How health literacy is taught and evaluated in dentistry, medicine, nursing, law, pharmacy, public health, and social work: a narrative review.

BACKGROUND: This narrative review examined the published peer-reviewed literature on how health literacy is taught and evaluated in seven health professional and adjacent disciplines: dentistry, medicine, nursing, law, pharmacy, public health, and social work. The study objectives were to assess how students are educated about health literacy and how their health literacy education and skills are evaluated. METHODS: Study selection followed guidelines outlined in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We searched PubMed, CINAHL, SocINDEX (EBSCOhost), Lexis Advance and Public Health (ProQuest) for English-language publications of health literacy education studies across seven disciplines at U.S.-based institutions. Inclusion criteria included: 1) methods describing a primary health literacy educational intervention, 2) professional education in one or more of the seven disciplines, 3) educational institutions in the United States, and 4) articles published in peer-reviewed journals between 2000 and 2020. RESULTS: The searches yielded 44 articles. Health literacy education is evident in six of the seven studied disciplines, and varies widely in the quality, quantity, timing and mode of education and evaluation. Despite the presence of health literacy accreditation requirements, none of the seven disciplines has developed and implemented a standard, rigorous health literacy education program for students. CONCLUSIONS: Graduating institutions and professional accreditation organizations that set the standards for education must lead the way by implementing upstream changes in health literacy professional education. Teaching health literacy to students in health professions is one strategy to help close gaps in patient/client professional communication for graduates and those they serve.

Health-equity issues related to childhood obesity: a scoping review.

PURPOSE: The purpose of this scoping review was to determine the health-equity issues that relate to childhood obesity. METHODS: Health-equity issues related to childhood obesity were identified by analyzing food environment, natural and built environment, and social environment. The authors searched Medline, PubMed, and Web of Science, using the keywords "children" and "obesity." Specific terms for each environment were added: "food desert," "advertising," "insecurity," "price," "processing," "trade," and "school" for food environment; "urban design," "land use," "transportation mode," "public facilities," and "market access" for natural and built environment; and "financial capacity/poverty," "living conditions," "transport access," "remoteness," "social support," "social cohesion," "working practices," "eating habits," "time," and "social norms" for social environment. Inclusion criteria were studies or reports with populations under age 12, conducted in the United States, and published in English in 2005 or later. RESULTS: The final search yielded 39 references (16 for food environment, 11 for built environment, and 12 for social environment). Most food-environment elements were associated with obesity, except food insecurity and food deserts. A natural and built environment that hinders access to physical activity resources and access to healthy foods increased the risk of childhood obesity. Similarly, a negative social environment was associated with childhood obesity. More research is needed on the effects of food production, living conditions, time for shopping, and exercise, as related to childhood obesity. CONCLUSIONS: Most elements of food, natural and built, and social-environments were associated with weight in children under age 12, except food insecurity and food deserts.

A community-driven obesity prevention and intervention in an elementary school.

UNLABELLED: In partnership with community agencies and organizations, University of Kentucky College of Medicine (UKCOM) launched an after-school program focusing on creating healthy, active lifestyles for students at a Lexington elementary school. Chosen for the underserved population of children it cares for, the school exhibits all of the national risk factors for obesity: low-income families (57% of annual household incomes less than $10,000); minority population (80% of the children African-American or Hispanic); and located in an unsafe neighborhood for outdoor physical activity. These demographics resulted in a school population that had body mass index (BMI) demographics of 48.8% overweight (BMI >85%), including 30.7% obese (BMI >95%), in contrast with the national average of 16% obese. METHODS: Targeting the school's children with a BMI >85th percentile, an after-school program was created. The students met twice a week for 90-minute sessions of fun physical activities, proper nutritional information, as well as small group sessions with pediatric psychiatry residents focusing on good choices and proper motivations in life. Universal school interventions were also instituted in an attempt to reach the entire school population. RESULTS: Initial findings after the first year of the program indicated a slowing in the average rate of weight gain by the targeted population. While the results, compared to accessible data in a school population with similar demographics, did not reach statistical significance, the trends were in the desired direction. A statistically significant difference (p=0.027) was observed in mean BMI percentile for the universal school population versus the comparison school. CONCLUSION: School-based prevention and intervention conducted by a coalition of community agencies and organizations is a promising and cost-effective approach to curtailing childhood obesity.