The purpose of this dissertation was to explore the mechanism of association between social determinants of health (SDH), particularly limited health literacy, and disparate outcomes related to cardiovascular disease in vulnerable populations. Specific aims were to 1) compare quality of life (QOL), anxiety, and depressive symptoms between genders in implantable cardioverter defibrillator (ICD) recipients; 2) examine the association between multi-morbidity burden and QOL; 3) determine whether health literacy levels independently predict CVD risk in the male prison population; 4) examine the relationship between health literacy and decisiveness regarding end of life (EOL) choices, and 5) examine SDH as predictors of perceived poor health status in ICD recipients. Specific aim one was addressed by analysis of data collected from individuals in the Swedish ICD and Pacemaker Registry. Multiple linear regression was used to determine predictors of anxiety, depression, and quality of life in men and women. A higher prevalence of anxiety symptoms in women was noted with no differences in depressive symptoms noted between the genders. The majority of the variance in the predictive models for QOL was explained by the addition of the psychosocial variables for both genders. Specific aim two was addressed by analysis of data collected from individuals in the Swedish ICD and Pacemaker Registry. Logistic regression was used to determine predictors of QOL. Greater multi-morbidity burden was associated with lower QOL in ICD recipients. Specific aim three was addressed by analysis of data collected from male inmates enrolled in a bio-behavioral educational and counselling intervention program to reduce CVD risk. Nonlinear regression was used to determine whether health literacy was an independent predictor of CVD risk while controlling for social and clinical variables. Inmates with adequate levels of health literacy had lower ten year CVD risk profiles than those inmates with inadequate health literacy. Specific aim four was addressed by analysis of data collected from ICD recipients. Multinomial regression was used to determine predictors of decisiveness regarding EOL choices. Within the context of terminal illness, health literacy and race were found to be predictors of decisiveness regrading generator replacement while gender was found to be a predictor of decisiveness regarding the withdrawal of defibrillation therapy. Specific aim five was addressed by analysis of data collected from ICD recipients. Logistic regression was used to determine predictors of perceived poor health status. Residential status in the Central Appalachian region of Kentucky, not working outside the home, higher levels of health literacy, and comorbid depression were predictors of perceived poor/very poor health status.

Limited health literacy is a barrier to understanding health information. Simplifying text can reduce this barrier and possibly other known disparities in health. Unfortunately, few tools exist to simplify text with demonstrated impact on comprehension. By leveraging modern data sources integrated with natural language processing algorithms, we are developing the first semi-automated text simplification tool. We present two main contributions. First, we introduce our evidence-based development strategy for designing effective text simplification software and summarize initial, promising results. Second, we present a new study examining existing readability formulas, which are the most commonly used tools for text simplification in healthcare. We compare syllable count, the proxy for word difficulty used by most readability formulas, with our new metric ‘term familiarity’ and find that syllable count measures how difficult words ‘appear’ to be, but not their actual difficulty. In contrast, term familiarity can be used to measure actual difficulty.

Understanding the short-and long-term impacts of a biomonitoring and exposure project and reporting personal results back to study participants is critical for guiding future efforts, especially in the context of environmental justice. The purpose of this study was to evaluate learning outcomes from environmental communication efforts and whether environmental health literacy goals were met in an environmental justice community. We conducted 14 interviews with parents who had participated in the University of Arizona's Metals Exposure Study in Homes and analyzed their responses using NVivo, a qualitative data management and analysis program. Key findings were that participants used the data to cope with their challenging circumstances, the majority of participants described changing their families' household behaviors, and participants reported specific interventions to reduce family exposures. The strength of this study is that it provides insight into what people learn and gain from such results communication efforts, what participants want to know, and what type of additional information participants need to advance their environmental health literacy. This information can help improve future report back efforts and advance environmental health and justice.

The thesis follows the theoretical foundation, options and practical application of Education for Health with regards to the growing significance in Person and Health in school educational programmes. The theoretical part focuses on the history and development in the filed of the Education for Health since the 16th century up until the reformation of the czech educational system after 1989. This part also concentrates on the options of fulfilling and understanding the curriculum goals in the current environment in primary schools. The practical part maps the approach of the Education for Health in a specific primary school environment, which focuses on different opinions of the educator, pupils and parents, with emphasis on the qualitative research. Based on the evaluation of the theoretical basis of the curriculum on the one hand and the practical realization of this domain in the selected school on the other hand, the author suggests possible adjustments in the realization of Education for Health in the specific school. KEYWORDS Health, secondary school, health literacy, value, educator, student, parent

The thesis looks into the health literacy of pupils at Primary school. The main aim of this work is to compare the pupils's health literacy with the computer literacy at chosen Primary school. To find out the level of knowledge, awareness, attitudes and perceptions of pupils in connection with computer and health literacy. Determine the causes of less interest in physical activities and the link between physical activity and health of pupils. The theoretical part deals with the definition of the basic concepts such as health literacy, computer literacy, healthy living, physical activity, etc… with the help of the specialized literature. This part describes the relationship between the pupil's physical activity, healthy lifestyle and health literacy. The practical part compares the level of student's knowledge in the field of computer and health literacy. It finds out the pupil's knowledge which are linked to beneficial effect of physical activities on human health, too. In this part questionnaires which are intended for children from the selected primary school and deal with primarily the level of knowledge of medical and computer literacy will be elaborated. Questions are also pointed at physical activities of students in extracurricular activities, their frequency and the motivation for them. In...

Master of Science / Department of Journalism and Mass Communications / Nancy Muturi / Health disparities are prevalent among ethnic minorities, including immigrants in the United States. These disparities come in the form of low health insurance, low social economic status, ethnic discrimination, language and cultural barriers. As ethnic minorities, international students also suffer from numerous health problems that are associated with their lower social, economic and immigration status when they come to the United States. Health communication is an effective tool for increasing health literacy and for reducing health disparities. Applying the uses and gratification theory and the staged model of trust, the study was conducted among 120 American students and 135 international students to examine the extent to which access to health information, the type of information accessed, how they use it, and how they determine what trustworthy information is differed between the two groups. Key findings indicate that nutrition is the most common health topic accessed online by college students regardless of place of origin. Though both groups access online health information with the same motivation of information, they use online health information in different situations. Source credibility is the most important factor for college students in determining trustworthy health websites, and government websites and other health organization websites were found to be more trustworthy. The study also provides both theoretical and practical implications, which include consideration of ethnic backgrounds in disseminating health information through online channels and understanding the needs and motivation for people’s access to health information and how they use it to be able to meet those needs. In designing health communication campaigns that target college students, the study proposes that the differences between native-born and international students need to be taken into consideration.

This project is part of the development phase of a health company called HälsoTanken, that is about to expand as a company. The purpose of the project is to develop HälsoTanken's website to present the company on the web so that the recipient feels confident. In the healthcare industry it is important for the customers to feel trust, therefore we will analyze how web design can be used to achieve trust in the health industry in this study. The background of the study consists of the concepts, risk society and health literacy to understand how people experience risks and expertise in society, as well as underlying knowledge in health. The main areas covered are web design, positive impression on the web and a theory about how the recipient makes their credibility assessment of web pages. The study is conducted by qualitative semi-structured interviews of HälsoTankens primary target group, which are men and women aged 50 to 60 years. The result of the study shows that a lot of text and elements in a web design does not have a positive effect when it comes to creating trust in web pages. However, trust is created through clear structure and professional images on premises. The result was used as the basis for the creation of HälsoTankens new web page, which is presented in the form of a prototype.

Thesis advisor: Ramsay Liem / Underutilization of mental health services among Asian Americans is a pressing concern. It is possible that knowledge and beliefs about mental illness (a.k.a. “mental health literacy”) serve as barriers to seeking appropriate help, and that Asian cultural values plays a role in determining such attitudes. This study investigated the relationships among mental health literacy, attitudes towards mental health services, and adherence to Asian cultural values. A sample of 17 Caucasian and 22 Asian American college students completed a questionnaire including the Asian Values Scale, the Attitudes Toward Seeking Professional Psychological Help Scale – Shortened Version, and four vignettes portraying depression, schizophrenia, alcohol dependency, and anorexia. Results indicated that Caucasians were slightly more likely to correctly recognize and identify mental illnesses than were Asian Americans. Causal attributions varied greatly across different mental disorders, and Asian Americans showed less positive attitudes towards seeking professional psychological help, and preferred to solve problems on their own or seek help from family or friends. The greatest barriers to treatment for Asian Americans were a fear of showing personal weakness and concern about stigma. Adherence to Asian cultural values was inversely associated with willingness to seek professional help, and with willingness to take medication for psychological problems. / Thesis (BA) — Boston College, 2005. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Psychology. / Discipline: College Honors Program.

Psykisk ohälsa är ett växande folkhälsoproblem som orsakar nedsatt välbefinnande och försämrad livskvalité. Vanliga tillstånd av psykisk ohälsa är depressioner och ångestsyndrom. Unga vuxna är en utsatt grupp där den psykiska ohälsan fortsätter att breda ut sig hos. Syftet med studien var att undersöka vad unga vuxna vet om orsakerna till psykisk ohälsa och vad det finns för stöd att få. En kvalitativ metod användes för att besvara studiens frågeställningar. Datainsamlingen skedde med semistrukturerade intervjuer och ett målinriktat urval användes för att rekrytera intervjupersoner som utgjordes av sex unga vuxna mellan 20–29 år som var antingen studerande eller yrkesverksamma. Det insamlade materialet analyserades med en manifest innehållsanalys. Resultatet visade att psykisk ohälsa kännetecknas av förlorad meningsfullhet, negativa tankar och kan yttra sig i försämrad koncentrationsförmåga som medför prestationssvårigheter. Det befintliga stödet vid psykisk ohälsa uppfattades otillräckligt med för långa väntetider och behov av andra insatser än medicinering. Orsaker till psykisk ohälsa uppfattas vara om individen upplevt ett trauma eller ställer för höga krav på sig själv. I resultatet framkom att individer jämför sig via sociala medier och i strävan efter kroppsideal och ett perfekt liv. Studien tyder på att sociala medier har bidragit till ökningen av psykisk ohälsa.

O conceito de saúde usado na sociedade tem mudado constantemente durante a história. Atualmente, deixou-se de associar o processo saúde-doença como opostos, dando lugar a conceitos que abrangem o bem-estar físico, social e ambiental do indivíduo. A partir disso, desenvolveram-se conceitos que organizaram o ensino da temática saúde: a Promoção em Saúde, que abrange a estruturação social de acesso a saúde; a Educação em Saúde (EeS) que se preocupa com um enfoque escolar que vise a emancipação dos estudantes a tomar decisões acerca da sua saúde e do ambiente onde vive; e a Alfabetização em Saúde, uma ferramenta para a implementação da EeS. Para que essas tendências sejam aplicadas é preciso que a formação dos profissionais esteja em acordo. Assim, um dos objetivos deste trabalho foi analisar como a formação de professores em cursos de Licenciatura em Ciências Naturais e Ciências Biológicas de instituições de ensino superior na Região Metropolitana de Porto Alegre está desenvolvendo temáticas relacionadas à saúde. Para isso realizamos uma pesquisa de caráter quali-quantitativo que utilizou como método a análise de conteúdo de Bardin (2014). Os documentos analisados foram os Planos Pedagógicos (PPC), os currículos dos cursos e a Base Nacional Comum Curricular – BNCC. Utilizamos também as respostas de um questionário por estudantes em final de curso, além de realizarmos uma revisão bibliográfica utilizando o termo em inglês Health Literacy (HL) usado no Brasil. Os resultados da pesquisa possibilitaram a elaboração de quatro produções textuais científicas. A primeira, artigo apresentado no XI Encontro Nacional de Pesquisa e Ensino de Ciências (XI ENPEC), investigou os PPCs e os currículos dos cursos de Licenciatura. A segunda, analisou as concepções dos estudantes concluintes dos cursos de Licenciatura em Ciências Naturais e de Ciências Biológicas sobre saúde, assim como suas dificuldades em trabalhar o tema. A terceira, analisou a BNCC quanto a forma como a saúde é apresentada nas três versões do documento, se de acordo com a EeS ou ligada ao higienismo e sanitarismo. A quarta, apresentada no II Encontro Regional de Ensino de Ciências (II EREC), fez uma revisão do termo HL nas pesquisas desenvolvidos no Brasil, tentando elucidar como e por quem está sendo feita a pesquisa sobre o tema no país. Observamos que os concluintes dos cursos se sentem inseguros, principalmente para abordar temas como a sexualidade, que transcendem o campo da biologia, e também conceitos relacionados a doenças. Infelizmente, a BNCC, documento que orienta a organização curricular da Educação Básica no país, também não tem uma visão única esclarecedora sobre a saúde. Em seu texto as abordagens se misturam e vários aspectos importantes não são trabalhados. Muito disso se deve a EeS ainda não constituir um campo de pesquisa concreto no Brasil, o que podemos observar quando analisamos que os estudos sobre HL são predominantemente realizados em áreas como a enfermagem, e não a educação. Concluímos que a formação dos profissionais docentes apresenta algumas lacunas, principalmente relacionadas aos contextos sociais e ambientais da saúde e ainda está bastante ligada a concepções biologicistas. / The concept of health used in societies has constantly changed throughout history. Nowadays, the processes of health and sickness are no longer associated in opposition. There are now concepts which encompass the physical, social, and environmental well-being of an individual. From this, other concepts have been developed which organize the education of the health theme: the Promotion of Health, which encompasses the social structure of access to health; Health Education (HE), which concerns itself with a schools focus that aims at the students’ independence in decision making regarding their own health and the environment they live in; and Health Literacy, a tool for implementing HE. For these health education tendencies to be applied, it is necessary for the education of the professionals to be in accordance. Thus, the objective of this work is to analyze how the teachers’ traning in the Metropolitan Region of Porto Alegre has been developing these themes. In order to do that, a quali-quantitative survey was carried out, which used as a method the contente analysis of bardin (2014). The documents analized were the Couse Pedagogics Plan (PPC), the BNCC (Brazil’s National Curriculum Basis). Mixed questionnaires developed from the courses’ pedagogical plans were applied to students in the final stages of these courses, besides performins a bibliografic reviem using the English term Health Literacy (HL) used in Brazil. This resulted in the elaboration of four articles. The first, presented in the XI Encontro Nacional de Pesquisa e Ensino de Ciências, investigated the PPCs and the courses’ curriculum. The second, analyses the conceptions of graduating students of the teaching courses of natural sciences and biology on health, as well as their difficulties in working with this topic. The third, analyses the BNCC regarding on the manner of the presentation of the health topic; whether it is according to the HE, or linked to the social hygiene movement and sanitarism. The fourth, presented in the II Encontro Regional de Ensino de Ciências, revises the term“health literacy” in researches developed in Brazil, and attempts to clarify how and by whom the research on this theme is being made in Brazil. We perceive that The recently graduated students feel insecure, especially regarding themes such as sexuality, which transcend the field of biology, but also regarding human physiology and diseases. Unfortunately, the BNCC, document that guides the curricular organization of Basic Education inthe country, also does now present a singular clear view on health. In its text, the approaches are puzzling, and several aspects are not presented. A lot of this is a consequence of the fact that the EeS still is not a concrete field of research in Brazil, which can be observed when a study on health literacy comes from an area such as nursing, areas connected to health, and not education.We have concluded that the formation of these professionals still has some gaps, especially in social and environmental contexts of health, and still strongly connected to biologic models and conceptions.