Patient navigation shows promise for improving healthcare access and health information, though its impact on health literacy among underserved populations in developing countries remains underinvestigated. This study evaluated the effectiveness of patient navigation services in improving health literacy in the Philippines. Using a quasi-experimental, one-group pretest-posttest design over 2 months, 105 participants were recruited through random sampling from a tertiary hospital. The intervention provided personalized guidance on healthcare access, health information, appointment scheduling, and referrals. Health literacy was assessed across four dimensions (Access, Understand, Appraise, Apply) using a researcher-developed questionnaire. Participant demographics showed a majority aged 18-30 years (68.6%), female (75.2%), single (63.8%), and college/university educated (53.3%). Nearly half (45.7%) had no income, while 31.4% earned below minimum wage. Participants reported using patient navigation to consult a doctor (75.2%) and were made aware of the available services mostly through other family members (28.6%). Follow-up data revealed significant improvements across all health literacy dimensions (P < .001). In the Access dimension, participants who strongly agreed increased from 18% to 35% in knowing where to find information, and from 16% to 34% in having easy access. The Understand dimension showed gains from 20% to 39% for comprehending provider information, and 21% to38% for understanding risks and benefits. The Appraise dimension improved from 22% to 36% for evaluating accuracy, and 24% to39% for asking pertinent questions, while the Apply dimension increased from 25% to 35% for making informed decisions, and 23% to37% for taking health action. These results suggest that patient navigation services can effectively enhance health literacy among Filipino adults, demonstrating the potential of this patient-centered approach in promoting health equity in similar settings.

Becoming nature 'literate' may promote nature engagement in early adolescence, supporting both health and well-being, while nurturing a sense of environmental stewardship. This study aimed to advance the formative research necessary for the development of a nature-based literacy framework including a set of indicators specific to its measurement during early adolescence. An e-Delphi study design was used with an expert panel comprised of international academics (n = 18) and practitioners (n = 8). After three rounds, experts agreed key components of nature-based literacy were knowledge, competence, confidence, motivation, experience, connection, and stewardship. The nature-based literacy framework comprehensively represents the intrapersonal factors and related indicators that influence nature engagement, particularly during early adolescence. This will support the development of interventions designed to enhance early adolescent health outcomes, strengthen their connection to nature, and inspire them to value and protect the natural world.

Through the commercial determinants of health framework, gambling has been identified as a powerful threat to health. This research critically examines cryptocurrency, which is promoted and sold as a highly gamblified product. Using the commercial determinants of health framework, the multifaceted ways in which cryptocurrency firm operations may impact health outcomes are highlighted. Political influence is exerted through substantial donations, with high-profile cases illustrating the sector's attempts to sway policy, whilst cryptocurrencies often operate in unregulated markets. Marketing strategies mirror those of traditional harmful industries, deploying immense advertising budgets and celebrity endorsements to promote highly speculative and risky financial products. Cryptocurrency mining, demanding considerable energy consumption, causes significant environmental damage. Financial practices include hundreds of outright frauds targeting low- and middle-income countries. Cryptocurrency investment, with 24/7 access and promises of huge wealth, mirrors gambling and is likely to result in public health harms through the same mechanisms as other forms of gambling. Despite the supposed potential of blockchain technology for improving payment and contract systems, the lack of realization of these benefits contrasts sharply with the immediate and growing costs associated with cryptocurrency speculation. Cryptoassets are a case study for the need for health promotion professionals to critically evaluate new technologies and advocate for regulatory measures to protect public health in the face of novel, high-risk products that overlap gambling and finance.

People with intellectual disabilities (IDs) face health issues and barriers to physical activity. Health promotion programmes targeting this group are often short-term. Few programmes have been designed for people with IDs who live in supported housing staffed by social care workers (SCWs). The potential that SCWs hold as health promoters has recently come into focus within literature with a setting approach. Drawing on an ethnographic study, this article explores how SCWs articulate health promotion and enact health promoter roles at supported housing for adults with moderate to severe IDs. Our findings show that SCWs perceive sport and diet as health promotion activities. Because of their background within social education and not health promotion, few perceived themselves as health promoters. However, using the holistic concept of active living, which focuses on everyday lifestyle rather than short-term programmes, our ethnographic data reveal the more unspoken and unconscious practices that SCWs enact to 'build' customized active living routines among residents. Our results suggest that this 'silenced' capacity of SCWs to build healthy routines adds to previous findings by emphasizing that, rather than lacking a health promotion ethos, employees may have the potential to promote health by adapting a more holistic approach to health promotion. We argue the active living approach can contribute to building such a holistic health approach. Such an approach may help SCWs identify with and strengthen their enactment of health promotion roles.

Disadvantaged adolescents, including those from lower socioeconomic status (SES) or geographically remote backgrounds, engage in higher rates of risk behaviours, including poor diet, alcohol and tobacco use. While digital interventions targeting lifestyle risk behaviours show potential, few studies have focused on their implementation and relevance for this population. This study conducted a process evaluation of 'Health4Life', a universal school-based digital program targeting multiple behaviours, among a sample of disadvantaged adolescents. Participants were from six schools classified as low SES (Index of Community Socio-educational Advantage percentile score ≤ 25%), and/or regional using the Australian Statistical Geography Standard. Self-reported student (n = 214) and teacher evaluations (n = 16) assessed Health4Life's acceptability, with qualitative questions capturing areas for improvement. Teacher-reported implementation data (n = 16) measured intervention fidelity and feasibility. Quantitative data were analysed using descriptive statistics and open-ended responses were thematically analysed. Compared to the entire sample, this subset of students evaluated Health4Life less favourably (66% versus 75%), with fewer enjoying the stories (63% versus 75%) and planning to use the skills and information (60% versus 70%). Teacher evaluations were mostly positive and aligned closely with the entire sample. Fidelity data also indicated comparable levels of student engagement (~92% versus ~85%). Key themes for refinement included improving content relevance and technical execution to better resonate with disadvantaged adolescents. While teacher evaluations suggest Health4Life is a valuable program in low SES or regional contexts, students' lower ratings indicate refinements are needed. Identified areas for improvement will guide co-designing the program's adaptation to improve effectiveness and relevance for disadvantaged adolescents. Trial registration: The Health4Life trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123).

This study investigated the prevalence and predictors of misperceptions about the healthiness of alcohol products carrying common health-oriented marketing cues and the relative importance of the type (versus amount) of alcohol consumed in contributing to health risks. Data were from a 2022 cross-sectional national population survey. Australian adults (18-65 years) who consumed alcohol in the past year (n = 1960) reported their agreement with statements that a selection of health-oriented marketing cues meant an alcohol product was 'better for you' and rated the importance of the type and amount of alcohol consumed in causing health risks. The majority of participants misperceived the type of alcohol to be at least as important as the amount in causing health risks (61%) and misperceived at least one health-oriented marketing cue as meaning a product was 'better for you' (75%). Misperceptions about low sugar, calorie and carbohydrate; and preservative-free claims (46-56%) were most common. Misperceptions about natural, organic, vegan, low sugar, low calorie, gluten-free and seltzer cues were less prevalent among older (45-65 years) than young adults (18-24 years, PR = 0.27-0.86). A lower proportion of women (compared to men) held misperceptions about vegan (PR = 0.66) and gluten-free claims (PR = 0.78), but a higher proportion held misperceptions about low sugar claims (PR = 1.13). There were also variations by socioeconomic status, alcohol consumption, education and regional/metropolitan location. Misperceptions about health-oriented marketing of alcohol are widespread. Further regulation of permissible alcohol marketing content is needed, but until then, differences in misperceptions between population segments may inform targeted health promotion efforts.

Flavoured oral nicotine pouches, manufactured and marketed by global tobacco companies, such as Philip Morris International (PMI) and British American Tobacco, entered the Australian market in 2024. Despite it being illegal for Australian retailers to sell nicotine pouches, the products have been seized in government enforcement raids of Australian retailers, and have also been promoted to young people by Australian social media influencers. The Australian Federal Government has recognized and expressed concern about the rising profile of nicotine pouches in Australia and the promotion of these products as unproven vaping and smoking cessation aids. Yet to date, there has been no published research on nicotine pouches in Australia. Using focus group and interview data collected in early 2024 as part of Generation Vape, an ongoing Australian national study into adolescent and young adult vaping and smoking, we explored their attitudes to and perceptions of nicotine pouches, including first-hand experiences and drivers of use. The participants perceived an increase in the use and popularity of oral nicotine pouches, including PMI's Zyn brand, for reasons including claimed sport performance enhancement, vaping cessation and as part of partying and clubbing culture. Some participants perceived nicotine pouches to be a 'healthier' alternative to smoking or vaping. It is critical that research on nicotine pouches is collected now to inform public health policy and to prevent the proliferation of a new class of addictive recreational nicotine products in Australia.

Early onset of alcohol consumption among Colombian adolescents highlights the need for effective and accessible preventive interventions. This project aimed to conduct formative work to inform the adaptation of an effective eHealth alcohol use prevention program originally developed in Australia, the OurFutures Alcohol Module, to the Bogotá context. Twenty-six adolescents and 10 teachers in Bogotá participated in the study. We used a mixed-methods approach comprising interviews, surveys and semi-structured discussions to evaluate the acceptability of OurFutures. Study materials were translated into Spanish before conducting three 1.5-hour focus groups with adolescents (aged 11–15; n = 26), and 1-hour interviews or online surveys with teachers to assess attitudes towards alcohol use and the acceptability of one lesson from the OurFutures Alcohol Module in the Bogotá context. Qualitative data were analysed thematically, and descriptive analyses of quantitative data reported percentage agreement for survey questions. Overall, 96% of students and 89% of teachers expressed strong satisfaction with the OurFutures Alcohol Module lesson. Most students (96%) liked its storyline and character portrayal, and most teachers (80%) said they would use OurFutures with their students. Participants provided feedback for improving program relatability, including adapting scenarios, character names, clothing and language to align with the Bogotá context and resonate with Colombian adolescents. This study marks the first step in informing the adaptation of the OurFutures Alcohol Module to the Bogotá context and highlights key considerations for cultural adaptations of other substance use prevention interventions. This research underscores the importance of place-based end-user involvement in co-designing adolescent prevention interventions.

The aim of this paper is to identify non-governmental organizations (NGOs) advocating for policy and practices to address rising health inequities in Australia. NGOs can play a critical role in shaping and influencing governance processes including public policy relating to the social and commercial determinants of health inequities. However, scholarship on who the NGOs are that are advocating to address health inequities in Australia and how they operate is sparse. Through desktop analysis in 2022, we searched NGO websites and documents for evidence of advocacy activities related to health inequities between 2017 and 2022. A database of the NGOs was compiled, noting the type of organization, function, advocacy activities and main issues their advocacy covered. A total of 137 NGOs were identified as engaging in activities advocating for change to address health inequities either directly (e.g. advocating directly to address health inequities) or indirectly (e.g. advocating on social determinants of health inequities such as housing and linking to their unequal health impacts). We noted the primary issues they advocated on, including topic categories: risk factor, disease-specific, broader health system, social determinants of health equity, and health workforce and service issues. The results indicate that Australian NGOs from multiple sectors are active in advocacy to address heath inequities on a variety of topics and through a variety of activities. This study provides a template for similar studies in other countries and suggests further research is needed to understand the role and impact of civil society advocacy to address growing health inequities.