Public perceptions of Internet‐based health scams,and factors that promote engagement with them

The prevalence of health scams in Canada is increasing, facilitated by the rise of the Internet as a mass communication medium. However, little is known about the nature of this phenomena. Building on previous work exploring the nature of Internet health scams (IHS), this project sought to better understand the reasons why people engaged with IHS, and if contemporary psychosocial theory can help explain IHS engagement. A mixed‐methods study, involving a web‐based survey incorporating qualitative questions and the Susceptibility to Persuasion‐II Brief psychometric scale (STP‐II Brief), were administered (N = 194) in British Columbia, Canada, in 2017. Results (n = 156) demonstrated that 40% of participants had ever engaged with IHS, but only 1% reported to have actually lost money to a deceptive product/service. Associations between scam engagement, participant demographics and STP‐II Brief scores were explored, with Sex and Employment Status both found to have a significant effect on odds of IHS engagement. STP‐II Brief scores were positively correlated with a likelihood of engagement with IHS, even when adjusting for demographic characteristics. The types of IHS most frequently engaged with were those related to body image products, and social influence appeared to be a dominant psychosocial factor promoting engagement. Participants reported that claims of products being ‘natural’, the result of scientific breakthroughs, use of pseudoscientific language, use of testimonials, and celebrity or professional endorsement could lead them to engage with a product. These findings can help inform health professionals’ understanding of public health‐seeking behaviours with respect to deceptive marketing.     

Developing a tool to assess responsibility in health innovation: Results from an international delphi study

Objectives

The way new health technologies are being developed and brought to market undermines the sustainability of health systems around the world and limits the emergence of innovations that could generate greater system-level benefits. While Responsible Research and Innovation (RRI) offers relevant principles to address this policy problem, there are no tools to assess whether an innovation qualifies as a Responsible Innovation in Health (RIH). Drawing on RRI and health policy research, we developed a RIH Tool that entails a three-step process: screening, assessment and rating.

Country‐of‐birth differences in adverse health behaviours among people with type 2 diabetes

Objective: To identify differences in patterns of adverse health behaviours among people with type 2 diabetes according to country or region of birth. Methods: Population‐based study of 23,112 individuals with type 2 diabetes aged 45 years and older, from New South Wales, Australia. Self‐reported questionnaire data and logistic regression models were used to estimate odds ratios for adverse health behaviours according to country or region of birth, adjusted for confounding factors. Results: People with diabetes born in the Middle East and in the United Kingdom (UK) were more likely to be current smokers than those born in Australian, while those from Asia were less likely to be smokers. Relative to Australian‐born people with diabetes, those born in the Middle East were more likely to have insufficient physical activity, while those born in Oceania, North West Europe and the UK were less likely. People with diabetes from Asia, North Africa, the Middle East and Sub‐Saharan Africa were less likely to consume alcohol than those born in Australia, but people born in the UK were slightly more likely to consume alcohol. People with diabetes born in the UK, Asia, and North Africa were more likely than those born in Australia to have an inadequate intake of fruit and vegetables. Conclusion: Adverse health behaviours among people with type 2 diabetes varied markedly according to country or region of birth. Promoting smoking cessation and increasing physical activity levels among people with diabetes who were born in Middle Eastern countries are clear priorities.     

中国居民营养与慢性病健康状况报(2015)

  目的  基于Delphi法构建慢性病患者健康素养评价指标体系,为提高慢性病的管理效果提供参考依据。  方法  采用Delphi专家咨询法构建慢性病患者健康素养评价指标体系,应用Fuzzy综合评判法计算各级指标的权重系数。  结果  2轮专家咨询的积极系数分别为90.0 %和96.3 %,专家权威系数分别为0.802 5和0.868 9;重要性、可操作性和敏感性第1轮专家意见协调系数分别为0.336 5、0.365 3和0.268 9,第2轮专家意见协调系数分别为0.451 8、0.461 8和0.441 9,差异均有统计学意义（均P < 0.05）,专家意见的协调性较好;经过2轮专家咨询后建立了慢性病患者健康素养评价指标体系,该指标体系包括一级指标4个、二级指标42个,重要性、可操作性和敏感性的权重值分别为0.386、0.325和0.289。  结论  本研究构建的慢性病患者健康素养评价指标体系具有客观性、可靠性和可取性,可为慢性病患者健康素养的评价提供依据。     

Effects of decentralisation and health system reform on health workforce and quality‐of‐care in Indonesia, 1993–2007

The impact of decentralisation, socioeconomic changes and healthcare reforms in Indonesia on type and distribution of healthcare providers and quality‐of‐care has been unclear. We examined workforce trends for healthcare facilities from 1993 to 2007 using the Indonesian Family Life Surveys. Each included a sample of public and private healthcare facilities, used standardised interviews for numbers and composition of staffing, and quality‐of‐care vignettes. There was an increase in multiprovider facilities and shift in profile of solo providers—increasing proportions of midwives and drop in doctors in rural areas (including facilities with doctors) and nurses in urban areas. Quality‐of‐care scores were low, particularly for nurses as solo providers. Despite increased numbers of healthcare workers and growth of the private sector, outer Java‐Bali and rural areas continued to be disadvantaged in workforce capacity and quality‐of‐care. The results have implications for accreditation and in‐service training requirements, the legal status of nurses and private sector regulation. Copyright © 2014 John Wiley & Sons, Ltd.     

The impact of out‐of‐pocket health expenditure on household impoverishment: Evidence from Morocco

Health financing in Morocco relies mainly on out‐of‐pocket (OoP) payments. World Health Organization (WHO) has shown that these payments can expose households to catastrophic health expenditure (hereinafter CHE) and impoverish them. The study examines the financial burden of OoP health payments on Moroccan households. Two approaches—that developed by Wagstaff and Doeslear and the one advocated by WHO—are adopted to estimate the extent of CHE. These show that 1.77% of households incurred CHE at the 40% threshold for nonfood expenditure. At the 10% threshold for total consumption expenditure, 12.8% of households incurred CHE. We find that these OoP payments have made 1.11% of Moroccan households poorer. In analyzing the determinants of CHE, we estimated an ordered probit model. It appears that any of (a) hospitalization, (b) presence of an elderly person in the household, or (c) the level of poverty increases significantly the likelihood of health expenditure becoming catastrophic. On the other hand, we find that coverage by health insurance protects against CHE.     

Impacts of care‐giving and sources of support: a comparison of end‐of‐life and non‐end‐of‐life caregivers in Canada

This is the second in a series of papers that deal with care‐giving in Canada, as based on data available from the Canadian General Social Survey (2007). Building on the first paper, which reviewed the differences between short‐term, long‐term and end‐of‐life (EOL) caregivers, this paper uniquely examines the caregiver supports employed by EOL caregivers when compared to non‐EOL caregivers (short‐term and long‐term caregivers combined). Both papers employ data from Statistics Canada's General Social Survey (GSS Cycle 21: 2007). The GSS includes three modules, where respondents were asked questions about the unpaid home care assistance that they had provided in the last 12 months to someone at EOL or with either a long‐term health condition or a physical limitation. The objective of this research paper was to investigate the link between the impact of the care‐giving experience and the caregiver supports received, while also examining the differences in these across EOL and non‐EOL caregivers. By way of factor analysis and regression modelling, we examine differences between two types of caregivers: (i) EOL and (ii) non‐EOL caregivers. The study revealed that with respect to socio‐demographic characteristics, health outcomes and caregiver supports, EOL caregivers were consistently worse off. This suggests that although all non‐EOL caregivers are experiencing negative impacts from their care‐giving role, comparatively greater supports are needed for EOL caregivers.     

Developing a tool for health professionals involved in producing and evaluating nutrition education leaflets

Introduction Nutrition education leaflets are widely used by dietitians and many dietitians are also involved in their production. However, there does not appear to be a suitable tool to assist health professionals to produce or evaluate nutrition education leaflets. There are Guidelines available that are either specifically concerned with nutrition but for all educational materials or specifically for use with leaflets, but not necessarily to do with nutrition. The aim of this study was to develop a tool suitable to assist health professionals when producing and evaluating nutrition education leaflets.
Methods Patients and dietitians were surveyed by self-completion questionnaire to determine their opinions of the importance of various criteria which might be applied to nutrition education leaflets were.
Results The research revealed significant differences in the opinions of dietitians and patients for seven of 11 criteria.
Conclusion The evaluation tool developed was based on the patients' ranking of all the criteria. Its reliability was assessed amongst a group of dietitians in Dorset but its wider use and acceptability should be looked at. The tool is likely to be appropriate as a checklist for health professionals producing new nutrition education leaflets or as a framework for evaluating existing nutrition education leaflets.     

Development of Australia's front‐of‐pack interpretative nutrition labelling Health Star Rating system: lessons for public health advocates

Objectives : To draw advocacy lessons from actions undertaken by public health groups to assist the development of Australia and New Zealand's Health Star Rating (HSR) front‐of‐pack nutrition labelling system. Methods : The advocacy approaches undertaken by the Public Health Association of Australia leading up to the time of the adoption of the HSR is examined using a 10 step advocacy framework. Key roles in advocacy planning and implementation are described, along with coordinating efforts by health and consumer groups during the HSR development processes. Results : HSR aims to support consumers to make informed choices to protect from diet‐related diseases, including obesity. The HSR launched despite a number of major obstacles, owing to a strategic, coordinated advocacy effort undertaken by a guiding coalition. Conclusions : Actions to improve nutrition are often highly contested, particularly if the desired outcome competes with commercial interests. However, by deploying a structured approach to public health advocacy it is possible to influence government despite opposition from commercial interests. Implications for public health : A shared vision and a coordinated effort by public health professionals enabled advocates to overcome undue commercial influence.     

The development and application of a public health skills assessment tool for use in primary care organisations

The public health skills assessment instrument described in this paper was developed to provide a key group of UK primary care practitioners (health visitors) with a personal development planning tool and researchers with a robust assessment tool for use in evaluations of innovative local public health programmes. Pilot testing with over 120 practitioners has provided evidence of its reliability and validity as a research instrument as well as yielding useful insights for public health educators, practitioners and policy-makers. Factor analysis confirms 10 core competency domains for health visitors which are remarkably consistent with those recently identified for UK public health specialists, interpreted here as grounds for optimism in the greater co-ordination between strategic and front-line approaches to public health work in primary care. However, results also confirm earlier findings indicating low levels of skill amongst health visitors in tackling health inequalities through interventions such as community development, raising questions about their capability to work effectively in new roles proposed by the Department of Health.