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Gray C, Crawford G, Lobo R, Maycock B. Getting the right message: a content analysis and application of the health literacy INDEX tool to online HIV resources in Australia. HEALTH EDUCATION RESEARCH 2021; 36:61-74. [PMID: 33319239 DOI: 10.1093/her/cyaa042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Health literacy is considered by some as a determinant of health. Research suggests that different levels of health literacy may be associated with human immunodeficiency virus (HIV) knowledge and behaviour, including willingness to test. This study assessed the health literacy demands of existing Australia HIV prevention resources available online using a health literacy assessment and content analysis. Two reviewers assessed 66 resources using the Health Literacy INDEX. Sixty-one (92%) scored below 50%, with an average score of 35.5%. A coding frame was developed to conduct a content analysis of the resources excluding videos, multiple webpages and booklets (n = 52). We coded for six categories of knowledge: HIV knowledge (100% of resources), transmission (96%), acquired immune deficiency syndrome (AIDS) knowledge (88%), testing (87%), consequence of infection (85%) and prevention (77%). We found that resources required a reading grade above grade 8, and very few resources considered audience appropriateness. There were missed opportunities to encourage HIV prevention or testing. Some resources used incorrect language to refer towards people living with HIV, and transmission and prevention messages were often inconsistent. Guidelines for developing HIV prevention resources are warranted to improve health literacy, accessibility and appropriateness of resources and ensure consistent messages and framing of HIV risk.
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Affiliation(s)
- Corie Gray
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia 6102, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia 6102, Australia
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, Western Australia 6102, Australia
| | - Bruce Maycock
- College of Medicine & Health, University of Exeter, Devon, Exeter EX4 4SB, UK
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Jafree SR, Bukhari N, Muzamill A, Tasneem F, Fischer F. Digital health literacy intervention to support maternal, child and family health in primary healthcare settings of Pakistan during the age of coronavirus: study protocol for a randomised controlled trial. BMJ Open 2021; 11:e045163. [PMID: 33653760 PMCID: PMC7929637 DOI: 10.1136/bmjopen-2020-045163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/15/2021] [Accepted: 02/23/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION There is a need to continue primary healthcare services through digital communication for disadvantaged women living in underdeveloped areas of Pakistan, especially in the age of the coronavirus pandemic, social distancing and lockdown of communities. This project will be the first of its kind in aiming to implement a digital health literacy intervention, using smartphone and internet, to disadvantaged women through female community healthcare workers. Improved health literacy in women of reproductive years is known to promote maternal, child and family health overall. METHODS AND ANALYSIS The study will include a baseline survey, a pre- and post-test survey and a 3-month lasting intervention on (1) hygiene and prevention and (2) coronavirus awareness and prevention. Women of reproductive years will be sampled from disadvantaged areas across the four provinces of Pakistan (Baluchistan, Khyber Pakhtunkhwa, Punjab and Sindh), and the selection criteria will be poor, semiliterate or illiterate, belonging to underdeveloped neighbourhoods devoid of universal healthcare coverage and dependent on free primary health services. A target of 1000 women will comprise the sample, with 500 women each assigned randomly to the intervention and control groups. Analysis of variance and multivariate analysis will be used for analysing the intervention's effects compared with the control group. ETHICS AND DISSEMINATION Ethics approval for this study has been received from the Internal Review Board of the Forman Christian College University (reference number: IRB-252/06-2020). Results will be published in academic journals of repute and dissemination to the international scientific community and stakeholders will also be planned through workshops. TRIAL REGISTRATION NUMBER NCT04603092.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Lahore, Pakistan
| | - Nadia Bukhari
- School of Pharmacy, University College London, London, UK
| | - Anam Muzamill
- Department of Mass Communications, Forman Christian College University, Lahore, Pakistan
| | - Faiza Tasneem
- Department of Business, Forman Christian College University, Lahore, Pakistan
| | - Florian Fischer
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
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Dennis CL, Marini F, Dick JA, Atkinson S, Barrett J, Bell R, Berard A, Berger H, Brown HK, Constantin E, Da Costa D, Feller A, Guttmann A, Janus M, Joseph KS, Jüni P, Kimmins S, Letourneau N, Li P, Lye S, Maguire JL, Matthews SG, Millar D, Misita D, Murphy K, Nuyt AM, O'Connor DL, Parekh RS, Paterson A, Puts M, Ray J, Roumeliotis P, Scherer S, Sellen D, Semenic S, Shah PS, Smith GN, Stremler R, Szatmari P, Telnner D, Thorpe K, Tremblay MS, Vigod S, Walker M, Birken C. Protocol for a randomised trial evaluating a preconception-early childhood telephone-based intervention with tailored e-health resources for women and their partners to optimise growth and development among children in Canada: a Healthy Life Trajectory Initiative (HeLTI Canada). BMJ Open 2021; 11:e046311. [PMID: 33568380 PMCID: PMC7878148 DOI: 10.1136/bmjopen-2020-046311] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION The 'Developmental Origins of Health and Disease' hypothesis suggests that a healthy trajectory of growth and development in pregnancy and early childhood is necessary for optimal health, development and lifetime well-being. The purpose of this paper is to present the protocol for a randomised controlled trial evaluating a preconception-early childhood telephone-based intervention with tailored e-health resources for women and their partners to optimise growth and development among children in Canada: a Healthy Life Trajectory Initiative (HeLTI Canada). The primary objective of HeLTI Canada is to determine whether a 4-phase 'preconception to early childhood' lifecourse intervention can reduce the rate of child overweight and obesity. Secondary objectives include improved child: (1) growth trajectories; (2) cardiometabolic risk factors; (3) health behaviours, including nutrition, physical activity, sedentary behaviour and sleep; and (4) development and school readiness at age 5 years. METHOD AND ANALYSIS A randomised controlled multicentre trial will be conducted in two of Canada's highly populous provinces-Alberta and Ontario-with 786 nulliparous (15%) and 4444 primiparous (85%) women, their partners and, when possible, the first 'sibling child.' The intervention is telephone-based collaborative care delivered by experienced public health nurses trained in healthy conversation skills that includes detailed risk assessments, individualised structured management plans, scheduled follow-up calls, and access to a web-based app with individualised, evidence-based resources. An 'index child' conceived after randomisation will be followed until age 5 years and assessed for the primary and secondary outcomes. Pregnancy, infancy (age 2 years) and parental outcomes across time will also be assessed. ETHICS AND DISSEMINATION The study has received approval from Clinical Trials Ontario (CTO 1776). The findings will be published in peer-reviewed journals and disseminated to policymakers at local, national and international agencies. Findings will also be shared with study participants and their communities. TRIAL REGISTRATION NUMBER ISRCTN13308752; Pre-results.
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Affiliation(s)
- Cindy-Lee Dennis
- Lawrence S. Bloomburg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Jennifer Abbass Dick
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Stephanie Atkinson
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jon Barrett
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rhonda Bell
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Anick Berard
- Faculty of Pharmacy, University of Montreal, Montreal, Québec, Canada
- Saint Justine Hospital, Montreal, Québec, Canada
| | - Howard Berger
- St Michael's Hospital, Toronto, Ontario, Canada
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
| | - Hillary K Brown
- Department of Health & Society (Scarborough Campus), University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Evelyn Constantin
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
- McGill University Health Centre, Montreal, Ontario, Canada
| | - Deborah Da Costa
- McGill University Health Centre, Montreal, Ontario, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Québec, Canada
| | - Andrea Feller
- Niagara Region Public Health, Thorold, Ontario, Canada
| | - Astrid Guttmann
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Magdalena Janus
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - K S Joseph
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Jüni
- St Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Kimmins
- Department of Animal Science, McGill University, Montreal, Québec, Canada
| | | | - Patricia Li
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Stephen Lye
- Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- St Michael's Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Stephen G Matthews
- Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - David Millar
- Monarch Maternal and Newborn Health Centre, Ottawa, Ontario, Canada
| | - Dragana Misita
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Kellie Murphy
- Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Anne Monique Nuyt
- Saint Justine Hospital, Montreal, Québec, Canada
- Department of Pediatrics, McGill University, Montreal, Québec, Canada
| | - Deborah L O'Connor
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Rulan Savita Parekh
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Paterson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Martine Puts
- Lawrence S. Bloomburg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Joel Ray
- St Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - Stephen Scherer
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Sellen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Sonia Semenic
- McGill University Health Centre, Montreal, Ontario, Canada
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
| | - Prakesh S Shah
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
| | - Robyn Stremler
- Lawrence S. Bloomburg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Peter Szatmari
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Deanna Telnner
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kevin Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Simone Vigod
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital, Toronto, Ontario, Canada
| | - Mark Walker
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Catherine Birken
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Luo Q, Shi K, Hung P, Wang SY. Associations Between Health Literacy and End-of-Life Care Intensity Among Medicare Beneficiaries. Am J Hosp Palliat Care 2021; 38:626-633. [PMID: 33472379 DOI: 10.1177/1049909120988506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Despite well-documented disparities in end-of-life (EOL) care, little is known about whether patients with low health literacy (LHL) received aggressive EOL care. OBJECTIVE This study examined the association between health literacy (HL) and EOL care intensity among Medicare beneficiaries. METHOD We conducted a retrospective analysis of Medicare fee-for-service decedents who died in July-December, 2011. ZIP-code-level HL scores were estimated from the 2010-2011 Health Literacy Data Map, where a score of 225 or lower was defined as LHL. Aggressive EOL care measures included repeated hospitalizations within the last 30 days of life, no hospice enrollment within the last 6 months of life, in-hospital death, and any of above. Using hierarchical generalized linear models, we examined the association between HL and aggressive EOL care. RESULTS Of 649,556 decedents, the proportion of decedents who received any aggressive EOL care among those in LHL areas was 82.7%, compared to 72.7% in HHL areas. In multivariable analyses, decedents residing in LHL areas, compared to those in HHL areas, had 31% higher odds of aggressive EOL care (adjusted odds ratio [AOR] 1.31; 95% confidence interval [CI]:1.21-1.42), including higher odds of no hospice use (AOR 1.35; 95% CI: 1.27-1.44), repeated hospitalization (AOR 1.07; 95% CI: 1.01-1.14) and in-hospital death (AOR 1.21; 95% CI: 1.13-1.29). CONCLUSION Medicare beneficiaries who resided in LHL areas were likely to receive aggressive EOL care. Tailored efforts to improve HL and facilitate patient-provider communications in LHL areas could reduce EOL care intensity.
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Affiliation(s)
- Qingying Luo
- Department of Chronic Disease Epidemiology, 5755Yale University School of Public Health, New Haven, CT, USA
| | - Kewei Shi
- Department of Chronic Disease Epidemiology, 5755Yale University School of Public Health, New Haven, CT, USA
| | - Peiyin Hung
- Department of Health Services Policy and Management, Arnold School of Public Health, 5755University of South Carolina, SC, USA.,Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and 5755Yale University School of Medicine, New Haven, CT, USA
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, 5755Yale University School of Public Health, New Haven, CT, USA.,Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and 5755Yale University School of Medicine, New Haven, CT, USA
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Luo Y, Oh CY, Jean BS, Choe EK. Interrelationships Between Patients' Data Tracking Practices, Data Sharing Practices, and Health Literacy: Onsite Survey Study. J Med Internet Res 2020; 22:e18937. [PMID: 33350960 PMCID: PMC7785405 DOI: 10.2196/18937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/07/2020] [Accepted: 10/26/2020] [Indexed: 01/22/2023] Open
Abstract
Background Although the use of patient-generated data (PGD) in the optimization of patient care shows great promise, little is known about whether patients who track their PGD necessarily share the data with their clinicians. Meanwhile, health literacy—an important construct that captures an individual’s ability to manage their health and to engage with their health care providers—has often been neglected in prior studies focused on PGD tracking and sharing. To leverage the full potential of PGD, it is necessary to bridge the gap between patients’ data tracking and data sharing practices by first understanding the interrelationships between these practices and the factors contributing to these practices. Objective This study aims to systematically examine the interrelationships between PGD tracking practices, data sharing practices, and health literacy among individual patients. Methods We surveyed 109 patients at the time they met with a clinician at a university health center, unlike prior research that often examined patients’ retrospective experience after some time had passed since their clinic visit. The survey consisted of 39 questions asking patients about their PGD tracking and sharing practices based on their current clinical encounter. The survey also contained questions related to the participants’ health literacy. All the participants completed the survey on a tablet device. The onsite survey study enabled us to collect ecologically valid data based on patients’ immediate experiences situated within their clinic visit. Results We found no evidence that tracking PGD was related to self-reports of having sufficient information to manage one’s health; however, the number of data types participants tracked positively related to their self-assessed ability to actively engage with health care providers. Participants’ data tracking practices and their health literacy did not relate to their data sharing practices; however, their ability to engage with health care providers positively related to their willingness to share their data with clinicians in the future. Participants reported several benefits of, and barriers to, sharing their PGD with clinicians. Conclusions Although tracking PGD could help patients better engage with health care providers, it may not provide patients with sufficient information to manage their health. The gaps between tracking and sharing PGD with health care providers call for efforts to inform patients of how their data relate to their health and to facilitate efficient clinician-patient communication. To realize the full potential of PGD and to promote individuals’ health literacy, empowering patients to effectively track and share their PGD is important—both technologies and health care providers can play important roles.
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Affiliation(s)
- Yuhan Luo
- College of Information Studies, University of Maryland, College Park, MD, United States
| | - Chi Young Oh
- Chicago State University, Chicago, IL, United States
| | - Beth St Jean
- College of Information Studies, University of Maryland, College Park, MD, United States
| | - Eun Kyoung Choe
- College of Information Studies, University of Maryland, College Park, MD, United States
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Beks H, King O, Clapham R, Alston L, Glenister K, McKinstry C, Quilliam C, Wellwood I, Williams C, Wong Shee A. Community health programs delivered through information and communications technology in high-income countries: a scoping review (Preprint). J Med Internet Res 2020; 24:e26515. [PMID: 35262498 PMCID: PMC8943572 DOI: 10.2196/26515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/15/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has required widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms has introduced new challenges. Objective The objective of this review is to scope for ICT-delivered health programs implemented within the community health setting in high-income countries and rapidly disseminate findings to health professionals. Methods The Joanna Briggs Institute’s scoping review methodology guided the review of the literature. Results The search retrieved 7110 unique citations. Each title and abstract was screened by at least two reviewers, resulting in 399 citations for full-text review. Of these 399 citations, 72 (18%) were included. An additional 27 citations were identified through reviewing the reference lists of the included studies, resulting in 99 citations. Citations examined 83 ICT-delivered programs from 19 high-income countries. Variations in program design, ICT platforms, research design, and outcomes were evident. Conclusions Included programs and research were heterogeneous, addressing prevalent chronic diseases. Evidence was retrieved for the effectiveness of nurse and allied health ICT-delivered programs. Findings indicated that outcomes for participants receiving ICT-delivered programs, when compared with participants receiving in-person programs, were either equivalent or better. Gaps included a paucity of co-designed programs, qualitative research around group programs, programs for patients and carers, and evaluation of cost-effectiveness. During COVID-19 and beyond, health professionals in the community health setting are encouraged to build on existing knowledge and address evidence gaps by developing and evaluating innovative ICT-delivered programs in collaboration with consumers and carers.
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Affiliation(s)
- Hannah Beks
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Renee Clapham
- St Vincents Health Australia, Melbourne, Australia
- Ballarat Health Services, Ballarat, Australia
| | - Laura Alston
- School of Medicine, Deakin University, Geelong, Australia
- Colac Area Health, Colac, Australia
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Kristen Glenister
- Department of Rural Health, University of Melbourne, Wangaratta, Australia
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Carol McKinstry
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Claire Quilliam
- Department of Rural Health, University of Melbourne, Wangaratta, Australia
| | - Ian Wellwood
- Faculty of Health Sciences, Australian Catholic University, Ballarat, Australia
| | | | - Anna Wong Shee
- School of Medicine, Deakin University, Geelong, Australia
- Ballarat Health Services, Ballarat, Australia
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Häikiö K, Cloutier D, Rugkåsa J. Is health literacy of family carers associated with carer burden, quality of life, and time spent on informal care for older persons living with dementia? PLoS One 2020; 15:e0241982. [PMID: 33216771 PMCID: PMC7678960 DOI: 10.1371/journal.pone.0241982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Family carers are cornerstones in the care of older people living with dementia. Family carers report extensive carer burden, reduced health-related quality of life (HRQoL), and extensive time spent on informal care (Time). Health literacy (HL) is a concept associated with people's ability to access health services, and navigate the healthcare system. This study's aim was to investigate HL among family carers, and investigate the associations between HL and carer burden, HRQoL, and Time spent on informal care. METHOD We designed a self-administered survey comprising validated instruments, including the Health Literacy Scale (HLS-N-Q12) to measure HL, Relative Stress Scale (RSS) to measure carer burden, the EQ-5D-5L instrument to measure HRQoL, and some modified questions from the Resource Utilization in Dementia (RUD) questionnaire to measure time spent on informal care (Time). Descriptive analysis in addition to bivariate and multiple linear regressions were undertaken. In multiple linear regression analysis, we used HL as the independent variable to predict the outcomes (carer burden, HRQoL, Time). Analyses were adjusted for the effects of explanatory independent variables: age, gender, education levels, urban residency, having worked as health personnel, caring for someone with severe/mild dementia, and being born abroad. FINDINGS In a non-probability sample of 188 family carers from across Norway, most of them female and over the age of 60, we found high levels of HL. In the bivariate analysis, carer burden and HRQoL (EQvalue) showed significant associations with HL. In the multiple regression analyses, HL was statistically significantly associated with carer burden (B = -0.18 CI:-0.33,-0.02 p = 0.02), HRQoL (EQvalue: B = 0.003 with 95% CI: 0.001, 0.006 p = 0.04), and Time (B = -0.03 with 95% CI: -0.06, 0.000, p = 0.046), after adjusting for the effect of independent variables. CONCLUSION This is one of the first studies to investigate the associations between HL and different outcomes for family carers of older people living with dementia. Additional research into the associations identified here is needed to further develop our understanding of how to support family carers in their roles. Targeted support that increases family carers' HL may have potential to enhance their ability to provide sustainable care over time.
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Affiliation(s)
- Kristin Häikiö
- HØKH-Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.,Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Denise Cloutier
- Department of Geography & Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
| | - Jorun Rugkåsa
- HØKH-Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.,Center for Care Research, University of South-Eastern Norway, Porsgrunn, Norway
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App-Based Pain Management and Opioid Education Program for Patients in Clinic Waiting Rooms. Pain Manag Nurs 2020; 22:164-168. [PMID: 33223470 DOI: 10.1016/j.pmn.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/18/2020] [Accepted: 10/18/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Best approaches to delivering patient education related to pain management and opioid safety are understudied. AIMS This study assessed the feasibility, acceptability, and preliminary patient-reported impact of an app-based patient pain education program. DESIGN Pilot study with data collection occurring on 43 weekdays between August 2019-February 2020. SETTING Waiting rooms at the pain clinic and a primary care medical home within two military treatment facilities. PARTICIPANTS Military health system beneficiaries seeking general care at the primary care medical home or pain-specific care at the pain clinic. METHODS The Joint Pain Education and Project curriculum includes patient-focused videos describing the biopsychosocial aspects of pain and pain management, medication take-back and safe disposal, and multidimensional pain assessments. The app-based videos were available on tablets in the waiting rooms for patients to view and complete surveys on after. RESULTS Overall, 152 patients viewed the videos and completed surveys. Most viewers were interested in receiving other tablet-based health education while in the waiting room (62%). Most viewers found videos to be moderately or very helpful (73%) and were satisfied or very satisfied with the information provided (85%). Participants at the primary care medical home were more likely to find videos helpful compared to participants at the pain clinic (OR = 2.11; 95% CI: 1.07, 4.20; p = .03). CONCLUSION Implementing app-based pain management education is feasible across clinic settings and is well received by patients. Clinics should consider providing pain education across care setting, rather than just pain specialty clinics, to help foster discussions between clinicians and patients regarding pain management and opioid safety.
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Thomas-Purcell K, Ibe TA, Purcell D, Quinn G, Ownby R. Exploring Spirituality and Technology Receptivity Among a Sample of Older Blacks to Inform a Tailored Chronic Disease Self-Management mHealth Intervention. PATIENT-RELATED OUTCOME MEASURES 2020; 11:195-207. [PMID: 33117016 PMCID: PMC7553651 DOI: 10.2147/prom.s260949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/21/2020] [Indexed: 11/23/2022]
Abstract
Introduction Having multiple chronic conditions (MCC) is the most common health condition in older US adults of which Blacks are disproportionally affected. The management of each condition presents many challenges. Blacks in the US frequently cite spirituality as facilitator to well-being. More information is needed to understand the many aspects of spirituality that older Black patients use to manage MCCs. Methods In the current study, focus groups were conducted with 30 black men and women with MCCs to examine how spirituality can be incorporated into a mobile health intervention designed to increase chronic disease self-management (CDSM) skills by improving health literacy. Groups discussed spiritual practices used to facilitate CDSM and their perceptions about mobile technology use. Results Inductive thematic analysis suggested that a chronic disease wellness plan that acknowledges the relationship between spirituality and health was preferred by most participants. Additionally, the desire for mobile health (mHealth) among this group points to an opportunity for intervention. Discussion Creating culturally appropriate educational messages about CDSM that incorporate spiritual practices may be a useful method for building sustainable CDSM skills. Next steps include the development of a mHealth intervention prototype based on the results and pre-testing it prior to deployment.
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Affiliation(s)
- Kamilah Thomas-Purcell
- Department of Health Science, Dr. Pallavi Patel College of Health Care Sciences, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Tochukwu Adaobi Ibe
- Mayo Clinic, College of Medicine and Science, Department of Internal Medicine, Jacksonville, FL, USA
| | - Donrie Purcell
- Department of Psychiatry, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA
| | - Gwendolyn Quinn
- Department of OB-GYN, Department of Population Health, New York University, Langone Medical Center, New York, NY, USA
| | - Raymond Ownby
- Department of Psychiatry, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA
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Meherali S, Punjani NS, Mevawala A. Health Literacy Interventions to Improve Health Outcomes in Low- and Middle-Income Countries. Health Lit Res Pract 2020; 4:e251-e266. [PMID: 33313935 PMCID: PMC7751448 DOI: 10.3928/24748307-20201118-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/30/2020] [Indexed: 01/05/2023] Open
Abstract
Background: Health care systems in many low- and middle-income countries (LMICs) face considerable challenges in providing high-quality, affordable, and universally accessible care. Feasible solutions to these issues require health literacy (HL) interventions for people who live in LMICs. Low HL is a significant problem in many LMICs because of the low levels of general literacy and poorly resourced and functioning health systems. A comprehensive understanding of HL interventions is essential to determine whether these interventions meet the health information needs of people who live in LMICs and to develop other effective HL interventions specifically for people who live in LMICs, improve health outcomes, and reduce inequalities. Methods: A medical research librarian developed and implemented search strategies to identify relevant evidence. Included studies needed to contain HL in LMICs component to understand or evaluate HL interventions that target people who live in LMICs. Two reviewers selected studies, conducted quality assessments, and extracted data by using standard forms. Discussion or third-party adjudication resolved disagreements. The collected data include the design of the study, type of HL intervention, target audience, theoretical influences, approaches to evaluating the intervention delivered, intervention received, intervention fidelity, intervention reach, data analysis, and study outcomes. Key Results: The reviewers systematically analyzed the data from 23 published research studies, including 20 quantitative, 1 qualitative, and 2 mixed-method studies, on HL interventions to improve the health outcomes in LMICs. The various HL interventions for different groups of the population depend on the health outcomes of the study. The reviewers identified four themes: traditional HL interventions, art-based HL interventions, interactive learning strategies, and technology-based HL interventions. The researchers of a few studies also used multicomponent interventions to improve the HL of the population. Discussion: Despite global improvements in health indicators over time, such as decreased mortality and morbidity, significant challenges remain regarding the quality of the delivery of health care in many LMICs. All of the HL interventions were effective and significantly improved the knowledge and awareness of the population. However, based on the literature review, the reviewers found significant evidence that only a limited number of HL interventions are delivered through innovative and technological learning strategies. In addition, the sustainability and scalability of these interventions is not clear. Therefore, future research on sustainability measures for effective HL interventions in LMICs is still needed. [HLRP: Health Literacy Research and Practice. 2020;4(4):e250–e266.]
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Affiliation(s)
- Salima Meherali
- Address correspondence to Salima Meherali, PhD, RN, Faculty of Nursing, University of Alberta, 4-259 Edmonton Clinic Health Academy, Edmonton, Alberta, Canada T6G 1C9;
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Kemp E, Trigg J, Beatty L, Christensen C, Dhillon HM, Maeder A, Williams PAH, Koczwara B. Health literacy, digital health literacy and the implementation of digital health technologies in cancer care: the need for a strategic approach. Health Promot J Austr 2020; 32 Suppl 1:104-114. [PMID: 32681656 DOI: 10.1002/hpja.387] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/25/2020] [Accepted: 07/13/2020] [Indexed: 01/29/2023] Open
Abstract
ISSUE ADDRESSED Digital health technologies can potentially reduce health disparities in cancer care. However, the benefits of digital health technology depend partly on users' digital health literacy, that is, "capabilities and resources required for individuals to use and benefit from digital health resources," which combines health and digital literacy. We examined issues for digital health technology implementation in cancer care regarding digital health literacy, via stakeholder consultation. METHODS Consumers, health care professionals, researchers, developers, nongovernment and government/policy stakeholders (N = 51) participated in focus groups/interviews discussing barriers, enablers, needs and opportunities for digital health implementation in cancer care. Researchers applied framework analysis to identify themes of digital health literacy in the context of disparity and inclusion. RESULTS Limited digital and traditional health literacy were identified as barriers to digital technology engagement, with a range of difficulties identified for older, younger and socio-economically or geographically disadvantaged groups. Digital health technology was a potential enabler of health care access and literacy, affording opportunities to increase reach and engagement. Education combined with targeted design and implementation were identified means of addressing health and digital literacy to effectively implement digital health in cancer care. CONCLUSIONS Implementing digital health in cancer care must address the variability of digital health literacy in recipients, including groups living with disadvantage and older and younger people, in order to be effective. SO WHAT?: If cancer outcome disparity is to be reduced via digital health technologies, they must be implemented strategically to address digital health literacy needs. Health policy should reflect this approach.
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Affiliation(s)
- Emma Kemp
- Flinders University College of Medicine and Public Health, Adelaide, SA, Australia
| | | | - Lisa Beatty
- Flinders University College of Medicine and Public Health, Adelaide, SA, Australia.,Flinders Centre for Innovation in Cancer, Bedford Park, SA, Australia
| | | | - Haryana M Dhillon
- Centre for Medical Psychology & Evidenced-based Decision-making, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Anthony Maeder
- Flinders Digital Health Research Centre, Adelaide, SA, Australia.,Flinders University College of Nursing and Health Sciences, Adelaide, SA, Australia
| | - Patricia A H Williams
- Flinders Digital Health Research Centre, Adelaide, SA, Australia.,Flinders University College of Science and Engineering, Adelaide, SA, Australia
| | - Bogda Koczwara
- Flinders University College of Medicine and Public Health, Adelaide, SA, Australia.,Flinders Centre for Innovation in Cancer, Bedford Park, SA, Australia
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62
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Zhang QL, Xu N, Huang ST, Chen Q, Cao H. Effect of using the WeChat platform on the perioperative health education of parents of children who underwent transthoracic device closure of VSDs. J Cardiothorac Surg 2020; 15:256. [PMID: 32933575 PMCID: PMC7493314 DOI: 10.1186/s13019-020-01282-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/01/2020] [Indexed: 11/18/2022] Open
Abstract
Objective To explore the effects of using the WeChat platform on the perioperative health education of parents of children who underwent transthoracic device closure of ventricular septal defects (VSDs). Methods Participants were divided into a WeChat group and a leaflet group. Responses to relevant questionnaires and clinical data were recorded and analyzed. Results Before the operation, the scores of the Caretaker Knowledge Questionnaire in the WeChat group were significantly higher than those in the leaflet group. The scores of PSQ-18 in the WeChat group were significantly higher than those in the leaflet group. All the children in the WeChat group were followed up 1 month after discharge, while four children in the leaflet group were lost to follow-up. The rate of attrition in the leaflet group was significantly higher than that in the WeChat group. For the postoperative complications, there was no significant difference between the two groups. Conclusion Perioperative health education for parents of children who undergo transthoracic device closure of VSDs through the WeChat platform can effectively enhance parents’ knowledge of care, improve parent satisfaction, which is an effective method to ensure convenient operation and reduce loss to follow-up.
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Affiliation(s)
- Qi-Liang Zhang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China. .,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.
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Hyman A, Stewart K, Jamin AM, Novak Lauscher H, Stacy E, Kasten G, Ho K. Testing a school-based program to promote digital health literacy and healthy lifestyle behaviours in intermediate elementary students: The Learning for Life program. Prev Med Rep 2020; 19:101149. [PMID: 32670779 PMCID: PMC7347644 DOI: 10.1016/j.pmedr.2020.101149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 12/22/2022] Open
Abstract
Promoting digital health literacy and healthy lifestyle behaviours in children can lead to positive long-term health outcomes and prevent chronic diseases. However, there are few school-based interventions promoting this education to intermediate elementary students. The objective of this study was to test the effectiveness of a novel intervention to increase students' digital health literacy and health knowledge. Learning for Life is a classroom-based education program, developed for grade 4-7 students and delivered by teachers over six weeks. Three Canadian schools were recruited to deliver the intervention in 2018. This study had a pre-post design and no control group. Students' self-reported digital health literacy and healthy lifestyle behaviours were measured at pre-intervention (n = 126), post-intervention (n = 119), and two-month follow-up (n = 104). Students at pre-intervention had a mean (SD) age of 10.98 (0.56) years (57.1% females). Almost all (97%) students had unsupervised access to the Internet through a computer or smartphone. From pre- to post-intervention, students' digital health literacy increased (p = 0.009), but decreased from post-intervention to follow-up (p < 0.001). Post-intervention, the majority of students could identify at least one healthy behaviour (e.g., exercising one hour/day) and reported making at least one healthy change in their lives (e.g., eating more fruits/vegetables). This study demonstrated that the Learning for Life intervention can improve intermediate elementary students' digital health literacy over the short-term and help them learn and retain healthy lifestyle knowledge and behaviours. These findings affirm the need for interventions promoting digital healthy literacy and healthy lifestyle behaviours for this age group.
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Affiliation(s)
- Antonia Hyman
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Kurtis Stewart
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Anne-Marie Jamin
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Helen Novak Lauscher
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Elizabeth Stacy
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Gerry Kasten
- Community Nutrition Services, Squamish Community Health Centre, Vancouver Coastal Health, PO Box 220 1140 Hunter Place, Squamish, BC V8B 0A2, Canada
| | - Kendall Ho
- Digital Emergency Medicine, Department of Emergency Medicine, Faculty of Medicine, The University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
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Ali MA, Alam K, Taylor B. Determinants of ICT usage for healthcare among people with disabilities: The moderating role of technological and behavioural constraints. J Biomed Inform 2020; 108:103480. [DOI: 10.1016/j.jbi.2020.103480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/03/2020] [Accepted: 06/07/2020] [Indexed: 01/06/2023]
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Nilsson L, Hellström A, Wennerberg C, Ekstedt M, Schildmeijer K. Patients' experiences of using an e-Health tool for self-management support after prostate cancer surgery: a deductive interview study explained through the FITT framework. BMJ Open 2020; 10:e035024. [PMID: 32601113 PMCID: PMC7328745 DOI: 10.1136/bmjopen-2019-035024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate patients' experiences of using a web-based application, especially its usability as support for self-care activities after prostate cancer surgery. DESIGN A deductive content analysis was used, stemming from the Fit between Individuals, Task and Technology (FITT) framework. SETTING One surgical department in south of Sweden between October 2015 and April 2016 and between September 2017 and July 2018. PARTICIPANTS Fifteen men who had undergone radical prostatectomy for prostate cancer. RESULTS By organising data in accordance with the FITT model, three main categories with ten subcategories were identified. Patients gave feedback on functions that suited them and their needs, as well as potential adjustments and improvements. Patients experienced that ePATH gave them easy access to reliable information regarding their rehabilitation. Directed information about ePATH at enrolment was seen as important. ePATH was perceived to have a logical structure that was easy to follow. However, when the structure was unclear, patients became less motivated to use a function. CONCLUSIONS Patients experienced ePATH as satisfactorily user-friendly and useful as a complementary self-management support after prostate cancer surgery, especially when the information and tasks were tailored to their preferences and the system design features supported individual autonomy.
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Affiliation(s)
- Lina Nilsson
- eHealth Institute, Linnaeus University, Kalmar, Sweden
| | | | | | - Mirjam Ekstedt
- eHealth Institute, Linnaeus University, Kalmar, Sweden
- Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Learning Informatics Managment and Ethics, Karolinska Institutet, Stockholm, Sweden
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Enhancing Trauma Patient Experience Through Education and Engagement: Development of a Mobile Application. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS GLOBAL RESEARCH AND REVIEWS 2020; 4:JAAOSGlobal-D-20-00025. [PMID: 32440637 PMCID: PMC7209794 DOI: 10.5435/jaaosglobal-d-20-00025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 01/07/2023]
Abstract
The purpose was to determine the utility of an open access mobile device application (App: http://bit.ly/traumaapp) to improve patient education and engagement.
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67
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Stassen G, Grieben C, Sauzet O, Frob�se I, Schaller A. Health literacy promotion among young adults: a web-based intervention in German vocational schools. HEALTH EDUCATION RESEARCH 2020; 35:87-98. [PMID: 32011701 PMCID: PMC7089709 DOI: 10.1093/her/cyaa001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
Against the background of an ageing population, the target group of young adults holds strong societal relevance as the future workforce. At the same time, young adults find themselves in a critical phase of life regarding the manifestation of a healthy lifestyle. In this context, young adults' health literacy gains importance. Web-based interventions implemented in educational settings offer the potential for promoting health literacy, although longitudinal studies remain scarce. Within a pre-post cluster randomized controlled trial with 6-month follow-up, this study investigated whether an 8-week web-based intervention in vocational schools (with or without an additional initial face-to-face measure) improves individual competencies within a structural model of health literacy ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The control condition was regular school lessons following the curriculum only. A multi-level regression analysis was performed using the control group as reference. None of the interventions showed a significant improvement in any of the dimensions. Significant differences between the intervention and control were obtained for some dimensions, albeit showing reductions. Future research must examine how to build impactful health literacy promotion in educational settings. Investigations into linking digital and face-to-face measures should continue.
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Affiliation(s)
- Gerrit Stassen
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| | - Christopher Grieben
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| | - Odile Sauzet
- Department of Epidemiology and International Public Health, Bielefeld School of Public Health, Bielefeld University, Universit�tsstra�e 25, Bielefeld 33501, Germany
- Centre for Statistics, Bielefeld University, Universit�tsstra�e 25, Bielefeld 33501, Germany
| | - Ingo Frob�se
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
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Abstract
Zusammenfassung. Die eigenständige Suche sowie das adäquate Verständnis von Gesundheitsinformationen bilden eine wichtige Grundlage für die fundierte Entscheidungsfindung bei gesundheitlichen Problemen. Die hierfür zentralen Fähigkeiten sind die Gesundheitsinformationskompetenz (Health Information Literacy, HIL) und die allgemeine kognitive Fähigkeit (IQ). Die Konsequenzen einer adäquaten oder weniger adäquaten Einschätzung der eigenen Fähigkeiten für alltägliche Entscheidungen können erheblich sein, wurden jedoch im Kontext der Suche nach Gesundheitsinformationen noch nicht untersucht. In dieser Studie wurde zunächst überprüft, inwiefern HIL und IQ einen differenzierbaren Vorhersagebeitrag hinsichtlich der Präferenz bestimmter Eigenschaften von Gesundheitsinformationsquellen (Expertise, Interaktion, Zugänglichkeit) aufweisen. In einer explorativen Analyse wurden anschließend Unterschiede im Vorhersagebeitrag von Selbsteinschätzungs- und Leistungsmaßen von HIL und IQ untersucht. Dabei wurden Auswirkungen einer Über- oder Unterschätzung der eigenen Fähigkeiten im Hinblick auf die Präferenz bestimmter Quelleneigenschaften betrachtet. N = 286 Personen nahmen an der Untersuchung teil. Mit Hilfe von Response Surface Analysen wurde ein differenzierbarer Einfluss von HIL und IQ ermittelt. Spezifische Effekte der selbst eingeschätzten und objektiv gemessenen Fähigkeiten sowie der Interaktion dieser Maße wurden in Form einer Über- oder Unterschätzung identifiziert. Neben der tatsächlichen Fähigkeit spielen somit auch die eigene Einschätzung dieser Fähigkeit sowie eine daraus resultierende Unter- oder Überschätzung eine wichtige Rolle. In Forschung und Praxis Tätige sollten dies bei der Entwicklung und Durchführung von Maßnahmen zur Förderung der fundierten Entscheidungsfindung bei Patientinnen und Patienten berücksichtigen. Eine englische Übersetzung als Rohfassung dieses Artikels finden Sie als Elektronisches Supplement 1.
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Affiliation(s)
- Oliver Wedderhoff
- Leibniz-Zentrum für Psychologische Information und Dokumentation (ZPID), Trier
| | - Anita Chasiotis
- Leibniz-Zentrum für Psychologische Information und Dokumentation (ZPID), Trier
| | - Tom Rosman
- Leibniz-Zentrum für Psychologische Information und Dokumentation (ZPID), Trier
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The Mediating Role of the Patient Health Engagement Model on the Relationship Between Patient Perceived Autonomy Supportive Healthcare Climate and Health Literacy Skills. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051741. [PMID: 32155975 PMCID: PMC7084351 DOI: 10.3390/ijerph17051741] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 02/03/2023]
Abstract
Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL; hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients in becoming more and more engaged in their healthcare, thus augmenting their literacy skills. Our main hypothesis is that the well-known relationship between patients’ perceived autonomy supportive healthcare climate and HL skills is mediated by the Patient Health Engagement Model (PHE-model) which describes the patients’ progressive maturation of a psychological readiness to become active players in their healthcare. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking an autonomy-supportive healthcare climate to PHE-model and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of the PHE-model between autonomy-supportive healthcare climate and HL. Results show that the theoretical model has a good fit indexes and that PHE-model fully mediates the relationship between autonomy-supportive healthcare climate and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.
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70
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Seljelid B, Varsi C, Solberg Nes L, Stenehjem AE, Bollerslev J, Børøsund E. Content and system development of a digital patient-provider communication tool to support shared decision making in chronic health care: InvolveMe. BMC Med Inform Decis Mak 2020; 20:46. [PMID: 32131808 PMCID: PMC7057594 DOI: 10.1186/s12911-020-1065-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/23/2020] [Indexed: 12/22/2022] Open
Abstract
Background Chronic conditions present major health problems, affecting an increasing number of individuals who experience a variety of symptoms that impact their health related quality of life. Digital tools can be of support in chronic conditions, potentially improving patient-provider communication, promoting shared decision making for treatment and care, and possibly even improving patient outcomes. This study aimed to develop a digital tool for patient-provider communication in chronic health care settings and describes the data collection and subsequent content and software development of the InvolveMe tool. InvolveMe will provide patients with the opportunity to report symptoms and preferences to their health care providers (HCP), and to use secure messaging to interact with the HCPs. Method The study employed a combination of interviews with patients with chronic conditions and focus groups with HCPs, examining experiences with chronic conditions and the potential use of a digital tool for support. Participants were recruited from two outpatient clinics at a university hospital. Data collected from interviews and focus groups were analysed using thematic analysis. Content and software development was informed by the data collection and by tool development workshops. Results Analyses from interviews with patients (n = 14) and focus groups with HCPs (n = 11) generated three main themes: 1) Making symptoms and challenges visible, 2) Mastering a new life, and 3) Digital opportunities for follow-up. Each main theme generated separate subthemes. Theme 1 and 2 gave input for content development of the symptom and needs assessment part of the tool, while theme 3 provided ideas for the software development of the InvolveMe tool. Tool development workshops with patients (n = 6) and HCPs (n = 6) supplemented the development. Conclusions A digital tool such as InvolveMe has the potential to support shared decision making for patients with chronic health conditions. Through integration with an existing patient portal such a tool can provide opportunities for meaningful interactions and communication between patients and HCP’s, particularly with regards to symptoms, needs and preferences for care.
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Affiliation(s)
- Berit Seljelid
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatry & Psychology, College of Medicine & Science, Mayo Clinic, Rochester, MN, USA
| | - Aud-E Stenehjem
- Department of Nephrology, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Jens Bollerslev
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Section of Specialized Endocrinology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.
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Kendir C, Breton E. Health Literacy: From a Property of Individuals to One of Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051601. [PMID: 32131441 PMCID: PMC7084319 DOI: 10.3390/ijerph17051601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 02/27/2020] [Indexed: 11/16/2022]
Abstract
Health literacy (HL) is increasingly hailed as a strategy to improve the control individuals have over their health. A central critic of HL intervention is its overemphasis on individual level factors, something recognised in the 2008 report of the Commission of Social Determinants of Health (SDoH) that recommended expanding the scope of HL to cover the SDoH. The objective of our study was to assess the extent to which recent progress on HL captures the need for collective action on the SDoH. We conducted a scoping review on PubMed looking for review papers published between 2013–2018 in English and French. Definitions of HL were analysed against two main dimensions (i.e., locus of change of HL strategies and foreseen outcome of HL improvements). Despite a number of authors calling for more research on HL interventions at the community level and an expansion of the definition to cover the SDoH, we found that the recommendation of the Commission has yet to be implemented. Even when the definitions include the capacities of individuals on distal determinants, both the locus of change and outcomes of HL improvement do not go beyond intra individual factors (knowledge, skills, etc.). It is noteworthy that communities were either framed as a setting outside of health care services or as an aggregate of individuals. We found no instance of HL intervention regarding communities as complex systems of actors sharing a common space and dynamic. We conclude by suggesting a new definition of HL and by drawing attention to the research gap in addressing the upstream SDoH through HL actions.
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Affiliation(s)
- Candan Kendir
- École des hautes études en sante publique (EHESP), 35043 Rennes, France;
- Correspondence:
| | - Eric Breton
- École des hautes études en sante publique (EHESP), 35043 Rennes, France;
- Laboratory Arènes (UMR CNRS 6051), 35700 Rennes, France
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Holmen H, Riiser K, Winger A. Home-Based Pediatric Palliative Care and Electronic Health: Systematic Mixed Methods Review. J Med Internet Res 2020; 22:e16248. [PMID: 32130127 PMCID: PMC7070344 DOI: 10.2196/16248] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/05/2019] [Accepted: 12/14/2019] [Indexed: 01/23/2023] Open
Abstract
Background Children and families in pediatric palliative care depend on close contact with health care personnel, and electronic health (eHealth) is suggested to support care at home by facilitating their remote interactions. Objective This study aimed to identify and review the use of eHealth to communicate and support home-based pediatric palliative care and appraise the methodological quality of the published research. Methods We conducted a convergent, systematic mixed methods review and searched Medical Literature Analysis and Retrieval System Online (Medline), EMBASE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Scopus for eligible papers. Studies evaluating 2-way communication technology for palliative care for children aged ≤18 years and applying quantitative, qualitative, or mixed methods from 2012 to 2018 were eligible for inclusion. Quantitative and qualitative studies were equally valued during the search, screening, extraction, and analysis. Quantitative data were transformed into qualitative data and analyzed using a thematic analysis. Overall, 2 independent researchers methodologically appraised all included studies. Results We identified 1277 citations. Only 7 papers were eligible for review. Evaluating eHealth interventions in pediatric palliative care poses specific methodological and ethical challenges. eHealth to facilitate remote pediatric palliative care was acknowledged both as an intrusion and as a support at home. Reluctance toward eHealth was mainly identified among professionals. Conclusions The strengths of the conclusions are limited by the studies’ methodological challenges. Despite the limitless possibilities held by new technologies, research on eHealth in home-based pediatric palliative care is scarce. The affected children and families appeared to hold positive attitudes toward eHealth, although their views were less apparent compared with those of the professionals. Trial Registration PROSPERO CRD42018119051; https://tinyurl.com/rtsw5ky
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Zanobini P, Lorini C, Baldasseroni A, Dellisanti C, Bonaccorsi G. A Scoping Review on How to Make Hospitals health Literate Healthcare Organizations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031036. [PMID: 32041282 PMCID: PMC7037285 DOI: 10.3390/ijerph17031036] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 12/13/2022]
Abstract
The concept of health literacy is increasingly being recognised as not just an individual trait, but also as a characteristic related to families, communities, and organisations providing health and social services. The aim of this study is to identify and describe, through a scoping review approach, the characteristics and the interventions that make a hospital a health literate health care organisation (HLHO), in order to develop an integrated conceptual model. We followed Arksey and O’Malley’s five-stage scoping review framework, refined with the Joanna Briggs Institute methodology, to identify the research questions, identify relevant studies, select studies, chart the data, and collate and summarize the data. Of the 1532 titles and abstracts screened, 106 were included. Few studies have explored the effect of environmental support on health professionals, and few outcomes related to staff satisfaction/perception of helpfulness have been reported. The most common types of interventions and outcomes were related to the patients. The logical framework developed can be an effective tool to define and understand priorities and related consequences, thereby helping researchers and policymakers to have a wider vision and a more homogeneous approach to health literacy and its use and promotion in healthcare organizations.
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Affiliation(s)
- Patrizio Zanobini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (G.B.)
- Correspondence: ; Tel.: +39-3663435179
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (G.B.)
| | - Alberto Baldasseroni
- Tuscany Regional Centre for Occupational Injuries and Diseases (CeRIMP), Central Tuscany LHU, Via di San Salvi, 12, 50135 Florence, Italy;
| | - Claudia Dellisanti
- Department of Epidemiology, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, 50141 Florence, Italy;
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, Viale GB Morgagni 48, 50134 Florence, Italy; (C.L.); (G.B.)
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Arsenijevic J, Tummers L, Bosma N. Adherence to Electronic Health Tools Among Vulnerable Groups: Systematic Literature Review and Meta-Analysis. J Med Internet Res 2020; 22:e11613. [PMID: 32027311 PMCID: PMC7055852 DOI: 10.2196/11613] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 05/26/2019] [Accepted: 09/26/2019] [Indexed: 01/19/2023] Open
Abstract
Background Electronic health (eHealth) tools are increasingly being applied in health care. They are expected to improve access to health care, quality of health care, and health outcomes. Although the advantages of using these tools in health care are well described, it is unknown to what extent eHealth tools are effective when used by vulnerable population groups, such as the elderly, people with low socioeconomic status, single parents, minorities, or immigrants. Objective This study aimed to examine whether the design and implementation characteristics of eHealth tools contribute to better use of these tools among vulnerable groups. Methods In this systematic review, we assessed the design and implementation characteristics of eHealth tools that are used by vulnerable groups. In the meta-analysis, we used the adherence rate as an effect size measure. The adherence rate is defined as the number of people who are repetitive users (ie, use the eHealth tool more than once). We also performed a meta-regression analysis to examine how different design and implementation characteristics influenced the adherence rate. Results Currently, eHealth tools are continuously used by vulnerable groups but to a small extent. eHealth tools that use multimodal content (such as videos) and have the possibility for direct communication with providers show improved adherence among vulnerable groups. Conclusions eHealth tools that use multimodal content and provide the possibility for direct communication with providers have a higher adherence among vulnerable groups. However, most of the eHealth tools are not embedded within the health care system. They are usually focused on specific problems, such as diabetes or obesity. Hence, they do not provide comprehensive services for patients. This limits the use of eHealth tools as a replacement for existing health care services.
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Affiliation(s)
- Jelena Arsenijevic
- Utrecht University School of Governance, Faculty of Law Economics and Governance, Utrecht, Netherlands
| | - Lars Tummers
- Utrecht University School of Governance, Faculty of Law Economics and Governance, Utrecht, Netherlands
| | - Niels Bosma
- Utrecht University School of Economics, Faculty of Law Economics and Governance, Utrecht, Netherlands
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Liew SJ, Gorny AW, Tan CS, Müller-Riemenschneider F. A Mobile Health Team Challenge to Promote Stepping and Stair Climbing Activities: Exploratory Feasibility Study. JMIR Mhealth Uhealth 2020; 8:e12665. [PMID: 32014845 PMCID: PMC7055777 DOI: 10.2196/12665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/31/2019] [Accepted: 10/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background Mobile health (mHealth) approaches are growing in popularity as a means of addressing low levels of physical activity (PA). Objective This study aimed to determine the validity of wearables in measuring step count and floor count per day and assess the feasibility and effects of a 6-week team challenge intervention delivered through smartphone apps. Methods Staff and students from a public university were recruited between 2015 and 2016. In phase 1, everyone wore a Fitbit tracker (Charge or Charge HR) and an ActiGraph for 7 days to compare daily step count estimated by the two devices under free-living conditions. They were also asked to climb 4 bouts of floors in an indoor stairwell to measure floor count which was compared against direct observation. In phase 2, participants were allocated to either a control or intervention group and received a Fitbit tracker synced to the Fitbit app. Furthermore, the intervention group participants were randomized to 4 teams and competed in 6 weekly (Monday to Friday) real-time challenges. A valid day was defined as having 1500 steps or more per day. The outcomes were as follows: (1) adherence to wearing the Fitbit (ie, number of days in which all participants in each group were classified as valid users aggregated across the entire study period), (2) mean proportion of valid participants over the study period, and (3) the effects of the intervention on step count and floor count determined using multiple linear regression models and generalized estimating equations (GEEs) for longitudinal data analysis. Results In phase 1, 32 of 40 eligible participants provided valid step count data, whereas all 40 participants provided valid floor count data. The Fitbit trackers demonstrated high correlations (step count: Spearman ρ=0.89; P<.001; floor count: Spearman ρ=0.98; P<.001). The trackers overestimated step count (median absolute error: 17%) but accurately estimated floor count. In phase 2, 20 participants each were allocated to an intervention or control group. Overall, 24 participants provided complete covariates and valid PA data for analyses. Multiple linear regressions revealed that the average daily steps was 15.9% higher for the intervention group (95% CI −8.9 to 47.6; P=.21) during the final two intervention weeks; the average daily floors climbed was 39.4% higher (95% CI 2.4 to 89.7; P=.04). GEE results indicated no significant interaction effects between groups and the intervention week for weekly step count, whereas a significant effect (P<.001) was observed for weekly floor count. Conclusions The consumer wearables used in this study provided acceptable validity in estimating stepping and stair climbing activities, and the mHealth-based team challenge interventions were feasible. Compared with the control group, the participants in the intervention group climbed more stairs, so this can be introduced as an additional PA promotion target in the context of mHealth strategies. Methodologically rigorous studies are warranted to further strengthen this study’s findings.
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Affiliation(s)
- Seaw Jia Liew
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
| | - Alex Wilhelm Gorny
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.,Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin, Berlin, Germany
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Semakula D, Nsangi A, Oxman M, Rosenbaum SE, Oxman AD, Austvoll-Dahlgren A, Glenton C, Lewin S, Kaseje M, Morelli A, Fretheim A, Sewankambo NK. Development of mass media resources to improve the ability of parents of primary school children in Uganda to assess the trustworthiness of claims about the effects of treatments: a human-centred design approach. Pilot Feasibility Stud 2019; 5:155. [PMID: 31890267 PMCID: PMC6935490 DOI: 10.1186/s40814-019-0540-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 12/02/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Claims about what we need to do to improve our health are everywhere. Most interventions simply tell people what to do, and do not empower them to critically assess health information. Our objective was to design mass media resources to enable the public to critically appraise the trustworthiness of claims about the benefits and harms of treatments and make informed health choices. METHODS Research was conducted between 2013 and 2016 across multiple iterative phases. Participants included researchers, journalists, parents, other members of the public. First, we developed a list of 32 key concepts that people need to understand to be able to assess the trustworthiness of claims about treatment effects. Next, we used a human-centred design approach, to generate ideas for resources for teaching the key concepts, and developed and user-tested prototypes through qualitative interviews. We addressed identified problems and repeated this process until we had a product that was deemed relevant and desirable by our target audience, and feasible to implement. RESULTS We generated over 160 ideas, mostly radio-based. After prototyping some of these, we found that a podcast produced collaboratively by health researchers and journalists was the most promising approach. We developed eight episodes of the Informed Health Choices podcast, a song on critical thinking about treatments and a reminder checklist. Early versions of the podcast were reportedly too long, boring and confusing. We shortened the episodes, included one key concept per episode, and changed to story-telling with skits. The final version of the podcast was found to be useful, understandable, credible and desirable. CONCLUSION We found many problems with various prototypes of mass media resources. Using a human-centred design approach, we overcame those problems. We have developed a guide to help others prepare similar podcasts.
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Affiliation(s)
- Daniel Semakula
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda
- University of Oslo, Oslo, Norway
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Sarah Ellen Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Andrew David Oxman
- University of Oslo, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Astrid Austvoll-Dahlgren
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Claire Glenton
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | | | - Atle Fretheim
- University of Oslo, Oslo, Norway
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213 Oslo, Norway
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Sousa P, Martinho R, Reis CI, Dias SS, Gaspar PJS, Dixe MDA, Luis LS, Ferreira R. Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysis. J Adv Nurs 2019; 76:1057-1068. [PMID: 31880009 DOI: 10.1111/jan.14301] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/15/2019] [Accepted: 12/17/2019] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the effectiveness on lifestyle change of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower) and to analyse the predictors of the mHealth intervention effectiveness. DESIGN This study is designed as a non-randomized controlled trial with a two-arm structure. METHODS Adolescents of 12-16-year old were recruited from three school districts, with access to the Internet and smartphone/tablet devices. The intervention group was invited to engage in the mHealth intervention (TeenPower) for 6 months in addition to a school-based intervention. The control group only followed the school-based intervention. A repeated measures factorial ANOVA was used and the main effectiveness outcome was the lifestyle change measured by the adolescent lifestyle profile. RESULTS The outcomes of the mHealth intervention (TeenPower) show a significant effect on nutrition (ƞ2 p = 0.03, p = .03), positive life perspective (ƞ2 p = 0.04, p = .01), and global lifestyle (ƞ2 p = 0.02, p = .05), with a dropout rate of 62.1%. The analysis of the effectiveness predictors of the mHealth intervention suggested that older adolescents tended to show a significant increase in the rates of stress management (r = .40; p < .05). CONCLUSIONS Although the considerable dropout rate, the mHealth intervention presented significant impact on multiple lifestyle domains, providing support for the effectiveness of mHealth interventions for health promotion as an add-on to standard interdisciplinary interventions. IMPACT Adolescents must have the necessary and appropriate knowledge for the correct and responsible decision-making regarding their health and lifestyle. Innovative strategies (mHealth intervention) were used to promote healthy behaviours. This study evaluates the effectiveness of an mHealth intervention (TeenPower) specifically designed for adolescents. We found a significant impact in several lifestyle domains such as health responsibility, nutrition, positive life perspective, and global lifestyle.
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Affiliation(s)
- Pedro Sousa
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.,ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Ricardo Martinho
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal.,Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Catarina I Reis
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal
| | - Sara S Dias
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal.,EpiDoC Unit - CEDOC, NOVA Medical School - Universidade Nova de Lisboa (NMS-UNL), Lisboa, Portugal
| | - Pedro J S Gaspar
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Maria Dos Anjos Dixe
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Luis S Luis
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Regina Ferreira
- CIIS-UC, UI-IPSantarém, School of Health Sciences, Polytechnic Institute of Santarém, Santarém, Portugal.,UMIS-School of Health Sciences, Santarém, Portugal
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Bray L, Appleton V, Sharpe A. 'If I knew what was going to happen, it wouldn't worry me so much': Children's, parents' and health professionals' perspectives on information for children undergoing a procedure. J Child Health Care 2019; 23:626-638. [PMID: 31431048 DOI: 10.1177/1367493519870654] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Children undergoing procedures such as blood tests and X-rays experience less anxiety and upset if they are well prepared and informed. Currently the provision of information about procedures can be ad hoc and there are barriers to children understanding this information. This study explored the perspectives of 32 children undergoing procedures (aged between 8 and 12 years), 27 parents and 19 health professionals on the provision of preparatory information to children. Qualitative interviews, prompted by visual images, were thematically analysed. The three themes, 'accessing information', 'understanding information' and 'using information', resonated with the central tenets of health literacy. Children reported mainly accessing information second-hand through their parents and demonstrated misconceptions about their procedure. Children identified that procedural information would help them to know what was going to happen and enable them to feel less worried and scared about their procedure. This study highlights that children can have low levels of health literacy in relation to a planned procedure. Their health literacy in this context is heavily influenced by the adults (parents and health professionals) around them. There needs to be further work conducted, informed directly by children, to improve the health literacy of children attending hospital for planned procedures.
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Affiliation(s)
- Lucy Bray
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Victoria Appleton
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Ashley Sharpe
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
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Vamos CA, Griner SB, Kirchharr C, Green SM, DeBate R, Daley EM, Quinonez RB, Boggess KA, Jacobs T, Christiansen S. The development of a theory-based eHealth app prototype to promote oral health during prenatal care visits. Transl Behav Med 2019; 9:1100-1111. [PMID: 31009536 PMCID: PMC6875649 DOI: 10.1093/tbm/ibz047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Poor maternal oral health during pregnancy is associated with adverse maternal and child outcomes, including preterm birth and early childhood caries. Subsequently, professional associations have developed prenatal oral health guidelines, but significant gaps exist in implementing guidelines into clinical practice. The purpose of this study was to develop and test the usability of an innovative, theory-driven, eHealth application ("app") to facilitate prenatal providers' (nurse practitioners and midwives) implementation of oral health promotion during prenatal care visits. App development was guided by previous research, an integrated conceptual framework, Scientific Advisory Board input, and consumer-engaged iterative processes utilizing mixed-methods (observations, surveys, in-depth interviews) among providers (n = 4) during 10 unique prenatal care visits at a federally qualified health care center. Triangulation of quantitative and qualitative data analysis produced descriptive frequencies and salient themes. Concepts and principles from the following theoretical frameworks informed intervention development and testing: Consolidated Framework for Implementation Research; Information-Motivation-Behavioral Skills Model; Health Literacy; and Brief Motivational Interviewing. Overall, providers reported the app was effective at providing the information, motivation, and behavioral skills needed to integrate oral health promotion (e.g., easy to use; provided cues to action via scripts and tailored education; and documented findings into the patient's record). Although providers reported high usability, time constraints and detailed patient counseling scripts were identified areas for improvement. Findings suggest that the eHealth app could serve as an innovative mechanism to assist providers in implementing the prenatal oral health guidelines into practice. Future research is needed to continue app development efforts and to determine efficacy and effectiveness in practice settings.
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Affiliation(s)
- Cheryl A Vamos
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Stacey B Griner
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Claire Kirchharr
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Shana M Green
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rita DeBate
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen M Daley
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Rocio B Quinonez
- Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Kim A Boggess
- School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Tom Jacobs
- Custom Thinking Media, LLC, Eugene, OR, USA
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Silva Moreira P, Chaves P, Dias R, Dias N, Almeida PR. Validation of Wireless Sensors for Psychophysiological Studies. SENSORS 2019; 19:s19224824. [PMID: 31698694 PMCID: PMC6891453 DOI: 10.3390/s19224824] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/16/2019] [Accepted: 10/29/2019] [Indexed: 12/29/2022]
Abstract
James One (MindProber Labs) is a wireless psychophysiological device comprising two sensors: one measuring electrodermal activity (EDA), the other photoplethysmography (PPG). This paper reports the validation of James One’s EDA sensor by comparing its signal against a research grade polygraph. Twenty participants were instructed to perform breathing exercises to elicit the modulation of EDA and heart rate, while the physiological signal was captured simultaneously on James One and a Biopac MP36. The resulting EDA and PPG records collected from both systems were comprehensively compared. Results suggest that James One captures EDA signal with a quality comparable to a research grade equipment, this constituting a reliable means of capturing data while minimizing setup time and intrusiveness.
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Affiliation(s)
- Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
- MindProber Labs, 4450-102 Porto, Portugal; (P.C.); (R.D.); (N.D.); (P.R.A.)
- Correspondence:
| | - Pedro Chaves
- MindProber Labs, 4450-102 Porto, Portugal; (P.C.); (R.D.); (N.D.); (P.R.A.)
- Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Ruben Dias
- MindProber Labs, 4450-102 Porto, Portugal; (P.C.); (R.D.); (N.D.); (P.R.A.)
| | - Nuno Dias
- MindProber Labs, 4450-102 Porto, Portugal; (P.C.); (R.D.); (N.D.); (P.R.A.)
- 2Ai-Polytechnic Institute of Cávado and Ave, Campus do IPCA, 4750-810 Barcelos, Portugal
| | - Pedro R Almeida
- MindProber Labs, 4450-102 Porto, Portugal; (P.C.); (R.D.); (N.D.); (P.R.A.)
- School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal
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“I Didn't Know”: Pregnant Women's Oral Health Literacy Experiences and Future Intervention Preferences. Womens Health Issues 2019; 29:522-528. [DOI: 10.1016/j.whi.2019.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/07/2019] [Accepted: 05/16/2019] [Indexed: 11/18/2022]
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Muscat DM, Morony S, Trevena L, Hayen A, Shepherd HL, Smith SK, Dhillon HM, Luxford K, Nutbeam D, McCaffery KJ. Skills for Shared Decision-Making: Evaluation of a Health Literacy Program for Consumers with Lower Literacy Levels. Health Lit Res Pract 2019; 3:S58-S74. [PMID: 31687658 PMCID: PMC6826761 DOI: 10.3928/24748307-20190408-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 03/05/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Shared decision-making (SDM) has been found to be significantly and positively associated with improved patient outcomes. For an SDM process to occur, patients require functional, communicative, and critical health literacy (HL) skills. Objective: This study aimed to evaluate the impact of a program to improve health literacy skills for SDM in adults with lower literacy. Methods: An HL program including an SDM component (HL + SDM) and teaching of the three “AskShareKnow” questions was delivered in adult basic education settings in New South Wales, Australia. The program was evaluated using a partially cluster-randomized controlled trial comparing it to standard language, literacy, and numeracy (LLN) training. We measured the effect of these programs on (1) HL skills for SDM (conceptual knowledge, graphical literacy, health numeracy), (2) types of questions considered important for health decision-making, (3) preferences for control in decision-making, and (4) decisional conflict. We also measured AskShareKnow question recall, use, and evaluation in HL + SDM participants. Key Results: There were 308 participants from 28 classes enrolled in the study. Most participants had limited functional HL (71%) and spoke a language other than English at home (60%). In the primary analysis, the HL + SDM program compared with the standard LLN program significantly increased conceptual knowledge (19.1% difference between groups in students achieving the competence threshold; p = .018) and health numeracy (10.9% difference; p = .032), but not graphical literacy (5.8% difference; p = .896). HL + SDM participants were significantly more likely to consider it important to ask questions that would enable SDM compared to standard LLN participants who prioritized nonmedical procedural questions (all p < .01). There was no difference in preferences for control in decision-making or in decisional conflict. Among HL + SDM participants, 79% (n = 85) correctly recalled at least one of the AskShareKnow questions immediately post-intervention, and 35% (n = 29) after 6 months. Conclusions: Teaching SDM content increased participants' HL skills for SDM and changed the nature of the questions they would ask health care professionals in a way that would enable shared health decisions. [HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S58–S74.] Plain Language Summary: We developed a health literacy program that included a shared decision-making (SDM) section. The program was delivered in adult basic education classes by trained educators and compared to standard language, literacy, and numeracy training. Teaching SDM content increased participants' health literacy skills for SDM and changed the nature of the questions they would ask health care professionals.
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Affiliation(s)
- Danielle M. Muscat
- Address correspondence to Danielle M. Muscat, PhD, School of Public Health, The University of Sydney, 127A Edward Ford Building, NSW, 2006, Australia;
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Huang Y, Wang L, Huo J, Wu Q, Wang W, Chang S, Zhang Y. Prevalence and causes of anaemia in children aged 6-23 months in rural Qinghai, China: findings from a cross-sectional study. BMJ Open 2019; 9:e031021. [PMID: 31501129 PMCID: PMC6738674 DOI: 10.1136/bmjopen-2019-031021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To investigate the current situation of anaemia among children aged 6-23 months in a rural county in China, and to explore the influencing factors and the main causes of anaemia. DESIGN A cross-sectional study. SETTING Huzhu County in Qinghai Province, China PARTICIPANTS: We selected 38 sampled villages using Proportional to Population Size sampling method. We obtained the name list of children aged 6-23 months in each sampled village and planned to survey all the eligible children aged 6-23 months and their caregivers. PRIMARY AND SECONDARY OUTCOMES MEASURES The prevalence of anaemia, the influencing factors of anaemia, the laboratory tests for biological causes of anaemia, including serum ferritin, soluble transferrin receptor, folic acid, homocysteine and vitamin B12. RESULTS A total of 754 children aged 6-23 months and their caregivers were surveyed, and 183 anaemic children aged 12-23 months were collected venous blood sample. The anaemia prevalence of children aged 6-23 months in Huzhu County was 59.1%. Children of younger age (OR=0.968, 95% CI 0.940 to 0.998), Tibetan nationality (OR=3.123, 95% CI 1.473 to 6.623) and not introducing meat (OR=0.698, 95% CI 0.499 to 0.976) were more likely to be anaemic. More than 80% of children with anaemia were due to iron deficiency (ID), and 20.2% of them had both iron and folic acid deficiencies. CONCLUSIONS The anaemia prevalence of children aged 6-23 months in Huzhu County was high and children of younger age, Tibetan nationality and not introducing meat were more likely to be anaemic. The main cause of anaemia was nutritional anaemia, with the vast majority being ID. Interventions of feeding counselling and nutrients supplements are appropriate and should be further strengthened. TRIAL REGISTRATION NUMBER ChiCTRPRC12002444.
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Affiliation(s)
- Yiwen Huang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Lijuan Wang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Junsheng Huo
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Qiong Wu
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Wei Wang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Suying Chang
- Health and Nutrition, Water, Environment and Sanitation Section, UNICEF, Beijing, China
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
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84
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Wentink MM, Siemonsma PC, van Bodegom-Vos L, de Kloet AJ, Verhoef J, Vlieland TPMV, Meesters JJL. Teachers' and students' perceptions on barriers and facilitators for eHealth education in the curriculum of functional exercise and physical therapy: a focus groups study. BMC MEDICAL EDUCATION 2019; 19:343. [PMID: 31492129 PMCID: PMC6731570 DOI: 10.1186/s12909-019-1778-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 08/30/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Despite the growing importance of eHealth it is not consistently embedded in the curricula of functional exercise and physical therapy education. Insight in barriers and facilitators for embedding eHealth in education is required for the development of tailored strategies to implement eHealth in curricula. This study aims to identify barriers/facilitators perceived by teachers and students of functional exercise/physical therapy for uptake of eHealth in education. METHODS A qualitative study including six focus groups (two with teachers/four with students) was conducted to identify barriers/facilitators. Focus groups were audiotaped and transcribed in full. Reported barriers and facilitators were identified, grouped and classified using a generally accepted framework for implementation including the following categories: innovation, individual teacher/student, social context, organizational context and political and economic factors. RESULTS Teachers (n = 11) and students (n = 24) of functional exercise/physical therapy faculties of two universities of applied sciences in the Netherlands participated in the focus groups. A total of 109 barriers/facilitators were identified during the focus groups. Most related to the Innovation category (n = 26), followed by the individual teacher (n = 22) and the organization (n = 20). Teachers and students identified similar barriers/facilitators for uptake of eHealth in curricula: e.g. unclear concept of eHealth, lack of quality and evidence for eHealth, (lack of) capabilities of students/teachers on how to use eHealth, negative/positive attitude of students/teachers towards eHealth. CONCLUSION The successful uptake of eHealth in the curriculum of functional exercise/physical therapists needs a systematic multi-facetted approach considering the barriers and facilitators for uptake identified from the perspective of teachers and students. A relatively large amount of the identified barriers and facilitators were overlapping between teachers and students. Starting points for developing effective implementation strategies can potentially be found in those overlapping barriers and facilitators. REGISTRATION The study protocol was a non-medical research and no registration was required. Participants gave written informed consent.
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Affiliation(s)
- M M Wentink
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands.
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
| | - P C Siemonsma
- Faculty of Health Care, University of Applied Sciences , Leiden, The Netherlands
| | - L van Bodegom-Vos
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - A J de Kloet
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
| | - J Verhoef
- Faculty of Health Care, University of Applied Sciences , Leiden, The Netherlands
| | - T P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Innovation, Quality + Research, Basalt Rehabilitation Centre, The Hague / Leiden, The Netherlands
| | - J J L Meesters
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Centre, Leiden, The Netherlands
- Faculty of Health, Nutrition and Sports, The Hague University of Applied Sciences, The Hague, The Netherlands
- Innovation, Quality + Research, Basalt Rehabilitation Centre, The Hague / Leiden, The Netherlands
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85
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Nguyen LH, Tran BX, Rocha LEC, Nguyen HLT, Yang C, Latkin CA, Thorson A, Strömdahl S. A Systematic Review of eHealth Interventions Addressing HIV/STI Prevention Among Men Who Have Sex With Men. AIDS Behav 2019; 23:2253-2272. [PMID: 31401741 DOI: 10.1007/s10461-019-02626-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A systematic review was conducted to summarize and appraise the eHealth interventions addressing HIV/STI prevention among men who have sex with men (MSM), and characterize features of successful eHealth interventions. Fifty-five articles (17 pilots and 38 full efficacy trials) were included with the predominance of web-based interventions in the United States-based settings. Intervention modalities include web-based, short message service (SMS)/text messges/email reminder, online video-based, computer-assisted, multimedia-based, social network, live chat and chat room, virtual simulation intervention, and smartphone applications. Forty-nine eHealth interventions achieved a short-term behaviour change among participants. Four studies were conducted with 12-month follow-ups; and only one of them could maintain the behaviour change over this longer time period which could be due to the lack of booster interventions. Our study suggests that eHealth interventions can achieve short term behaviour change among MSM, however limited interventions could maintain behaviour change over 12 months. Further eHealth intervention strategies to promote HIV prevention among MSM should be conducted and rigorously evaluated.
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86
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Madkins K, Moskowitz DA, Moran K, Dellucci TV, Mustanski B. Measuring Acceptability and Engagement of The Keep It Up! Internet-Based HIV Prevention Randomized Controlled Trial for Young Men Who Have Sex With Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2019; 31:287-305. [PMID: 31361516 PMCID: PMC6939469 DOI: 10.1521/aeap.2019.31.4.287] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
HIV disproportionately impacts young men of color who have sex with men. Keep It Up! (KIU!) is an online intervention that addresses the needs of this population. The study objective was to examine intervention acceptability and engagement. Outcomes of interests were qualitative and quantitative acceptability and engagement measures, content ratings, and paradata. On average, participants rated content (4 out of 5 stars) and acceptability (3.5 out of 4) highly. Compared to White participants, Black participants found KIU! more useful, engaging, and acceptable; Latino participants found KIU! more engaging; and other non-White participants found KIU! more engaging and acceptable. Participants with high school or less education found KIU! more useful, engaging, acceptable, and deserving of five stars than college graduates (p values = .047, <.001, .002, .01) and graduate degree holders (p values = .04, .001, <.001, .004). KIU! is a promising prevention tool for highest risk populations.
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Affiliation(s)
- Krystal Madkins
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - David A. Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Kevin Moran
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Trey V. Dellucci
- The Graduate Center of the City University of New York, New York, NY
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
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McNeill C, Washburn L, Hadden KB, Moon Z. Evaluating the Effectiveness of the How to Talk to Your Doctor HANDbook Program. Health Lit Res Pract 2019; 3:e103-e109. [PMID: 31294311 PMCID: PMC6607764 DOI: 10.3928/24748307-20190404-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/09/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Millions of Americans have low health literacy, potentially leading to a number of issues including medication errors, hospital admissions, unnecessary emergency department visits, skipped screenings and shots, and misinterpretation of treatment plans. People with low health literacy have less knowledge of illness management, less ability to share in decision-making, and poorer self-reported health status. Addressing health literacy is necessary to improve health care quality, reduce costs, and reduce disparities. Objective: The How to Talk to Your Doctor (HTTTYD) HANDbook Program addresses health literacy among rural participants who have low incomes, with a focus on improving health communication among populations that are medically vulnerable by using the HANDbook tool. Methods: Participants were recruited from 55 rural counties by county extension agents (CEA) to participate in the 1-hour HTTTYD session. Pre- and post-test surveys were completed. A subset of the sample completed a 3-month follow-up survey. Key Results: Of the 548 participants who fully completed the survey, a Wilcoxon Signed-Rank Test was performed on 484 of the participants who completed both the pre- and post-test. A statistically significant median increase in overall confidence among the participants from pre- (M = 15.99) to post-test (M = 17.76), (z = 13.454, p = .000), was noted. A subset of 166 participants also completed the 3-month follow-up survey. A significant increase in health literacy after participation in the HTTTYD HANDbook program from pre-test to 3-month follow-up was noted; effect sizes ranged from moderate to large. Conclusion: The HTTTYD HANDbook program meets recommendations for successful health literacy programs; significant positive outcomes demonstrate program effectiveness. HTTTYD HANDbook program delivery in rural communities by CEAs demonstrates access to understudied and often difficult-to-reach populations. [HLRP: Health Literacy Research and Practice. 2019;3(2):e103–e109.] Plain Language Summary: The How to Talk to Your Doctor HANDbook program delivered by county extension agents in rural communities showed capacity to access understudied and often difficult-to-reach populations. The significant, sustained improvement in health literacy noted among program participants demonstrated program effectiveness among those with low health literacy.
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Affiliation(s)
- Charleen McNeill
- Address correspondence to Charleen McNeill, PhD, MSN, RN, College of Nursing, East Carolina University, 4165S Health Sciences Building, Greenville, NC 27858;
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88
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Chen S, Sudharsanan N, Huang F, Liu Y, Geldsetzer P, Bärnighausen T. Impact of community based screening for hypertension on blood pressure after two years: regression discontinuity analysis in a national cohort of older adults in China. BMJ 2019; 366:l4064. [PMID: 31296584 PMCID: PMC6619453 DOI: 10.1136/bmj.l4064] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To estimate the causal impact of community based blood pressure screening on subsequent blood pressure levels among older adults in China. DESIGN Regression discontinuity analysis using data from a national cohort study. SETTING 2011-12 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, a national cohort of older adults in China. PARTICIPANTS 3899 older adults who had previously undiagnosed hypertension. INTERVENTION Community based hypertension screening among older adults in 2011-12. MAIN OUTCOME MEASURE Blood pressure two years after initial screening. RESULTS The intervention reduced systolic blood pressure: -6.3 mm Hg in the model without covariates (95% confidence interval -11.2 to -1.3) and -8.3 mm Hg (-13.6 to -3.1) in the model that adjusts additionally for demographic, social, and behavioural covariates. The impact on diastolic blood pressure was smaller and non-significant in all models. The results were similar when alternative functional forms were used to estimate the impact and the bandwidths around the intervention threshold were changed. The results did not vary by demographic and social subgroups. CONCLUSIONS Community based hypertension screening and encouraging people with raised blood pressure to seek care and adopt blood pressure lowering behaviour changes could have important long term impact on systolic blood pressure at the population level. This approach could address the high burden of cardiovascular diseases in China and other countries with large unmet need for hypertension diagnosis and care.
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Affiliation(s)
- Simiao Chen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Nikkil Sudharsanan
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
- Harvard Center for Population and Development Studies, Harvard T H Chan School of Public Health, Cambridge, MA, USA
| | - Feng Huang
- School of Economics and Key Laboratory of Mathematical Economics, Shanghai University of Finance and Economics, Shanghai, China
| | - Yuanli Liu
- School of Public Health, Peking Union Medical College, Beijing, China
| | - Pascal Geldsetzer
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
- Africa Health Research Institute, Somkhele, KwaZulu-Natal, South Africa
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89
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O’Donnell R, Richardson B, Fuller-Tyszkiewicz M, Staiger PK. Delivering Personalized Protective Behavioral Drinking Strategies via a Smartphone Intervention: a Pilot Study. Int J Behav Med 2019; 26:401-414. [DOI: 10.1007/s12529-019-09789-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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90
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Narcisse MR, Rowland B, Long CR, Felix H, McElfish PA. Heart Attack and Stroke Symptoms Knowledge of Native Hawaiians and Pacific Islanders in the United States: Findings From the National Health Interview Survey. Health Promot Pract 2019; 22:122-131. [PMID: 31018704 DOI: 10.1177/1524839919845669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Native Hawaiians and other Pacific Islanders (NHPI) suffer disproportionate rates of death from heart attack and stroke; however, little is known about NHPI heart attack and stroke symptoms knowledge. We used multivariable logistic regression to examine associations between heart attack and stroke symptoms knowledge and electronic health (eHealth) use, education, engaging in health risk behaviors, and having an at-risk diagnosis or a past heart attack and/or stroke. The analytic sample included 2,172 NHPI adults responding to the 2014 NHPI-National Health Interview Survey. NHPI reported moderate to high levels of heart attack and stroke symptoms knowledge. NHPI with an at-risk diagnosis were significantly more likely to know three of five heart attack symptoms. Engaging in health risk behaviors increased the odds of knowing one heart attack symptom. Neither a prior heart attack nor a prior stroke increased the likelihood of recognizing most symptoms of heart attack or stroke. eHealth use was associated with increased likelihood for knowing heart attack and stroke symptoms. The findings of this study can be used to inform interventions that support the Healthy People 2020 goals to increase the proportion of adults who are aware of the symptoms of heart attack and stroke and to reduce heart attack and stroke disparities.
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Affiliation(s)
- Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Brett Rowland
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Holly Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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91
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Oftedal B, Kolltveit BH, Graue M, Zoffmann V, Karlsen B, Thorne S, Kristoffersen M. Reconfiguring clinical communication in the electronic counselling context: The nuances of disruption. Nurs Open 2019; 6:393-400. [PMID: 30918689 PMCID: PMC6419105 DOI: 10.1002/nop2.218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/22/2018] [Accepted: 10/25/2018] [Indexed: 11/13/2022] Open
Abstract
AIM This study expands on an earlier study about diabetes nurses' experiences of the Guided Self-Determination intervention in face-to-face consultations among people with type 2 diabetes. This current study investigates Guided Self-Determination in an electronic format with the aim to explore what can be learned about the written form for health communication from the perspectives of diabetes nurses in primary care. DESIGN The study has an explorative, qualitative design. METHOD Four diabetes nurses were individually interviewed after completing the electronic intervention. The analysis was guided by Interpretive Description. RESULTS Small sample size apart, the rich empirical data and quality of dialogue point to the interviewees' earlier contact, comfort and trust with the researcher. The written electronic communication could disrupt nurses' possibilities for using basic and advanced communication skills. Findings also indicate that written electronic communication can foster thoughtful responses to patients and increase possibilities for a transparent counselling delivery process.
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Affiliation(s)
- Bjørg Oftedal
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Beate‐Christin Hope Kolltveit
- Faculty of Health and Social Sciences, Centre for Evidence‐Based PracticeWestern Norway University of Applied SciencesBergenNorway
| | - Marit Graue
- Faculty of Health and Social Sciences, Centre for Evidence‐Based PracticeWestern Norway University of Applied SciencesBergenNorway
| | - Vibeke Zoffmann
- The Research Unit Women’s and Children’s HealthThe Juliane Marie CentreUniversity HospitalCopenhagenCopenhagenDenmark
| | - Bjørg Karlsen
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Sally Thorne
- School of NursingUniversity of British ColumbiaVancouverBCCanada
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92
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Millar RJ, Sahoo S, Yamashita T, Cummins P. Problem Solving in Technology-Rich Environments and Self-Rated Health Among Adults in the U.S.: An Analysis of the Program for the International Assessment of Adult Competencies. J Appl Gerontol 2019; 39:889-897. [PMID: 30762453 DOI: 10.1177/0733464819829663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Problem-solving skills in the context of technologically complex modern societies have become increasingly important to health management in later life. This study is designed to investigate the associations between problem-solving skills in technology-rich environments (PSTRE) and health, and to explore whether age differences exist. Using data from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC), we used logistic regression to examine the relationship between PSTRE and self-reported health among a representative sample of American adults aged 35 years and older (N = 3,260). Overall, greater PSTRE (odds ratio [OR] = 1.012, p < .001) was significantly associated with better self-rated health even after adjusting for the sociodemographic characteristics. Yet, PSTRE was only partially predictive of health in some age groups. Our findings highlight the potential of PSTRE to reduce health disparities among middle-aged and older adults living in modern technology and information-rich societies.
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93
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Nakamura D, Ogawa M, Nakamura T, Izawa KP. Impact of Parents' Comprehensive Health Literacy on BMI in Children: A Multicenter Cross-Sectional Study in Japan. THE JOURNAL OF SCHOOL HEALTH 2018; 88:910-916. [PMID: 30392184 DOI: 10.1111/josh.12700] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Low-functional health literacy (HL) of parents influences poor child health outcomes. This study aimed to assess the relationship between comprehensive HL of parents and body mass index (BMI) of their children. METHODS We enrolled 3- to 6-year-old preschool-aged children and their parents in this multicenter cross-sectional cohort study. We evaluated parents' comprehensive HL with the 14-item HL scale. Children's BMI categories were defined using International Obesity Task Force cutoffs according to age and sex. We analyzed differences in data between the high-HL group and the low-HL group and investigated the association between HL of parents and their children's BMI by multivariate logistic regression analysis. RESULTS The high-HL group comprised 208 (75.1%) children and the low-HL group comprised 69 (24.9%) children of whom 23 (8.3%) were overweight and 35 (12.6%) were thin. The low-HL group had more children with poor BMI than the high-HL group. Multivariate analysis showed an association between the low HL of parents and the poor BMI of their children after adjustment for all other confounding factors. CONCLUSIONS Comprehensive HL of parents appears to affect the BMI of their children independently, suggesting that interventions to improve HL in parents are necessary.
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Affiliation(s)
- Daisuke Nakamura
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
- Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Masato Ogawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
- Cardiovascular stroke Renal Project (CRP), Kobe, Japan
| | - Teruhiko Nakamura
- Educational Corporation Tukushi Gakuen, 2-3-11 Takadai, Chitose, Hokkaido 066-0035, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
- Cardiovascular stroke Renal Project (CRP), Kobe, Japan
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Gorini A, Mazzocco K, Triberti S, Sebri V, Savioni L, Pravettoni G. A P5 Approach to m-Health: Design Suggestions for Advanced Mobile Health Technology. Front Psychol 2018; 9:2066. [PMID: 30429810 PMCID: PMC6220651 DOI: 10.3389/fpsyg.2018.02066] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022] Open
Abstract
In recent years, technology has been developed as an important resource for health care management, especially in regard to chronic conditions. In the broad field of eHealth, mobile technology (mHealth) is increasingly used to empower patients not only in disease management but also in the achievement of positive experiences and experiential growth. mHealth tools are considered powerful because, unlike more traditional Internet-based tools, they allow patients to be continuously monitored and followed by their own mobile devices and to have continual access to resources (e.g., mobile apps or functions) supporting health care management activities. However, the literature has shown that, in many cases, such technology not accepted and/or adopted in the long term by its users. To address this issue, this article reviews the main factors influencing mHealth technology acceptance/adoption in health care. Finally, based on the main aspects emerging from the review, we propose an innovative approach to mHealth design and implementation, namely P5 mHealth. Relying on the P5 approach to medicine and health care, this approach provides design suggestions to address mHealth adoption issues already at the initial stages of development of the technologies.
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Affiliation(s)
- Alessandra Gorini
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Stefano Triberti
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Valeria Sebri
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Lucrezia Savioni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan, Italy
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Lissitsa S, Madar G. Do disabilities impede the use of information and communication technologies? Findings of a repeated cross-sectional study - 2003-2015. Isr J Health Policy Res 2018; 7:66. [PMID: 30367657 PMCID: PMC6204019 DOI: 10.1186/s13584-018-0260-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The current research focuses on trends of Internet adoption and digital uses among people with disabilities over a thirteen-year period. METHODS The study is based on data elicited from a repeated cross-sectional study collected by means of Annual Social Surveys conducted by Israel's Central Bureau of Statistics between 2003 and 2015. The sample included 95,145 respondents, among them 22,290 respondents with disabilities. RESULTS The rate of Internet access and digital uses increased continuously among disabled people; however the gap between them and the population without disabilities was preserved. We found that Internet use depends on a number of socio-economic characteristic. Socio-demographic variables were much more powerful in predicting Internet use vs non-use among the total population, compared to predicting digital uses among Internet users. CONCLUSIONS Our findings make it possible to identify disadvantaged groups in which disability intersects with low rates of Internet adoption and belonging to unprivileged groups: Arabs, the religious, the elderly, lower SES individuals. The effects of most of these variables did not change in the period under study. Generally, we recommend finding a way to promote courses that focus on promoting digital literacy in general and eHealth literacy in particular in small groups of people of similar age, digital skill level and motor / health problems. Considering the high representation of Arabs among people with disabilities and lower rates of Internet adoption and use among Arabs, it is recommended that efforts continue to increase the scope and quality of Arabic language content published on Israeli eHealth sites. In order to diminish income-based digital divide we recommend providing publicly accessible free information technologies, for example, in community clubs, senior citizen clubs, and independent- and assisted- living projects for the disabled.
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Affiliation(s)
| | - Galit Madar
- Faculty of Health Sciences, Ariel University, Ariel, Israel
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96
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Silverman T, Asante N, van den Berg JJ. Quality of HIV Websites With Information About Pre-Exposure Prophylaxis or Treatment as Prevention for Men Who Have Sex With Men: Systematic Evaluation. JMIR Public Health Surveill 2018; 4:e11384. [PMID: 30327291 PMCID: PMC6231722 DOI: 10.2196/11384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/06/2018] [Accepted: 09/23/2018] [Indexed: 11/24/2022] Open
Abstract
Background Knowledge and uptake of high-efficacy HIV prevention strategies such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP) remain low among men who have sex with men (MSM) who are at the highest risk for HIV infection in the United States. Electronic health (eHealth) interventions are promising tools for disseminating information about these critical yet underutilized strategies and addressing key barriers to uptake among target populations. However, existing HIV prevention websites are understudied and unevaluated. Objective This study aimed to systematically review and evaluate existing HIV websites that include information about PrEP or TasP for MSM. Methods From March 2018 to May 2018, 2 trained research assistants (RAs) entered relevant key words and phrases into 3 commonly used search engines and applied exclusion criteria to all returned results to identify 31 websites included in this review. RAs independently scored each website for authority, usability, interactivity, and PrEP/TasP-related content based on a standardized rating scale and then averaged the results. Results No website received a perfect score in any of the 4 categories, and the average website score was 62% (37/60). Less than a quarter of the websites (23%, 7/31) received a score of more than 75% (7.5/10) for content. Approximately two-thirds of the websites (65%, 20/31) received a score of 50% (5/10) or lower for interactivity. The average score in usability was 68% (6.8/10) and in authority was 69% (6.9/10). Other deficiencies observed included difficulty locating relevant content and lack of information targeting audiences with the highest likelihood of HIV infection. Conclusions Existing HIV prevention websites with information about PrEP or TasP for MSM fail to provide adequate content as well as present that content to users in an interactive and audience-conscious way. Future eHealth interventions should attempt to rectify these deficiencies to successfully engage and educate MSM at high risk for HIV regarding prevention strategies.
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Affiliation(s)
- Taylor Silverman
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, United States
| | - Nicole Asante
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, United States
| | - Jacob J van den Berg
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, United States.,Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
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97
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Liu J, Zheng X, Chai S, Lei M, Feng Z, Zhang X, Lopez V. Effects of using WeChat-assisted perioperative care instructions for parents of pediatric patients undergoing day surgery for herniorrhaphy. PATIENT EDUCATION AND COUNSELING 2018; 101:1433-1438. [PMID: 29499997 DOI: 10.1016/j.pec.2018.02.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/10/2018] [Accepted: 02/16/2018] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This study examined the effects of WeChat-assisted perioperative instructions for parents whose children were to undergo herniorrhaphy. METHOD A randomized controlled trial was conducted in a day surgery center in China. Participants were randomly assigned to the intervention (WeChat) group (n = 209) and the control (Leaflet) group (n = 209). The primary outcomes of this study were parents' knowledge regarding hernia and rate of cancellation of children's surgery. The secondary outcomes were the rate of lost-to-follow-up and the rate of complications and adverse events during the seventh postoperative follow-up day. RESULTS There was a significant difference in the rate of cancelling the surgery and the mean knowledge score between the WeChat group and leaflet groups. The lost-to-follow-up rate was significantly lower in the WeChat group (0.54%) than in the leaflet group (3.66%). The incidence of postoperative complications were higher in the control group. CONCLUSIONS WeChat-assisted perioperative care instructions enhanced parents' knowledge on perioperative instructions and promoted the preparation of their children for day surgery resulting in lower rate of cancelling the surgery. PRACTICE IMPLICATIONS WeChat has the ability to expand health services outside the hospital confines and could be used as an important low-cost health educational medium in China.
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Affiliation(s)
- Jun Liu
- Department of General Surgery, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Xin Zheng
- Department of General Surgery, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Shouxia Chai
- College of Nursing, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Meirong Lei
- College of Nursing, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Zehui Feng
- Department of General Surgery, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Xuelin Zhang
- College of Nursing, Hubei University of Medicine, Shiyan, Hubei, China.
| | - Violeta Lopez
- Alice Lee Centre for Nursing Studies, Young Loo Lin School of Medicine, National University of Singapore, Singapore.
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98
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Narcisse MR, Felix H, Long CR, Hudson T, Payakachat N, Bursac Z, McElfish PA. Frequency and predictors of health services use by Native Hawaiians and Pacific Islanders: evidence from the U.S. National Health Interview Survey. BMC Health Serv Res 2018; 18:575. [PMID: 30031403 PMCID: PMC6054839 DOI: 10.1186/s12913-018-3368-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/08/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Native Hawaiians and Pacific Islanders (NHPIs) are one of the fasting growing racial groups in the United States (US). NHPIs have a significantly higher disease burden than the US population as a whole, yet they remain underrepresented in research. The purpose of this study is to examine factors associated with health care utilization among NHPIs. METHODS Drawing from the 2014 NHPI-National Health Interview Survey, we used stereotype logistic regressions to examine utilization of emergency department (ED) and outpatient services among 2172 individuals aged 18 and older. RESULTS NHPIs with chronic diseases were twice as likely to be multiple ED users and nearly four times as likely to be frequent-users of outpatient services. Social support played a protective role in preventing multiple use of ED. Having a usual source of care made it more than eight times as likely to be a frequent-user of outpatient services. Use of eHealth information increased the odds of using ED and outpatient services. Ability to afford health care increased the odds of using outpatient services. There was no association between health insurance coverage and use of ED and outpatient services among NHPIs. CONCLUSIONS This research provides the first available national estimates of health services use by NHPIs. Efforts to improve appropriate use of health services should consider leveraging the protective factors of social support to reduce the odds of frequent ED use, and having a usual source of care to increase use of outpatient services.
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Affiliation(s)
- Marie-Rachelle Narcisse
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 North College Ave, Fayetteville, AR 72703 USA
| | - Holly Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR 72205 USA
| | - Christopher R. Long
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 North College Ave, Fayetteville, AR 72703 USA
| | - Teresa Hudson
- Division of Health Services Research, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR 72205 USA
| | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, 4301 West Markham St, Little Rock, AR 72205 USA
| | - Zoran Bursac
- Division of Biostatistics, University of Tennessee Health Science Center, 910 Madison Ave, Memphis, TN 38163 USA
| | - Pearl A. McElfish
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 North College Ave, Fayetteville, AR 72703 USA
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99
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van den Berg JJ, Silverman T, Fernandez MI, Henny KD, Gaul ZJ, Sutton MY, Operario D. Using eHealth to Reach Black and Hispanic Men Who Have Sex With Men Regarding Treatment as Prevention and Preexposure Prophylaxis: Protocol for a Small Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e11047. [PMID: 30012549 PMCID: PMC6066633 DOI: 10.2196/11047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Black and Hispanic men who have sex with men in the United States continue to be disproportionately affected by HIV and AIDS. Uptake of and knowledge about biobehavioral HIV prevention approaches, such as treatment as prevention and preexposure prophylaxis, are especially low in these populations. eHealth campaigns and social media messaging about treatment as prevention and preexposure prophylaxis may help to fill this gap in knowledge and lead to increased uptake of such strategies; however, no evidence exists of the effects of these targeted forms of communication on treatment as prevention and preexposure prophylaxis uptake in these populations. OBJECTIVE We describe the protocol for a 3-part study aiming to develop and evaluate an eHealth intervention with information about treatment as prevention and preexposure prophylaxis for HIV-positive and HIV-negative black and Hispanic men who have sex with men. METHODS Phases 1 and 2 will involve focus groups and cognitive interviews with members of the target populations, which we will use to create a culturally tailored, interactive website and applicable social media messaging for these men. Phase 3 will be a small randomized controlled trial of the eHealth intervention, in which participants will receive guided social media messages plus the newly developed website (active arm) or the website alone (control arm), with assessments at baseline and 6 months. RESULTS Participant recruitment began in August 2017 and will end in August 2020. CONCLUSIONS Public health interventions are greatly needed to increase knowledge about and uptake of biobehavioral HIV prevention strategies such as treatment as prevention and preexposure prophylaxis among black and Hispanic men who have sex with men. eHealth communication campaigns offer a strategy for engaging these populations in health communication about biobehavioral HIV prevention. TRIAL REGISTRATION ClinicalTrials.gov NCT03404531; https://www.clinicaltrials.gov/ct2/show/NCT03404531 (Archived by WebCite at http://www.webcitation.org/70myofp0R). REGISTERED REPORT IDENTIFIER RR1-10.2196/11047.
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Affiliation(s)
- Jacob J van den Berg
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Taylor Silverman
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - M Isabel Fernandez
- College of Osteopathic Medicine, Division of Health Professions, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Kirk D Henny
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Zaneta J Gaul
- Centers for Disease Control and Prevention, Atlanta, GA, United States.,ICF, Atlanta, GA, United States
| | - Madeline Y Sutton
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Don Operario
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
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100
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DeRosa AP, Stribling JC. A Case Report of Health Seminars Supporting Patient Education, Engagement, and Health Literacy. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2018. [DOI: 10.1080/15398285.2018.1513269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Antonio P. DeRosa
- Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr Biomedical Information Center, New York, New York, USA
| | - Judy C. Stribling
- Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr Biomedical Information Center, New York, New York, USA
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