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- Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related FactorsPublication . Costa, Andreia; Feteira-Santos, Rodrigo; Alarcão, Violeta; Henriques, Maria Adriana; Madeira, Teresa; Virgolino, Ana; Arriaga, Miguel; Nogueira, PauloAlthough the health literacy level of the general population was described recently, little is known about its specific levels among older adults in Portugal. Therefore, this cross-sectional study aimed to investigate the levels of health literacy demonstrated by older adults in Portugal and explore associated factors. Using a randomly generated list of telephone numbers, adults aged 65 years or more living in mainland Portugal were contacted in September and October 2022. Sociodemographic, health and healthcare-related variables were collected, and the 12-item version of the European Health Literacy Survey Project 2019–2021 was used to measure health literacy. Then, binary logistic regression models were used to investigate factors associated with limited general health literacy. In total, 613 participants were surveyed. The mean level of general health literacy was (59.15 ± 13.05; n = 563), whereas health promotion (65.82 ± 13.19; n = 568) and appraising health information (65.16 ± 13.26; n = 517) were the highest scores in the health literacy domain and the dimension of health information processing, respectively. Overall, 80.6% of respondents revealed limited general health literacy, which was positively associated with living in a difficult household financial situation (4.17; 95% Confidence Interval (CI): 1.64–10.57), perceiving one’s own health status as poorer (7.12; 95% CI: 2.02–25.09), and having a fair opinion about a recent interaction with primary healthcare services (2.75; 95% CI: 1.46–5.19). The proportion of older adults with limited general health literacy in Portugal is significant. This result should be considered to inform health planning according to the health literacy gap of older adults in Portugal
- Effectiveness of Social Prescribing Programs in the PrimaryHealth-Care Context:Publication . Costa, Andreia; Sousa, Carla Joana; Seabra, Paulo; Virgolino, Ana; Santos, Osvaldo; Lopes, Joaquim Manuel de Oliveira; Henriques, Maria Adriana; Nogueira, Paulo; Alarcão, VioletaSocial prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.
- Active aging awareness and well-being among older adults in PortugalPublication . Costa, Andreia; Henriques, Joana; Alarcão, Violeta; Henriques, Maria Adriana; Madeira, Teresa; Virgolino, Ana; Sousa, Joana; Santos, Rodrigo Feiteira; Arriaga, Miguel; Rocha, Jorge; Nogueira, PauloObjective: This study aims to assess the active aging awareness of older adults in mainland Portugal and their levels of overall well-being and to identify social and health-related factors. Methods: A cross-sectional study was conducted with a representative sample of 613 older adults, aged 65 or older, who participated in the PROKnos – Knowing Social Prescribing needs of the elderly study in Portugal. The questionnaire consisted of the Active Ageing Awareness Questionnaire and the World Health Organization – Five Well-Being Index, as well as sociodemographic, economic, and health status questions. Correlation coefficients, t-tests for independent samples, and one-way ANOVA were used to explore potential associations between variables. Results: The active aging awareness levels were significantly higher for women (p = 0.031), and those who were younger (p = 0.011), more educated (p < 0.001), had a better financial situation (p < 0.001), and had better health (p < 0.001). The same pattern was found for well-being, except in relation to gender, as men had higher levels (p = 0.016). These variables were found to be correlated. Discussion: Even though active aging is an important strategy to implement, it is indispensable to consider the perceptions and conditions that need to be in place before that. This study reveals that several social and health-related factors are associated with well-being and active aging awareness, as well as the differences between groups that exist in mainland Portugal in relation to that. This emphasizes how vital it is to address social inequalities in active aging efforts, which are not necessarily uncovered when only considering actual active aging measures.
- The Effectiveness of eHealth Interventions in Promoting the Health Literacy of Informal Caregivers: A Systematic Literature Review ProtocolPublication . Valentim, Patrícia; Costa, Paulo; Henriques, Adriana; Costa, Andreia; Nogueira, PauloDigital Information and Communication Technologies (ICTs) offer significant opportunities to enhance public health, particularly through their strategic use in promoting health literacy. Objectives: This systematic review protocol aims to outline the methodological steps necessary to conduct a systematic review of the effectiveness of digital interventions in improving health literacy among informal caregivers. Methods: This review will include studies involving adult informal caregivers (≥18 years) undergoing a digital health intervention promoting health literacy. Intervention, effectiveness or efficacy, RCT, quasi-experimental, and observational studies will be eligible. This review will follow the methodology for Cochrane Systematic Review and Meta-Analysis. The search strategy will identify studies published in the databases SCOPUS and Web of Science, as well as CINAHL (via EBSCO) and PubMed and gray literature sources. Two in-dependent reviewers will screen the studies, extract data, and critically appraise the selected studies. It is planned that the risk of bias will be assessed using the RoB2, Newcastle-Ottawa Scale (NOS), and the ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions). From the included studies, data will be extracted on the identification of the study, the aim of the study, characteristics of the population, study method and intervention and control conditions, study variables, and significant results. Conclusions: It is anticipated that the results of the study will guide healthcare professionals and managers in incorporating digital technologies into health literacy programs for informal caregivers. Whenever possible, a statistical meta-analysis will be performed to combine study results. The PROSPERO registration number is CRD42024589465.
- Monthly Analysis of Infant Mortality Rate in Portugal during the COVID-19 Pandemic: Insights from Continuous MonitoringPublication . Nogueira, Paulo Jorge; Camarinha, Catarina; Feteira-Santos, Rodrigo; Costa, Andreia Silva; Nobre, Miguel de Araújo; Nicolau, Leonor Bacelar; Furtado, Cristina; Elias, CecíliaIntroduction: The COVID-19 pandemic significantly impacted global public health. Infant mortality rate (IMR), a vital statistic and key indicator of a population's overall health, is essential for developing effective health prevention programs. Existing evidence primarily indicates a decrease in IMR during the COVID-19 pandemic. We conducted a national-level analysis to calculate IMR and describe its course over the years (from 2016 until 2022), using a month-by-month analysis. Methods: Data on the number of deaths under one year of age was collected from the Portuguese E-Death Certification System (SICO), and data on the number of monthly live births was obtained from Statistics Portugal. The IMR was calculated per month, considering the previous 12 months' cumulative number of deaths under one year of age and the number of live births. Results: In Portugal, the IMR decreased before and during the COVID-19 pandemic. The lowest values were observed in September and October 2021 (2.15 and 2.14 per 1000 live births, respectively). The IMR remained below the threshold of three deaths per 1000 live births during the pandemic's critical period. Conclusion: Portugal has achieved remarkable progress in reducing its IMR over the last 60 years. The country recorded its lowest-ever IMR values during the COVID-19 pandemic. Further studies are needed to fully understand the observed trends.