Health Promotion International最新文献

{"title":"Reconciliation or reputation: critical analysis of commercial sector commitments and framing in reconciliation action plans.","authors":"Petrina Leersen, Bronwyn Fredericks, Andrew D Brown, Jennifer Browne, Yin Paradies","doi":"10.1093/heapro/daag061","DOIUrl":"10.1093/heapro/daag061","url":null,"abstract":"<p><p>Reconciliation action plans (RAPs) are increasingly used by commercial organizations in Australia to demonstrate commitment to Aboriginal and Torres Strait Islander peoples. Framed as tools to promote understanding and address historical injustice, these documents also serve organizational interests, particularly in reputation management and corporate social responsibility (CSR). This research critically examined the structure, practices, portfolios, resources, and transparency of high-level RAPs of for-profit organizations operating in the state of Queensland, Australia. Drawing on frame analysis, critical discourse analysis (CDA), and commercial determinants of health frameworks, this study explored how reconciliation and associated commitments are defined, justified, and operationalized within corporate discourse. The analysis showed that resource-rich corporations leveraged their power to manage reconciliation as a corporate asset rather than address structural inequities. Five overlapping frames, 'instrumental reconciliation, performative accountability, symbolic leadership, truth signalling, and substantive recognition', were identified through which reconciliation is positioned within corporate discourse of legitimacy, measurement, and control. While many organizations adopt languages of codesign, self-determination, and cultural safety, translation into demonstrable processes and measurable outcomes remains inconsistent and limited. These findings highlight how RAPs can both provide entry points for engagement while simultaneously reinforcing existing power relations. The research contributes to understanding the commercial determinants influencing Aboriginal and Torres Strait Islander health and wellbeing, calling for stronger accountability, transparency, and Aboriginal and Torres Strait Islander leadership within corporate reconciliation agendas.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International consensus on school health literacy responsiveness: findings from a modified Delphi process.","authors":"Teresa Cheng-Chieh Chu, Shandell Elmer, Vaughan Cruickshank, Louisa R Peralta, Rebecca K Kelly, Rosie Nash","doi":"10.1093/heapro/daag060","DOIUrl":"10.1093/heapro/daag060","url":null,"abstract":"<p><p>There is a lack of validated tools to assess health literacy responsiveness, defined as the organizational capacity of schools to create accessible and equitable environments that support health literacy development, in school settings internationally. This study, the second phase of a three-part research program, aimed to develop a school-based health literacy assessment tool through a systematic, multi-step development process. Building on a prior scoping review that identified 629 items from existing tools, 210 refined items were presented to 22 international experts via a modified Delphi survey. Experts rated relevance, domain fit, and need for revision. Consensus, derived from qualitative analysis of expert feedback, revealed 47 items as highly important, 119 as potentially relevant, and 44 as unsuitable for schools. Expert feedback informed conceptualization of organizational health literacy in schools. The items reflect practical considerations, cross-national, and multidisciplinary perspectives. Findings highlight strong support for domains such as communication, engagement, and workforce development. The next phase includes pilot testing and validation to support implementation of a tool to promote health literacy among students, teachers, and leaders.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a patient reported measure on out-of-pocket healthcare expenditure among Aboriginal patients: a formative study.","authors":"Courtney Ryder, Patrick Sharpe, Georga Sallows, Julieann Coombes, Ray Mahoney, Andrew Goodman, Jaquelyne T Hughes, Jessie Sleep, Talia Johnson, Odette Pearson, Candice Oster, Jonathan Karnon, Claire Drummond, Shanti Omodei-James, Lavender Otieno, Pip Henderson, Shane D'Angelo, Nayia Cominos, Billie Bonevski","doi":"10.1093/heapro/daag058","DOIUrl":"https://doi.org/10.1093/heapro/daag058","url":null,"abstract":"<p><p>Healthcare costs not subsidized by the government and are covered by patients, are known as out-of-pocket healthcare expenditure (OOPHE). In Australia, OOPHE disproportionately impacts Aboriginal households, particularly in rural and remote regions. Currently no patient reported measures (PRM) to assess OOPHE exist, despite being an identified priority in Aboriginal communities. This study developed and psychometrically evaluated (validity and test-retest reliability) of an OOPHE PRM for Aboriginal households in outer regional to remote areas. This Aboriginal led study was governed by an Aboriginal Governance Group, which involved a 4-stage process: (i) identification of community-derived OOPHE themes; (ii) item development and expert judgment quantification; (iii) exploratory factor analysis (EFA) to determine factor structure through pilot testing with Aboriginal participants; and (iv) assessment of reliability and stability through test-retest methods. Stage 1 identified OOPHE themes (i.e. barriers, financial strain), informing development of a 15 item PRM in Stage 2. In Stage 3, 39 Aboriginal participants completed Test 1, with EFA revealing a two-factor model; Factor 1 (8 items, internal consistency = 0.91) and Factor 2 (6 items, internal consistency = 0.85). In Stage 4, 32 participants completed Test 2, with over 60% of items showing substantial to perfect agreement (κ = 0.61-0.87) and scale-level reliability as good to excellent (ICC = 0.75-0.92). Two items performed poorly and were removed, resulting in a final 13-item PRM. The OOPHE PRM demonstrates promising psychometric properties as a culturally grounded measure of OOPHE burden among Aboriginal families, supporting advocacy for equitable policy, funding, and health system reform.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How participation in health promotion affects peer-experts and experts-by-experience from vulnerable neighborhoods: a case study from The Netherlands.","authors":"Samantha Elkhuizen, Bente van Aken, Emma Stulen, Dagmar Niewold, Annemarie Wagemakers, Kristina Thompson","doi":"10.1093/heapro/daag035","DOIUrl":"10.1093/heapro/daag035","url":null,"abstract":"<p><p>Residents of vulnerable neighborhoods often experience economic hardship, poor health, and social exclusion. Health promotion in vulnerable neighborhoods is often unsuccessful due to residents' mistrust toward professionals and governmental institutions and misaligned interventions. Engaging experts-by-experience and peer-experts, people drawing on lived experience to support others, offers a promising means to overcome these hurdles. While this approach is gaining ground in the social domain, little is known about its impact on the experts themselves. Therefore, this study addresses the question: \"What is the impact of being an expert-by-experience or peer-expert within the social domain on the expert-by-experience and peer-experts themselves?\" Using Participatory Action Research, we conducted seventeen participatory observations and nine semi-structured interviews with two peer-experts, one expert-by-experience, and nine professionals in a Dutch city. A reflexive thematic analysis identified four impacts of the expert-by-experience and peer-expert role: (1) feeling connected-through mutual recognition and community engagement; (2) feeling valued-by contributing meaningfully and being respected; (3) personal growth-gaining self-reflection, self-acceptance, and self-confidence; and (4) acquiring transferable skills and future prospects-such as language skills, boundary-setting, and employment opportunities. Challenges included balancing pressures associated with role identity, financial insecurity, and boundary-setting. We conclude that, working as an expert-by-experience and peer-expert offers personal benefits, but also presents risks without adequate support. Reciprocal learning between peer-experts, as well as supportive environments, and focus on financial security are needed to ensure sustainability. Ultimately, integrating experiential knowledge may help health promotion initiatives building trust, address health inequities, and achieve lasting impact in vulnerable neighborhoods.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calling for a more coherent policy response to driving harm.","authors":"Kate Gray, Grant Ennis, Greg Fell","doi":"10.1093/heapro/daag026","DOIUrl":"10.1093/heapro/daag026","url":null,"abstract":"<p><p>High rates of population-level driving are associated with multiple adverse health outcomes arising from road crashes, air and noise pollution, physical inactivity, global warming, and social and economic isolation. However, population-level driving is not widely treated as a public health issue, and efforts to reduce driving harms focus on lowering the prevalence of specific high-risk behaviours and exposures (e.g. speeding or drink-driving), not on reducing overall levels of population-driving itself. Silence on driving harms pervades because driving and cars have become deeply embedded in our surroundings, in our policies, and in our social fabric. Urban planning approaches prioritize mobility over access, and the ever-increasing road capacity, combined with underinvestment in walking and sustainable transport, has made society car dependent. Thanks to the influence of the road lobby, the harms of driving are underestimated and overlooked, while measures that make walking, cycling, and public transport the easiest option are viewed with suspicion. Policy responses to reducing population-level driving, as measured by vehicle kilometres travelled per capita and relative mode share, can create positive change. Efforts should focus on (i) improving population-level accessibility-by ensuring shops, schools, and public facilities are close to where people live and work; (ii) making walking and cycling possible and desirable; (iii) realigning incentives for transport so that walking, cycling, and public transport are cheaper and easier than driving; and (iv) communicating effectively and deliberately about transport, health, and happiness.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of health literacy for Global Health and One Health: nurturing the socioecological environment of schools.","authors":"Orkan Okan, Andrea S Winkler","doi":"10.1093/heapro/daag036","DOIUrl":"10.1093/heapro/daag036","url":null,"abstract":"<p><p>This perspective examines health literacy through a One Health lens, emphasizing its relevance for developing One Health-literate citizens, as advocated by the Lancet One Health Commission's recommendation on school health literacy. It argues for a comprehensive understanding of health literacy across the socioecological continuum, integrating both individual agency and structural influences. Rather than viewing low health literacy as an individual deficiency, this perspective situates it within broader systemic and contextual factors, particularly pertinent to low- and middle-income countries and underserved populations. Building on this premise, the Health-Literate School (HeLit-School) framework offers a whole-of-school approach to advancing health literacy by embedding the concept of organizational health literacy within school systems. Drawing on socioecological and organizational development principles, HeLit-School fosters institutional transformation across all levels of school development, supporting the implementation of holistic, multi-level interventions to enhance health literacy in the school setting. It highlights the critical roles of principals and the importance of adequate resources as structural enablers of sustainable health promotion within educational settings. This perspective calls for integrating agency-based, behavioural approaches with structural, determinant-oriented strategies to strengthen both personal and organizational health literacy in schools. Aligning One Health principles with the HeLit-School framework helps bridge the behavioural and environmental determinants of health. The proposed adaptation of HeLit-Schools for One Health and its contextualization in low- and middle-income countries illustrate how upstream, setting-based interventions can support systemic capacity-building and the formation of health-literate students, educators, and policymakers in relation to One Health.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging youth in systems thinking for active recreation: piloting a Collective Intelligence approach.","authors":"Jiani Ma, David Cao, Michael Hogan, Kristy A Bolton, Jo Salmon, Maja Vilhelmsen, Harriet Koorts","doi":"10.1093/heapro/daag049","DOIUrl":"10.1093/heapro/daag049","url":null,"abstract":"<p><p>Youth active recreation is influenced by complex interactions among factors in the active recreation system. Systems approaches can help identify ways to intervene; however, young people are rarely involved in this process. This study piloted the use of Collective Intelligence (CI), a participatory systems approach, to engage young people in identifying barriers to active recreation and co-creating solutions. Three CI workshops were conducted in Victoria, Australia, involving nine participants aged 12-17. In each workshop, participants generated and prioritized barriers, co-created systems maps, and collaboratively designed solutions aligned to the mapped systems. Field notes captured reflections on facilitation and youth engagement. Across workshops, 48 barriers were identified and grouped into eight categories: Shyness and social skills, Lack of support, Financial, Time, Space and equipment, Public Transport, Safety, and Medical. Participants then co-created solutions across individual (n = 5), community (n = 11), and government (n = 5) levels. Individual-level strategies focused on enhancing social skills; community-level ideas focused on public transport and inclusive spaces; Government actions included subsidies for extracurricular activities. Reflections highlight the value of CI to engage young people in articulating interconnected influences in their lived experience with active recreation. Key strengths of the process included making complexity visible and actionable. Challenges included uncertainty of upstream issues, uneven participant engagement, conflation of terms, and maintaining focus. This study offers actionable strategies to potentially overcome these challenges for anyone who wants to engage young people in systems thinking. The inclusion of a youth researcher was valuable in supporting young people to contribute their ideas.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Australia's proposed gambling reforms may be good for industry, but not for public health.","authors":"Samantha Thomas, Hannah Pitt, Simone McCarthy, Monique Murray, Mike Daube","doi":"10.1093/heapro/daag057","DOIUrl":"https://doi.org/10.1093/heapro/daag057","url":null,"abstract":"","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating food security systems change in regional Australia through a strengths-based, co-design process.","authors":"Isabelle Chiera, Jess Doe, Melissa Stoneham, Amanda Devine, Stephanie L Godrich","doi":"10.1093/heapro/daag050","DOIUrl":"10.1093/heapro/daag050","url":null,"abstract":"<p><p>Food security is a multifaceted, 'wicked' issue that refers to the sufficient physical, social, and economic access to food at all times. Given its complexity, food security action requires a systems-based, collaborative, and adaptive approach. This paper outlines the application of a strengths-based, co-design process to support food security systems change among government and community-led initiatives operating in rural, regional, and remote areas of Western Australia. Baseline, semistructured interviews were conducted with leaders of food initiatives to understand whether and how the initiatives were contributing to food security systems change and identify the 'windows of opportunity' where initiatives could be strengthened. Participants co-designed actions to address the 'windows of opportunity' and enhance their initiatives. Six months after the co-design process, follow-up interviews were conducted to understand which actions had been implemented. Interview data were analysed thematically using NVivo. Twenty-seven initiative leaders co-designed an action plan, which included 244 actions in total. Based on the 10 six-month follow-up interviews that were conducted, 28 actions were implemented across nine initiatives. Initiative leaders were most likely to implement actions that required fewer resources and could leverage existing activities in comparison to actions that required collaborating or engaging with government representatives. To enhance food security systems change, initiative leaders require support to undertake actions related to government advocacy and collaborating with government organizations.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease risk reduction interventions for indigenous women: an umbrella review.","authors":"Tabassum Rahman, Amie Bingham, Melinda J Carrington, Richard Chenhall, Francine Eades, Grace Joshy, Emily Banks, Sandra Eades","doi":"10.1093/heapro/daag051","DOIUrl":"10.1093/heapro/daag051","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) prevention strategies are predominantly informed by studies conducted in men from the general population, which can disadvantage women-particularly Indigenous women-whose CVD needs differ in terms of symptom presentation, healthcare access, receipt of guideline-recommended care and sociocultural roles. This review aims to summarize the effectiveness of CVD prevention interventions in Indigenous women in the USA, Canada, New Zealand and Australia. Umbrella review of systematic reviews and randomized and non-randomized interventions examines the effectiveness of pharmacological and nonpharmacological interventions in reducing CVD risk in target countries in Indigenous adult studies with ≥50% women. Systematic searches were conducted across six electronic databases between January and February 2024 (update: February 2025). Quality assessment applied standard methods and evidence was synthesized qualitatively. The protocol was PROSPERO registered (CRD42024575310). Six systematic reviews and 16 primary studies (7 randomized and 9 non-randomized; 11,473 participants; 50%-100% women) in Indigenous participants were included. Evidence was limited and generally of low certainty. Four randomized studies were exclusively in Indigenous women (Australia and USA). Only one pharmacological study was identified, investigating vitamin D in reducing blood pressure. Non-pharmacological interventions demonstrated potential to improve CVD risk factors, primarily adiposity, blood pressure, lipids, and glucose. Participant involvement was generally limited and continuation was problematic. This first umbrella review on CVD risk reduction in Indigenous women suggests an urgent need for high-quality evidence to inform and make CVD prevention accessible and equitable for them. Future studies should employ consumer-led, innovative, and context-specific strategies to ensure inclusive recruitment and sustain participant engagement.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"41 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}