Health literacy research and practice最新文献

{"title":"A Structural Model Linking Health Literacy to Quality of Life in Thai Adults.","authors":"Benjawan Poonthananiwatkul, Wonpen Yodkong, Chadawan Runlert, Peera Deelert, Paisit Jirarattanasopa, Apaporn Kritsanapan Pakeekaow","doi":"10.3928/24748307-20260510-01","DOIUrl":"https://doi.org/10.3928/24748307-20260510-01","url":null,"abstract":"<p><strong>Background: </strong>Several factors affect Quality of Life (QoL) such as health literacy, health behaviors, and mental health.</p><p><strong>Objective: </strong>This quantitative study examined the relationships between health literacy (HL), health behaviors (HB), mental health (MH), and QoL among Thailand's working-age population.</p><p><strong>Methods: </strong>A total of 360 individuals were selected using multistage sampling. Seven of 13 health regions were randomly chosen, followed by random selection of one province, district, and agency per region. Participants age 15 to 59 years were purposively recruited. Data were collected from December 2024 to January 2025 by using four questionnaires consisting of HL, HB, MH, and QoL (rating scale 1 to 5). Structural equation modeling (SEM) was used for data analysis.</p><p><strong>Key results: </strong>Most participants demonstrated excellent health literacy (78.06%) and QoL (48.89%), with good HB (Mean = 3.82) and MH (Mean = 3.95). SEM showed HB and MH had significant direct positive effects on QoL (<i>β</i> = 0.315, <i>p</i> < .001; <i>β</i> = 0.860, <i>p</i> < .001), while HL exerted significant direct positive effects on both HB (<i>β</i> = 0.396, <i>p</i> < .001) and MH (<i>β</i> = 0.391, <i>p</i> < .001). HL indirectly influenced QoL (<i>β</i> = 0.464, <i>p</i> < .001) through these mediating variables. The model explained 92% of QoL variance and demonstrated excellent fit with empirical data (χ² = 94.905, <i>df</i> = 76, χ²/<i>df</i> = 1.249, <i>p</i> = .070, RMSEA (root mean square error of approximation) = 0.026, RMR (root mean square residual) = 0.030, GFI (goodness-of-fit index)= 0.972, NFI (normed fit index) = 0.975, TLI (Tucker-Lewis Index) = 0.990, CFI (comparative fit index) = 0.995). A significant sequential pathway was observed (HL → HB → MH → QoL), with no significant direct path from HL to QoL.</p><p><strong>Conclusion: </strong>These findings suggest two potential pathways for improving QoL among working-age Thais: directly enhancing MH and HB to prevent illness or promoting HL to indirectly improve health outcomes. Health care providers should develop programs targeting these factors, with particular emphasis on MH given its stronger influence.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 4","pages":"e148-e155"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scoping Review of Health Literacy Measurement in U.S. Interventions: Trends, Tools, and Gaps.","authors":"Yunlin Zhou, Marissa Mathew, Megan S Patterson, Jason Rosenfeld, Melanie Stone, Tyler Prochnow, Joshua Yudkin","doi":"10.3928/24748307-20260508-01","DOIUrl":"10.3928/24748307-20260508-01","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is a critical determinant of health outcomes, yet considerable variability exists in how it is measured across intervention studies. This scoping review article systematically mapped health literacy measurement tools and implementation reporting practices in United States-based interventions published between 2014 and 2024, with particular attention to validated and nonvalidated instruments and their application across diverse populations and settings.</p><p><strong>Methods: </strong>Following Joanna Briggs Institute guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, we searched Ovid MEDLINE in January 2025 for studies describing health literacy interventions focusing on health care providers, patients, educators, or community organizations in the U.S. Two independent reviewers screened records and extracted data using the Population-Concept-Context framework. Implementation outcomes were assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to evaluate reporting of Reach, Effectiveness, Adoption, Implementation, and Maintenance dimensions.</p><p><strong>Key results: </strong>Of 117 included studies, most targeted health care patients, with strong representation of racial and ethnic groups but limited inclusion of non-English speakers. Health literacy measurement was reported in 71 studies, with only 49 employing validated instruments. The Newest Vital Sign, eHealth Literacy Scale, and RE-AIM were most frequently used. Nearly all studies reported effectiveness with statistically significant results, predominantly measuring behavioral rather than clinical outcomes. RE-AIM analysis revealed substantial reporting gaps, particularly in demographic details, implementation fidelity, cost documentation, and maintenance planning. Only 18% of studies reported fidelity and fewer than 10% described sustainability strategies.</p><p><strong>Discussion: </strong>While health literacy intervention research has grown substantially, significant inconsistencies in measurement practices and implementation reporting limit comparability and translation into practice. The field requires greater standardization in measurement approaches, more comprehensive demographic reporting to assess equity impacts, and systematic application of implementation science frameworks from intervention inception. Improved reporting standards are essential to accelerate translation of health literacy research into sustainable, equitable practice.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 4","pages":"e130-e147"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Development of Plain Language Summaries of Clinical Trial Results.","authors":"Jennifer Doralt, Bernie Keohane, Adrienne McGilvray, Daniela Pobinger, Borislava G Pavlova","doi":"10.3928/24748307-20260410-02","DOIUrl":"10.3928/24748307-20260410-02","url":null,"abstract":"<p><strong>Background: </strong>Plain language summaries (PLSs) play a crucial role in communicating complex clinical trial information to patients and the public. Due to the European Union Clinical Trials Regulation (EU CTR) 536/2014 requirement to disclose PLSs in parallel with the technical results, clinical trial sponsors will need to develop such summaries swiftly and efficiently, while avoiding potential obstacles. Their creation can be challenging for sponsor company stakeholders who typically use highly technical, scientific language.</p><p><strong>Brief description of activity: </strong>This manuscript describes the PLS development and review process established at our company. It also considers the collection of feedback via an anonymous survey, both of which were intended to optimize PLS preparation. Finally, it explores internal stakeholder preparedness for EU CTR requirements, and further opportunities to enhance PLS quality to better support patient centricity.</p><p><strong>Implementation: </strong>We observed a learning curve among stakeholders (content contributors and reviewers) and an enhanced appreciation for the PLS process.</p><p><strong>Results: </strong>This resulted in improved best practice principles for PLS writing, such as describing only the primary endpoint(s) and adverse drug reactions. The process of PLS development was streamlined following implementation of stakeholders' feedback received in PLS surveys circulated in 2023 and 2024. This led to increased satisfaction with the instructions provided for stakeholders and with the processes for PLS development, including the company-developed PLS template and glossary of plain language terms. Here we suggest that regularly adjusting PLS tools based on continuous feedback from internal stakeholders contributes to a more efficient and clear process.</p><p><strong>Lessons learned: </strong>Optimization of the PLS development process using feedback from internal stakeholders supports efficiency, clarity, and patient-centricity, as well as ensuring preparedness for EU CTR requirements.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e108-e116"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Literacy and Type 1 Diabetes Mellitus: A Mixed Method Study.","authors":"Anne-Sofie Kortegaard, Anette Andersen, Anne Emilie Aastrup, Helle Rokkedal Sandersen, Annesofie Lunde Jensen","doi":"10.3928/24748307-20260311-01","DOIUrl":"10.3928/24748307-20260311-01","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of type 1 diabetes underscores the need for health literacy responsiveness, as effective self-management depends on understanding and using health information. The Ophelia process supports identifying diverse strengths and needs among people with type 1 diabetes.</p><p><strong>Objectives: </strong>To systematically identify health literacy strengths, needs, and preferences among individuals with type 1 diabetes attending specialized outpatient care using a mixed methods approach guided by phase 1, step 1 and 2 of the Ophelia process.</p><p><strong>Methods: </strong>Adults (≥18 years) with type 1 diabetes or subtypes (MODY/LADA) at a Danish specialist diabetes center were invited to complete a survey including the Health Literacy Questionnaire (HLQ) and three scales from the electronic HLQ (eHLQ). Cluster analysis and in-depth interview were integrated for the development of representative vignettes.</p><p><strong>Key results: </strong>Of 1,193 eligible patients, 238 participated (response rate 19.9%). The mean age was 54.2 years and 52% were men. HLQ and eHLQ scores revealed a wide diversity in health literacy strengths and needs. Health literacy profiles ranged from higher health literacy with active self-management to lower health literacy with low engagement and high reliance on family support. Vignettes vividly illustrated archetypal patient experiences, supporting a tailored understanding of health literacy challenges in clinical practice.</p><p><strong>Conclusions: </strong>Seven distinct health literacy profiles were identified among adults with type 1 diabetes, showing significant variation in health literacy and low health literacy among nearly one fifth, with difficulties navigating the health care system being common. The findings underscore the necessity of developing tailored, person-centered, and health literacy responsive interventions to strengthen diabetes self-management and advance equity in health care access.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e69-e77"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Theory-Based Adolescent Health Literacy Intervention: A Case of Nepal.","authors":"Shanti Prasad Khanal, Chitra Bahadur Budhathoki, Bhimsen Devkota, Shyam Krishna Maharjan, Orkan Okan","doi":"10.3928/24748307-20260413-01","DOIUrl":"10.3928/24748307-20260413-01","url":null,"abstract":"<p><strong>Background: </strong>Evidence indicates a lack of school-based interventions targeting adolescents' health literacy. To date, no structured, theory-driven, Delphi-guided health literacy intervention has been designed for Nepalese adolescents.</p><p><strong>Objective: </strong>This study aims to report the systematic development of a context-specific intervention to enhance adolescent health literacy and health-promoting actions.</p><p><strong>Methods: </strong>Using a concurrent mixed-methods design and a comprehensive health literacy model, the research involved 501 9th grade students from four randomly selected community schools in Birendranagar Municipality, Surkhet District, as well as their health and physical education teachers (HPE) and school nurses. Quantitative data were collected using self-administered standardized questionnaires measuring health literacy, self-efficacy, perceived social support, school environment, community environment, and health-promoting actions. Qualitative data were obtained through focus group discussions with students and key informant interviews with HPE teachers and school nurses.</p><p><strong>Key results: </strong>The intervention design process followed the fundamental steps of the intervention mapping approach. After engaging with the school through formal and informal means, health literacy needs were identified and prioritized. Goals were then set, focusing on the individual and interpersonal levels. Next, all components of the intervention, including objectives, content, facilitators, methods, materials, modes, and evaluation techniques, were refined through a two-round modified Delphi process, resulting in the first draft. This draft was discussed with students, teachers, and school nurses before finalizing. The completed intervention, consisting of 13 sessions, is designed to be implemented by nine interdisciplinary facilitators using the SHOWED questioning framework (What do you see here? What is happening? How does this relate to our lives? Why does the problem exist? What can we do?).</p><p><strong>Conclusions: </strong>This article reports on an intervention development process, systematically using mixed methods and the Delphi process, to offer a replicable approach to enhance adolescent health literacy and health-promoting actions.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e117-e129"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toolkit Development for Plain-Language Communication in Team-Based Care.","authors":"Amy Kruger Howard, Elsie Stines, Everett Smith, Jill A Morgan","doi":"10.3928/24748307-20260410-01","DOIUrl":"10.3928/24748307-20260410-01","url":null,"abstract":"<p><p>Experts recommend incorporating health literacy into training to enhance providers' self-awareness and ability to implement these techniques, ultimately improving health outcomes. Interprofessional faculty developed training on plain language and health literacy as a social determinant of health. Clinical students participated in an asynchronous orientation, live educational sessions, and patient visits. Pre- and post-surveys assessed students' knowledge and attitudes toward health literacy and plain language. A faculty member collected unclarified jargon terms during each patient visit. Results were analyzed using descriptive statistics. Paired <i>t</i>-tests were performed for jargon use frequency and McNemar's test for knowledge scores. The purpose was to develop and pilot an interprofessional training program to improve students' knowledge and use of plain language communication in a pediatric ambulatory clinic. Fifty-five pharmacy, medicine, nursing, social work, physical therapy, and dentistry students participated. Composite knowledge scores about health literacy increased, <i>p</i> < .001. 93.3% of students understood how this course contributed to their professional development, and 81.6% rated live content as effective. The average number of unclarified jargon terms per visit decreased from 2.8 in week 1 to 2.4 in week 2. This study is a pilot of a real-world application that prioritizes patient-centered plain language and can be modeled in other clinical settings to support early exposure to health literacy concepts and enhance learners' knowledge.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e103-e107"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum for \"The Impact of Care Delivered Through the Self-Management Promotion Model on Health Literacy Levels in Patients with Chronic Obstructive Pulmonary Disease: Quasi-Experimental Research\".","authors":"","doi":"10.3928/24748307-20260616-02","DOIUrl":"10.3928/24748307-20260616-02","url":null,"abstract":"","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e91"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Sexual Health Literacy Scale for Young Adults and Adults.","authors":"Vasfiye Bayram Değer, Hıdır Apak, Kadriye Olğaç Ak, Nilay Filoğlu","doi":"10.3928/24748307-20260409-01","DOIUrl":"10.3928/24748307-20260409-01","url":null,"abstract":"<p><strong>Background: </strong>Cultural norms, taboos, and insufficient education are among the significant barriers to individuals' access to sexual health information. In some societies, sexual health education may be inadequate, which can lead to unhealthy sexual behaviors due to low levels of sexual health literacy. Moreover, individuals often experience difficulties in accessing, understanding, and utilizing reliable information. These factors underline the critical need for context-specific, reliable, and valid tools to measure sexual health literacy. Therefore, there is a need for the development of a culturally appropriate sexual health literacy scale tailored to the specific characteristics of the target population.</p><p><strong>Objectives: </strong>This quantitative study aimed to develop a valid and reliable measurement tool to assess sexual health literacy levels among Turkish-speaking adults, addressing the gap in assessing individuals' ability to obtain, comprehend, and utilize sexual health information effectively.</p><p><strong>Methods: </strong>A pool of items was generated to measure sexual health literacy, followed by exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing. A total of 1,013 adult individuals participated in the study. It has been determined that the Sexual Health Literacy Scale for Adults consists of 17 items and three factors (knowledge, cognitive, and behavioral). The EFA was conducted with a sample of primarily young university students (age 18 to 25 years), while CFA involved a broader adult population. The scale demonstrated strong internal consistency reliability (Cronbach's alpha = .97).</p><p><strong>Key results: </strong>Structural analyses revealed that the scale consisted of 17 items and three factors. Reliability tests demonstrated strong internal consistency, with a Cronbach's alpha coefficient of .97.</p><p><strong>Conclusions: </strong>This study presents a valid and reliable measurement tool for assessing sexual health literacy in adults. The developed scale can be used in Türkiye to investigate sexual health literacy. Given the significance of the subject, it is recommended to determine sexual health literacy levels among various groups and expand sexual and reproductive health education. One limitation of the study is that the EFA sample consisted predominantly of university students, which may limit generalizability to the broader adult population.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e78-e90"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Functional Health Literacy Among Patients With Type-2 Diabetes in Bangladesh: A Cross-sectional Study.","authors":"Md Monirul Islam, Syed Billal Hossain, Kazi Mahfujur Rahman, Meheruba Khan Sinthia, A B M Alauddin Chowdhury, Salim Khan","doi":"10.3928/24748307-20260409-02","DOIUrl":"10.3928/24748307-20260409-02","url":null,"abstract":"<p><strong>Objective: </strong>Functional health literacy (FHL) plays a dynamic role in diabetes care, yet research on its implications is erratic in Bangladesh. The aim of this study was to ascertain the level of FHL among patients with type 2 diabetes (T2D) in Dhaka and its correlation with their glycemic level, lifestyle, sleep quality, and sociodemographic characteristics.</p><p><strong>Methods: </strong>A total of 401 patients with T2D were included by simple random sampling method in this cross-sectional study from three diabetes centers in Dhaka. A Bengali adaptation of the S-TOFHLA (Short Test of Functional Health Literacy) and a semi-structured questionnaire was used to collect data on FHL and other study information. Bivariate analysis, multi-nominal regression, Pearson's χ² test, and Cramér's V coefficient was used to assess the correlations between variables, with a significance threshold of <i>p</i> < .05.</p><p><strong>Key results: </strong>Among the 401 participants, 59% were female and 34.9% lived in rural areas; among whom only 27.3% had adequate FHL. Sex, occupation, education, income, physical activity regularity, diabetes treatment regimen, family history, current fasting blood sugar (FBS), 3-month average FBS, 3-month average 2-hour after breakfast blood glucose, and hemoglobin A1c showed significant associations (<i>p</i> < .0001) with the level of FHL. Higher education level significantly increased the odds for adequate FHL (adjusted odds ratios (AOR) = 5.70 to 78.81). Adequate FHL was significantly associated with higher sleep metrics (A<i>OR</i> = 5.67 and 9.17). Longer sleep duration and higher quality sleep increased the likelihood of having adequate FHL (A<i>OR</i> = 9.17 and 5.67, respectively; <i>p</i> < .05) and higher glucose levels were linked to reduced FHL odds (AOR <1).</p><p><strong>Conclusions: </strong>Higher FHL was associated with better diabetes management. FHL interventions should be evaluated to determine if increasing a patient's health literacy will improve their diabetes management.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 3","pages":"e92-e102"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Thematic Analysis Exploring Bowel Cancer Screening Promotional Visuals in the United Kingdom and India.","authors":"Ioanna Yfantidou, Marek Palace, Christian von Wagner, Sandro Stoffel, Carlos Santos Barea, Lee Smith, Brandon May, Meghna Srivastava, Jazzine Samuel","doi":"10.3928/24748307-20260304-01","DOIUrl":"10.3928/24748307-20260304-01","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this qualitative study is to explore and identify elements used in bowel cancer screening visuals that promote health literacy and participation in screening tests in the United Kingdom and India.</p><p><strong>Methods: </strong>A total of 17 participants from the United Kingdom and India took part in a thematic analysis study. Individuals were eligible for this study, if they were within the National Health Service bowel cancer screening target between ages 50 and 74 years. A total of 58 bowel cancer screening promotional images were presented to the participants, and they had to indicate whether they believed the image effectively encouraged participation in bowel cancer screening. Then, participants were invited for a remote interview to explore their verbal constructions of the bowel cancer screening images. The interview questions were designed to explore participants' preferences and aversions toward the visual elements used in promoting health literacy around bowel cancer screening.</p><p><strong>Key results: </strong>The findings highlight key visual features that resonate with the target audience and those that may hinder the effectiveness of screening messages. Encouraging elements include images of happy families, the portrayal of screening consequences, clear details about the screening process, and the inclusion of health care professionals. The study also underscores the importance of using both gain-framed and loss-framed messages. In contrast, discouraging elements, such as ambiguous images, such as pictures of toilets, and visuals evoking negative emotions, such as pictures showing internal organs, were identified as barriers to engagement. These visuals may confuse audiences or evoke feelings of disgust, which can deter individuals from participating in screening. The findings suggest that screening promotion materials should incorporate clear, informative visuals that directly relate to the screening process, such as test kits and health care professionals.</p><p><strong>Conclusions: </strong>The study provides practical recommendations for designing effective, culturally relevant promotional materials that balance informational content with emotional appeal, improving the likelihood of increasing bowel cancer screening uptake.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"10 2","pages":"e28-e38"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}