INTERNATIONAL HANDBOOK OF HEALTH LITERACY Research, practice and policy across the lifespan Edited by Orkan Okan, Ullrich Bauer, Diane Levin-Zamir, Paulo Pinheiro and Kristine Sørensen First published in Great Britain in 2019 by Policy Press North America office: University of Bristol Policy Press 1-9 Old Park Hill c/o The University of Chicago Press Bristol 1427 East 60th Street BS2 8BB Chicago, IL 60637, USA UK t: +1 773 702 7700 t: +44 (0)117 954 5940 f: +1 773-702-9756 pp-info@bristol.ac.uk sales@press.uchicago.edu www.policypress.co.uk www.press.uchicago.edu © Policy Press 2019 The digital PDF version of this title is available Open Access and distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 license (http://creativecommons. org/licenses/by-nc/4.0/) which permits adaptation, alteration, reproduction and distribution for non-commercial use, without further permission provided the original work is attributed. 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Cover design by Hayes Design Front cover image: istock Printed and bound in Great Britain by CPI Group (UK) Ltd, Croydon, CR0 4YY Policy Press uses environmentally responsible print partners iii Contents List of figures, tables and boxes ix Notes on contributors xiii Introduction xxi Part 1: Research into health literacy: An overview of recent developments 1 The many facets of health literacy: Scoping the current research of theories, concepts and models 1 Defining health literacy: Exploring differences and commonalities 5 Kristine Sørensen 2 From Saranac Lake to Shanghai: A brief history of health literacy 21 Orkan Okan 3 Health literacy of children and adolescents: Conceptual approaches 39 and developmental considerations Janine Bröder and Graça S. Carvalho 4 The concept of mental health literacy 53 Anthony F. Jorm Measuring health literacy: What, why and how? 5 Measuring health literacy in adults: An overview and discussion 67 of current tools Andrew Pleasant, Caitlin Maish, Catina O’Leary and Richard Carmona 6 Measuring children’s health literacy: Current approaches and challenges 83 Torsten Michael Bollweg and Orkan Okan 7 Developing an instrument for measuring the health literacy of adolescents: 99 Lessons learned Christiane Firnges, Olga Domanska and Susanne Jordan 8 Measuring health literacy in Europe: Introducing the European Health 115 Literacy Survey Questionnaire (HLS-EU-Q) Jürgen M. Pelikan, Kristin Ganahl, Stephan Van den Broucke and Kristine Sørensen International handbook of health literacy iv Health literacy, health outcomes and health inequalities: Some empirical findings 9 Health literacy and health disparities: A global perspective 139 Sarah Mantwill and Nicola Diviani 10 Health literacy in later phases of life: Findings from Germany and 153 other countries Dominique Vogt, Doris Schaeffer and Eva-Maria Berens 11 Critical health literacy for the marginalised: Empirical findings 167 Susie Sykes and Jane Wills 12 Health literacy and chronic conditions: A life course perspective 183 Gill Rowlands, Joanne Protheroe, Luis Saboga-Nunes, Stephan Van den Broucke, Diane Levin-Zamir, and Orkan Okan 13 Health literacy research in the Nordic Countries 199 Kristine Sørensen and Josefin Wångdahl Part 2: Programmes and interventions to promote health literacy 215 An overview of interventions and programmes 14 Improving health literacy in clinical and community populations 219 Don Nutbeam and Bronwyn McGill Interventions and programmes for children and adolescents 15 MEDIA PROTECT: A setting- and parent-targeted intervention for 233 a healthy childhood in the digital age Paula Bleckmann, Hanna Schwendemann, Simone Flaig, Lea Kuntz, Anja Stiller, Thomas Mößle and Eva Maria Bitzer 16 Using Photovoice as a participatory approach to promote youth 247 health literacy Paola Ardiles, Marlies Casteleijn, Charlene Black and Kristine Sørensen 17 Mental health literacy for refugee youth: A cultural approach 261 E. Anne Marshall and Deborah L. Begoray 18 Media health literacy, eHealth literacy and health behaviour across 275 the lifespan: Current progress and future challenges Diane Levin-Zamir and Isabella Bertschi Contents v 19 School-based mental health literacy interventions 291 Kathryn Cairns and Alyssia Rossetto 20 Health literacy interventions for children or adolescents: An overview 307 and insights into practical applications Andrew Pleasant, Kristen Haven Griffin, Caitlin Maish, Catina O’Leary and Richard Carmona Interventions and programmes for adults and older adults 21 Health literacy interventions in the delivery of pharmaceutical care 323 Laura J. Sahm, Suzanne McCarthy and Sarah Marshall 22 A stated preference discrete choice health literacy intervention 335 framework for the control of non-communicable diseases (NCDs) in Africa Kenneth Yongabi Anchang and Theckla Kwangsa Mbunwe 23 Occupational health literacy: Healthy decisions at work 347 Marie Birk Jørgensen and Anne Konring Larsen 24 Mental health literacy interventions in adults 359 Anthony F. Jorm 25 An empirical perspective on the concept of mental health literacy 371 in the field of families with parental mental illness Kathrin Schulze, Patricia Wahl, Dirk Bruland, Stefanie Harsch and Michael Rehder 26 Putting the literacy back into health literacy: Interventions in 385 US adult literacy and English language programmes Maricel G. Santos and Julie McKinney Part 3: Policy programmes to promote health literacy 399 27 Health literacy policies: European perspectives 403 Iris van der Heide, Monique Heijmans and Jany Rademakers 28 Developing health literacy policy in Scotland: A case study 419 Graham Kramer, Blythe Robertson, Phyllis Easton and Andrew Pearson 29 Health literacy policies: National examples from Canada 435 Sandra Vamos, Irving Rootman, Linda Shohet and Lorie Donelle International handbook of health literacy vi 30 Health literacy policies: National example from Austria – A unique 453 story and some lessons learned from an ongoing journey Peter Nowak, Christina Dietscher and Marlene Sator 31 Health literacy policy in Australia: Past, present and future directions 471 Anita Trezona, Emma Fitzsimon and Sarity Dodson 32 Health literacy policies: National examples from the United States 489 Julie McKinney and R.V . Rikard 33 Health literacy in New Zealand: A tale of serendipity and 505 indigenous health Susan Reid and Carla White 34 Health literacy and the school curriculum: The example of Finland 521 Olli Paakkari and Leena Paakkari Part 4: Future dialogue and new perspectives 535 35 Health-literate healthcare organisations 539 Jürgen M. Pelikan 36 Future avenues for health literacy: Learning from literacy and 555 literacy learning Paulo Pinheiro 37 The social embeddedness of health literacy 573 Ullrich Bauer 38 Children as active participants in health literacy research and practice? 587 From rhetoric to rights Emma Bond and Vanessa Rawlings 39 Health literacy practices of adults in an avatar-based immersive 601 social virtual world: A sociocultural perspective of new media health literacies Evelyn McElhinney 40 Health literacy and participation in the healthcare of adults: 617 (In)compatible approaches? Melanie Messer 41 A lifespan perspective on health literacy: Ageing and end-of-life issues 633 Barbara K. Kondilis Contents vii 42 Salutogenesis and health literacy: The health promotion simplex! 649 Luis Saboga-Nunes, Uwe H. Bittlingmayer and Orkan Okan 43 Health literacy in a social context: A meta-narrative review 665 Ruth Pitt, Terry Davis, Jennifer Manganello, Phillip Massey, Orkan Okan, Elizabeth McFarlane, Opal Vanessa Buchthal, James Davis, Connie Arnold and Tetine Sentell 44 Health literacy for all? Inclusion as a serious challenge for health literacy: 689 The case of disability Uwe H. Bittlingmayer and Diana Sahrai 45 Capacity building for health literacy 705 Stephan Van den Broucke Index 721 ix List of figures, tables and boxes Figures 6.1 Age of participants in the studies 85 8.1 Generic Vienna model of health literacy defining the principal determinants and consequences of health literacy 118 14.1 Health literacy as a product of personal skills moderated by environmental complexity 222 14.2 Logic model for prevention planning 227 15.1 Outline of the digital balance literacy (DBL) model on which the MEDIA PROTECT intervention is based 237 15.2 Components of the MEDIA PROTECT intervention 239 16.1 The Circle of Health 254 23.1 The occupational health literacy model 350 23.2 Path model 353 24.1 Hypothesised links from mental health literacy to behaviours that benefit mental health and improved mental health 359 27.1 Policy cycle 408 28.1 Vicious and virtuous cycles of social isolation, health literacy and health outcomes 423 28.2 Attributes of an enabling health-literate society 423 29.1 Framework for health literacy 441 29.2 Logic model for the intersectoral approach to improving health literacy for Canadians 444 30.1 Organisational chart of the ÖPGK 459 32.1 Elaborations on the foundations of a health-literate organisation 498 40.1 Conceptual relationship between health literacy and participation in the healthcare setting 623 41.1 Ancient female mourners, Crete, Greece 642 41.2 Ioannis Poulakos family grave, Laconia, Greece 642 41.3 Lexington Cemetery, Lexington, Massachusetts, United States 643 42.1 The salutogenic perspective of health literacy and the sense of coherence theory in the dis-ease/ease continuum 658 42.2 The salutogenic perspective placed into the health literacy framework 660 43.1 Search strategies 670 43.2 Research traditions 672 44.1 Mean scores of general health literacy by education for countries and total 691 44.2 ICF model of functioning, disability and health 697 45.1 Conceptual framework for public health capacities 708 International handbook of health literacy x Tables 1.1 Definitions of health literacy 7 3.1 Examples of health literacy levels according to age groups 44 4.1 Examples of vignettes used in community surveys of mental health literacy 55 5.1 Most mentioned or cited health literacy measurement tools 69 5.2 Supporting definitions and size of existing health literacy tools 70 5.3 Attributes and limitations of existing health literacy tools 72 6.1 Measures of children’s health literacy 88 8.1 HLS-EU health literacy matrix 119 8.2 Overview of general population studies using the HLS-EU-questionnaire 127 11.1 Studies of interventions to promote critical health literacy 171 13.1 Health literacy glossary for the Nordic languages 200 19.1 Promoting mental health literacy across the spectrum of mental health interventions 293 20.1 Selected outcomes for adults and youth in the Healthy Community Program 313 20.2 Selected outcomes reported by adult and youth participating in the LEP for teens 317 20.3 Key points for consideration when building health literacy interventions for youth and adolescents 318 23.1 Components of the intervention and the purpose and focus of the components for employee and supervisor 352 23.2 Occupational health literacy 354 23.3 Participation in the courses 356 27.1 Level of establishment of the concept of health literacy in policies across EU member states 406 27.2 Aims of policies and actions across EU member states 407 27.3 Implementation of national policies across countries 408 27.4 Type and number of actions at a national level and involved initiators/stakeholders 413 27.5 Type and number of actions at a regional level and involved initiators/stakeholders 414 29.1 Milestones in the development of health literacy in Canada 443 31.1 Early national policies containing health literacy (2009-13) 474 31.2 Proposed actions/strategies within national and state government policies developed prior to 2014 475 31.3 Current state government policies that incorporate health literacy 478 31.4 Org-HLR framework domains and descriptions 483 34.1 Examples of objectives in grades 1-2, divided into health literacy components 527 34.2 Examples of objectives in grades 3-6, with health literacy components and assessment criteria for ‘good’ knowledge at the end of grade 6 528 List of figures, tables and boxes xi 34.3 Examples of objectives in grades 7-9, health literacy components and final assessment criteria for ‘good’ knowledge 530 42.1 The World Health Organization’s Global Conferences on Health Promotion 652 43.1 Empirical studies identified under each research tradition 669 44.1 Examples for the interplay between individual and social/environmental factors 698 Boxes 23.1 Example of (some of) the occupational health literacy competences required to ensure good return-to-work for a previously sick listed employee 349 25.1 Knowledge and beliefs 378 25.2 Recognition of disorders to facilitate help-seeking 378 25.3 Knowledge of professional help and treatments available, of effective self-help strategies and skills to give first aid and support to others 379 25.4 Knowledge of how to prevent mental disorders 379 25.5 Structures (additional dimension) 379 25.6 System (additional dimension) 380 25.7 Everyday life (additional dimension) 380 25.8 Professional role (additional dimension) 380 27.1 Applied work definitions of policy and action 405 27.2 Austria: Example of a national policy to promote health literacy 409 27.3 Ireland: Example of a national policy to promote health literacy 410 27.4 Italy: Example of a national policy to promote health literacy 410 27.5 Portugal: Example of a national policy to promote health literacy 411 27.6 United Kingdom: Example of a national policy to promote health literacy 412 28.1 Key concepts underpinning Scotland’s health literacy approach 421 28.2 Five simple tools and techniques 426 30.1 The Austrian Health Literacy Alliance (ÖPGK) 459 30.2 A national strategy for improving the quality of personal communication in healthcare 460 30.3 Manual for evidence-based, independent, understandable and gender-sensible health information 461 31.1 National statement on health literacy 476 31.2 Northern New South Wales health literacy framework 2016-17 479 31.3 Tasmanian Communication and health literacy action plan 2015-17 480 32.1 Goals of the National action plan to improve health literacy 495 34.1 The core components of health literacy 525 35.1 Ten attributes of health-literate healthcare organisations 544 35.2 The nine standards of a health-literate organisation 546 44.1 UN Convention on the Rights of Persons with Disabilities, Article 25 – Health 696 xiii Notes on contributors Paola Ardiles , Lecturer, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada, paola.ardiles@health.torrens.edu.au; pardiles@sfu.ca Connie Arnold , PhD, Professor at LSU Health Sciences Center and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA, CArnol@lsuhsc.edu Ullrich Bauer , Professor, Bielefeld University, Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld, Germany, ullrich.bauer@uni-bielefeld.de Deborah L. Begoray , Professor and Interim Chair, University of Victoria, Victoria, BC, Canada, dbegoray@uvic.ca Eva-Maria Berens , Postdoctoral Researcher, Bielefeld University, School of Public Health, Bielefeld, Germany, Eva-maria.berens@uni-bielefeld.de Isabella Bertschi , MSc, Teaching Assistant, PhD student, University of Zurich, Department of Psychology, Clinical Psychology for Children/Adolescents and Couples/Families, Zürich, Switzerland, isabella.bertschi@psychologie.uzh.ch Uwe H. Bittlingmayer , Professor of Sociology, University of Education, Freiburg, Institute of Sociology, Germany, uwe.bittlingmayer@ph-freiburg.de Eva Maria Bitzer , Professor, University of Education, Public Health & Health Education, Freiburg, Germany, evamaria.bitzer@ph-freiburg.de Charlene Black (nee King), MPH, Project Manager, Health Literacy, BC Children’s Hospital, Vancouver, BC, Canada, Charlene.black@cw.bc.ca Paula Bleckmann , Professor, Alanus University of Arts and Social Sciences, Alfter, Germany, Paula.Bleckmann@alanus.edu Torsten Michael Bollweg , Research Associate, Bielefeld University, Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld, Germany, torsten.bollweg@uni-bielefeld.de Emma Bond , Director of Research and Professor of Socio-Technical Research, University of Suffolk, Ipswich, UK, e.bond@uos.ac.uk International handbook of health literacy xiv Janine Bröder , Research Associate, Bielefeld University, Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld, Germany, janine.broeder@uni-bielefeld.de Opal Vanessa Buchthal , PhD, Assistant Professor, Office of Public Health Studies, University of Hawai‘i at Manoa, Honolulu, HI, USA, opalb@hawaii.edu Dirk Bruland , University of Applied Sciences Bielefeld, Institute of Educational and Healthcare Research, Bielefeld, Germany, dirk.bruland@fh-bielefeld.de Kathryn Cairns , Senior Evaluation Manager, ReachOut Australia and Honorary Research Fellow, Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Australia, Kathryn@reachout.com Marlies Casteleijn MSc, Consultant/Advisor Strategic Health Management at Inhealth, Utrecht, The Netherlands, marlies@inhealth.nl Richard Carmona , MD, MPH, FACS, Chief of Health Innovations, Tucson, AZ, USA Graça S. Carvalho , Full Professor, University of Minho, Braga, Portugal, graca@ie.uminho.pt James Davis , PhD, Associate Professor & Senior Biostatistician, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA, jamesdav@ hawaii.edu Terry Davis , PhD, Professor, Departments of Medicine, Pediatrics, & Feist- Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA, tdavis1@lsuhsc.edu Christina Dietscher , Acting Head of Department, Health Promotion & Disease Prevention, Austrian Ministry of Labor, Social Affairs, Health and Consumer Protection, Australia, christina.dietscher@sozialministerium.at Nicola Diviani , PhD, Postdoctoral Research Fellow, University of Lucerne, Department of Health Sciences & Health Policy, Lucerne, Switzerland, Nicola. Diviani@unilu.ch Sarity Dodson , Global Lead, Development Effectiveness, The Fred Hollows Foundation, Australia, sdodson@hollows.org Olga Domanska , Researcher, Robert Koch Institute, Berlin, Germany, DomanskaO@rki.de Notes on contributors xv Lorie Donelle , Associate Professor, Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, ON, Canada, ldonelle@ uwo.ca Phyllis Easton , Health lntelligence Manager, Directorate of Public Health, NHS Tayside, Dundee, UK, phyllis.easton@nhs.net Christiane Firnges , Research Associate, Robert Koch Institute, Berlin, Germany, firngesc@zedat.fu-berlin.de Emma Fitzsimon , Executive Officer, Inner North West Primary Care Partnership, Brunswick, Australia, EmmaFi@inwpcp.org.au Simone Flaig , Academic Assistant, University of Education, Public Health & Health Education, Freiburg, Germany, simone.flaig@ph-freiburg.de Kristin Ganahl , MA, Project Manager, Agency for preventive and social medicine, Bregenz, Austria, Kristin.ganahl@aks.or.at Stefanie Harsch , MA Gesundheitspädagogin, Junior Researcher, Health Literacy in Childhood and Adolescence Consortium, Institute of Sociology, University of Education, Freiburg, Germany, stefanie.harsch@ph-freiburg.de Kristen Haven Griffin , MA, MPH, Scientific and Technical Writer, Children’s Minnesota Research Institute, Minneapolis, MN, USA, Kristen.Griffin@ childrensmn.org Monique Heijmans , Senior Researcher, Netherlands Institute for Health Services Research, Utrecht, The Netherlands, m.heijmans@nivel.nl Susanne Jordan , MPH, Project leader, Robert Koch Institute, Berlin, Germany, JordanS@rki.de Marie Birk Jørgensen , Senior Researcher, National Research Centre for the Working Environment, Copenhagen, Denmark, marie.birk.joergensen@sund. ku.dk Anthony F. Jorm , Professorial Fellow, University of Melbourne, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia, ajorm@unimelb.edu.au Barbara K. Kondilis , Assistant Professor, Hellenic American University & Hellenic American College, Nashua, NH, USA, bkondilis@hauniv.edu International handbook of health literacy xvi Anne Konring Larsen , PhD, National Research Centre for the Working Environment, Copenhagen, Denmark, akl@nrcwe.dk Graham Kramer , GP and former National Clinical Lead for Self Management & Health Literacy, Scottish Government, Edinburgh, UK, gkramer@nhs.net Lea Kuntz , Academic Assistant, University of Education, Public Health & Health Education, Freiburg, Germany, lea.kuntz@ph-freiburg.de Theckla Kwangsa Mbunwe , Phytobiotechnology Research Foundation, Bamenda, Cameroon, ladythec@gmail.com Diane Levin-Zamir , Associate Professor, School of Public Health, University of Haifa, Israel, National Director of Department of Health Education and Promotion, Clalit Health Services, Israel and IUHPE Global Working Group on Health Literacy, diamos@zahav.net.il Caitlin Maish , PhD, LMSW, Evaluation Coordinator, Health Literacy Media, Tucson, AZ, USA, cmaish@healthliteracy.media Jennifer Manganello , PhD, Professor, School of Public Health, University at Albany, Rensselaer, NY, USA, jmanganello@albany.edu Sarah Mantwill , PhD, Coordinator Swiss Learning Health System, Postdoctoral Researcher, University of Lucerne, Department of Health Sciences & Health Policy, Lucerne, Switzerland, Sarah.Mantwill@unilu.ch E. Anne Marshall , Professor, University of Victoria, Educational Psychology & Leadership Studies, Faculty of Education, Victoria, BC, Canada, amarshal@ uvic.ca Sarah Marshall , MPSI, PhD candidate in Clinical Pharmacy Practice, Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland, smarshall5786@gmail.com Phillip Massey , PhD, Assistant Professor, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA, pmm85@drexel.edu Suzanne McCarthy , MPSI, PhD, Lecturer in Clinical Pharmacy Practice, Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland, s.mccarthy@ucc.ie Notes on contributors xvii Evelyn McElhinney , PhD, Senior Lecturer Advanced Practice, Glasgow Caledonian University, Department of Nursing & Community Health, School of Health and Life Sciences, Glasgow, UK, evelyn.mcelhinney@gcu.ac.uk Elizabeth McFarlane , PhD, Associate Professor, Office of Public Health Studies, University of Hawai‘i at Manoa, Honolulu, HI, USA, ecmcfarl@hawaii.edu Bronwyn McGill , Research Officer, PhD Candidate, Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, Australia, bronwyn.mcgill@sydney.edu.au Julie McKinney , Health Literacy Discussion List Moderator, Institute for Healthcare Advancement, Health Literacy Specialist and Director of Product Content, Exceptional Lives, Inc, jmckinney11@gmail.com Melanie Messer , Doctor of Public Health, External Lecturer, APOLLON Hochschule der Gesundheitswirtschaft, Bremen, Germany, messermelanie@ googlemail.com Thomas Mößle , Professor, State Police College Baden-Württemberg, Villingen- Schwenningen, Germany, ThomasMoessle@hfpol-bw.de Peter Nowak , Head of the Department Health and Society, Gesundheit Österreich GmbH (Austrian Public Health Institute), Austria, Peter.Nowak@ goeg.at Don Nutbeam , Professor of Public Health, Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, Australia, don.nutbeam@sydney.edu.au Orkan Okan , Bielefeld University, Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld, Germany: orkan.okan@uni-bielefeld.de Catina O’Leary , PhD, LCSW, President and CEO, Health Literacy Media, St Louis, MO, USA, coleary@healthliteracy.media Leena Paakkari , Doctor of Health Sciences, Senior Lecturer, Faculty of Sport and Health Sciences, University of Jyväskylä, Research Centre for Health Promotion, Finland, leena.paakkari@jyu.fi Olli Paakkari , Senior Lecturer, Faculty of Sport and Health Sciences, University of Jyväskylä, Research Centre for Health Promotion, Finland, olli.paakkari@jyu.fi International handbook of health literacy xviii Andrew Pearson , Specialist Trainee in Geriatric Medicine, and Scottish Clinical Leadership Fellow, Scottish Government, Edinburgh, UK, Andrew.pearson5@ nhs.net Jürgen M. Pelikan , Professor and Director WHO-CC, University of Vienna and Austrian Public Health Institute, Vienna, Austria, juergen.pelikan@univie.ac.at Paulo Pinheiro , Senior Researcher, Bielefeld University, Faculty of Educational Science, Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld, Germany, paulo.pinheiro@uni-bielefeld.de Ruth Pitt , MPH, Office of Public Health Studies, University of Hawai‘i at Manoa, Honolulu, HI, USA, ruthpitt@hawaii.edu Andrew Pleasant PhD, Senior Advisor on Health Literacy Interventions, Research, and Evaluation, Tucson, AZ, USA, apleasant@healthliteracy.media Joanne Protheroe , Professor of General Practice, Research Institute for Primary Care & Health Sciences, Keele University, UK, j.protheroe@keele.ac.uk Jany Rademakers , Professor/Head of Research Department, Netherlands Institute for Health Services Research, Utrecht, The Netherlands and CAPHRI – Care and Public Health Research Institute, Department of Family Medicine, Maastricht University, The Netherlands, j.rademakers@nivel.nl Vanessa Rawlings , Lecturer in Early Childhood Studies (ECS), Early and Primary Education Studies (EPES) and Special Educational Needs and Disability Studies (SENDS), University of Suffolk, School of Psychology and Education, Ipswich, UK, vanessa.rawlings@uos.ac.uk Michael Rehder , MA, Diplom Sozialpädagoge/Kinder- und Jugendlichen- pschotherapeut, Klinik am Geesthof, Institutsambulanz für Kinder und Jugendliche, Geldern, Germany, michael.rehder@lvr.de Susan Reid , Director, Health Literacy New Zealand Ltd, sreid@healthliteracy. co.nz R.V . Rikard , Senior Research Associate, Michigan State University, East Lansing, MI, USA, rvrikard@msu.edu Blythe Robertson , Policy Lead, Self Management & Health Literacy, Healthcare Quality and Improvement, Scottish Government, Edinburgh, UK, Blythe. robertson@gov.scot; email for the next year: blythe.robertson@gmail.com Notes on contributors xix Irving Rootman , Adjunct Professor, University of Victoria, School of Public Health & Social Policy, Canada, irootman@telus.net Alyssia Rossetto , Honorary Research Fellow, Melbourne School of Population and Global Health, The University of Melbourne and Product Development Officer, Mental Health First Aid England, alyssia.rossetto@unimelb.edu.au Gill Rowlands , Professor of Primary Care, Institute of Health and Society, Newcastle University, UK, gill.rowlands@newcastle.ac.uk Luis Saboga-Nunes , Institute of Sociology, University of Education Freiburg, Freiburg, Germany; Centro de Investigacão em Saúde Pública (CISP), National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal, saboga@prosalus.com Laura J. Sahm , MPSI, PhD, Senior Lecturer in Clinical Pharmacy Practice, Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland, L.Sahm@ucc.ie Diana Sahrai , Professor of Social Learning Under Difficult Circumstances, University of Applied Sciences & Arts Northwestern Switzerland – School of Education, Muttenz, Switzerland, diana.sahrai@fhnw.ch Maricel G. Santos , EdD, Professor of English, San Francisco State University, San Francisco, CA, USA, mgsantos@sfsu.edu Marlene Sator , Senior Researcher, Gesundheit Österreich GmbH (Austrian Public Health Institute), Austria, marlene.sator@goeg.at Doris Schaeffer , Professor of Public Health, Bielefeld University, School of Public Health, Bielefeld, Germany, Doris.schaeffer@uni-bielefeld.de Kathrin Schulze , Diplompädagogin, Universität Duisburg-Essen, Germany, kathrin.schulze@uni-due.de Hanna Schwendemann , Academic Assistant, University of Education, Public Health & Health Education, Freiburg, Germany, hanna.schwendemann@ph- freiburg.de Tetine Sentell , PhD, Associate Professor, Office of Public Health Studies, University of Hawai’i at Manoa, Honolulu, HI, USA, tsentell@hawaii.edu Linda Shohet , Consultant Researcher of Literacy Policy, linda.shohet@gmail. com