Evaluation of culturally sensitive educational video for informed screening decisions among migrants

Abstract Background In the Netherlands, especially Turkish- and Moroccan-Dutch women show low cervical cancer screening participation and limited informed decision-making in this regard. To meet the needs of these women, a culturally sensitive educational video was developed. The objective was to evaluate the effect of the video on informed decision-making regarding cervical cancer screening participation among Turkish and Moroccan women aged 30-60 years in the Netherlands. Methods Initial respondents were recruited via several social media platforms and invited to complete an online questionnaire. Following respondent-driven sampling, respondents were asked to recruit a number of peers from their social network to complete the same questionnaire. Respondents were randomly assigned to the control condition (current information brochure) or intervention condition (brochure and video). We evaluated the added effect of the video on knowledge, attitude, intention, and informed decision-making using intention-to-treat analyses. Results The final sample included 686 Turkish- and 878 Moroccan-Dutch women. Of this sample, 793 were randomised to the control group (350 Turkish and 443 Moroccan) and 771 to the intervention group (336 Turkish and 435 Moroccan). Among Turkish-Dutch women, 33.1% of the control respondents and 40.5% of the intervention respondents consulted the brochure (not statistically significant). Among Moroccan-Dutch women, these percentages were 28.2% and 37.9%, respectively (P = 0.003). Of all intervention respondents, 96.1% (Turkish) and 84.4% (Moroccan) consulted the video. The video resulted in more positive screening attitudes among Moroccan-Dutch women, in comparison to the brochure (74.3% versus 68.4%, P = 0.07). Conclusions Our short, easily implementable video resulted in more positive screening attitudes in Turkish- and Moroccan-Dutch women and can thus contribute to informed cervical cancer screening decisions. Key messages Audio-visual interventions lead to a greater reach and impact in informed decision-making among immigrant women, compared to the currently implemented textual information materials. Culturally sensitive educational videos, tailored to the needs of vulnerable populations, contribute to informed decision-making and participation in European preventive healthcare programmes.


Background:
Health literacy (HL) concerns the knowledge and competences of people to meet the complex demands of health in modern society. It is essential for health promotion, disease prevention and healthcare. Young adults can perform a very important role in taking a more active role in managing and protect their health, so this study aimed to identify the HL levels in the population of higher education students, according to the European Health Literacy Survey (HLS-EU-PT) and to evaluate its association with social and academic determinants.

Methods:
A quantitative, observational, and cross-sectional study was carried out based on an online survey disseminated in Portuguese universities. Data were analysed using binary logistic regression, adjusted for age, income, parents' education, gender, and chronic disease report.

Results:
In total, 4801 students were surveyed, 76% female. Of those, 44% revealed a problematic or inadequate level of HL. Those students with higher income levels (OR (95% CI), OR = 4.5 (3.4; 5.9) and whose parents had higher education levels (OR = 1.3(1.1; 1.5) had higher odds of achieving sufficient or excellent levels of HL, even after adjusting for confounders. In what concerns academic determinants, data revealed that HL tends to be sufficient or excellent among those students from health-related courses (OR = 2.0 (1.6; 2.5). In the subgroup of students from non-health-related courses, it was found that HL levels do not differ in 1st year and last year's students. However, in students from health-related courses, data revealed that a last yeaŕs students had higher odds of having sufficient or excellent HL levels compared to a 1st-year student (OR = 1.7 (1.4; 2.2).

Conclusions:
This study reveals low HL levels and addresses that socioeconomic and familiar context are determinants of HL in higher education students. Future intervention studies are needed, focused on these determinants so that adequate levels of HL are achieved in higher education students.

Background:
In the Netherlands, especially Turkish-and Moroccan-Dutch women show low cervical cancer screening participation and limited informed decision-making in this regard. To meet the needs of these women, a culturally sensitive educational video was developed. The objective was to evaluate the effect of the video on informed decision-making regarding cervical cancer 15th European Public Health Conference 2022 screening participation among Turkish and Moroccan women aged 30-60 years in the Netherlands. Methods: Initial respondents were recruited via several social media platforms and invited to complete an online questionnaire. Following respondent-driven sampling, respondents were asked to recruit a number of peers from their social network to complete the same questionnaire. Respondents were randomly assigned to the control condition (current information brochure) or intervention condition (brochure and video). We evaluated the added effect of the video on knowledge, attitude, intention, and informed decisionmaking using intention-to-treat analyses.

Results:
The final sample included 686 Turkish-and 878 Moroccan-Dutch women. Of this sample, 793 were randomised to the control group (350 Turkish and 443 Moroccan) and 771 to the intervention group (336 Turkish and 435 Moroccan). Among Turkish-Dutch women, 33.1% of the control respondents and 40.5% of the intervention respondents consulted the brochure (not statistically significant). Among Moroccan-Dutch women, these percentages were 28.2% and 37.9%, respectively (P = 0.003). Of all intervention respondents, 96.1% (Turkish) and 84.4% (Moroccan) consulted the video. The video resulted in more positive screening attitudes among Moroccan-Dutch women, in comparison to the brochure (74.3% versus 68.4%, P = 0.07).

Conclusions:
Our short, easily implementable video resulted in more positive screening attitudes in Turkish-and Moroccan-Dutch women and can thus contribute to informed cervical cancer screening decisions.

Key messages:
Audio-visual interventions lead to a greater reach and impact in informed decision-making among immigrant women, compared to the currently implemented textual information materials. Culturally sensitive educational videos, tailored to the needs of vulnerable populations, contribute to informed decisionmaking and participation in European preventive healthcare programmes.

Background:
Many community-based interventions have been developed to increase parent/caregiver health literacy, yet no systematic review of their effectiveness has been published. Therefore, the aim of this systematic review was to examine the effectiveness of community-based health literacy interventions in improving the health literacy of parents/caregivers.

Methods:
A systematic review of six databases; MEDLINE, PsycINFO, CINAHL, Cochrane Library, Embase, and Education Source were conducted to identify relevant articles. Risk of bias were assessed using version two of the Cochrane risk of bias tool for randomised controlled trials or the Cochrane Collaboration Risk of Bias in Non-Randomised Studies of Interventions. The study findings were grouped and synthesised following the Synthesis Without Meta-analysis framework.

Results:
Eleven community-based health literacy interventions for parents/caregivers were identified. Study design included randomised controlled trials (n = 4), non-randomised studies with comparison group (n = 4), and non-randomised studies without a comparison group (n = 3). Interventions were delivered digitally, in person or a combination of the two. The main findings of the studies showed some potential for both in person and digital interventions to increase parental health literacy. The risk of bias was high in over half the studies (n = 7) Studies were heterogeneous preventing a metaanalysis.

Discussion:
Although no definitive conclusion of the effectiveness of community-based interventions can be drawn there are suggestions of improvement in many of the studies included in this review. The review has brought into question whether the health literacy measurement tools used met the needs of assessing the interventions outcomes. When comparing the cost and resources needed for digital with in person interventions, the findings of this review have implications for both practise and research. Key messages: Methodologically stronger primary research, informed by theory, is needed to capture the components of effective health literacy intervention for parents. Researchers in the field of health literacy need to consider the suitability of using screening tools to measure change in health literacy post intervention.