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APP1155125. The present publication was funded by Funda??o Ci?ncia e Tecnologia, lP national support through CHRC (UIDP/04923/2020), and NOVA National School of Public Health ? NOVA University of Lisbon. Publisher Copyright: © Copyright © 2021 Dias, Gama, Maia, Marques, Campos Fernandes, Goes, Loureiro and Osborne. The drivers of high prevalence of non-communicable diseases (NCD) among migrants are well-documented. Health literacy is regarded as a potential tool to reduce health inequalities and improve migrant's access to and quality of health care. Yet, little is known about the health literacy needs among these groups and how to address them. This paper outlines the protocol for a migrant community-based co-design project that seeks to optimize health literacy, health promotion, and social cohesion in support of prevention of NCDs among migrants in Lisbon using the OPtismizing HEalth LIteracy and Access (Ophelia) process. This participatory implementation research project starts with a mixed-methods needs assessment covering health literacy strengths, weaknesses and needs of migrants, and local data about determinants of health behaviors, service engagement, and organizational responsiveness. Diverse migrant groups will be engaged and surveyed using the Health Literacy Questionnaire and questions on sociodemographic and economic characteristics, health status, use of health services, and perceived impact of the COVID-19 pandemic. Semi-structured interviews with migrants will also be conducted. Based on data collected, vignettes will be developed representing typical persons with diverse health literacy profiles. Migrants and stakeholders will participate in ideas generation workshops for depth co-creation discussions in simulated real-world situations based on the vignettes, to design health literacy-based multisectoral interventions. Selected interventions will be piloted through quality improvement cycles to ensure ongoing local refinements and ownership development. Through a genuine engagement, the project will evaluate the uptake, effectiveness and sustainability of the interventions. This protocol takes a grounded approach to produce evidence on real health literacy needs from the perspective of key stakeholders, especially migrants, and embodies strong potential for effective knowledge translation into innovative, locally relevant, culturally and context congruent solutions for prevention of NCDs among migrants. Given the diverse communities engaged, this protocol will likely be adaptable to other migrant groups in a wide range of contexts, particularly in European countries. The scale-up of interventions to similar contexts and populations will provide much needed evidence on how health literacy interventions can be developed and applied to reduce health inequality and improve health in diverse communities. publishersversion published

Supplemental material, sj-docx-1-sjp-10.1177_14034948211004320 for Health literacy responsiveness: a cross-sectional study among pregnant women in Denmark by Eva Brorsen, Trine D. Rasmussen, Claus T. Ekstrøm, Richard H. Osborne and Sarah F. Villadsen in Scandinavian Journal of Public Health

Supplemental material, sj-pdf-1-chi-10.1177_1742395321999441 for Exploring patients’ and health professionals’ perspectives on health literacy needs in the context of chronic obstructive pulmonary disease by Christine R. Borge, Marie H. Larsen, Richard H. Osborne, Eivind Engebretsen, Marit H. Andersen, Ingrid Asbjørnsen Holter, Marit Leine and Astrid K. Wahl in Chronic Illness

Andrea Pozza,1 Richard H Osborne,2,3 Gerald R Elsworth,2 Giacomo Gualtieri,4 Fabio Ferretti,1 Anna Coluccia1 1Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy; 2Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia; 3Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 4Legal Medicine Unit, Santa Maria alle Scotte University Hospital, Siena, Siena, ItalyCorrespondence: Fabio FerrettiDepartment of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci 16, Siena 53100, ItalyTel +39 0577 586409Fax +39 0577 233222Email ferrefa@unisi.itBackground: The Health Education Impact Questionnaire (heiQ) aims to evaluate eight self-management skills in people with chronic conditions. Knowledge about the relations between these self-management skills and different quality of life (QoL) outcomes has received little attention. It is also important to provide further evidence on its properties in non-English healthcare contexts, as the questionnaire is being used in cross-cultural research. Furthermore, in the Italian healthcare context, the relationship between the medical staff and the patients remains asymmetrical, with the latter having the role of passive recipients of medical prescriptions and services. The current study provided further evidence about the psychometric properties of the heiQ among Italian people with chronic conditions, specifically by assessing the factor structure, reliability, convergent/divergent and criterion validity (ie, the specific contribution of each of the self-management skills to QoL outcomes).Methods: Two hundred ninety-nine individuals with a chronic condition (mean age = 61.4 years, 50% females) completed the heiQ and the Medical Outcomes Study-Short Form (MOS SF-36). Confirmatory factor analyses, Composite Reliability Indices (CRI), bivariate correlations and linear regression analyses were computed.Results: A model with 8 correlated factors showed good fit, in a similar way to previous studies. CRI values were acceptable to good for all the subscales. Associations between some of the heiQ subscales and some of the MOS SF-36 subscales supported criterion validity. In particular, it was confirmed by the moderate associations between the constructive attitudes and approaches subscale and the MOS SF-36 vitality and perceived mental health and by the moderate correlations between the health directed activities subscale and the MOS SF-36 Vitality. In linear regressions, higher emotional distress predicted higher physical and mental QoL, while higher mental QoL was also associated with stronger constructive attitudes and approaches.Conclusion: The heiQ has robust properties across translations and it can also be used routinely in Italian healthcare contexts. The evidence that all the other self-management skills did not predict either physical or mental QoL could suggest that the self-management model of chronic diseases is still not sufficiently developed in the Italian context, where patients are passive recipients of medical instructions.Keywords: chronic diseases, self-management, health education, psychometric properties, health status, quality of life, diabetes, cardiovascular diseases