Browsing by Author "Jansen, Carel J. M."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Health literacy among older adults is associated with their 10-years cognitive functioning and decline : the Doetinchem Cohort Study
    (BioMed Central, 2018-03) Geboers, Bas; Uiters, Ellen; Reijneveld, Sijmen A.; Jansen, Carel J. M.; Almansa, Josue; Nooyens, Astrid C. J.; Verschuren, W. M. Monique; De Winter, Andrea F.; Picavet, H. Susan J.
    Background: Many older adults have low levels of health literacy which affects their ability to participate optimally in healthcare. It is unclear how cognitive decline contributes to health literacy. To study this, longitudinal data are needed. The aim of this study was therefore to assess the associations of cognitive functioning and 10-years’ cognitive decline with health literacy in older adults. Methods: Data from 988 participants (mean age = 65.3) of the Doetinchem Cohort Study were analyzed. Health literacy was measured by the Brief Health Literacy Screening. Memory, mental flexibility, information processing speed, and global cognitive functioning were assessed at the same time as health literacy and also 10 years earlier. Logistic regression analyses were performed, adjusted for age, gender, and educational level. Results: Higher scores on tests in all cognitive domains were associated with a lower likelihood of having low health literacy after adjustment for confounders (all ORs < 0.70, p-values<.001). Similar associations were found for past cognitive functioning (all ORs < 0.75, p-values<.05). Before adjustment, stronger cognitive decline was associated with a greater likelihood of having low health literacy (all ORs > 1.37, p-values<.05). These associations lost significance after adjustment for educational level, except for the association of memory decline (OR = 1.40, p = .023, 95% CI: 1.05 to 1.88). Conclusion: Older adults with poorer cognitive functioning and stronger cognitive decline are at risk for having low health literacy, which can affect their abilities to promote health and self-manage disease. Low health literacy and declining cognitive functioning might be a barrier for person-centered care, even in relatively young older adults.
  • Thumbnail Image
    Item
    The story against smoking : an exploratory study into the processing and perceived effectiveness of narrative visual smoking warnings
    (SAGE Publications, 2019-08) Ooms, Joelle A; Jansen, Carel J. M.; Hoeks, John C. J.
    Objectives: This study compared the effects of two types of health warnings on cigarette packages: ‘narrative visual warnings’, showing an image portraying people plus a corresponding slogan that could evoke a story-like interpretation, and ‘non-narrative visual warnings’ with non-narrative content (i.e. body parts). Moreover, the mechanisms underlying the effects of these health warnings were explored. Design: A within-participants experiment was conducted comparing narrative and non-narrative visual warnings. Path analyses were performed to investigate the relationship between the narrative concepts transportation and identification, the emotions evoked by the health warning and the perceived effectiveness of the message. Method: Participants (N = 200) were presented with one narrative warning and one non-narrative warning. After each warning, they answered questions on narrative perception, transportation, identification, emotions and perceived effectiveness. Results: The narrative warnings were seen as more story-like than the non-narrative warnings. There was a statistical trend for narrative warnings to be perceived as more effective than the non-narratives. The narrative warnings caused more transportation, fear, sadness, compassion and anger; the non-narrative warnings evoked more disgust and surprise. For the narrative warnings, both narrative concepts of transportation and identification were directly related to perceived effectiveness, and also indirectly via sadness. For the non-narrative warnings, transportation was related to perceived effectiveness, both directly and indirectly via disgust. Conclusion: Seeing a story in a still picture with a slogan helps to increase the effectiveness of the antismoking message. Both narrative and non-narrative visual warnings may persuade receivers directly, but also by the evoking of emotions, although the specific emotions responsible for the persuasive effects may differ.