Dysglycemia and Abnormal Adiposity Drivers of Cardiometabolic-Based Chronic Disease in the Czech Population: Biological, Behavioral, and Cultural/Social Determinants of Health

In contrast to the decreasing burden related to cardiovascular disease (CVD), the burden related to dysglycemia and adiposity complications is increasing in Czechia, and local drivers must be identified. A comprehensive literature review was performed to evaluate biological, behavioral, and environmental drivers of dysglycemia and abnormal adiposity in Czechia. Additionally, the structure of the Czech healthcare system was described. The prevalence of obesity in men and diabetes in both sexes has been increasing over the past 30 years. Possible reasons include the Eastern European eating pattern, high prevalence of physical inactivity and health illiteracy, education, and income-related health inequalities. Despite the advanced healthcare system based on the compulsory insurance model with free-for-service healthcare and a wide range of health-promoting initiatives, more effective strategies to tackle the adiposity/dysglycemia are needed. In conclusion, the disease burden related to dysglycemia and adiposity in Czechia remains high but is not translated into greater CVD. This discordant relationship likely depends more on other factors, such as improvements in dyslipidemia and hypertension control. A reconceptualization of abnormal adiposity and dysglycemia into a more actionable cardiometabolic-based chronic disease model is needed to improve the approach to these conditions. This review can serve as a platform to investigate causal mechanisms and secure effective management of cardiometabolic-based chronic disease.

Mental Health Literacy in Iranian Adolescents

Background: Mental health literacy (MHL) is a relatively ignored determinant of community mental health in Iran, in which its level and determinants should be addressed. Aim: To investigate MHL and its components among Iranian adolescents. Methods: A cross-sectional study was conducted. After multistage cluster random sampling, 500 high school students were enrolled. Previously validated Persian version of theMHL Scale (MHLS) was used for data collection. In addition, data on socio-demographic variables were also collected. Adolescents with an MHL score of less than 60% of the achievable score were considered as at-risk of mental health illiteracy. Relevant statistical analyses were used to determine the MHL level and its association with sociodemographic variables. Results: Overall prevalence of being at-risk of mental health illiteracy was estimated at 71.5 % (95% CI: 67.1, 75.6). Prevalence of being at-risk of stigmatization, inadequate self-help knowledge, and information seeking was 91.2 (95% CI: 88.3, 93.7), 60.3 (95% CI: 59.8, 60.8), and 36.6 (95% CI: 36.1, 37.1), respectively. Having religious beliefs was associated with the stigmatization component (adjusted OR= 2.66, 95% CI: 1.27-5.59). Conclusions: Prevalence of being at-risk of mental health illiteracy is high among Iranian adolescents. Mental disorders are highly stigmatized in Iran. Keywords: Mental Health Literacy, Health Literacy, Adolescent, Iran, Mental Disorder

Facilitating factors and barriers in help-seeking behaviour in adolescents and young adults with depressive symptoms: A qualitative study

Objective Despite the availability of mental health care, only a minority of depressed adolescents and young adults receive treatment. This study aimed to investigate facilitating factors and barriers in help-seeking behaviour of adolescents and young adults with depressive symptoms, using qualitative research methods. Methods In-depth, semi-structured interviews with 32 participants with current or previous depressive symptoms aged 16 to 24 years using thematic content analysis. Findings Our sample consisted mainly of adolescents who eventually found their way to professional help. Five main themes in help-seeking by adolescents and young adults were identified: (I) Individual functioning and well-being, (II) Health literacy, (III) Attitudinal aspects, (IV) Surroundings, and (V) Accessibility. Prompts to seek treatment were disease burden and poor academic performance. Health illiteracy negatively influenced treatment-seeking behaviour. Attitudinal aspects either hampered (shame, wanting to handle the problem oneself, negative attitudes towards treatment) or facilitated (positive attitudes towards treatment) help-seeking. Furthermore, adolescents’ surroundings (school, family, and peers) appeared to play a critical role in the recognition of depressive symptoms and encouragement to seek help. Barriers regarding accessibility of mental health care were found, whereas direct and easy access to treatment greatly improved mental health care use. Conclusion Facilitating factors can play a critical role in the help-seeking process of depressed adolescents and young adults, and may guide efforts to increase access to mental health care of this vulnerable age group. In particular, recognition and encouragement from school personnel and peers and easy access to care providers positively influenced help-seeking in our sample. Health illiteracy and attitudinal aspects appeared to be important barriers to seeking treatment and public/school campaigns aimed at reducing health illiteracy and stigma might be necessary to improve treatment-seeking and health care utilization in this age group.

Overview of Vitamin D, its status and consequences: Challenges and prospects for Pakistani population: A Review

Vitamin D, like other vitamins, is an essential micronutrient required for proper human metabolic function. It refers to a group of compounds, the most important of which are D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D is acquired from two main sources, synthesis in lower layers of the skin triggered by exposure to the sun (90%) and through diet (10%). Vitamin D levels can be determined by measuring 25(OH)D concentration in the serum and deficiencies are responsible for a wide range of issues including bone-related problems, depression, diabetes, autoimmune disorders, cardio and respiratory problems, infections, autism and obesity. Synthesis in the body can be affected by a variety of factors including skin color, age, lifestyle, clothing, weather and even general health illiteracy. In terms of diet, the staple foods of the Pakistani population are generally deficient in vitamin D. As a result, a significant proportion of the Pakistani population, in particular women and children, suffer from vitamin D deficiency. The various challenges that need to be addressed to overcome this issue are discussed, along with potentially employable strategies such as food fortification (for example by micro and nano encapsulation technologies) and bio fortification.

Health Promotion in the Community Via an Intergenerational Platform: Intergenerational e-Health Literacy Program (I-HeLP)

The increase in life expectancy and emphasis on self-reliance for older adults are global phenomena. As such, living healthily in the community is considered a viable means of promoting successful and active aging. Existing knowledge indicates the prevalence of health illiteracy among the older population and the impact of poor health literacy on health outcomes and health care costs. Nevertheless, e-health literacy is a critical issue for a rapidly aging population in a technology-driven society. Intergenerational studies reported that older adults enjoy engaging with younger people and benefit from the social stimulation by improved social behaviours, intergenerational social network, and participation.An Intergenerational e-health Literacy Program (I-HeLP) is developed to draw upon the IT-savvy strength of the youth, and teach older adults to seek, understand and appraise health information from electronic sources and apply knowledge gained to address the health problem. I-HeLP is an evidence-based program, which provides comprehensive coverage on relevant health-related e-resources. I-HeLP aims to engage youth volunteers to teach older adults regarding e-health literacy, and enhance older adults’ sense of coherence, e-health literacy, physical and mental health, cognitive function, quality of life, and intergenerational communication. I-HeLP promotes social participation, health, and wellbeing of older adults, and empowers the younger generation to play an active role in society. Furthermore, I-HeLP aligns with the ‘Smart Nation’ initiative by the Singapore government to empower citizens to lead meaningful and fulfilled lives with the use of technology.

Abstract P202: Providers' Perspectives On Adherence To Antihypertensive Treatment In Vietnamese Patients

Background: Medical adherence is one of the most effective ways of controlling hypertension among those under treatment. Vietnamese Americans have a high prevalence of hypertension and low rates of adherence to treatment. Yet there is a minimal body of literature that addresses this condition among Vietnamese Americans. Objectives: Our principle objectives are: 1) identify the level of adherence and 2) identify the attitudes, beliefs, and behaviors that influence adherence to antihypertensive treatment among Vietnamese in New Orleans. Methods: The first phase of the study examined 250 randomly selected medical records of Vietnamese hypertensive patients from a local community clinic to determine the adherence rate. Semi-structured interviews were conducted with four providers that work at the same clinic who treat these patients. Providers were asked about their perceptions of factors that influence antihypertensive treatment adherence in Vietnamese patients, and potential points of interventions. A thematic analysis of the semi-structured interviews was conducted. Results: The medical record review identified 20.4% (51 out of 250) of patients were non-adherent to antihypertensive treatment. The common theme that emerged from the interviews was health illiteracy, particularly limited access to knowledge in the native language was a major factor to non-adherence. Patients preferred to seek information from loved ones and to utilize therapies outside of Western medicine. Factors that increased adherence included having patients track blood pressure measurements and establishing trusting provider-patient relationships. Discussion/Conclusions: Patient education is a critical component to adherence to antihypertensive treatment in Vietnamese patients. Language barriers and limited knowledge about the disease are significant problems that need to be addressed to improve the rate of adherence. The interview data will guide the remainder of the study where we will interview patients to better understand what influences adherence, and what approaches to improving adherence might be appropriate for Vietnamese patients.