Longitudinal relationships between youth assets, seat belt use as a rider, and the environment

Abstract Background Positive youth development theory can provide an alternative approach to promote Seat Belt Use while Riding in a Car (SBURC) among youth. The study aims to explore the relationship between youth assets, and the neighborhood environment in predicting SBURC. Methods The Youth Asset Study (YAS) is a 4-year (5 waves) longitudinal study of a random sample of 1,111 youth (12-17 years old) and their parents, taking place in a Midwestern city, USA from 2003-2008. Seventeen youth assets were developed. The environment was measured objectively via the broken windows survey and subjectively via parents’ interviews. Assets and environmental factors at Waves 1-4 predicted SBURC at Waves 4-5 while controlling for demographics. Data were analyzed via marginal logistic regression and generalized estimated equations analyses. Results The sample consisted of 1001 youth: 53% female; mean age=14.36 (SD = 1.59); 50% with income <$35,000; and 69% two-parent families. The proportion of youth not wearing a seat belt while riding in a car decreased from wave 4 to 5 among all youth. Individually, most assets had a positive relationship with SBURC (ORs ranged from 1.4 to 2.0), with parental monitoring, responsible choices, general aspirations for the future and good health practices having the largest ORs [2.0, 95% CI (1.5, 2.7); 1.9, 95% CI (1.5, 2.6); 1.8, 95% CI (1.2,2.8); 1.8, 95% CI (1.5,2.3)] respectively. Youth with a higher (≥ 12) number of assets were almost twice as likely to use a SBURC than those with a lower (<12) number [OR = 1.9, 95% CI (1.5, 2.3)]. Only one environmental factor, had a significant effect on SBURC [(OR = 0.64, 95% CI (0.45, 0.90)]. Assets retained their impact on SBURC, controlling for the environmental and demographic factors. Conclusions Youth assets can be an alternative approach to promote SBURC among teens with emphasis on promoting parental monitoring, responsible choices, general aspirations for the future, and good health practices. Key messages • Building youth assets can be another mechanism to promote seat belt use while driving among youth. • The neighborhood environment might not be as important as other factors are in the promotion of seat belt use while driving.

Cancer services were negatively affected due to the Covid-19 pandemic and will have likely delayed early detection and diagnosis. The Irish Cancer Society (ICS) planned and delivered a number of cancer roadshow events in 4 deprived regions in Ireland to address improvements in awareness of cancer signs, importance of screening, positive lifestyle changes and encourage medical care-seeking behaviour. Health checks (blood pressure, BMI & CO2 monitoring) and motivational interviews were carried out by ICS nurses and trained ICS volunteers. Data was collected via anonymous questionnaire from participants and volunteers. SPSS was used for analysis. 98 people (54 male, 44 female) participated; 87.7% found the information provided useful, 84.7% approved of the health check and 72.5% stated that they would likely make changes to their current lifestyle to reduce their cancer risk. Moderate/ high understanding of cancer signs and symptoms and moderate/high awareness of cancer risk factors both rose post event (from 62.2% to 81.6% (p < 0.001) and from 49% to 61.2% (p < 0.001) respectively). If symptomatic for cancer 77.6% of participants would likely visit their GP and 73.5% would likely contact ICS. Younger people (aged 40 years) were more likely to consider consulting a healthcare professional if symptomatic (p = 0.027) and to contact the ICS (p = 0.007) for more information. High numbers of participants (98.9%) and volunteers (95.2%) recommended a nationwide roll out. Volunteers reported moderate/high levels of public engagement; the most common topics discussed were own treatment experience, cancer screening, information on making lifestyle changes and ICS services. Volunteers reported the need for more training and improvements to some organisational aspects. More rigorous cancer health promotion programmes are required to counter disrupted cancer services. Our results suggest such cancer roadshow events are both feasible and beneficial at this time post pandemic. Key messages: Health literacy is continuous process to achieve positive health outcomes.
Reaching out to people in different setting is acceptable and potentially effective.

Background:
As migration affects health, migrants need context-appropriate health literacy (HL) to maintain and promote health. Possible venues to improve HL are adult education programs, i.e., language courses (LC). However, empirical evidence on these courses and their contribution to HL is scarce. Moreover, general HL recommendations and conceptually developed HL programs often proved unsuitable in practice as they insufficiently incorporate the multiple influences. This paper's purpose is to show, using key findings, how ethnographic research can contribute to developing appropriate programs and how the transfer from research to practice can succeed.

Methods:
The SCURA project conducted extensive ethnographic research on HL in second LC, i.e., 100 h participant observation in 2 classes, 40 teacher interviews, analysis of 24 textbooks, and teacher training. On this basis, we designed programs and drew lessons from comparison with other programs.

Results:
The study revealed that health and HL as a situational social practice play a key role in LC e.g., as prerequisites for attendance and learning, part of the syllabus, and an occasion for informal conversations. Multiple concepts of health and HL coexist and influence HL promotion. Besides the setting and course conditions, teachers strongly shape HL activities and students show varying degrees of HL practice. We exposed the complexity and diversity of HL situations, meaningmaking processes, strategies to acquire and promote HL, and actual space of action. Then, we developed participatory practicable approaches to promote HL in the educational offer. Compared to other programs, the ethnographic study allowed us to address the major factors, tap into the actual space of action, and increase acceptance, uptake, and sustainability.

Conclusions:
Improving HL in existing offers requires a profound understanding of the logic of the field. Ethnographic studies facilitate describing these peculiarities and tailoring interventions.

Problem:
Migration is a global phenomenon, and migrants face myriad challenges, e.g., building context-specific health literacy (HL).
To sustainably promote HL, translations, interpreters, or programs in other languages are insufficient. Courses that promote HL holistically are needed, e.g., second language courses. In the SCURA research project, part of the HLCA Consortium, we ethnographically studied language courses and developed interventions. The insights gained are relevant not only for courses promoting HL of migrants or in Germany but also for other target groups and countries.

Description:
Based on extensive ethnographic research, we participatory created interventions to promote HL. As language courses promote HL to varying degrees but are severely limited by the rigid conditions and support, we identified strategies to improve HL therein and ensure uptake and sustainability: add-in, pimp-up, dive deeper. The multimodal intervention consists of an extensive collection of teaching ideas, materials to prepare and reflect on sessions, and a 6-part teacher training (in-house, online, and self-study course, based on adult learning principles). The 90-minutes sessions address Health in Language Courses, Health and Me, Using materials, Critically Analyzing Materials and Developing Empowering Activities, Promoting Family HL, and Mental HL. A hands-on tool was developed to help teachers intentionally promote the seven components of HL.

Results:
The preliminary results of the ongoing evaluation showed that the flexibly adaptable and applicable offerings, the online workshop, and self-study courses, were well received. The teachers liked the choice of topics and the combination of short inputs and many recommendations for practice.