BACKGROUND: Low health literacy and numeracy are significant problems facing the United States. Recent research focuses heavily on the role health literacy and numeracy play in perception of disease risk, health care costs, all-cause mortality, and access to care; however, there has been relativity little emphasis on the relationships between health literacy or numeracy with health promotion behaviors, such as nutrition or physical activity. As our nation continues to face challenges with the high prevalence of obesity and other chronic diseases, it is increasingly important to understand the role that health literacy and numeracy play in nutrition and physical activity behaviors, as well as in the prevalence and control of chronic disease. PRIMARY AIMS: The proposed research is embedded within a larger randomized-control trial, Talking Health, which is a 2-arm behavioral trial targeting residents in eight counties in southwest Virginia with sugar-sweetened beverage (SSB) consumption as the primary outcome. The primary aims of this cross-sectional study, using baseline Talking Health data, are to 1) examine correlations among health literacy and numeracy measures, namely the Newest Vital Sign (NVS), separated by reading (NVS Reading) and math (NVS Math) scores, the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Subjective Numeracy Scale (SNS); 2) explore the relationships between demographic factors and the NVS, REALM, and SNS scores; 3) determine the relationships between the NVS, REALM, and SNS and dietary quality [i.e. Health Eating Index (HEI) scores], physical activity behaviors, and anthropometric and biological variables (body mass index, blood pressure, fasting blood lipids, and fasting blood glucose); and 4) determine if NVS, REALM, and SNS scores predict metabolic syndrome (MetS), while controlling for relevant demographic factors. METHODS: Eligibility requirements for the study include being 18 years of age or older, having reliable access to a telephone, drinking ≥200 kilocalories of SSB per day, and being a resident of Southwest Virginia. Using previously validated instruments and standardized data collection protocol, a variety of baseline variables was collected on 264 participants. Health literacy was measured using the NVS and REALM and health numeracy was measured using the SNS. Dietary intake was measured via three 24-hour dietary recalls and HEI scores were calculated. Physical activity behaviors were assessed using the Godin Leisure Time Exercise Questionnaire. Weight was measured using a calibrated digital Tanita scale (Model: 310GS), height was measured using a portable research-grade stadiometer, blood pressure measurements were made with an OMRON automated oscillometric device (Model: HEM-907XL), and fasting blood samples were obtained via a finger stick and the CardioChek PA system was used to assess blood glucose, cholesterol, and triglycerides. MetS scores were determined based on an adaptation of the National Cholesterol Education Program guidelines. Statistical analysis included descriptive statistics, simple correlations (Pearson bivariate), one-way ANOVAs, and regression models. RESULTS: Of 264 enrolled participants (mean age 41.1 + 13.5 years; 92.0% Caucasian; 81.8% female; 30.6% > high school education; 42% > $15,000 annual income), 33.7% were classified as having a high probability of low health literacy or possibility of low health literacy as measured by the NVS, 19.7% had less than a high school reading level as measured by the REALM, and 45.4% had low health numeracy as measured by the SNS. Additionally, 78.8% were overweight or obese and 29.0% meet the criteria for metabolic syndrome. Nine of the ten correlations between the NVS Total, NVS Reading, NVS Math, REALM, and SNS were statistically significant (p < .01, two-tailed). NVS scores were found to be significantly different by age (F = 2.36, p = .05), race (F = 4.49, p = .03), education level (F = 20.97, p < .001), and income (F = 13.88, p < .001); while REALM scores were only significantly different by race (F = 3.74, p = .05), education level (F = 21.06, p < .001), and income (F = 6.80, p < .001). SNS scores were significantly different by gender (F = 12.40, p = .001), education level (F = 11.01, p < .001), and income (F = 14.45, p < .001). Only systolic blood pressure, diastolic blood pressure, and strength training activity was found to be significantly different by health literacy and/or numeracy level; however, when controlling for hypertension medication use and/or demographic variables, only the relationship between health literacy (i.e, NVS) and strength training activity remained significant (R2 = 0.09, p = .01). Finally, health literacy and numeracy were not found to be predictive of metabolic syndrome while controlling for demographic variables. DISCUSSION: Although numerous demographic factors were related to baseline health literacy and numeracy levels, anthropometric/biological variables, physical activity behaviors, and diet quality did not differ by health literacy and health numeracy level, with the exception of systolic blood pressure and strength training activity. This research helps to fill the gaps in the literature surrounding the prevalence of health literacy, health numeracy, and health promoting behaviors and chronic disease among rural residents in medically underserved counties in southwest Virginia. While few cross-sectional relationships were found, future research from this RCT should examine if health literacy and health numeracy moderates or mediates intervention changes in anthropometric/biological variables, physical activity behaviors, diet quality, and metabolic syndrome scores. / Master of Science

Health literacy represents the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health, according to WHO. Common health literacy level may be sufficient in the case of smooth pregnancy and natural childbirth. However, if there are some health problems, it is necessary to support an increase in health literacy level of mothers. Main objective of this thesis is to describe the objective health literacy level of mothers with premature baby and to identify areas that are for these mothers most problematic. The theoretical part deals with demographic data related to premature births, the basic definition of prematurity, an essential characteristic of neonatology and organization of care, premature baby, the most common medical complications and prognosis. Defines and operationalizes health literacy of mothers with premature baby. Research used a qualitative methodology. Data were collected using semi-structured interviews. Respondents for interview were physicians who care for preterm infants. The selection of respondents was conducted using the snowball sampling to facilitate data analysis, were interviews transcribed and then analyzed using the cluster analysis. Results were...

Introduktion: En god handhygien utgör grunden för att minska smittspridning av smittsamma sjukdomar. Vårdrelaterade infektioner kostar samhället mycket rent ekonomiskt och i lidande för den enskilde. Individer med funktionsnedsättning som bor på gruppbostad riskerar att drabbas om inte vårdpersonalen tillämpar de basala hygienrutinerna och är relevant ur ett folkhälsovetenskapligt perspektiv. Syfte: Att analysera en befintlig självskattningsenkät avseende efterlevnad av basala hygienrutiner gällande handhygien som genomförts under våren samt hösten 2020 bland kommunanställd omvårdnadspersonal på gruppboenden inom en kommun i Stockholm. Metod: En upprepad tvärsnittsstudie med kvantitativ och kvalitativ analys av en befintlig självskattningsenkät. Analysen baseras på enkätsvar med en svarsfrekvens på 78 % från personal inom kommunens 15 gruppboenden och bestod av 80 deltagare på våren respektive 81 deltagare på hösten2020. Resultat: Mellan 69 - 97,5 % av deltagarna ansåg att de följde hygienrutinerna avseende basal handhygien under år 2020. I jämförelse mellan vår och höst sågs en signifikant förbättring av användning av handsprit före omvårdnadsmoment. I studiens kvalitativa del framkom deltagarnasupplevelse av hinder i tillämpningen och dessa utgjordes bland annat av; varierad användning av handskar, ovetskap, glömska, tidsbrist, tillgänglighet samt praktiska hinder i verksamheten. Slutsats: En stor del av omvårdnadspersonalen ansåg att de följde de basala hygienrutinerna avseende handhygien men kravet på att all personal skall arbeta efter hygienrutinerna avseende handhygienuppfylls inte. Hygienutbildningen som omvårdnadspersonalen erbjuds behöver utvecklas för att främja utveckling av health literacy vilket kan bidra till en ökad förståelse för varför tillämpningen är viktig. Detta kan förbättra följsamheten till de basala hygienrutinerna. / Introduction: Good hand hygiene is the basis for reducing the spread of infections. Healthcare-related infections cost society a great deal financially and in suffering for the individual. Individuals with disabilities who live in group housing are at risk if the care staff does not apply the basic hygiene routines. Aim: Analyze an existing self-assessment survey regarding compliance with basic hygiene routines regarding hand hygiene that was carried out during the spring and autumn of 2020 among municipally employed nursing staff in group housing. Method: A repeated cross-sectional study with quantitative and qualitative analysis of an existing self-assessment survey. The analysis is based on questionnaire responses from staff with a response rate of 78%, within the municipality's 15 group homes and consisted of 80 participants in the spring and 81 participants in the autumn of 2020. Results: Between 69-97.5% of the participants considered that they followed the hygiene routines regarding basic hand hygiene during the year 2020. In a comparison between spring and autumn, a significant improvement was seen in the use of hand alcohol before nursing. The qualitative part of the study also revealed the participants' experience of obstacles, and included use of gloves, ignorance, forgetfulness, lack of time, accessibility and practical obstacles. Conclusion: A large part of the nursing staff believed that they followed the basic hygiene routines regarding hand hygiene. The hygiene training offered by the nursing staff needs to be developed to promote the development of health literacy. This can improve compliance with the basic hygiene routines.

This study assessed music educators' health literacy, musician health literacy, and intentions to teach the health-related Fine Arts TEKS in ensembles. An online survey was developed using the integrated behavior model, Newest Vital Sign (NVS), and Musician Health Literacy Questionnaire (MHL-Q19). Texas music educators who taught secondary band, choir, or orchestra were recruited via email and social media. Results: This survey yielded N = 207 respondents, with 43%, 29%, 14.5%, and 13.5% teaching band, choir, orchestra, and multiple ensembles, respectively. Most participants (67.6%) demonstrated adequate health literacy by answering at least four items correctly on the NVS. Attitude (p =.47) and personal agency (p =.30) were significant predictors of behavioral intention, while perceived norm was not (R2 =.484). Including NVS total score and MHL-Q19 total score in the model showed that while both factors improved the model (ΔR2=.038), only NVS total score was significant (p =.26) in predicting behavioral intention. Music educators in this study had adequate health literacy, which may contribute to their intentions to teach health concepts in ensembles. However, future efforts to improve these intentions should focus on bolstering perceived norms and personal agency by providing music educators with opportunities to take charge of implementing these concepts in their classrooms while showing that other stakeholders (i.e., campus administration, parents of students, and music educator colleagues) are also invested in presenting health concepts to student-musicians.

Introduktion: Psykisk sjukdom är en växande samhällsutmaning. Individer som lider av psykisk sjukdom har olika grader av allvarlighet och varaktighet, och får vanligtvis stöd från kommunen och/eller regionen, inklusive boende med särskilt service och boendestöd. Boendestödet utvecklas kontinuerligt och blir alltmer digitaliserat för att möta dagens behov och förbättra tillgängligheten och effektiviteten i tjänsterna. Syfte: Syftet med studien var att undersöka boendestödjarnas upplevelser av utmaningar och fördelar med att använda digitala verktyg inom boendestöd för personer med psykisk sjukdom. Metod: En semistrukturerad intervjustudie genomfördes med sex boendestödjare från tre olika boenden i en storstadsregion. Metoden involverade ett tvåstegsurval. Rekrytering av boendestödjarna skedde genom fysiska informationsträffar. Intervjuerna spelades in och transkriberades sedan. Genom en noggrann innehållsanalys bröts texten ner i meningsenheter, vilka sedan kodades och kategoriserades för att identifiera mönster och kategorier. Därefter analyserades resultatet med hjälp av teorin om digital health literacy. Resultat: Genom innehållsanalys framkom tre huvudkategorier: teknik, utbildning och säkerhet. Inom dessa kategorier identifierades sex underkategorier som inkluderade fördelar och utmaningar relaterade till digitala verktyg inom boendestöd. Resultaten visade att boendestödjarna ser potentialen i digitala verktyg för att förbättra boendestödet, samtidigt identifierades utmaningar kring säkerhet, integritet och hantering av personuppgifter. För att hantera dessa utmaningar och utnyttja fördelarna fullt ut krävs att de olika kompetensnivåerna inom digital health literacy beaktas. / Introduction: Mental illness is a growing societal challenge. Individuals with mental illness experience varying degrees of severity and duration, and typically receive support from municipalities and regions, including housing support. Housing support is evolving and becoming increasingly digitalized to improve accessibility and efficiency. Aim: This study aimed to investigate housing support workers' experiences of the challenges and benefits of using digital tools in housing support for individuals with mental illness. Methods: A semi-structured interview study was conducted with six housing support workers from three different residences in a metropolitan area. Participants were recruited through physical information meetings. Interviews were recorded, transcribed, and analyzed using content analysis to identify patterns and categories. The results were then analyzed using the theory of digital health literacy. Results: Three main categories emerged from the content analysis: technology, education, and security. Six subcategories were identified within these categories, highlighting benefits and challenges related to digital tools in housing support. Housing support workers recognized the potential of digital tools to enhance support, but challenges regarding security, privacy, and handling of personal data were noted. Addressing these challenges requires considering various competency levels in digital health literacy. Conclusion: Successful implementation of digital tools in housing support requires continued investment in education and fostering a culture of knowledge sharing, taking into account the experiences of housing support workers

Bakgrund: Att "googla" på sina symptom och söka hälsoinformation på Internet kräver en viss förkunskap för att kunna ta del av informationen. Dagens lättåtkomliga hälsoinformation kan leda till konsekvenser så som felaktiga behandlingar och feldiagnostisering vilket vidare kan orsaka negativa följder för den individuella hälsan. Syfte: Syftet med studien var att utifrån ett hälsopedagogiskt perspektiv studera samband mellan olika bakgrundvariabler och hälsokomponenter i relation till hur individer använder Internet som informationskälla för att finna kunskap som främjar den egna hälsan.    Metod: Datainsamlingen har skett genom kvantitativ forskningsmetod där en webbenkät besvarats i både en social- och en webbaserad kontext inom målgruppen vuxna människor &gt;18 år. Studiedeltagarna rekryterades utanför välkända matbutiker på tre olika platser i Halmstad stad samt via plattformen Facebook där webbenkäten publicerades på studieansvarigas profiler. Webbenkäten undersökte respondenternas egenskaper, hur deltagarna upplever sig kunna tolka, granska, förstå hälsoinformationen, samt hur de handlar och hanterar hälsoinformation på Internet. Efter datainsamlingen överfördes webbenkäten till statistiskprogrammet SPSS för vidare analys. Resultat: Totalt 178 personer deltog i undersökningen. 92,1% av de personer som deltog använder någon gång Internet för att söka efter en förklaring på sina hälsorelaterade symptom. Resultatet visar att personer med högre inkomstnivå och högre utbildningsnivå upplever sig kunna förbättra sin hälsa med hjälp av hälsorelaterad information på Internet oftare än personer med lägre inkomst- och utbildningsnivå. Resultatet visade även på skillnader i relation till bakgrundsvariabeln kön då kvinnor generellt sett var mer aktiva än män på att använda Internet för att söka hälsorelaterad kunskap i hälsofrämjande syfte.   Slutsats: Det finns flera samband mellan individers bakgrundvariabler och olika hälso-komponenter. Kön, socioekonomisk status och utbildningsnivå påverkar hur personer tolkar, hanterar och förstår hälsoinformation på Internet. Med hjälp av hälsoinformation från Internet självdiagnostiserar sig personer, behandlar sig själva och söker vård. Framtida forskning och implikationer: Mer kunskap och ökad hälsolitteracitet hos befolkningen är att rekommendera för att säkra populationens framtida hälsostatus. Förslag till framtida forskning blir därmed att undersöka effekten av olika tillvägagångssätt för att öka populationens hälsolitteracitet samt undersöka hur hälsoinformation på Internet påverkar den enskilde individen men även hälso-sjukvårdens arbete. / Background: To "google" symptoms and search for health information on the Internet requires prior knowledge, to be able to extract relivant information. Today's easy access to health information, can lead to consequences regaurding our health. Incorrect treatments and misdiagnosis are both examples which could lead to negative consequences for individual health. Aim: The aim of the study was to study the relationship between different background variables and health components through a health educational point of view, to see how individuals use Internet as an information source to find knowledge that promote their personal health. Method: Quantitative research method has been done to collect data. The data was collected through a web survey. Answered by adults &gt;18 years, both through a social- and a web-based context. Study participants were recruited at three different locations in Halmstad city, and also on Facebook where the online surveys were posted on the study manager's profiles. The online survey examined the participant’s characteristics, how the participants perceive themselves to interpret, review and understand health information. It also examined how they apply and manage health information on the Internet. After the data was collected it was transferred to the statistical program SPSS for further analysis. Results: A total of 178 people participated in the survey. 92.1% of the people who participated use the Internet to search for an explanation of their health-related symptoms. The results show that people with higher income and higher education experience believe they have a better ability, than people with lower income and education level, to improve their health with information found on the Internet. The results also showes a difference when it comes to gender, since women were generally more active than men using the Internet to search for health-related knowledge to promot there personal health. Conclusion: There are several connections between individual background variables and different health components. Gender, socioeconomic status, and education level affects how individuals interpret, review and understand health information on the Internet. With help from searching health information on Internet people self-diagnose themselves, treat themselves and reach out to medical care. Future research and implications: More knowledge and increased health literacy of the population is recommended in order to ensure the population's future health status. Proposals for future research include, investigating different approaches to increase the health literacy among the population. To study how health information on the Internet affects the individual and also health-care work.

Increasing lifestyle-related ill health, escalating health care costs, expanding health inequalities within and between nations, and an aging population are challenges facing governments globally. Governments, especially in industrialized countries like Sweden, are investing in health promotion and health communication, especially in ICT-supported health communication as a way to increase health literacy and empowerment at individual and population levels. Studies show that many eHealth communication efforts are narrow in scope, medical oriented and therefore not enough to address the complexity of lifestyle-related ill health and equity issues. This thesis proposes integrating health promotion values and principles in the design process of eHealth systems for health promotion in order to develop usable, sustainable, engaging, eHealth resources that are adaptable to their context of use and user’s skills. The overall aim of this thesis was study the participatory development process of an interactive ICT-supported health communication channel for health promotion and enhancing health literacy in PHC context. Participatory Action Research (PAR) with a multi-phase and multi-method approach was used in this thesis. A model entitled Spiral Technology Action Research’ (STAR) was used to guide the development of the health channel. This design process was framed in three developmental and evaluation phases corresponding to formative, process and outcome evaluation. A total of 146 participants consisting of professionals from primary health care services, information technology and academia, and local citizens participated in the project’s different phases. A triangulation of methods was used to collect the data; survey, document analysis, participatory observations with field notes, individual interviews, focus groups, think aloud protocols and log statistics. Qualitative and quantitative content analyses were used to analyse data. The results revealed that integrating health promotion values and principles in the design process proved to be valuable not only to the content of the channel, but also in PHC practice. The different design phases yielded valuable results that built into each other and contributed to an eHealth channel that was perceived as relevant to the local people’s need for health communication; accessible and user friendly. The results also indicated that an Internet based interactive health channel, could be a valuable resource for enhancing health literacy if users are involved in the design.

The purpose of the present study is to examine the pathways between gender and behavioral intention to engage in sexual HISB through application of the Theory of Planned Behavior (TPB). It was found that feminine and masculine gender role stress differentially influence perceived behavioral control and behavioral attitudes, and that intention to engage in HISB was higher among women than men. Attitudes and PBC significantly predicted behavioral intention in this model. Further, women in the sample were more likely to search for sexual health information, with online sources being the most frequently reported resource. Additionally, past HISB was a significant predictor of sexual health literacy, eHealth literacy, and sexual health knowledge. These findings indicate that gender role stress may play a role in the maintenance of attitudes and perceived behavioral control about sexual health information seeking behaviors, and that HISB in general is higher among women.

One of the areas concerning the medical literacy is the first aid giving. The aim of this diploma thesis is to answer the question whether the skills of beginning teachers concerning the first aid are on a sufficient level and whether the teachers are able to react adequately in emergency situations. The theoretical part describes the bases of these skills. It analyses the accident rate of children, professional training of teachers, new methods and projects how to increase the medical literacy of teachers. The practical part provides the results of a questionnaire survey analysing the first aid skills of beginning teachers. It observes whether the level of teachers is sufficient and whether they are able to react properly in health endangering situations. It also discusses the opinions of teachers concerning the first aid giving and the general vision of the first aid area in school environment. The conclusion of the survey shows that the teachers' first aid skills are not up to standard and that teachers assess the professional training concerning the first aid as insufficient. The thesis offers possible changes which would develop the skills of beginning teachers. Keywords health, health literacy, first aid, health care, beginning teacher

The nutritional status is significantly influenced by changes in eating habits of entire families. The baby is not born obese, but becomes it in the course of its development, due to heredity, family educational activities, psychosocial and cultural conditions of the society in which he or she lives. Everyday improper habits of adults are also transferred into the lives of children and violations of the principles of healthy eating, lack of physical activity, lack of rest and relaxation, stress and many other factors of present is involved in the onset of many diseases and complications of health. Base on fact that there are no standardised textbooks for teaching subjects Health Education and healthy lifestyle, while neither the directive which would lead teachers in pre-school education to systematic education of children in this area, I deal in my work with the question, which are the options to learn on healthy lifestyle and how get quality information teachers themselves. Futhermore I address the issue of overweight and obesity of children in terms of health literacy, strategy of selected primary schools and kindergartens on the question of exercise and diet and appropriate / inappropriate eating habits of children. The first part focuses on the implementation of programs in the field of...