative during th...BACKGROUND: The Africa Centres for Disease Control and Prevention established and launched the Public Health Risk Communication and Community Engagement Community of Practice in Africa (PH-RCCE-CoPA) initiative during the COVID-19 pandemic in May 2020 in collaboration with the World Health Organization Regional Office for Africa and developed terms of reference. This initiative aimed to strengthen capacity of Member States and institutionalize Risk Communication and Community Engagement (RCCE) for public health emergencies in Africa through the exchange of knowledge and best practices, as well as respond to rumours and misconceptions. CONCLUSIONS: Establishing the PH-RCCE-CoPA and subsequent training of RCCE focal points in Member States facilitated a coordinated approach to RCCE which helped to reduce rumours and misconceptions and increase COVID-19 vaccine confidence and uptake.
Gazibara T, Cakic J, Cakic M
… +2 more, Grgurevic A, Pekmezovic T
Glob Health Promot
· 2026 Mar · PMID 40420391
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BACKGROUND: Many adolescents do not have access to sexual and reproductive health education due to the lack of structural support specific to cultural formatting and overall negative attitude toward this type of educatio...BACKGROUND: Many adolescents do not have access to sexual and reproductive health education due to the lack of structural support specific to cultural formatting and overall negative attitude toward this type of education. Therefore, adolescents often use the internet as the main source of health information. The purpose of this study was to investigate specific internet websites associated with online searching for information about sex and sexually transmitted infections (STIs). METHODS: A cross-sectional study was carried out on 702 high school students in Belgrade, the capital city of Serbia. Relevant data were obtained through an anonymous questionnaire. The questionnaire included socio-demographic characteristics, use of the internet and online platforms. Electronic health literacy was tested by the e-Health literacy scale. RESULTS: All students used the internet. The prevalence of seeking online information about sex was 31.9% and 12.4% about STIs. Being a boy, having lower grades, attending the humanities-languages program, being younger when using the internet for the first time, using forums and social media, but not websites run by physicians, and browsing online information about STIs were associated with seeking online information about sex. Girls, who had lower grades, had higher family income, were older when they first started using the internet, used social media and websites run by physicians and searched for online information about sex were more likely to seek online information about STIs. CONCLUSIONS: Adolescents in this study sought online information about sex more often than STIs. Social media were used to search both topics online, suggesting that participatory media which offer engaging content could be the preferred manner of online learning about sex and STIs. These online resources could be used for information delivery about reproductive health for high school students.
Pourmarzi D, Fitzpatrick P, McKinnon M
… +1 more, Lambert S
Glob Health Promot
· 2026 Mar · PMID 40346811
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BACKGROUND: Access to timely, accurate health-related information can protect migrants' health during public health crises. However, unmet language needs, social alienation and mistrust were among the barriers that migra...BACKGROUND: Access to timely, accurate health-related information can protect migrants' health during public health crises. However, unmet language needs, social alienation and mistrust were among the barriers that migrants faced in accessing official information about COVID-19 and recommended vaccines. This study aimed to explore information-seeking behaviour about COVID-19 vaccines among Eastern Mediterranean Region (EMRO) born migrants in Australia. METHODS: With an explanatory mixed-method approach, we employed an online survey followed by semi-structured interviews. Survey and interviews were advertised through migrants-specific organisations' websites and social media posts, and Facebook advertisements. The survey collected data on socio-demographics, sources of information, preferred communication channels and information-gathering capacity from 300 individuals between September and November 2021. Seventeen adults participated in interviews between December 2021 and February 2022. The qualitative data were analysed using inductive thematic analysis. RESULTS: The survey participants' mean age was 41.4 ± 11.8 years and 52% were male. Around 70% reported that the Australian government was among their main sources of information, and 37% preferred receiving information via email or SMS. Around 70% agreed that they can easily access the information they need, feel included in government communications, and can distinguish between fake and good information. Around 60% agreed they could access information in their language, while approximately 50% of respondents indicated they had difficulty understanding vaccine information. Analysis of the interview transcripts revealed that the information sources used depended on their perceived need, their information-gathering capacity, ease of access and trust in sources. Lack of trust in official sources made it more difficult to accept uncertainty. Sources of information favoured included community networks and personal experience. CONCLUSION: To ensure equitable access to health information, health communications should be tailored to migrants' specific needs, preferences and information-gathering capacity. Such communication should be practised in all aspects of health, not only during a public health crisis, to improve trust in official sources.
Van Hoye A, Winand M, Crochet L
… +6 more, Simon F, Rostan F, Lemonnier F, Johnson S, Tezier B, Vuillemin A
Glob Health Promot
· 2026 Mar · PMID 40346807
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Research has shown that sports clubs call upon support from national sports federations (NSFs) to develop into a setting to promote health. The present study investigates how French NSFs themselves promote health. A two-...Research has shown that sports clubs call upon support from national sports federations (NSFs) to develop into a setting to promote health. The present study investigates how French NSFs themselves promote health. A two-step case study design was undertaken. A website analysis of 51 NSFs recognized as health promoting by the French National Olympic Committee was executed to examine health promotion (HP) visibility, and presence in strategic plans, committees and programs. Based on this search, four NSFs were chosen for an in-depth study, including interviews with representatives and a document analysis. Data were analyzed based on the Ottawa Charter strategies for HP. Results across all studied NSFs confirmed that NSFs are committed to HP, but HP is not mentioned directly, not visible, nor properly understood. Rather, a health topic approach is adopted, specifically focusing on strategies to enhance social and physical health. HP implementation lacks coordination, where resource investment is based on the sports ministry's focus on specific health topics, in a reactive manner, to implement national policies. NSFs' implementation of HP is very similar to that of a sports club, demonstrating that sports federations' vision and actions towards HP have to quit the silo and health topics approach in order to better support HP in their affiliated clubs. Future research should investigate determinants of HP implementation among NSFs. Practical implications include a recognition of HP beyond health topics, an integration of health as a transversal aim in NSFs' policies and programs, and a governance system to coordinate HP activities.
Glob Health Promot
· 2026 Mar · PMID 40091152
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This paper examines the transdisciplinary collaboration between health practitioners, Indigenous community members, and doctoral researchers to democratize knowledge transfer enhancing social justice outcomes in the cont...This paper examines the transdisciplinary collaboration between health practitioners, Indigenous community members, and doctoral researchers to democratize knowledge transfer enhancing social justice outcomes in the context of hepatitis C awareness with Indigenous communities in Alberta, Canada. Utilizing the impactful intersection between media and healthcare disciplines, two social science researchers built on each other's qualitative research projects using relational engagement and participatory action research to co-create a DocuStory film and accompanying impact campaign. Diverse expertise and varied life experiences contribute unique perspectives transferring insights informing knowledge translation. Communication scholars, media producers, and academics are exploring the social function of documentaries and how they can be used to generate change. This innovative collaboration draws on the strength and creativity of transdisciplinary relationships providing opportunity for social justice praxis at the intersections of culture, theory, health, and media. This successful approach is relevant for numerous health topics and inspires transdisciplinary collaboration and media innovation in health promotion.
Kennedy LJ, Kirk SFL, Sim M
… +3 more, Parsons Leigh J, Wong H, Mah CL
Glob Health Promot
· 2025 Dec · PMID 40082398
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Healthy eating is influenced by a myriad factors ranging from individual to societal. Healthcare organizations have recently adopted healthy eating policies to improve food environments; however, how such policies shape...Healthy eating is influenced by a myriad factors ranging from individual to societal. Healthcare organizations have recently adopted healthy eating policies to improve food environments; however, how such policies shape practice is still unknown. This qualitative study explores perspectives on continuous quality improvement (CQI) among healthcare staff and managers working in hospital foodservices post-implementation of a healthy eating policy aimed at improving food environments. We conducted semi-structured interviews with 12 foodservices staff at Nova Scotia Health. Participants varied in role (administrative, point-of-sale) and location (rural/urban). We analyzed findings using directed content analysis. Participants' approach to quality revealed a range of definitions of healthy eating, from health promotion efforts directed towards individual behavior change management to a broader emphasis on supportive food environments. This research also highlighted the complexity of the healthcare food environment in which health promotion was being implemented, a 'setting' as per the 'settings approach' to health promotion, but also revealing a 'setting within a setting': food environments within healthcare environments. These nested environments are alternatively more business or healthcare service-centric, within the larger healthcare environment. Healthcare practitioners' views on effective implementation of the policy also spanned many scales of healthy eating, informed by concepts within their core healthcare practice (dietetics: nutrients), the organization (historical nutrition contexts) and broader food culture (food trends and choice). This study has demonstrated that CQI for a healthier food environment within healthcare needs a broader focus to advance benchmarks for health promotion.
Torosyan A, Grigoryan L, Hayrumyan V
… +8 more, Sargsyan Z, Bhanot P, Shaffer L, Petrosyan V, Bazarchyan A, Alayan N, Kegler MC, Berg CJ
Glob Health Promot
· 2025 Dec · PMID 40071452
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Smoke-free homes (SFHs) reduce secondhand smoke exposure (SHSe), which is particularly crucial where smoking prevalence is high and public smoke-free policies are nascent, as in some low- and middle-income countries (LMI...Smoke-free homes (SFHs) reduce secondhand smoke exposure (SHSe), which is particularly crucial where smoking prevalence is high and public smoke-free policies are nascent, as in some low- and middle-income countries (LMICs). This study examined perspectives regarding SFHs, including barriers and facilitators, among adults in Armenia, a LMIC with high male smoking prevalence and recently-implemented smoke-free policies. In February-March 2024, focus groups were conducted with adults reporting smoking and non-smoking, separately, in two Armenian communities ( = 39; = 41.00, 46.2% female, 61.5% married, 74.4% children in household). Data were examined using thematic analysis. All participants reporting smoking ( = 18) were male, non-smoking participants ( = 21) were primarily (87.5%) female, 53.8% had no SFH restrictions and 12.8% partial. Commonly, smoking was allowed for certain people (e.g. guests) or rooms/spaces (e.g. kitchen, balcony). Common SFH motives were health of children and vulnerable adults (e.g. pregnant women). Salient challenges included high male smoking rates paired with hierarchical gender roles. When asked about strategies to promote SFHs, many suggested leveraging children by involving them in a SFH intervention or emphasizing SHSe's impact on children. While some suggested empowering women as change agents, others suggested targeting men. It is crucial that SFH interventions for Armenian households address Armenia's specific characteristics, such as high male smoking rates and more hierarchical social dynamics. Effective SFH interventions for Armenia may serve as models for other countries with similar characteristics.
Bataineh J, Bartlett S, Nayab A
… +1 more, Pickett W
Glob Health Promot
· 2025 Mar · PMID 40071392
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The perception of one's own body image is an important determinant of adolescent health. While positive body image is associated with health-promoting behaviours, negative body image may be related to engagement in healt...The perception of one's own body image is an important determinant of adolescent health. While positive body image is associated with health-promoting behaviours, negative body image may be related to engagement in health-compromising risk behaviours. Hypothetically, an adolescent's perceived body image may also be influenced by racial/cultural ideals and related gendered expectations, governed by social norms within distinct cultural groups. Variations in perceived body image by race/ethnicity remain largely unexplored in Canada, even descriptively. A descriptive, cross-sectional study was employed using data from the 2017-2018 cycle of the Canadian Health Behaviour in School-aged Children (HBSC) study (weighted = 18,766 participants). Self-perceptions of body image were described for Canadian adolescents, stratified by race/ethnicity and gender (boys vs. girls). There were two main findings. , variations in perceptions of body image mainly varied by gender. Boys were more likely to report feeling 'too thin' while a higher proportion of girls reported feeling 'too fat'. These trends were observed across different races/ethnicities. , there was little variation in patterns of self-reported body image by race/ethnicity, while the gendered variations remained within all major racial/ethnic groups. Existing research on adolescent body image typically focuses on gender norms, overlooking the potential of racial and ethnic influences on body image perceptions. Our study confirms that adolescent body image does not appear to vary substantially on racial/ethnic lines among Canadian adolescents, consistent with existing studies that highlight the strong influence of gender norms on adolescent body image.
Calarco R, Prevot-Monsacre P, Paternoster M
… +3 more, Vignier N, Trévidy F, Cailhol J
Glob Health Promot
· 2025 Dec · PMID 39851203
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Health mediation, similar to health navigation in the United States or Canada, is known by various terms worldwide. In France, health mediation has historically been implemented by civil society organizations to support...Health mediation, similar to health navigation in the United States or Canada, is known by various terms worldwide. In France, health mediation has historically been implemented by civil society organizations to support hard-to-reach populations. Health mediation is increasingly considered by health authorities as a valuable tool for health promotion to reduce health inequalities. However, systematic evaluations of its effects are scarce, making it difficult for decision-makers to generalize health mediation as a health policy. Our study aims to bridge this gap, by framing a research protocol to evaluate a health mediation intervention. The intervention consists of setting up a biweekly mobile booth using an 'outreach' approach at the base of a social housing complex in 12 neighborhoods of Seine-Saint-Denis with marked indicators of social deprivation. We chose a realistic evaluation approach and a mixed-methods methodology, which is the best fit for assessing complex interventions such as the one we aim to assess. Realistic evaluation is a relatively new approach, and sharing studies based on this type of epistemological and methodological approach is required. This study aims to contribute to the reflection on and the production of standard tools to ensure that the use of this evaluation approach is improved.