Health literacy is the level of individual’s capacity in obtaining, processing and understanding the basic information and services concerning health for making suitable health decisions. On the other hand, health education is the learning opportunities which have been consciously constructed. It also involves communication intended to improve the knowledge and the life skills development which are important to the health of individuals and that of the community as a whole.
Therefore, health education results in improvement of skills and knowledge which is the foundation of health literacy. Consequently, health literacy facilitates change attitude which leads to eventual behavior change in favor of health. These health-promoting attitudes and behaviors are the major factors for the management and reduction of obesity in adults aged 25-60. The Ottawa charter provides the health literacy and education framework for ensuring the management of diabetes. Therefore, this study’s objective is to establish the role of health literacy and education in relation to the change in behavior in the Management of diabetes in adults with obesity based on the Ottawa charter framework.
Background
The issue of health literacy is of significance to all people who are involved in the protection and promotion of health, early screening, and prevention of diseases, the maintenance of health care as well as the policy-making process. According to Flynn (2015), health literacy and education are significant in the health sector as it comes handy in the discussion and dialogue, reading of the health information, the interpretation of health charts, making the decision concerning research, voting on health policies and many more personal and community decisions in relation to health.
In this regard, most people have low health literacy. For instance, in Australia, 60 percent of the adult population has been found to possess low literacy concerning health. This means that these people are not in a position to effectively decide on matters of healthcare (Commonwealth of Australia, 2014). It is evident that health literacy is a determinant of health in the society (Sørensen, eta l., 2012). Therefore, health promotion should be encouraged in the healthcare system to enable individuals to increase their control over the health determinants which will eventually help in improving their health.
The Ottawa charter
In 1986 The initial international conference concerning health promotion introduced the Ottawa Charter which was for action meant for the achievement of health for all people globally(WHO, 1986). This charter was introduced in the same period the obesity epidemic was starting to spread. Thus, the charter provided a framework for promotions of action in each and every public health areas (Fynn, 2015). The Ottawa charter provided an outline of key action areas necessary for the improvement of the health of a population. These were the development of personal skills, re-orientation of the health services, the strengthening of the community action, the creation of a supportive environment and building of public policy which is healthy. Only the development of personal skills is action on an individual level but the rest are at the interventional level.
The relationship between health, literacy, health promotion and outcome in diabetes
“Diabetes is a metabolic disorder which is either diagnosed with chronic hyperglycemia or with disturbance of carbohydrate, protein and lipids metabolism caused by the failure in secretion or function of insulin or both” (Fynn, 2015). The type II diabetes is common among the public as it covers almost 90 percent of the diabetes population (International Diabetes Federation, 2017). According to the International Diabetes Federation (2015), the diabetes patients will increase from 415 million in 2015 to 642 million in 2040. Hence, diabetes is now considered a serious problem for the healthcare system globally (Tucker et al, 2014). There is no cure for diabetes but it can be managed through the change in lifestyle as well as following the health promotional behaviors. This would result in minimized costs of health care, stress and other side effects which are normally caused by diabetes (Nerat et al, 2016).
Health literacy is one of the factors which is related to the lifestyle behaviors of individuals. People with the diabetes condition require some kind of abilities in obtaining, processing and understanding of information concerning healthcare so as to make appropriate decisions on matters of health (Chahardar-cherik et al 2018). In these patients with the diabetes condition, health literacy is directly related with their understanding of self-efficiency and self-care in the acceptance of the disease, following treatment plans, management of the disease, the self-management, and the better health outcomes.
Low literacy can be associated with the weaker diabetes self-management, deteriorated control of the blood sugar, more side effects which are self-reported, side effects which are more severe, longer hospitalization periods and many more adverse effects. Thus, health literacy and health promotion have positive relations and are the basic factors capable of promoting the health behaviors in the diabetes patients and improving the patients’ outcome (Flynn, 2015). Hence, the healthcare providers should strive to increase the literacy of patients which will make possible the development of patients’ health-promoting behaviors.
The Ottawa framework
Prevention approaches to adult diabetes at the individual levels as well as in the population levels differ from that of children. The objective of adult prevention strategies is assisting the adults in the establishment and the maintenance of stable weight by having a healthy lifestyle. Addressing the obesity condition of people between 25-60 years of age has rippling effects to the broader population and the generations to come. Therefore, both individual as well the collective actions are necessary for the management and treatment of obesity. The Ottawa charter sets up five strategic areas for promotion of health through the creation of a comprehensive approach to addressing the issues of weight, obesity, and health.
Building public policy which is healthy
A healthy public policy is a set of coordinated actions resulting to social, health and income policies which advocate for equality in the society. The approaches involved include legislation, taxation, fiscal measures and organizational change (The Ottawa Charter, 1986). Thus, local, provisional, regional and federal entities have a role in the creation of healthy public policies which are capable of promoting a healthy weight and obesity approach (North health, 2012). Some of these approaches include regulation of practices and marketing in the weight loss sector, expansion/continuation of support with funding and financial incentives to promote healthy living. In addition, setting transferable standards for physical activities and food in all settings and provide support through education, evaluation, toolkits, and enforcement. Also, Support for community planning and policies for the promotion of healthy eating as well as the active living.
Creating Supportive Environments
Change in the patterns of work, leisure and life have an impact on the health of individuals. Work and leisure should be organized so that they are a source of health to people but not a source of problems. Thus, promotion of healthy lifestyle develops safe, satisfying and conducive living as well as working conditions (The Ottawa Charter, 1986). Adults have daily interactions in different settings such as work and home. The settings need to be carefully considered while seeking to create a supportive environment for the obese and overweight people. The home framework is set up to support and develop the eating competence in people diagnosed with diabetes (North health, 2012). This is achieved through the support, development, advocating and education on matters of active living. Moreover, the framework advocates for support and development of the workplace wellness policies, strategies, and programs which focus on the improvement of wellness and the health of patients rather than on weight loss and dieting.
Strengthening the Community Action
Setting up substantial and effective communal action for decision making, strategic planning and implementation is a way of promoting health. The main focus of the promotion of community action is to empower communities’ control and ownership of their actions and destinies (The Ottawa Charter, 1986). Partnership and collaboration between the private, public and non-governmental organization is an effective tool for implementation of a successful action for the promotion of an approach which is health-focused (North health, 2012). Thus, collaboration at the local regional, provincial and federal level is essential to foster the capacity of the community and improve approaches to obesity and weight-loss. Moreover, resources are developed to facilitate the engagement of the community on healthy eating, sedentary behavior, and bodily inactivity. Moreover, Support can be offered to the communities’ initiatives on healthy living and the knowledge to action technique can be used to translate the evidence-based learning into useful information for the community.
Development of Personal Skills
Personal skills are essential as they help individuals to continuously learn, prepare and cope with injuries and chronic illnesses. These skills are facilitated in at work, home, and community setting in adults between the ages of 25-60 years. Thus, commercial, professional and voluntary actions are needed within these institutions where the people with diabetes interact (The Ottawa Charter, 1986). Resources and programs should be set up to support individuals and their families in improving their health outcomes through the creation of awareness, education, engagement, and capacity building (North health, 2012). Such initiatives include support of literacy programs focused on the weight management, eating competencies and the reduction of the sedentary programs. In addition, the evidence-based health promotions should be supported.
Reorientation of Health Services
The individuals, community, health professionals, institutions dealing with health services and the government share the responsibility of ensuring the promotion of health. Hence, these institutions should work in unison to achieve a health-focused health care system (The Ottawa Charter, 1986). Reorientation of the healthcare services can be performed by health professionals, community planners, local governments, professionals concerned with sports and recreational, allied and general practitioners and volunteers (North health, 2012). As a result, a health-focused approach in relation to obesity and weight can be successfully achieved. These strategies include sharing of materials capable of supporting decision making and health-focused approach to obesity and weight loss. Also, development of comprehensive guidelines for health measurements and proving training and leadership for clear messaging concerning weight bias is among the strategies available for the reorientation of the health services. What’s more, the strategies involve the development of support which is community-based and the integration of the management of weight management resources into the primary care.
Conclusion
Health literacy and education facilitate change attitude which leads to eventual behavior change in regards to health. These health-promoting attitudes and behaviors are the major factors for the management and reduction of obesity in adults aged 25-60. The Ottawa charter provides the health literacy and education framework to ensure the management of diabetes. The framework includes Building public policy which is healthy, Creating Supportive Environments, Strengthening the Community Action, Development of Personal Skills and Reorientation of Health Services. Thus, by sharing responsibility in the health promotion, the stakeholders in the health sector will be able to achieve and manage diabetes in adults 25-60 years of age.
References
Chahardar-cherik et al. (2018). The Relationship between Health Literacy and Health Promoting Behaviors in Patients with Type 2 Diabetes. Int J Community Based Nurs Midwifery, 6(1): 65–75.
Commonwealth of Australia. (2014). Australian Commission on Safety and Quality in Health Care. Health literacy: Taking action to improve safety and quality. Sydney: ACSQHC.
Fynn, M.A. (2015). Empowering People to be Healthier: Public Health Nutrition through the Ottawa Charter, Proc Nutr Soc, 74(3): 303–312.
International Diabetes Federation. (2017). About Diabetes. Brussels(Belgium): International Diabetes Federation. Retrieved April 7, 2018, from https://www.idf.org/about-diabetes/what-is-diabetes.html.
International Diabetes Federation. (2015). About Diabetes: Facts and Figures. Brussels(Belgium): International Diabetes Federation, Retrieved April 7, 2018, from www.idf.org/about-diabetes/facts-figures.
Nerat. T, Locatelli. I, Kos. M. (2016). Type 2 Diabetes: Cost-effectiveness of Medication Adherence and Lifestyle Interventions. Patient Prefer Adherence, 10:2039–49.
North health. (2012). Position on Health, Weight, and Obesity: An Integrated Population Health Approach retrieved from https://www.northernhealth.ca/Portals/0/About/PositionPapers/documents/HealthWtObesityPosition_20120730_WEB.pdf
Sørensen, K. (2012). Health Literacy and Public Health: A Systematic Review and Integration of Definitions and Models, BMC Public Health, 12, 80.
Tucker. C.M, Lopez. M.T, Campbell, K. et al. (2014). The Effects of Culturally Sensitive, Empowerment-focused, Community-based Health Promotion Program on Health Outcome of Adults with Type 2 Diabetes. J Health Care Poor Underserved, 25:292–307.
World Health Organization (n.d) Ottawa charter for health promotion. Retrieved from www.who.int/healthpromotion/conferences/previous/ottawa/en/
