Background The Australian National Lung Cancer Screening Program offers early detection opportunities for people at high risk of lung cancer. However, the stigma associated with smoking – central to screening eligibility – may deter screening participation.Aims To understand the current social and discursive context, a media content analysis of Australian newspaper articles was conducted to examine how people who smoke are portrayed.Methods An online search using Dow-Jones Factiva identified Australian newspaper articles published between 2nd May 2023 (announcement of the Program) and 31st December 2024, to provide a contextual anchor to interpret and apply findings. Eligible articles (n = 174) underwent qualitative content analysis to classify representations of people who smoke and to assess language for stigma based on established guidelines.Results Seventeen representations of people who smoke were categorised. Most common was people who smoke as “supported to potentially stop smoking” (42.5%), often emphasised by encouragement to seek smoking cessation support. Many representations were understanding, including portrayals of people who smoke as “vulnerable youth” (32.8%) or “addicted to nicotine” (22.4%). Negative representations were less frequent but included people who smoke as a “selfish polluter” (7.5%) or “drain on the economy” (4.0%). Person-first language appeared consistently in 47.8% of articles, 28.7% used an empathetic tone towards people who smoke, however 18.7% used judgemental or blaming sentiments.Discussion Findings highlight instances of stigmatising representation of people who smoke which could perpetuate negative public discourse. Use of standard, person-first language is encouraged, such as promotion of evidence-based language guidelines and strengths-based messaging, complemented by broader community-based interventions, to support respectful and consistent public discourse to address societal-level stigma.
Background The end of the COVID-19 emergency has prompted reflection for future pandemic preparedness. Young people were a priority group during the pandemic due to high case numbers, developing health literacy skills and potentially high exposure to online misinformation, yet their experience with COVID-19 information remains understudied.Aim To investigate young people’s COVID-19 vaccine information sources, understanding of government information and endorsement of vaccine misbeliefs during the COVID-19 vaccine roll-out stage in Australia.Methods A nationally representative sample of 14–25-year-olds completed an online cross-sectional survey between the Delta and Omicron outbreaks. Descriptive statistics and regression models were conducted using post-stratification weighted frequencies to reflect national gender and age distributions.Results 1617 participants completed the survey. The top five COVID-19 vaccine information sources were: government sources (52%), news (40%), family (34%), social media (32%) and health professionals (28%). The top five trusted sources were: health professionals (61%), government sources (50%), family (33%), news (18%) and politicians (14%). Only 7% of participants trusted social media; trust was higher amongst those who endorsed misbeliefs or had low digital health literacy. Overall, 20% of participants endorsed vaccine misbeliefs, with young men (OR 2.10, 95% CI 1.63–2.72; p<.001) and participants with low digital health literacy (OR 2.12, 95% CI 1.64–2.74; p<.001) having greater odds of endorsing misbeliefs. On average, young people reported moderate difficulty understanding government vaccine information (mean 4.9/10), with 18–21-year-olds, young men, those who endorsed misbeliefs and those with low digital health literacy reporting greater difficulty.Discussion Young people generally reported using reliable sources of COVID-19 information, yet found government sources moderately difficult to understand. Clear, accessible and youth-centered public health communication is needed, particularly to support young people with low digital health literacy, who reported greater challenges. Future emergency preparedness efforts should prioritize age-appropriate health communication, leveraging social media platforms for increased youth engagement and building vaccine knowledge in early adolescence.
Introduction Gastric cancer remains a major cause of morbidity and mortality in Japan. Digital search data such as Google Trends have been increasingly used to capture population-level health information–seeking behavior and may complement traditional surveillance systems. However, it remains unclear whether gastric cancer awareness campaigns are associated with measurable changes in online search activity and whether search interest reflects regional disease burden.Aim This study aimed to evaluate changes in national online search activity during the Gastric Cancer Awareness Month and to assess whether prefecture-level search volume was associated with regional gastric cancer incidence.Methods We conducted a population-level ecological study using publicly available Google Trends data for Japan from 2012 to 2021. Interrupted time series analysis was applied to evaluate monthly changes in search activity during the awareness month. Prefecture-level associations between annual mean search volume and age-standardized gastric cancer incidence were examined for 2017–2021.Results At the national level, search activity related to gastric cancer remained relatively stable, with no significant changes in level or trend during the awareness month. In contrast, prefecture-level analyses revealed positive associations between search volume and gastric cancer incidence, although several high-burden regions showed comparatively low search interest.Conclusions The awareness month was not associated with measurable increases in online search activity at the national level, suggesting limited population response to current campaigns. Google Trends data can complement traditional surveillance by identifying regions with low public attention despite high disease burden, thereby supporting more targeted and data-informed cancer communication strategies.
Background Health literacy plays a crucial role in physical and mental health outcomes. Patients with chronic diseases, cancer patients in particular, shoulder a disproportionate burden due to limited health literacy. Limited cancer health literacy (LCHL) is a risk factor for disease prevention, treatment adherence, and management, leading to poor health.Aims Currently, there are no standardized instruments to measure cancer health literacy in Arabic and identify Arabic-speaking cancer patients with LCHL. This study aimed to test the psychometric properties of the Arabic translation of Cancer Health Literacy Test (CHLT-30-Arabic and CHLT-6-Arabic) for use among cancer patients.Methods Data collected from a sample of cancer patients (N = 260) from a comprehensive medical center in Riyadh, Saudi Arabia were used to test the measurement structures and estimate item statistics using classical test theory, factor analysis and Item Response Theory driven two-parameter logistic model (2PL). Additionally, an independent sample of 19 patients was used to estimate one-month stability of CHLT-30-Arabic scores.Results A one-factor model was confirmed as the measurement structure of CHLT-30-Arabic (RMSEA = 0.04; CFI = 0.92; TLI = 0.91). Test scores were highly reliable (Cronbach’s α = 0.86; McDonald’s ω = 0.92; one-month test-retest r = 0.93). The CHLT-6-Arabic measurement structure, latent class analysis with two classes (adequate vs. limited), was consistent with the observed response patterns of six items (LR χ2(50) = 59.95, p = 0.16) with high class separation (entropy = 0.81). The model estimated LCHL rate was 22% (accuracy = 93%). Both instruments had invariant measurement properties across age, gender, educational attainment, and income groups.Discussion The CHLT-30-Arabic and CHLT-6-Arabic offer valuable standardized instruments for measuring cancer health literacy needs among Arabic-speaking patients with cancer and help to improve care management and healthcare services for this population. These instruments can identify cancer patients with LCHL and inform targeted interventions to potentially minimize adverse health and financial consequences of LCHL.
Background In the context of an aging population, older adults with fewer basic skills face compounded challenges in achieving healthy aging. These individuals often experience barriers to health literacy and self-reliance, exacerbated by conventional educational programs that inadequately reflect their needs and experiences. Little is known about how to develop educational solutions that match this groups preferences and language that supports access to, comprehension, and application of health information in everyday life.Aims To fill this gap, we describe and reflect on the participatory development of a healthy aging educational program. Our goal is twofold in showing: 1) how the co-design process was shaped by participants needs and preferences, and 2) to identify what practice-based lessons can be drawn from this process for developing inclusive educational programs for this population.Methods The educational program was co-created with community-dwelling older adults (50+) with fewer basic skills in three countries: Denmark, the Netherlands, and Portugal. Following a participatory design approach, our process involved three phases; 1) exploration of the learning needs and formats of our target audience (N = 55), 2) co-design of the program with participants (N = 7) and interdisciplinary experts (N = 11), 3) field testing with iterative adjustments based on participant feedback (N = 73).Results Phase one yielded five core curriculum themes – the aging body, nutrition, wellbeing, being heard, digital (safety) - as well as two learning approaches: meaningful play and collaborative learning. The resulting program took the form of a physical, card-based game designed with accessible language, peer-learning, and practical information on healthy aging. Field testing showed that focusing on lived experiences through playful and collaborative activities helped participants engage with health and digital literacy skills without stigma, while learning together about healthy aging.Discussion We distilled three practice-based lessons for inclusive co-design: 1) centering learners lived experiences through co-creation, 2) playful and collaborative learning methods that reduce barriers to participation, and 3) iterative and flexible design that builds trust and agency. These lessons demonstrate how participatory design focused on participants’ needs and lived experiences, has the potential to promote more equitable health literacy programs and support healthy aging among underserved older adults.
