Considering Health Literacy, Health Decision Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai‘i: A Pilot Feasibility Study

Abstract

Health literacy is understudied in the context of social networks. Our pilot study goal was to consider this research gap among vulnerable, low-income mothers of minority ethnic background in the state of Hawai‘i, USA. Recruitment followed a modified snowball sampling approach. First, we identified and interviewed seven mothers (“egos”) in a state-sponsored home visiting program. We then sought to interview individuals whom each mother said was part of her health decision-making network (“first-level alters”) and all individuals whom the first-level alters said were part of their health decision-making networks (“second-level alters”). Health literacy was self-reported using a validated item. A total of 18 people were interviewed, including all mothers (n = 7), 35% of the first-level alters (n = 7/20), and 36% of the second-level alters (n = 4/11). On average, the mothers made health decisions with 2.9 people (range: 1-6); partners/spouses and mothers/mothers-in-law were most common. One mother had low health literacy; her two first-level alters also had low health literacy. Across the full sample, the average number of people in individuals’ health decision networks was 2.5 (range: 0–7); 39% of those interviewed had low health literacy. This can inform the design of future studies and successful interventions to improve health literacy.

Health Literacy, Digital Health Literacy, and COVID-19 Pandemic Attitudes and Behaviors in U.S. College Students: Implications for Interventions

“…Nevertheless, the finding that college students had active health-related social network sizes of roughly five people is still important to note. The number of average members in these social networks was higher than in previous studies in more vulnerable groups [42][43][44]. On the one hand, a larger network size allows for a diversity of perspectives to inform decision making; however, five sources of health information may require significant individual skills and competency to unify varying-and sometimes contradictory-perspectives.…”

Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

“…The article by Amoah [60], "The Relationship between Functional Health Literacy, Self-Rated Health, and Social Support between Younger and Older Adults in Ghana", considers which aspect of social support (instrumental, informational, and emotional support) is responsible for health literacy by comparing two groups in an understudied context. In "Considering Health Literacy, Health Decision-Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai'i", Sentell and colleagues [61] consider the importance of health literacy in the decision-making networks of new mothers, and how to measure this shared capacity using social network analyses. Bessems et al [62] created and tested small-group nutrition education intervention for adults with low socioeconomic status and small incomes in "The Effectiveness of the Good Affordable Food Intervention for Adults with Low Socioeconomic Status and Small Incomes".…”

Addressing COVID-19 vaccine hesitancy: Lessons from the role of community participation in previous vaccination programs

“…17,18 Way forward in addressing COVID-19 vaccine hesitancy Communities are not a homogenous entity, but composed of individuals with different values, expectations, and different levels of health literacy. 19 A top-down one-sizefits-all approach is therefore unrealistic in the context of the COVID-19 vaccine in promoting global health. Drawing on the lessons learnt from the effectiveness of CP in previous immunization programs, we hereby recommend the following evidence-based strategies to reduce COVID-19 vaccine hesitancy.…”

“…The coronavirus disease 2019 (COVID- 19) pandemic has ushered in a global public health threat hitting both developing and developed countries hard. 1,2 The lack of COVID-19 vaccines contributed to an increase in COVID-19 cases and deaths, with more than 500 000 deaths recorded globally particularly among people with underlying health conditions, such as diabetes and immune-compromised health status.…”