Protocol for a feasibility randomised controlled trial of administering daytime only enteral feeding compared to standard continuous enteral feeding, to reduce delirium in mechanically ventilated, cri

Promoting health literacy across the life course is central to the Healthy China 2030 initiative and to global public health improvement (, ). However, providing accurate, accessible, and contextually appropriate health information to heterogeneous populations remains challenging. A structured assessment of perceived health education and science communication needs is therefore necessary before designing population-oriented health literacy activities (, ). In this study, these needs refer to individuals’ or caregivers’ perceived need for understandable, trustworthy, and contextually relevant educational content that supports health understanding, caregiving, self-management, health information appraisal, and linkage to appropriate services. These perceived content needs are distinct from communication preferences, which refer to preferred formats and channels for receiving health information. Guided by life-course theory and the socio-ecological model of health, this study developed and initially validated a modular needs-assessment scale for Chinese clinical and community service users and their primary caregivers. Life course theory, originally proposed by the sociologist Glen H. Elder, provides a foundational temporal lens for understanding the dynamic evolution of human health needs (). A core tenet of this theory is that health risks, health awareness, and preferences for accessing health information change systematically across developmental stages and social transitions. Health concerns that are highly salient during adolescence, such as reproductive health, differ markedly from those prioritized by older adults, such as fall prevention. This stage-specific heterogeneity renders generic assessment tools insufficient for capturing the nuanced health information needs of different populations across the life course. This perspective is also consistent with the life course orientation emphasized in the Healthy China 2030 Planning Outline, which extends health promotion from fetal development to the end of life (). Accordingly, this instrument divides the continuous life course into six age-specific modules: infancy and toddlerhood, preschool age, school age, adolescence, adulthood, and older adulthood. Each module is tailored to reflect the developmental characteristics and stage-specific health risks of its intended population. Life course theory further emphasizes that certain critical life transitions, such as childbearing and end-of-life care, may occur across different age groups. The health-related tasks and information needs triggered by these transitions are context-specific rather than solely age-dependent, and therefore cannot be fully captured by a single age-based module (, ). Therefore, the proposed scale includes two independent context-specific modules: the pregnancy and maternity module and the hospice and palliative care module. Notably, these critical transitions often intersect with structural vulnerabilities. For example, individuals with lower socioeconomic status may face disproportionate barriers to accessing reliable health information during pregnancy and maternity, whereas patients receiving hospice and palliative care may have limited access to online resources because of disease burden, caregiver dependence, or the digital divide. The inclusion of independent context-specific modules facilitates the identification of, and targeted response to, differentiated needs that may be amplified by structural inequalities.