Sandra Vamos

To explore health literacy (HL) experiences, needs, and future training directions among college students enrolled in health-related degree programs during the COVID-19 pandemic.Students (n = 169) ...

BACKGROUND: Food literacy, a sub‐area of health literacy, is achieving attention in schools, academia, research, health care, businesses, and governments worldwide. Against the current COVID‐19 pandemic backdrop, the relevance of food literacy's interconnected attributes such as nutritional knowledge, food skills, and food environment is gaining traction. Enhancing health and food literacy in the K‐12 school environment are important empowerment tools with the potential to reduce health inequalities as vulnerable people are at risk of limited health literacy.METHODS: We aim to clarify the meaning of food literacy and its relationship to health literacy and other factors influencing eating behavior.RESULTS: We offer a proposed conceptual model depicting connections between relevant theories and constructs in the field of health and nutrition. Concrete actions are offered that contemporary schools can take guided by the utility of the model.CONCLUSIONS: This visual can help guide schools' multidimensional health and food literacy efforts while considering the realities of the current COVID‐19 pandemic context and beyond. This model will provide an overarching reference for schools to consider key constructs to support practice, research, policy, and intervention efforts to advance their health and food literacy agendas.

BACKGROUND: The relationship between health and learning generally goes without question in developed countries, and has a philosophic, economic, and statutory basis. Historically, school health and school health education have evolved in response to addressing the public health needs of the times. Health literacy skills are more important now than ever. Living in an ongoing COVID‐19 global pandemic reminds us of the vital role of being in control of our health, wherein health literacy plays a “life or death” role in our daily lives.METHODS: Considering the evolution of school health education, we examine the significance of health literacy in our society and schools in contemporary times.RESULTS: We must take a critical look at a place for education for health literacy and why it should be an innovative path in adaptive, reimagined, and revitalized schools.CONCLUSIONS: It is time to rebrand school health in general, and school health education specifically. Improved health literacy is an asset leading to greater opportunities for health and life‐long learning.

BACKGROUND: Branding involves “labeling” (for identification) and “meaning” (for understanding) to a product, service, person, idea, or other entity. We are familiar with “brands” of soft drinks, automobiles, mobile phones, soups, cigarettes, and sports teams, and some brands have greater “market share” than others.METHODS: In this commentary, we review some of the ways that school health has been branded over the past 50+ years.RESULTS: The brand we know as school health education has failed to compete successfully with other school subject areas (eg, the so‐called STEM subjects) for the attention of school board members, administrators, legislators, and other policymakers. Perhaps more importantly, school health education advocates have lost the market share game to subject areas that school board members and legislators see as ones with better return on investment, at least politically speaking. In short, we have failed to make the sale.CONCLUSION: An alternative is to re‐brand and re‐frame school health education as education for health literacy. Literacy as a brand commands the attention of education gatekeepers, and may be more strongly related conceptually to what gatekeepers see as education‐centric programs deserving of funding. Adopting a marketing mindset may elevate education for health literacy to a place where key stakeholders are more likely to “purchase” it as a relevant school “product.”

The Conceptual Model Map (CMM) presented here is intended to show the connections between different theories and constructs in the field of health and nutrition behavior (including literacy models, the knowledge–attitude(s)–practice(s) survey structure (KAP), behavior change theories, and Maslow’s pyramid of needs). The CMM can be used as a map to locate existing and future studies, to show their range of effect as well as their limitations. In this context, the CMM also reveals reasons for the attitude/intention–behavior gap.

As we write our editorial for a health literacy special issue in the midst of the international COVID-19 crisis, we take this opportunity to highlight the importance of individual, community, and population health literacy. We are not only in a “pandemic” but also an “infodemic”. Health literacy is more important than ever in the face of these global health threats, which have impacted outcomes across the levels of the socio-ecological model (SEM), including individual health behaviors, family relationships, organizational behavior, state policy-making, national mortality statistics, and the international economy in the span of weeks. Our special issue sought to pull together interdisciplinary threads guided by two principles. The first was defining health literacy as essential skills and situational resources needed for people to find, understand, evaluate, communicate, and use information and services in a variety of forms across various settings throughout their life course to promote health and wellbeing. The second was the idea that enhancing health literacy in populations and systems is critical to achieving health equity. In this time of public health need across traditional borders, the inter-sectoral and international perspectives of special issue articles are more urgent than ever. A greater understanding, appreciation, and application of health literacy can support policy action on multiple levels to address major public health challenges. Health literacy should be built deliberately as a population-level resource and community asset. We have summarized the set of articles in this special issue across the levels of the SEM, hoping their thoughtful considerations and interesting findings will help to support global health and wellness and inspire future research, policy, and practice in this global public health emergency and beyond.

In many countries, health literacy research, practice, and policy have been moving away from a focus only on medical care and health-care settings to a much broader conceptualization. In this broader perspective, health literacy can be obtained and used across many other settings (e.g., school, home, workplaces, government) towards achieving health and wellness goals across the life-course for individuals, families, and communities. The education sector is a critical domain towards these achievements and education for health literacy is a fundamental process and outcome. This can help towards important public health goals, including critical health literacy, as oriented not only towards individual actions, but also towards supporting effective social and political action. This Perspective Article describes the importance and utility of the education for health literacy perspective, which, follows a view that health literacy is a key outcome of health education from which improved population health, health promotion and disease prevention could be achieved across diverse contexts. We first describe different educational paradigms to address health literacy and clarify the education for health literacy perspective as a supportive, instructional and capacity-building global resource across the life-course. Then, using specific examples from Canada, America, and Germany, we provide a snapshot of the diverse ways in which the education for health literacy perspective can be found in national policies. These include broad national goals and standards (Germany and Canada) and major health care reform (America). We next consider the tensions and gaps that can arise in the translation and implementation of these policies relative to the ideal education for health literacy perspective, especially related to equity. These include the need for funding, goals of the educational system, and limited evaluation of policy in practice. Finally, we highlight strategic opportunities to achieve education for health literacy and equity especially offering examples from innovative practice in Canada across the lifespan.

BACKGROUND: In this study, we explore how a health education course may play a role in pre‐service teachers' perceptions in teaching and integrating health education activities to nurture K‐8 students' health literacy.METHODS: We used mixed methods to examine the effect of a health education course in a teacher education program. Of 55 pre‐service teachers, 41voluntarily participated in the study. Quantitative data were obtained through an online questionnaire administered to participants at the beginning and end of the course. We conducted 6 focus groups at the end of the course.RESULTS: The inferential analysis from a series of analysis of variance with repeated measures revealed significant differences in health knowledge (F = 113.39, p < .01, η² = 0.74), preparedness (F = 104.74, p < .01, η² = 0.73), attitudes (F = 15.02, p < .01, η² = 0.28), and beliefs (F = 8.87, p < .01, η² = 0.19) between time points. Qualitative data led to the conclusion that where one health education course is insufficient, such a course is the first step into future curriculum development and implementation.CONCLUSION: One health education course might be beneficial for general education teachers to increase their knowledge and preparation to teaching school health. On‐going training is needed for program success.