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Aim
Health literacy has gained increasing importance worldwide. As a result of several studies indicating low health literacy levels in large parts of the population, strategies and action plans promoting health literacy were developed in many countries. The article analyses the origin, development and structure of the German Health Literacy Action Plan.
Subject and methods
In 2016, a civil society initiative was formed, aiming at developing a national action plan in an expert-based and collaborative manner. A group of 15 experts elaborated the core elements of the action plan, based on a literature review on existing health literacy approaches, action plans and empirical evidence. These core elements were further developed collaboratively in workshops with key stakeholders, self-help and patient organizations and individual consultation meetings. Afterwards, the National Action Plan was reviewed and previously formulated recommendations were refined before being published.
Results and conclusion
The National Action Plan Health Literacy in Germany presents 15 recommendations in four areas of action for promoting health literacy in Germany. This bottom-up strategy and the expert-based yet at the same time collaborative approach have proved to be successful when developing a national action plan.
There is an “infodemic” associated with the COVID-19 pandemic—an overabundance of valid and invalid information. Health literacy is the ability to access, understand, appraise, and apply health information, making it crucial for navigating coronavirus and COVID-19 information environments. A cross-sectional representative study of participants ≥ 16 years in Germany was conducted using an online survey. A coronavirus-related health literacy measure was developed (HLS-COVID-Q22). Internal consistency was very high (α = 0.940; ρ = 0.891) and construct validity suggests a sufficient model fit, making HLS-COVID-Q22 a feasible tool for assessing coronavirus-related health literacy in population surveys. While 49.9% of our sample had sufficient levels of coronavirus-related health literacy, 50.1% had “problematic” (15.2%) or “inadequate” (34.9%) levels. Although the overall level of health literacy is high, a vast number of participants report difficulties dealing with coronavirus and COVID-19 information. The participants felt well informed about coronavirus, but 47.8% reported having difficulties judging whether they could trust media information on COVID-19. Confusion about coronavirus information was significantly higher among those who had lower health literacy. This calls for targeted public information campaigns and promotion of population-based health literacy for better navigation of information environments during the infodemic, identification of disinformation, and decision-making based on reliable and trustworthy information.
Background
The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic.
Methods
A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total, n = 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors.
Results
The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic.
Discussion
Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health
Purpose
The German population-based longitudinal COVID-19 and Psychological Health study monitors changes in health-related quality of life (HRQoL) and mental health of children and adolescents during the COVID-19 pandemic and identifies vulnerable groups.
Methods
A nationwide, population-based survey was conducted in May 2020 to June 2020 (Wave 1), December 2020 to January 2021 (Wave 2), and September 2021 to October 2021 (Wave 3). In total, n = 2,097 children and adolescents aged 7–17 years were investigated using measures to assess HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), depressive symptoms(PHQ-2), and psychosomatic complaints(HBSC-SCL).
Results
The prevalence of low HRQoL increased from 15% prepandemic to 40% and 48% in Waves 1 and 2 and improved slightly to 35% in Wave 3 (all differences significant). Similarly, overall mental health problems increased from 18% prepandemic to 29% in Wave 1 and 31% in Wave 2 to 28% in Wave 3 (all differences significant, except Wave 3 vs. 2), anxiety increased from 15% prepandemic to 24% and 30% in Waves 1 and 2 and was still 27% in Wave 3. Depressive symptoms increased from 10% prepandemic to 11% and 15% in Waves 1 and 2 and were 11% in Wave 3. A group with low parental education, restricted living conditions, migration background, and parental mental health problems was at significantly increased risk of HRQoL and mental health impairments.
Discussion
The prevalence of low HRQoL, mental health problems, and anxiety has been elevated throughout the pandemic. Thus, mental health promotion, prevention, and intervention strategies need to be implemented to support adolescents–particularly those at risk.
Understanding Public Health
(2019)
This book develops a new model of the genesis of health, on the basis of the interplay between genetic and environmental factors. Hurrelmann and Richter build upon the basic theories of health and the popular model of salutogenesis to offer a comprehensive interdisciplinary theory of health genesis and success: Productive Processing of Reality (PPR).
The authors show that health is the lifelong dynamic process of dealing with the internal reality of physical and psychological impulses and the external reality of social and material impulses. To demonstrate this, the book is split into three interconnected parts. Part A analyses the determinants of health, providing an overview of the insights of current research and the impact of socioeconomic influences and gender on health. Part B covers public health, social, learning and coping theories, all of which understand health as an interaction between people and their environment. Part C draws on these four theories to outline PPR, stressing the interrelation between physical and mental constitution and the demands of the social and mental environment, and suggesting strategies for coping with these demands during the life course.
Understanding Public Health: Productive Processing of Internal and External Reality will be valuable reading for students and researchers in psychology, sociology, educational science, public health and medical science, and for policymakers in public health.
Population and individual deficits in health literacy, and their associated negative health outcomes, have received growing attention in the political arena in recent years. In order to respond to the problem, several governments have adopted national action plans, which outline strategies to improve health literacy. Drawing on the action plans of the USA, Australia, Scotland, and Wales and applying Entman’s concept of framing, this paper analyses how health literacy debates are framed within the political arena as well as the factors that influence framing. Analysing data from policy documents and in-depth expert interviews, this paper identifies relevant frames developed to (i) define the problem of limited health literacy, (ii) provide causal explanations, (iii) rationalise why health literacy requires political action, and (iv) present solutions. The findings indicate that the malleability of the concept allows that a diversity of frames and solutions are promoted, yet risks that debates remain vague. Health literacy seems to have been successfully used to instigate political debates about health system reforms, patient empowerment, and shared decision making. The analysis suggests that health literacy might, if applied strategically, help to focus policy debates on key public health problems and the development of systemic solutions.
This study investigates whether class-level school performance affects students’ life satisfaction and if there are differential effects for high- and low-performing students. Data were derived from the National Educational Panel Study, including n = 5196 students (49.6% girls), nested in 478 classes and 250 secondary schools. School performance in class was measured by aggregating individual grade point average in Mathematics and German. The study could not reveal the “big-fish-little-pond”-effect regarding students’ life satisfaction but found differential effects for high- vs. low performing students. There was no significant association for low-performing students attending classes with higher class-level performance However, low-performing students revealed the lowest life satisfaction. High-performing students placed in classes with higher average performance reported lower life satisfaction compared to high-performing students in classes with lower average performance. This study provides evidence for the impact of the learning environment in class on school-aged children’s life satisfaction, by highlighting the differential sensitivity of high-performing students when placed in classes with higher or lower average performance.