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There are only a small number of reported intervention studies to improve health literacy among older populations. This paper reports on a study designed to investigate the feasibility and potential impact on health literacy and health practices of embedding an intervention programme to improve health literacy with older people through established primary health care units (PHCUs) in a disadvantaged urban community in Brazil. This investigation utilized a quasi-experimental design, with 42 participants recruited for the intervention group and comparison group. The Alfa-Health Program was offered by a nurse in a PHCU as part of the public universal health system over a period of 5 months, and was compared for its impact on a range of health literacy and self-reported health outcomes with routine health care available for older people. The intervention achieved relatively high levels of participation, and positive feedback from participants. Some improvements in vaccination rates, health literacy and reported health behaviours related to food choices and physical activity were observed. The intervention made good use of existing facilities; the content and methods were well received by the participants. However, there were some difficulties in recruitment and in retention of participants. The study has demonstrated the practical feasibility of delivering a comprehensive health education programme designed to improve health literacy in a PHCU in Brazil. [ABSTRACT FROM AUTHOR]

Community health workers in developing countries usually perform house calls in degraded and violent territories. Thus, in this paper we study the effects of urban violence in the performance of CHWs in poorly developed territories, in order to understand the challenges of delivering care to dangerous communities in developing countries. We conducted telephone surveys for 5 months in 2017, within a systematic sample of 2.000 CHWs based on clinics distributed along the health regions of the city of Rio de Janeiro, Brazil. We completed 766 interviews, approximately 40% of the sample, 86% man and 14% women. Most participants are 30 to 39 years old (35%), followed by 27% of 40 to 49 years old participants. As CHWs work on the sharp end of the healthcare system, responsible for outreaching, community education, counseling, and social support, our study presents contributions to government and management levels on working conditions inside communities, constraints in assistance, and difficulties in implementing primary care policies. [ABSTRACT FROM AUTHOR]