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Bröder J, Okan O, Bollweg TM, Bruland D, Pinheiro P, Bauer U. Child and Youth Health Literacy: A Conceptual Analysis and Proposed Target-Group-Centred Definition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183417. [PMID: 31540040 PMCID: PMC6765952 DOI: 10.3390/ijerph16183417] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
(1) Background: This article adopts an interdisciplinary perspective to analyse, examine, and reflect upon prominent health literacy (HL) understandings in childhood and youth. (2) Method: The conceptual analysis combined Rodgers’ and Jabareen’s approaches to conceptual analysis in eight phases. (3) Results: First, we present exploratory entry points for developing a child-specific HL understanding based on the six dimensions of a ‘health-literacy 6D model’. Second, we describe and reflect upon five meta-level dimensions covering the HL definitions and models for children and youth found in the conceptual analysis. Third, we integrate our findings into a target-group-centred HL definition for children and youth. (4) Discussion/Conclusion: This article raises awareness for the heterogeneity of the current conceptual HL debate. It offers a multidisciplinary approach for advancing the existing understanding of HL. Four recommendations for future actions are deduced from the following four principles, which are inherent to the proposed target-group-centred HL definition: (a) to characterize HL from an asset-based perspective, (b) to consider HL as socially embedded and distributed, (c) to recognize that HL develops both in phases and in flexible ways, and (d) to consider the multimodal nature of health-related information. Further research is necessary to test the feasibility and applicability of the proposed definition and conceptual understanding in both research and practice.
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Affiliation(s)
- Janine Bröder
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Orkan Okan
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Torsten M Bollweg
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Dirk Bruland
- Institute for Education and Care research in the health sector (InBVG), University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany.
| | - Paulo Pinheiro
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Ullrich Bauer
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
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Lima LCMD, Neves ÉTB, Dutra LDC, Firmino RT, Araújo LJSD, Paiva SM, Ferreira FM, Granville-Garcia AF. Psychometric properties of BREALD-30 for assessing adolescents' oral health literacy. Rev Saude Publica 2019; 53:53. [PMID: 31432910 PMCID: PMC6703894 DOI: 10.11606/s1518-8787.2019053000999] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/24/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents. METHODS The study included 750 adolescents: 375 aged 12 years and 375 aged 15–19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%. RESULTS BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach’s alpha = 0.871 and 0.834, respectively) and good test-retest reliability [intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively]. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions [12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48–3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24–3.11]. CONCLUSIONS BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy.
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Affiliation(s)
| | | | - Laio da Costa Dutra
- Universidade Estadual da Paraíba. Programa de Pós-Graduação em Odontologia. Campina Grande, PB, Brasil
| | - Ramon Targino Firmino
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Programa de Pós-Graduação em Odontologia. Belo Horizonte, MG, Brasil
| | | | - Saul Martins Paiva
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontopediatria e Ortodontia. Belo Horizonte, MG, Brasil
| | - Fernanda Morais Ferreira
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontopediatria e Ortodontia. Belo Horizonte, MG, Brasil
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Solomonian L, Kwan V, Bhardwaj S. Group-Based Naturopathic Education for Primary Prevention of Noncommunicable Disease in Families and Children: A Feasibility Study. J Altern Complement Med 2019; 25:740-752. [PMID: 31314562 DOI: 10.1089/acm.2019.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objectives: Naturopathic medicine has demonstrated efficacy at reducing risk factors for chronic disease. Targeting health behaviors of parents and caregivers in a group-based setting may improve the behaviors of children in their care. This study sought to assess the feasibility of such a program. Design: Participants of a six-session health education series were invited to respond to surveys and participate in a focus group about their health behaviors and their experience in the program. Subjects: Caregivers of children aged 0-6 attending publicly funded community centers in Ontario, Canada. Interventions: A 6-week group-based naturopathic education program to promote healthy lifestyle behaviors among caregivers. Outcome measures: Satisfaction with content and delivery, and frequency of healthy behaviors. Results: The majority of responses indicated satisfaction with the program, and an ongoing benefit 6 weeks and more after completion. There was a clear correlation between healthy behaviors of parents and children. Conclusions: A group-based naturopathic education program may be a feasible method of delivering primary-prevention education to caregivers, particularly in the domains of practicality and acceptability.
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Affiliation(s)
| | - Vivian Kwan
- Canadian College of Naturopathic Medicine, Toronto, Canada
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Sadeghi A, Rohani H, Bidkhori M, Davari M, Mohammadi vahid F, Bazi HA. Health Literacy Status of Newly Delivered Mothers and its Related Factors; A Case Study in Esfarayen City. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2019. [DOI: 10.29252/jech.6.3.177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Abstract
Health literacy is an important issue to consider in the provision of health-care to children. Similar to the adult population, most parents face health literacy challenges. Of particular concern, 1 in 4 parents have low health literacy, greatly affecting their ability to use health information to make health decisions for their child. High expectations are placed on parents and children to achieve effective disease management and positive health outcomes in the context of complex health-care systems and disease treatment regimens. Low health literacy affects parent acquisition of knowledge, attitudes, and behaviors, as well as child health outcomes across the domains of disease prevention, acute illness care, and chronic illness care. The effect of low health literacy is wide ranging, including 1) poor nutrition knowledge and behaviors, 2) higher obesity rates, 3) more medication errors, 4) more emergency department use, and 5) poor asthma knowledge, behaviors, and outcomes. Health-care providers can mitigate the effects of health literacy by seeking to align health-care demands with the health literacy skills of families. Effective health literacy-informed interventions provide insights into methods that can be used by providers and health systems to improve health outcomes. Health literacy-informed communication strategies should be used with all families in a "universal precautions approach" because all parents likely benefit from clear communication. As scientific advances are made in disease prevention and management, unless families understand how to follow provider recommendations, the benefit of these advances will not be realized and disparities in outcomes will be exacerbated.
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Affiliation(s)
- Andrea K Morrison
- Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | | | - H Shonna Yin
- Department of Pediatrics and.,Department of Population Health, New York University School of Medicine/NYU Langone Health, New York, NY
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Sadeghi R, Mazloomy Mahmoodabad SS, Khanjani N, Fallahzadeh H, Rezaeian M. The association between health literacy and smoking (Hookah and Cigarette) among the young men in Sirjan, Iran. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1620886] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Reza Sadeghi
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Saeed Mazloomy Mahmoodabad
- Social Determinants of Health Research Center, Department of Health Education & Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Narges Khanjani
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hossein Fallahzadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Rezaeian
- Epidemiology and Biostatistics Department, Occupational Environmental Research Center, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Fäldt A, Nordlund H, Holmqvist U, Lucas S, Fabian H. Nurses' experiences of screening for communication difficulties at 18 months of age. Acta Paediatr 2019; 108:662-669. [PMID: 30153364 DOI: 10.1111/apa.14557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/20/2018] [Accepted: 08/23/2018] [Indexed: 01/22/2023]
Abstract
AIM Early identification of communication disorders is important and may be possible through screening in the child health services. The aim of the study was to investigate nurses' experiences and sense of competence when using the Infant-Toddler Checklist (ITC) communication screening at the 18-month health visit. METHODS A mixed-methods design including three focus group interviews (n = 14) and a web-based survey (n = 22) among nurses using the ITC or the standard method. Interview data were analysed through systematic text condensation and a deductive analysis based on implementation theory. Groups were compared using Mann-Whitney tests. RESULT Three themes emerged: Using a structured evaluation of communication changes, the dynamic, ITC is a beneficial tool and Implementation of the ITC faces a few challenges. Nurses who used the ITC perceived to a greater extent that they used a structured method (p = 0.003, r = 0.9) and felt more secure in describing the child's communication and language development to parents (p = 0.006, r = 0.83) compared to the standard method group. CONCLUSION Using the ITC supported the nurses in their assessment of communication at 18 months. Nurses' sense of competence was higher when using the ITC, both in their assessment and in communicating with parents.
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Affiliation(s)
- A Fäldt
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - H Nordlund
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - U Holmqvist
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - S Lucas
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - H Fabian
- Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
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Fleary SA. Association Between the Medical Home Model of Care and Demographic Characteristics in US Children. Clin Pediatr (Phila) 2019; 58:270-281. [PMID: 30449155 PMCID: PMC6642684 DOI: 10.1177/0009922818813568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Given the medical home model of care's (MHMOC) potential to reduce disparities in health care, this study determined the relationship between MHMOC, MHMOC indicators, and (1) demographic characteristics and (2) health outcomes in US children. Caregivers (n = 50 212) of children 0 to 17 years completed the 2016 National Survey of Children's Health. The MHMOC measure comprised 5 indicators (e.g., having a personal doctor/nurse and receiving family-centered care). Bivariate and multiple logistic regressions assessed the relationships between MHMOC, MHMOC indicators, and (1) demographic characteristics and (2) health outcomes. Approximately 49% of the children were served in a MHMOC. MHMOC and MHMOC indicators were related to race, ethnicity, nativity, caregiver education, federal poverty level, insurance type, and predicted health outcomes. These findings suggest that children most in need of MHMOC are less likely to be served in them. Thus, the current distribution of MHMOC likely contributes to greater disparities in care.
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Bress LE, Horowitz AM, Capobianco DM, Fleming DE, Kleinman DV. Assessing Dental Hygiene Students' and Community Caregivers' Knowledge of Strategies for Caries Prevention. J Dent Educ 2019; 83:351-358. [PMID: 30692188 DOI: 10.21815/jde.019.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 08/30/2018] [Indexed: 11/20/2022]
Abstract
With dental caries being a common chronic disease in children and adults, oral health literacy is needed to improve oral health and prevent caries. If oral health providers themselves are confused about preventive strategies, they cannot effectively educate the public or other health care providers. The aim of this study was to assess University of Maryland dental hygiene students' understanding of and ability to communicate caries preventive strategies to low-income populations during a community service-learning program in 2013 and 2014. Fifty baccalaureate degree dental hygiene students were asked to complete surveys before and after receiving a presentation on caries preventive strategies and after an outreach event, and 77 low-income caregivers were asked to complete surveys before and after receiving oral health education from the students. The key knowledge question on all surveys asked respondents to select the "single best way to prevent tooth decay" (i.e., provide caries prevention) from a list that included the following items: limit sweets, going to the dentist, brushing teeth, using fluoride toothpaste, flossing, drinking fluoridated water, fluoride varnish, and sealants. Of the 50 students, 41 completed all three surveys, for a response rate of 82%; all 77 caregivers (100%) completed the survey before the counseling session, and 37 (48%) completed the survey afterwards. While the results showed a significant knowledge increase for the students that drinking fluoridated water is the best caries prevention strategy, only 44% of them correctly ranked that option first even on the final survey, and only 8% of the caregivers ranked that option first even after counseling. These results suggested that neither the students nor the caregivers understood the benefits of community water fluoridation (CWF), even after the interventions. In spite of their low knowledge scores, it was encouraging that 86-92% of the caregivers reported that the students demonstrated respect for them and spent an appropriate amount of time with them and that they understood the information the students communicated. In discussions after the surveys, the students reported that they had received inconsistent messages from faculty members regarding the benefits of CWF, which resulted in their confusion. These results led the authors to revise their program's instruction to increase the students' knowledge of caries prevention strategies.
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Affiliation(s)
- Lisa E Bress
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health.
| | - Alice M Horowitz
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
| | - Diana M Capobianco
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
| | - Deborah E Fleming
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
| | - Dushanka V Kleinman
- Lisa E. Bress is Assistant Professor, University of Maryland School of Dentistry; Alice M. Horowitz is Research Associate Professor, University of Maryland School of Public Health; Diana M. Capobianco is Owner and Founder of Growing Smiles Dental Practice, Bel Air, MD; Deborah E. Fleming is Academic Manager, Colgate Oral Pharmaceuticals, Inc.; and Dushanka V. Kleinman is Associate Dean for Research, University of Maryland School of Public Health
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Boland L, Graham ID, Légaré F, Lewis K, Jull J, Shephard A, Lawson ML, Davis A, Yameogo A, Stacey D. Barriers and facilitators of pediatric shared decision-making: a systematic review. Implement Sci 2019; 14:7. [PMID: 30658670 PMCID: PMC6339273 DOI: 10.1186/s13012-018-0851-5] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/27/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) is rarely implemented in pediatric practice. Pediatric health decision-making differs from that of adult practice. Yet, little is known about the factors that influence the implementation of pediatric shared decision-making (SDM). We synthesized pediatric SDM barriers and facilitators from the perspectives of healthcare providers (HCP), parents, children, and observers (i.e., persons who evaluated the SDM process, but were not directly involved). METHODS We conducted a systematic review guided by the Ottawa Model of Research Use (OMRU). We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, PubMed, and PsycINFO (inception to March 2017) and included studies that reported clinical pediatric SDM barriers and/or facilitators from the perspective of HCPs, parents, children, and/or observers. We considered all or no comparison groups and included all study designs reporting original data. Content analysis was used to synthesize barriers and facilitators and categorized them according to the OMRU levels (i.e., decision, innovation, adopters, relational, and environment) and participant types (i.e., HCP, parents, children, and observers). We used the Mixed Methods Appraisal Tool to appraise study quality. RESULTS Of 20,008 identified citations, 79 were included. At each OMRU level, the most frequent barriers were features of the options (decision), poor quality information (innovation), parent/child emotional state (adopter), power relations (relational), and insufficient time (environment). The most frequent facilitators were low stake decisions (decision), good quality information (innovation), agreement with SDM (adopter), trust and respect (relational), and SDM tools/resources (environment). Across participant types, the most frequent barriers were insufficient time (HCPs), features of the options (parents), power imbalances (children), and HCP skill for SDM (observers). The most frequent facilitators were good quality information (HCP) and agreement with SDM (parents and children). There was no consistent facilitator category for observers. Overall, study quality was moderate with quantitative studies having the highest ratings and mixed-method studies having the lowest ratings. CONCLUSIONS Numerous diverse and interrelated factors influence SDM use in pediatric clinical practice. Our findings can be used to identify potential pediatric SDM barriers and facilitators, guide context-specific barrier and facilitator assessments, and inform interventions for implementing SDM in pediatric practice. TRIAL REGISTRATION PROSPERO CRD42015020527.
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Affiliation(s)
- Laura Boland
- Faculty of Health Sciences, University of Ottawa, 540 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Ian D Graham
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 307D-600 Peter Morand Cresent, Ottawa, ON, K1G 5Z3, Canada
| | - France Légaré
- CHU de Québec Research Centre-Université Laval site Hôpital St-Francois d'Assise, 10 Rue Espinay, Quebec City, Quebec, G1L 3L5, Canada
| | - Krystina Lewis
- Faculty of Health Sciences, University of Ottawa, 540 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, 31 George Street Kingston, Ottawa, ON, K7L 3N6, Canada
| | - Allyson Shephard
- Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Margaret L Lawson
- Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
| | - Alexandra Davis
- Learning Services, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, K1Y 4E9, Canada
| | - Audrey Yameogo
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Dawn Stacey
- Faculty of Health Sciences, University of Ottawa, 540 King Edward Avenue, Ottawa, ON, K1N 6N5, Canada.
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Khan A, Spector ND, Baird JD, Ashland M, Starmer AJ, Rosenbluth G, Garcia BM, Litterer KP, Rogers JE, Dalal AK, Lipsitz S, Yoon CS, Zigmont KR, Guiot A, O'Toole JK, Patel A, Bismilla Z, Coffey M, Langrish K, Blankenburg RL, Destino LA, Everhart JL, Good BP, Kocolas I, Srivastava R, Calaman S, Cray S, Kuzma N, Lewis K, Thompson ED, Hepps JH, Lopreiato JO, Yu CE, Haskell H, Kruvand E, Micalizzi DA, Alvarado-Little W, Dreyer BP, Yin HS, Subramony A, Patel SJ, Sectish TC, West DC, Landrigan CP. Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. BMJ 2018; 363:k4764. [PMID: 30518517 PMCID: PMC6278585 DOI: 10.1136/bmj.k4764] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether medical errors, family experience, and communication processes improved after implementation of an intervention to standardize the structure of healthcare provider-family communication on family centered rounds. DESIGN Prospective, multicenter before and after intervention study. SETTING Pediatric inpatient units in seven North American hospitals, 17 December 2014 to 3 January 2017. PARTICIPANTS All patients admitted to study units (3106 admissions, 13171 patient days); 2148 parents or caregivers, 435 nurses, 203 medical students, and 586 residents. INTERVENTION Families, nurses, and physicians coproduced an intervention to standardize healthcare provider-family communication on ward rounds ("family centered rounds"), which included structured, high reliability communication on bedside rounds emphasizing health literacy, family engagement, and bidirectional communication; structured, written real-time summaries of rounds; a formal training programme for healthcare providers; and strategies to support teamwork, implementation, and process improvement. MAIN OUTCOME MEASURES Medical errors (primary outcome), including harmful errors (preventable adverse events) and non-harmful errors, modeled using Poisson regression and generalized estimating equations clustered by site; family experience; and communication processes (eg, family engagement on rounds). Errors were measured via an established systematic surveillance methodology including family safety reporting. RESULTS The overall rate of medical errors (per 1000 patient days) was unchanged (41.2 (95% confidence interval 31.2 to 54.5) pre-intervention v 35.8 (26.9 to 47.7) post-intervention, P=0.21), but harmful errors (preventable adverse events) decreased by 37.9% (20.7 (15.3 to 28.1) v 12.9 (8.9 to 18.6), P=0.01) post-intervention. Non-preventable adverse events also decreased (12.6 (8.9 to 17.9) v 5.2 (3.1 to 8.8), P=0.003). Top box (eg, "excellent") ratings for six of 25 components of family reported experience improved; none worsened. Family centered rounds occurred more frequently (72.2% (53.5% to 85.4%) v 82.8% (64.9% to 92.6%), P=0.02). Family engagement 55.6% (32.9% to 76.2%) v 66.7% (43.0% to 84.1%), P=0.04) and nurse engagement (20.4% (7.0% to 46.6%) v 35.5% (17.0% to 59.6%), P=0.03) on rounds improved. Families expressing concerns at the start of rounds (18.2% (5.6% to 45.3%) v 37.7% (17.6% to 63.3%), P=0.03) and reading back plans (4.7% (0.7% to 25.2%) v 26.5% (12.7% to 7.3%), P=0.02) increased. Trainee teaching and the duration of rounds did not change significantly. CONCLUSIONS Although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved after implementation of a structured communication intervention for family centered rounds coproduced by families, nurses, and physicians. Family centered care processes may improve safety and quality of care without negatively impacting teaching or duration of rounds. TRIAL REGISTRATION ClinicalTrials.gov NCT02320175.
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Affiliation(s)
- Alisa Khan
- Harvard Medical School, Boston, MA, USA
- Department of Medicine and Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Nancy D Spector
- Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Jennifer D Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Michele Ashland
- Family-Centered Care Department, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Amy J Starmer
- Harvard Medical School, Boston, MA, USA
- Department of Medicine and Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Glenn Rosenbluth
- University of California San Francisco School of Medicine, San Francisco, CA, USA
- Department of Pediatrics, Benioff Children's Hospital, San Francisco, CA, USA
| | - Briana M Garcia
- University of California San Francisco School of Medicine, San Francisco, CA, USA
- Department of Medicine and Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | | | - Jayne E Rogers
- Inpatient Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Anuj K Dalal
- Harvard Medical School, Boston, MA, USA
- Center for Patient Safety Research, Division of General Medicine, Department of Medicine at Brigham and Women's Hospital, Boston, MA, USA
| | - Stuart Lipsitz
- Harvard Medical School, Boston, MA, USA
- Center for Patient Safety Research, Division of General Medicine, Department of Medicine at Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine S Yoon
- Center for Patient Safety Research, Division of General Medicine, Department of Medicine at Brigham and Women's Hospital, Boston, MA, USA
| | - Katherine R Zigmont
- Center for Patient Safety Research, Division of General Medicine, Department of Medicine at Brigham and Women's Hospital, Boston, MA, USA
| | - Amy Guiot
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jennifer K O'Toole
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Aarti Patel
- University of California San Diego School of Medicine, San Diego, CA, USA
- Division of Pediatric Hospital Medicine, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - Zia Bismilla
- Pediatrics, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Maitreya Coffey
- Pediatrics, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Kate Langrish
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Division of Pediatric Hospital Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Rebecca L Blankenburg
- Stanford School of Medicine, Palo Alto, CA, USA
- Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Lauren A Destino
- Stanford School of Medicine, Palo Alto, CA, USA
- Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Jennifer L Everhart
- Stanford School of Medicine, Palo Alto, CA, USA
- Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA
| | - Brian P Good
- University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Pediatrics, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Irene Kocolas
- University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Pediatrics, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Rajendu Srivastava
- University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Pediatrics, Primary Children's Hospital, Salt Lake City, UT, USA
| | - Sharon Calaman
- Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Sharon Cray
- Family Advisory Council, St Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Nicholas Kuzma
- Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Kheyandra Lewis
- Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, USA
| | - E Douglas Thompson
- Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Jennifer H Hepps
- Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Joseph O Lopreiato
- Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Clifton E Yu
- Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - Elizabeth Kruvand
- Family Partner Program, St Louis Children's Hospital, St Louis, MO, USA
- St Louis Children's Hospital, St Louis, MO, USA
| | - Dale A Micalizzi
- The Justin's HOPE Project, Task Force for Global Health, Decatur, GA, USA
| | - Wilma Alvarado-Little
- New York State Department of Health, New York, NY, USA
- New York State Department of Health, New York, NY, USA
| | - Benard P Dreyer
- New York University School of Medicine, New York, NY, USA
- Division of Developmental-Behavioral Pediatrics, New York University Langone Medical Center, New York, NY, USA
| | - H Shonna Yin
- New York University School of Medicine, New York, NY, USA
- Departments of Pediatrics and Population Health at New York University Langone Medical Center, New York, NY, USA
| | - Anupama Subramony
- Cohen Children's Medical Center, New York, NY, USA
- Hofstra Northwell School of Medicine, Queens, NY, USA
| | - Shilpa J Patel
- University of Hawaii John A Burns School of Medicine, Honolulu, HI, USA
- Hawai'i Pacific Health, Honolulu, HI, USA
| | - Theodore C Sectish
- Harvard Medical School, Boston, MA, USA
- Department of Medicine and Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Daniel C West
- University of California San Francisco School of Medicine, San Francisco, CA, USA
- Department of Pediatrics, Benioff Children's Hospital, San Francisco, CA, USA
| | - Christopher P Landrigan
- Harvard Medical School, Boston, MA, USA
- Department of Medicine and Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
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Bohn B, Stachow R, Gellhaus I, Matthias J, Lichtenstern H, Holl RW. Heterogeneity in sociodemographic characteristics and cardiovascular risk factors at the initiation of a lifestyle intervention for obesity within Germany: an APV multicenter study on 40,942 children and adolescents. CHILD AND ADOLESCENT OBESITY 2018. [DOI: 10.1080/2574254x.2018.1547070] [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] Open
Affiliation(s)
- Barbara Bohn
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Rainer Stachow
- Rehabilitation Clinic for Children and Adolescents, Fachklinik Sylt, Westerland, Germany
| | - Ines Gellhaus
- Consensus Group Obesity Education for Children and Adolescents (KgAS), Paderborn, Germany
| | | | | | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
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Lane HG, Deitch R, Wang Y, Black MM, Dunton GF, Aldoory L, Turner L, Parker EA, Henley SC, Saksvig B, Song HJ, Hager ER. "Wellness Champions for Change," a multi-level intervention to improve school-level implementation of local wellness policies: Study protocol for a cluster randomized trial. Contemp Clin Trials 2018; 75:29-39. [PMID: 30342257 PMCID: PMC6594543 DOI: 10.1016/j.cct.2018.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/01/2018] [Accepted: 10/16/2018] [Indexed: 12/01/2022]
Abstract
Schools are a recommended place for childhood obesity prevention. Local Wellness Policies (LWPs) establish guidelines for schools to provide opportunities for students to access nutritious foods and be physically active. Little is known about the impact of LWPs, when implemented, on students' behavior and body mass index (BMI). The Wellness Champions for Change trial assesses the student-level impact of providing theory-based training and technical assistance to help schools implement LWPs. This 3-arm, cluster randomized controlled trial will take place in 30 low- or middle-income schools (15 elementary and 15 middle) in five Maryland school districts. Ten schools will receive both Wellness Champions for Change (WCC), which involves training teacher-led wellness teams, and Wellness Champions for Change-Student (WCC-S), which engages students as wellness team members. Ten schools will receive WCC only, and ten control schools will receive a delayed intervention. The RE-AIM framework will guide evaluation. Student Effectiveness measures will include BMI z-scores, self-reported diet patterns, and objectively-measured physical activity. The sample size (1080 students across 30 schools, followed for 2.5 years) will enable power (>0.8) to detect BMI z-score differences. A three-level linear mixed model that accounts for clustering will be used to assess Effectiveness. A mixed methods approach will assess school- and district-level Reach, Adoption, and Implementation. If effective, this approach will represent a sustainable, multi-level, school-based strategy to prevent childhood obesity. The evaluation framework will allow for the description of factors necessary to broadly disseminate this approach for obesity prevention on a large scale.
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Affiliation(s)
- Hannah G Lane
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA.
| | - Rachel Deitch
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA.
| | - Yan Wang
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA.
| | - Maureen M Black
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA.
| | - Genevieve F Dunton
- University of Southern California, Departments of Preventive Medicine and Psychology, 2001 N. Soto St., Los Angeles, CA 90032, USA.
| | - Linda Aldoory
- University of Maryland College Park, Department of Communication, College of Arts and Humanities, College Park, MD 20742, USA.
| | - Lindsey Turner
- Boise State University, College of Education, 1910 University Drive, #1740, Boise, ID 83725, USA.
| | - Elizabeth A Parker
- University of Maryland School of Medicine, Department of Family and Community Medicine, Center for Integrative Medicine, 520 W. Lombard Street, East Hall, Baltimore, MD 21201, USA.
| | - Shauna C Henley
- University of Maryland Extension, Department of Agriculture and Natural Resources, 1114 Shawan Road, Cockeysville, MD 21030, USA.
| | - Brit Saksvig
- University of Maryland College Park, Department of Epidemiology and Biostatistics, School of Public Health, College Park, MD 20742, USA.
| | - Hee-Jung Song
- University of Maryland College Park, Department of Nutrition and Food Science, College of Agriculture and Natural Resources, College Park, MD 20742, USA.
| | - Erin R Hager
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA.
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Jalali-Farahani S, Amiri P, Akbar HM, Cheraghi L, Karimi M, Azizi F. Effects of a Healthy Lifestyle Education on the Incidence of Metabolic Syndrome in Children during a 13-Year Follow-up. Int J Behav Med 2018; 25:131-140. [PMID: 28795355 DOI: 10.1007/s12529-017-9680-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to determine effects of community-based healthy lifestyle education on the incidence of metabolic syndrome (MetS) in Tehranian children considering parental factors during a 13-year follow-up. METHODS This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) on 1603 healthy children, aged 8-18 years, who had complete parental data. Parental factors including MetS, education, age, occupation, and smoking were considered to distinguish parental clusters which could potentially predispose children to MetS. Lifestyle interventions were aimed at achieving healthy dietary patterns and increasing physical activity. Cluster analysis and survival Cox model were used to determine potential low and high risk parental clusters and the effect of intervention on the hazard of MetS in children respectively. RESULTS In a model adjusted for children's age and sex, the hazard of the MetS incidence was 36% higher in children from high-risk parental cluster than those from low-risk parental cluster (HR = 1.36, 95% CI = 1.07-1.73). Moreover, the intervention group showed a 39% lower risk for MetS incidence (HR = 0.61, 95% CI = 0.44-0.85) compared to controls, during the first 6 years after baseline assessment (short term), although the risk lowering effect of the intervention was not maintained long term. CONCLUSION A healthy lifestyle education was successful in reducing the short-term risk of MetS in children. To identify ways of maintaining long-term results, further research is definitely warranted. TRIAL REGISTRATION This study was funded by National Research Council and Planning and Management Organization and has been reviewed and approved by the Iranian registry of clinical trials (ISRCTN52588395).
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Affiliation(s)
- Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
| | - Hasti Masihay Akbar
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Leila Cheraghi
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chi DL, Richman J, Senturia K, Zahlis E. Caregivers' understanding of fluoride varnish: implications for future clinical strategies and research on preventive care decision making. J Public Health Dent 2018; 78:282-286. [PMID: 30152869 PMCID: PMC6279504 DOI: 10.1111/jphd.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/30/2018] [Accepted: 05/25/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe caregivers' understanding of fluoride varnish. METHODS We administered the Oral Health Literacy Inventory for Parents within a pediatric dental clinic (N = 113). Caregivers were asked to read and define each item. Interviews were audio recorded, transcribed, and coded inductively. The main analyses focused on responses to "fluoride varnish" and were conducted at the response level. RESULTS Of the 140 responses, 22.1 percent of the responses indicated lack of knowledge about fluoride varnish, 23.6 percent that it was for teeth, 8.6 percent as something in toothpaste or water, and 45.7 percent as something that helps teeth. About 52.7 percent of responses indicated lack of knowledge, incomplete, or incorrect understanding. At the caregiver-level, 50.4 percent did not know what fluoride varnish was or provided an incorrect or incomplete response. CONCLUSION Many caregivers have an incomplete or inaccurate understanding of fluoride varnish, which has implications for how healthcare providers communicate about preventive care and future research on caregiver decision making.
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Affiliation(s)
- Donald L Chi
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Julia Richman
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Kirsten Senturia
- Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - Ellen Zahlis
- Oral Health Sciences, University of Washington, Seattle, WA, USA
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Austvoll‐Dahlgren A, Johansen M. "A waste of time without patients": The views of patient representatives attending a workshop in evidence-based practice. J Evid Based Med 2018; 11:191-199. [PMID: 29938926 PMCID: PMC6175114 DOI: 10.1111/jebm.12303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 01/23/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Shared decision-making is a central element of evidence-based practice (EBP). Training in EBP has traditionally focused on providers, but there is an increasing interest in developing such educational resources for patients. The aim of this study is to explore the views of patient representatives attending a workshop in EBP. METHODS We conducted three focus groups with participants attending EBP workshops in 2013, 2014, and 2015. We used the framework method for content analysis. We reviewed the transcribed interviews independently and assigned initial codes and final categories to the transcriptions. We created an analytical framework and a flow diagram to visualize the category hierarchy and the relationship between categories. RESULTS We identified two main themes; "How to facilitate training in evidence-based practice for patients," and "Outputs of training in evidence based practice for patients." Training in EBP for patient representatives "should reflect the principles EBP," and include interaction with both health professionals and other representatives. The educational needs of representatives are much the same as those of health professionals, and the training should therefore be "on a par with professionals." The relevance of such training may depend on the representatives' mandate, and costs might be an important barrier. Important outputs of such training include "becoming a knowledge manager," "enabling participation and informed decisions" and "re-defining the patient representatives' role." CONCLUSIONS The findings of this study suggest that training in EBP is attractive to patient representatives with outputs perceived important. Organizers should consider the principles of EBP when planning such training.
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Nash R, Elmer S, Thomas K, Osborne R, MacIntyre K, Shelley B, Murray L, Harpur S, Webb D. HealthLit4Kids study protocol; crossing boundaries for positive health literacy outcomes. BMC Public Health 2018; 18:690. [PMID: 29866099 PMCID: PMC5987446 DOI: 10.1186/s12889-018-5558-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/10/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Health attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement. METHODS HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children's health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school. DISCUSSION Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.
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Affiliation(s)
- Rose Nash
- School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, TAS, 7000, Australia.
| | - Shandell Elmer
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Katy Thomas
- School of Education, College of Arts, Law and Education (CALE), University of Tasmania, Private Bag 66, Hobart, 7001, Tasmania, Australia
| | - Richard Osborne
- Health Systems Improvement Unit, WHO Collaboration Centre for Health Literacy, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kate MacIntyre
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Public Health Services, Department of Health and Human Services, Hobart, Tasmania, Australia
| | - Becky Shelley
- Peter Underwood Centre for Educational Attainment, Academic Division, University of Tasmania, Hobart, Tasmania, Australia
| | - Linda Murray
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Siobhan Harpur
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Public Health Services, Department of Health and Human Services, Hobart, Tasmania, Australia
| | - Diane Webb
- Public Health Services, Department of Health and Human Services, Launceston, Tasmania, Australia
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Magnani JW, Mujahid MS, Aronow HD, Cené CW, Dickson VV, Havranek E, Morgenstern LB, Paasche-Orlow MK, Pollak A, Willey JZ. Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association. Circulation 2018; 138:e48-e74. [PMID: 29866648 PMCID: PMC6380187 DOI: 10.1161/cir.0000000000000579] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Health literacy is the degree to which individuals are able to access and process basic health information and services and thereby participate in health-related decisions. Limited health literacy is highly prevalent in the United States and is strongly associated with patient morbidity, mortality, healthcare use, and costs. The objectives of this American Heart Association scientific statement are (1) to summarize the relevance of health literacy to cardiovascular health; (2) to present the adverse associations of health literacy with cardiovascular risk factors, conditions, and treatments; (3) to suggest strategies that address barriers imposed by limited health literacy on the management and prevention of cardiovascular disease; (4) to demonstrate the contributions of health literacy to health disparities, given its association with social determinants of health; and (5) to propose future directions for how health literacy can be integrated into the American Heart Association's mandate to advance cardiovascular treatment and research, thereby improving patient care and public health. Inadequate health literacy is a barrier to the American Heart Association meeting its 2020 Impact Goals, and this statement articulates the rationale to anticipate and address the adverse cardiovascular effects associated with health literacy.
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Bashirian S, Esmaeilpour-Zanjani S. Assessing the Health Literacy Level of Mothers of Under 5-year-old Children With Malnutrition. JOURNAL OF HOLISTIC NURSING AND MIDWIFERY 2018. [DOI: 10.29252/hnmj.28.3.157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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The Mediator Role of Mental Health Literacy in the Relationship Between Demographic Variables and Health-Promoting Behaviours. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2018. [DOI: 10.5812/ijpbs.12603] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Salerno JP, McEwing E, Matsuda Y, Gonzalez-Guarda RM, Ogunrinde O, Azaiza M, Williams JR. Evaluation of a nursing student health fair program: Meeting curricular standards and improving community members' health. Public Health Nurs 2018; 35:450-457. [PMID: 29667239 DOI: 10.1111/phn.12402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 02/01/2018] [Accepted: 02/08/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. AIMS The purpose of this manuscript is to describe a PHN-student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge. METHODS Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open-ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process. RESULTS We report that results from participants surveyed indicated that PHN-student delivered health fairs improved health knowledge among community members in this sample (p = .000). CONCLUSION Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community.
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Affiliation(s)
- John P Salerno
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Evan McEwing
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Yui Matsuda
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | | | - Olutola Ogunrinde
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Mona Azaiza
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Jessica R Williams
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
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May M, Brousseau DC, Nelson DA, Flynn KE, Wolf MS, Lepley B, Morrison AK. Why Parents Seek Care for Acute Illness in the Clinic or the ED: The Role of Health Literacy. Acad Pediatr 2018; 18:289-296. [PMID: 28625711 PMCID: PMC5732897 DOI: 10.1016/j.acap.2017.06.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/02/2017] [Accepted: 06/10/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the decision to seek care and decision-making regarding location of care among parents with low and adequate health literacy. METHODS Parents of children 8 years old or younger who presented for 'sick child' visits at a clinic or a nonurgent emergency department (ED) visit (triage level 5) were interviewed. The Newest Vital Sign was used to categorize parental health literacy. Interviewers followed a semistructured interview guide to understand: 1) care-seeking for current illness, and 2) choice of clinic or ED. Themes emerged using a grounded theory process, facilitated by NVivo version 10.0 software (QSR International, Melbourne, Australia). Themes included the experiences of low and adequate health literacy in the clinic as well as in the ED. RESULTS Fifty semistructured interviews were completed with parents who brought their child to the ED for a nonurgent visit (n = 30) and clinic parents (n = 20) with 56% possessing low health literacy. Parents with low health literacy were more inclined to overestimate severity of illness and seek care sooner to gain answers about the illness and treatment options, and visit the clinic only when an appointment was available within hours. Parents with adequate health literacy sought reassurance for their ongoing illness management and valued close relationships with their physician, and were willing to wait longer for an appointment. Fever, vomiting, and young child age prompted some parents to seek expedient care regardless of health literacy. CONCLUSIONS Caregiving skills (eg, assessing and treating illness, understanding illness severity, and navigating the health care system) in addition to physician-parent relationships and perception of care seem to influence the behavior of parents managing their child's mild acute illness. These factors might be amenable to a future health literacy intervention.
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Affiliation(s)
| | - David C Brousseau
- Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee
| | - David A Nelson
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee
| | - Kathryn E Flynn
- Department of Medicine and Center for Patient Care and Outcomes Research, Medical College of Wisconsin, Milwaukee
| | - Michael S Wolf
- Department of Medicine, Northwestern University, Chicago, Ill
| | | | - Andrea K Morrison
- Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee.
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DeLuca JM. Public Attitudes Toward Expanded Newborn Screening. J Pediatr Nurs 2018; 38:e19-e23. [PMID: 29033105 DOI: 10.1016/j.pedn.2017.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE There is limited research available on public knowledge and understanding of expanded newborn screening (NBS). The aims of this study were to assess current public knowledge and understanding of newborn screening disorders and procedures, perceived education needs, and preferences for the delivery of NBS information and education. An additional aim was to develop a beginning understanding of public attitudes toward screening for complex, severe, and in some cases untreatable disorders. DESIGN AND METHODS In this preliminary descriptive study, eighty-eight participants completed surveys querying their general knowledge of NBS, preferred means of receiving NBS information and education, and their opinions about screening for severe disorders such as lysosomal storage diseases (LSD). RESULTS Most study participants lacked general knowledge about current NBS practices, however, they supported expanding screening for severe and in some cases untreatable conditions. Most participants were enthusiastic about expanding NBS; however, those with more years of education were cautious regarding extensive costs of diagnosing and treating rare disorders. CONCLUSIONS Newborn screening continues to evolve through new technological developments and the addition of more disorders to screening panels. More research of into public acceptance of newborn screening is needed. Addressing the educational needs of the public is important for improving their understanding of NBS and promoting patient-centered care in the era of genomic screening. PRACTICE CONSIDERATIONS Enhanced educational efforts are necessary for improving public understanding of newborn screening.
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Affiliation(s)
- Jane M DeLuca
- Clemson University School of Nursing, Clemson, SC, USA.
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74
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Improving Access to Child Health Care in Indonesia Through Community Case Management. Matern Child Health J 2017; 20:2254-2260. [PMID: 27449650 DOI: 10.1007/s10995-016-2149-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives In order to reduce infant mortality in Indonesia, community case management (CCM) was introduced. CCM is a community-based service delivery model to improve children's wellness and longevity, involving the delivery of lifesaving, curative interventions to address common childhood illnesses, particularly where there are limited facility-based services. This paper reports the findings of a qualitative study that investigated the implementation of CCM in the Kutai Timur district, East Kalimantan Indonesia from the perspective of mothers who received care. Methods Seven mothers and health workers were observed during a consultation and these mothers were interviewed in their home weeks after delivery. Field notes and the interview transcriptions were analysed thematically. Findings Mothers reported that their access to care had improved, along with an increase in their knowledge of infant danger signs and when to seek care. Family compliance with care plans was also found to have improved. Mothers expressed satisfaction with the care provided under the CCM model. The mothers expressed a need for a nurse or midwife to be posted in each village, preferably someone from that village. However two mothers did not wish their children to receive health interventions as they did not believe these to be culturally appropriate. Conclusion CCM is seen by rural Indonesian mothers to be a helpful model of care in terms of increasing access to health care and the uptake of lifesaving interventions for sick children. However there is a need to modify the program to demonstrate cultural sensitivity and meet cultural needs of the target population. While CCM is a potentially effective model of care, further integrative strategies are required to embed this model into maternal and child health service delivery.
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Otto C, Barthel D, Klasen F, Nolte S, Rose M, Meyrose AK, Klein M, Thyen U, Ravens-Sieberer U. Predictors of self-reported health-related quality of life according to the EQ-5D-Y in chronically ill children and adolescents with asthma, diabetes, and juvenile arthritis: longitudinal results. Qual Life Res 2017; 27:879-890. [PMID: 29189988 DOI: 10.1007/s11136-017-1753-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) is an important patient-reported outcome in clinical and health research. The EQ-5D-Y assesses child and adolescent HRQoL by five items on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression as well as a visual analogue scale (VAS) on the current health state. This study investigates predictors of self-reported HRQoL according to the EQ-5D-Y in chronically ill children and adolescents using longitudinal data. METHODS Data from the German Kids-CAT study on children and adolescents with asthma, diabetes, and juvenile arthritis gathered over a period of six months were analyzed (n = 310; 7-17 years old; 48% female). Self-, parent-, and pediatrician-reported data were collected from June 2013 to October 2014. Generalized linear mixed models and linear mixed models served to examine effects of socio-demographic as well as disease- and health-specific predictors on the items as well as on the VAS of the EQ-5D-Y. RESULTS Ceiling effects for the EQ-5D-Y indicated low burden of disease in the analyzed sample. Longitudinal analyses revealed associations between less health complaints and better HRQoL for all investigated HRQoL domains. Further, age- and gender-specific effects, and associations of better disease control, longer duration of the disease and less mental health problems with better HRQoL were found. CONCLUSIONS Subjective health complaints and mental health problems should be considered in the care of children and adolescents with asthma, diabetes, and juvenile arthritis. Future research should suggest administering the items of the EQ-5D-Y with five instead of three response options, and investigate HRQoL over a longer period.
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Affiliation(s)
- Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany.
| | - Dana Barthel
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany
| | - Sandra Nolte
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Matthias Rose
- Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Quantitative Health Sciences, Outcomes Measurement Science, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany
| | - Marcus Klein
- Department of Pediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Ute Thyen
- Hospital for Pediatrics and Adolescent Medicine, University of Lübeck, Lübeck, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52 (W29), 20246, Hamburg, Germany
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Hutton JS, Gupta R, Gruber R, Berndsen J, DeWitt T, Ollberding NJ, Van Ginkel JB, Ammerman RT. Randomized Trial of a Children's Book Versus Brochures for Safe Sleep Knowledge and Adherence in a High-Risk Population. Acad Pediatr 2017; 17:879-886. [PMID: 28450082 DOI: 10.1016/j.acap.2017.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/14/2017] [Accepted: 04/15/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Sleep-related infant deaths have plateaued in the past decade, disproportionately affecting low socioeconomic status (SES) families. Printed materials are widely used for anticipatory guidance, yet none for safe sleep has been studied. We tested the efficacy of a specially designed children's book compared to brochures for safe sleep knowledge and adherence, which we hypothesized would be greater due to superior readability and engagement. METHODS This randomized controlled trial involved low-SES mothers (n = 282) enrolled in a home visiting program. Home visitors (n = 56) were randomly assigned to perform safe sleep teaching and assessments during 3 visits: third trimester, 1 week old, and 2 months old, exclusively utilizing a specially designed children's book or brochures, and surveys incorporating the American Academy of Pediatrics' safe sleep recommendations. Outcomes were safe sleep knowledge, adherence, and usefulness of materials, controlling for maternal health literacy. RESULTS Safe sleep knowledge increased across all time points with no overall group difference, though gains for sleep-evocative and general health items varied. Odds of bed sharing were higher and exclusive crib use lower for the brochure group (P < .05). Mothers and home visitors reported similar usefulness, though home visitors reported greater dialogue via the book and mothers in the book group reported more book sharing with their baby. CONCLUSIONS While a specially designed children's book and brochures were equally effective conveying aggregate safe sleep knowledge in low-SES mothers, adherence to exclusive crib use and avoiding bed sharing were greater in the book group, attributable to enhanced dialogue, readability and emotional engagement. Children's books are a promising mode of anticipatory guidance, warranting further investigation.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Resmi Gupta
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Rachel Gruber
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jennifer Berndsen
- Every Child Succeeds, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Nicholas J Ollberding
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Judith B Van Ginkel
- Every Child Succeeds, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert T Ammerman
- Every Child Succeeds, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Zoellner JM, Hill J, You W, Brock D, Frisard M, Alexander R, Silva F, Price B, Marshall R, Estabrooks PA. The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013-2015. Prev Chronic Dis 2017; 14:E87. [PMID: 28957032 PMCID: PMC5621521 DOI: 10.5888/pcd14.160421] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction Few interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose). Methods This pre–post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes. Results No significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001). Conclusion By incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.
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Affiliation(s)
- Jamie M Zoellner
- Department of Public Health Sciences, School of Medicine, University of Virginia, PO Box 800717, Charlottesville, VA 22908-0717. .,University of Virginia Cancer Center, Charlottesville, Virginia
| | - Jennie Hill
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Wen You
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, Virginia
| | - Donna Brock
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Madlyn Frisard
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
| | - Ramine Alexander
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Fabiana Silva
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Bryan Price
- University of Virginia Cancer Center, Charlottesville, Virginia
| | | | - Paul A Estabrooks
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska
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Health literacy in childhood and youth: a systematic review of definitions and models. BMC Public Health 2017; 17:361. [PMID: 28441934 PMCID: PMC5405535 DOI: 10.1186/s12889-017-4267-y] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 04/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children and young people constitute a core target group for health literacy research and practice: during childhood and youth, fundamental cognitive, physical and emotional development processes take place and health-related behaviours and skills develop. However, there is limited knowledge and academic consensus regarding the abilities and knowledge a child or young person should possess for making sound health decisions. The research presented in this review addresses this gap by providing an overview and synthesis of current understandings of health literacy in childhood and youth. Furthermore, the authors aim to understand to what extent available models capture the unique needs and characteristics of children and young people. METHOD Six databases were systematically searched with relevant search terms in English and German. Of the n = 1492 publications identified, N = 1021 entered the abstract screening and N = 340 full-texts were screened for eligibility. A total of 30 articles, which defined or conceptualized generic health literacy for a target population of 18 years or younger, were selected for a four-step inductive content analysis. RESULTS The systematic review of the literature identified 12 definitions and 21 models that have been specifically developed for children and young people. In the literature, health literacy in children and young people is described as comprising variable sets of key dimensions, each appearing as a cluster of related abilities, skills, commitments, and knowledge that enable a person to approach health information competently and effectively and to derive at health-promoting decisions and actions. DISCUSSION Identified definitions and models are very heterogeneous, depicting health literacy as multidimensional, complex construct. Moreover, health literacy is conceptualized as an action competence, with a strong focus on personal attributes, while also recognising its interrelatedness with social and contextual determinants. Life phase specificities are mainly considered from a cognitive and developmental perspective, leaving children's and young people's specific needs, vulnerabilities, and social structures poorly incorporated within most models. While a critical number of definitions and models were identified for youth or secondary school students, similar findings are lacking for children under the age of ten or within a primary school context.
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79
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An Internet-Based Medicine Education Intervention: Fourth Graders’ Perspectives. EDUCATION SCIENCES 2017. [DOI: 10.3390/educsci7020046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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80
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Asfaw A, Colopy M. Association between parental access to paid sick leave and children's access to and use of healthcare services. Am J Ind Med 2017; 60:276-284. [PMID: 28169438 DOI: 10.1002/ajim.22692] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. METHODS We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. RESULTS Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06-1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04-1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76-0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27-0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82-0.97] fewer ER visits per year. CONCLUSION PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. Am. J. Ind. Med. 60:276-284, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Abay Asfaw
- Department of Health and Human Services; Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Washington District of Columbia
| | - Maria Colopy
- Department of Health and Human Services; Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Washington District of Columbia
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81
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Hoffman S, Marsiglia FF, Nevarez L, Porta M. Health Literacy among Youth in Guatemala City. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:30-37. [PMID: 27392315 DOI: 10.1080/19371918.2016.1188741] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Health literacy (HL) is recognized as an important health construct that is correlated with various health-related outcomes, but outside of the United States there is limited HL research available, particularly among youth. This study looked at the HL and harmful health behavior (i.e., substance use) of 210 youth across 10 schools in Guatemala City. Based on results from the Newest Vital Sign (NVS) HL assessment, fewer than one third of youth sampled had adequate HL. Training/education to improve adolescent HL is needed in Guatemala City, and the unique skillset of social workers could be an idea method of reaching at-risk youth.
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Affiliation(s)
- Steven Hoffman
- a Department of Social Work , University of Texas at San Antonio , San Antonio , Texas , USA
| | - Flavio F Marsiglia
- b Department of Social Work , Arizona State University , Tempe , Arizona , USA
- c Southwest Interdisciplinary Research Center , Phoenix , Arizona , USA
| | - Lucinda Nevarez
- a Department of Social Work , University of Texas at San Antonio , San Antonio , Texas , USA
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82
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Valerio MA, Peterson EL, Wittich AR, Joseph CLM. Examining health literacy among urban African-American adolescents with asthma. J Asthma 2016; 53:1041-7. [PMID: 27359106 PMCID: PMC5056364 DOI: 10.1080/02770903.2016.1175473] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 03/31/2016] [Accepted: 04/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This exploratory study assessed health literacy among urban African-American high school students to improve understanding of the association between adolescent health literacy and asthma. METHODS We conducted a secondary data analysis of the control group (n = 181) of the Puff City randomized controlled trial (2006-2010), a web-based intervention to promote asthma management among students, grades 9 through 12. A validated self-report 3-item health literacy screening instrument was completed at final online follow-up survey. Logistic regression was used to explore the association between health literacy, demographic characteristics, quality of life, asthma management, and health care utilization. RESULTS Multivariate analysis revealed that an overall inadequate health literacy score was associated with students who were more likely to be younger (OR 0.61; 95% CI 0.44-0.84), not on Medicaid (OR 0.36; 95% CI 0.17-0.76), have at least one hospitalization (OR 1.29; 95% CI 1.07-1.56); and a lower overall quality of life (OR 0.75; 95% CI 0.59-0.95). Those lacking confidence in filling out medical forms, needing help reading hospital materials, and having difficulty understanding written information were more likely to not have a rescue inhaler (OR 0.49; 95% CI 0.25-0.94), have one or more emergency visits (OR 1.21 95% CI 1.02-1.43), and one or more hospitalizations (OR 1.19; 95% CI 1.01-1.41), respectively. CONCLUSIONS The findings indicate a significant association between inadequate health literary and suboptimal asthma management. It is important to advance understanding of adolescent health literacy, especially those at-risk, as they assume asthma self-management tasks and move toward independent adult self-care.
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Affiliation(s)
- Melissa A Valerio
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Edward L Peterson
- b Department of Public Health Sciences , Henry Ford Health System , Detroit , MI , USA
| | - Angelina R Wittich
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Christine L M Joseph
- c Department of Public Health Sciences , Health Disparities Research Collaborative, Henry Ford Health System , Detroit , MI , USA
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83
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Winkelman TNA, Caldwell MT, Bertram B, Davis MM. Promoting Health Literacy for Children and Adolescents. Pediatrics 2016; 138:peds.2016-1937. [PMID: 27940702 DOI: 10.1542/peds.2016-1937] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tyler N A Winkelman
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan; .,Veteran's Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Martina T Caldwell
- Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan.,Veteran's Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | | | - Matthew M Davis
- Division of Academic General Pediatrics, Ann and Robert H. Lurie Children's Hospital, Northwestern Feinberg School of Medicine, Chicago, Illinois
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Shepherd-Banigan M, Bell JF, Basu A, Booth-LaForce C, Harris JR. Mothers' Employment Attributes and Use of Preventive Child Health Services. Med Care Res Rev 2016; 74:208-226. [PMID: 26928958 DOI: 10.1177/1077558716634555] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines whether paid sick leave and hours worked per week are associated with receipt of recommended well-child visits, preventive dental care, influenza vaccines, obesity screening, and vision screening among U.S. children aged 0 to 17 years whose mothers were employed using data from the Medical Expenditure Panel Survey. Residual inclusion instrumental variables methods were used to address unobserved confounding related to maternal employment and child health care use. Instruments were the industry-specific mean of paid leave and hours worked. Fewer than half of children received the recommended number of well-child visits and dental care; only 14% of children received an influenza vaccine in the past year. Paid sick leave was associated with increased adherence to recommended well-child visits (marginal probability, 0.12; 95% confidence interval [CI] = 0.23, 0.01), preventive dental care (marginal probability, 0.28; 95% CI = 0.34, 0.33), and receipt of the influenza vaccine (marginal probability, 0.09; 95% CI = 0.13, 0.05 ).
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Affiliation(s)
| | - Janice F Bell
- 2 University of California Davis, Sacramento, CA, USA
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85
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Liu CH, Liao LL, Cheng CCJ, Chang TC. Development and validation of the Taiwan Children’s Health Literacy Test. Glob Health Promot 2016; 25:34-46. [DOI: 10.1177/1757975916656365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Currently, health literacy (HL) worldwide is measured primarily among adults from a medical perspective. A children’s HL test from a health promotion perspective is needed. This study develops the Taiwan Children’s Health Literacy Test (TCHL) targeted at Taiwanese sixth-graders. Methods: HL indicators were identified through interviews of sixth-grade teachers, primary caregivers, and sixth-graders. They were used to develop a 25-item online test, which was finalized after pretesting and administered to a stratified random sample of 671 students across 29 sixth-grade classes. Results: The response rate was 87.2% (585 participants). Cronbach’s α was 0.60–0.78 for the HL subtests and 0.79 for the overall HL test. Correlation coefficients among subtests ranged from 0.49 to 0.87. The average proportion correct was 0.80 for overall HL. In item response theory analysis, the difficulty level ranged from −2.77 to −0.40, while the degree of discrimination was 0.44–2.65. Item information peaked when the ability value was approximately −1.8. Furthermore, HL scores had a significant positive correlation with health behaviors. Conclusions: Overall, the test was found to be reliable and valid, with a low level of difficulty for basic HL ability. The present results can be used as a reference by government health education units to investigate national HL in children.
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Affiliation(s)
- Chieh-Hsing Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Taiwan
| | | | - Tzu-Chau Chang
- Graduate Institute of Environmental Education, National Taiwan Normal University, Taiwan
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Parisod H, Axelin A, Smed J, Salanterä S. Determinants of tobacco-related health literacy: A qualitative study with early adolescents. Int J Nurs Stud 2016; 62:71-80. [PMID: 27459318 DOI: 10.1016/j.ijnurstu.2016.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/25/2016] [Accepted: 07/13/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Today's adolescents are used to a constant information flow, but many face difficulties in processing health-related information due to low health literacy. There is still need for deeper understanding on the determinants of health literacy in relation to adolescents to guide the development of health literacy instruments and interventions. PURPOSE The purpose of this study was to explore, from the perspective of early adolescents, the determinants of health literacy in the context of tobacco-related health communication. DESIGN A qualitative descriptive study. SETTING Two schools located in the south of Finland. One school represented a typical Finnish public school with students following general curriculum and the other represented a Finnish public school with students with special educational needs. PARTICIPANTS Purposively selected sample of 10-13-year-old early adolescents (n=39) from the two schools to obtain a varied group of early adolescents representing different kinds of literacy levels. METHODS We conducted 10 focus groups with early adolescents and analyzed the data using the theoretical thematic analysis method. We used a combination of the determinants presented in three adolescent-specific health literacy models as the theoretical framework of deductive analysis. The remaining data extracts were coded inductively. We sorted the codes under sub-themes that represented different determinants of health literacy. These were further divided between three themes: "personal", "external", and "mediating" determinants. Finally, we named the themes with an expression that embodied the early adolescents' views and experiences. RESULTS Early adolescents' descriptions revealed that the list of determinants presented in the three adolescent-specific health literacy models is not comprehensive enough. Early adolescents brought up how their motives, self-efficacy, and role expectations determine their health literacy in addition to the other personal determinants presented in the previous models. Their descriptions also suggest that external determinants include interpersonal relations with authorities, idols and random people, and the socio-cultural atmosphere as new factors. New mediating determinants that have a separate influence on health literacy were recognized based on early adolescents' descriptions as well. CONCLUSION Our findings give a new, adolescent-oriented insight on the determinants of adolescents' health literacy. Based on the findings, there are additional personal, external, and mediating determinants that are not included in the current adolescent-specific health literacy models. These newly found determinants require attention and further exploration. The acquired knowledge can be used for strengthening existing adolescent-specific health literacy models, and as a basis of health literacy instrument and intervention development.
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Affiliation(s)
- Heidi Parisod
- University of Turku, Department of Nursing Science, FI-20014 Turku, Finland.
| | - Anna Axelin
- University of Turku, Department of Nursing Science, FI-20014 Turku, Finland
| | - Jouni Smed
- University of Turku, Department of Information Technology, FI-20014 Turku, Finland
| | - Sanna Salanterä
- University of Turku, Department of Nursing Science, FI-20014 Turku, Finland; Turku University Hospital, FI-20521 Turku, Finland
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Porepa M, Chan M, Huber J, Lam CG, Au H, Birken CS. Creating a student-led health magazine with an urban, multicultural, resource-restricted elementary school: Approach, process and impact. Paediatr Child Health 2016; 21:119-22. [PMID: 27398046 DOI: 10.1093/pch/21.3.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Health magazines effectively deliver health information. No data regarding student-led magazines to promote health exist. OBJECTIVE To evaluate whether children's health knowledge, interests and lifestyle choices improve following distribution of a student-led health magazine. METHODS Elementary students worked with teachers and paediatric residents to publish a health magazine. A healthy lifestyle challenge page promoted reduction in soda pop consumption. Pre- and poststudent questionnaires explored knowledge, interests and behaviours related to health. RESULTS Sex and grade distributions were similar in pre- and post-questionnaires. Ninety-seven percent of children reported the magazine helped them learn about health. Pre- and postknowledge scores did not differ (P=0.36). Following distribution, the percentage of students who reported drinking no soda increased from 43% to 67% (P=0.004), and those who reported drinking <2 glasses of soda per day increased from 66% to 85% (P=0.01). CONCLUSIONS A student-led health magazine was effective in motivating short-term student-reported behavioural change.
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Affiliation(s)
- Michelle Porepa
- Department of Paediatrics, Division of Developmental Paediatrics, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Ontario
| | - Melissa Chan
- Division of Emergency Medicine, Department of Paediatrics, University of Alberta, Edmonton, Alberta
| | - Joelene Huber
- Developmental Pediatrician, St Michael's Hospital & The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario
| | - Catherine G Lam
- Department of Oncology, St Jude Children's Research Hospital, Department of Pediatrics, University of Tennessee, Memphis, Tennessee, USA
| | - Hosanna Au
- Division of Paediatric Medicine, Department of Paediatrics, Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario
| | - Catherine S Birken
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, Ontario
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88
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Kavanaugh JR, Lavallee K, Rudd R. A librarian’s role in media effects health literacy. REFERENCE SERVICES REVIEW 2016. [DOI: 10.1108/rsr-02-2016-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to assess a pediatric media health effects’ toolkit from a health literacy perspective. A secondary aim is to highlight the collaborative role of an embedded librarian.
Design/methodology/approach
The authors assessed ten items from the toolkit in several formats (text, survey and video) using the following health literacy assessment tools: the Simple Measure of Gobbledygook, the Suitability Assessment of Materials, the Patient Education Materials Assessment Tool for Printed Materials and the Patient Education Materials Assessment Tool for Audio/Visual Materials.
Findings
Both the toolkit’s readability scores and understandability scores provided a deeper understanding of where improvements to the toolkit need to be made. The review process also highlighted issues with the assessment tools themselves that prevent them from providing a complete analysis of each materials’ readability and suitability.
Research limitations/implications
This initial assessment of the toolkit will serve as the backbone for additional formative research, revisions and pilot tests, which will be conducted for the toolkit to become a viable, available and usable tool for pediatricians and health-care providers. The insight gleaned from this study serves as an example, for other institutions across fields, of the importance of having professionals, such as librarians, become well-versed in health literacy and offer guidance and insight for the development of health-focused patient materials.
Originality/value
This project provides further insight into the evolving role of the embedded librarian. As gatekeepers of information with the responsibility of vetting sources, informing the creation of content, and developing resources, the integration of health literacy knowledge is imperative for librarians to further the work of their institutions and aid in the progression of their field.
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89
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Ip P, Ho FKW, So HK, Chan DFY, Ho M, Tso W, Nelson EAS. Socioeconomic Gradient in Childhood Obesity and Hypertension: A Multilevel Population-Based Study in a Chinese Community. PLoS One 2016; 11:e0156945. [PMID: 27258094 PMCID: PMC4892679 DOI: 10.1371/journal.pone.0156945] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/23/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aims to assess evidence for any socioeconomic gradients in childhood obesity and hypertension in a population-representative sample in Hong Kong, China. METHODS The data of a stratified random sampled growth survey collected in 2005-2006 was matched with a population by-census. Obesity was defined using the International Obesity Task Force standard and hypertension was defined using the Hong Kong norm table. Family socioeconomic status (SES) was measured by maternal education level. Neighbourhood SES was measured by median household income of the neighbourhood. Multilevel Poisson regression models with robust standard error were used to test the association. Body mass indices of children's parents were included as potential confounders. Intra-school/neighbourhood correlations were adjusted using random factors. RESULTS Totally 14842 children (age 6-19 years) included in the analysis, in which 16.6% of them were overweight or obese. Children whose mother only completed secondary school or below had higher risk of childhood obesity (RR 1.41, 95% CI 1.13-1.76, p = 0.003) and hypertension (RR 1.18, 95% CI 1.01-1.36, p = 0.03). Meanwhile, children in the lowest neighbourhood SES group had higher risk of childhood underweight (RR 1.61, 95% CI 1.04-2.49, p = 0.03), overweight (RR 1.35, 95% CI 1.05-1.72, p = 0.02), and obesity (RR 2.07, 95% CI 1.11-3.88, p = 0.02). CONCLUSIONS Socioeconomic gradient in childhood obesity and hypertension existed in Hong Kong, one of the most developed cities in China. These results have implications for policymakers and public health experts and highlight the need to monitor trends in other parts of China.
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Affiliation(s)
- Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Frederick Ka Wing Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Hung-Kwan So
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Matthew Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Winnie Tso
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - E. Anthony S. Nelson
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
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90
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Chen P, Rea C, Shaw R, Bottino CJ. Associations between Public Library Use and Reading Aloud among Families with Young Children. J Pediatr 2016; 173:221-227.e1. [PMID: 27056451 DOI: 10.1016/j.jpeds.2016.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 02/03/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To measure public library use in a sample of families with young children and examine associations with reading aloud. STUDY DESIGN We interviewed 200 parents of 6- to 18-month-old children visiting a hospital-based pediatric clinic. We assessed public library card ownership, public library visitation, and awareness of public library programming. We assessed reading aloud using the StimQ READ questionnaire. We used multivariable logistic and linear regression to examine associations while adjusting for sociodemographic characteristics. RESULTS In multivariable analysis, parents who owned a public library card had greater odds of reading aloud daily to their 6- to 18-month-old child (aOR, 2.0; 95% CI, 1.0-3.8) and higher StimQ READ scores (β = 0.9; 95% CI, 0.2-1.6). Parents who visited a public library once a month or more often had greater odds of reading aloud daily (aOR, 3.4; 95% CI, 1.8-6.7) and higher StimQ READ scores (β = 1.3; 95% CI, 0.6-2.0). Parents whose 6- to 18-month-old child had ever visited a public library did not have greater odds of reading aloud daily (aOR, 1.4; 95% CI, 0.7-2.9), but did have higher StimQ read scores (β = 1.2; 95% CI, 0.4-2.0). Parents who felt informed about available public library programs for children had greater odds of reading aloud daily (aOR, 2.5; 95% CI, 1.3-5.1) and higher StimQ READ scores (β = 1.1; 95% CI, 0.4-1.9). CONCLUSION In this sample of families with young children, we found positive associations between public library use and reading aloud.
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Affiliation(s)
- Pamela Chen
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA; Harvard College, Faculty of Arts and Sciences, Harvard University, Cambridge, MA
| | - Corinna Rea
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Rebecca Shaw
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA
| | - Clement J Bottino
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
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91
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Shih SF, Liu CH, Liao LL, Osborne RH. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan. BMC Public Health 2016; 16:280. [PMID: 27000035 PMCID: PMC4802836 DOI: 10.1186/s12889-016-2879-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. METHODS Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. RESULTS The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese. CONCLUSIONS This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.
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Affiliation(s)
- Shu-Fang Shih
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Chieh-Hsing Liu
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Li-Ling Liao
- />Department of Health Management, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445 Taiwan
| | - Richard H. Osborne
- />Deakin University Centre for Population Health Research, School of Health and Social Development, Geelong, Victoria Australia
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92
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Bonuck KA, Schwartz B, Schechter C. Sleep health literacy in head start families and staff: exploratory study of knowledge, motivation, and competencies to promote healthy sleep. Sleep Health 2016; 2:19-24. [PMID: 27239486 DOI: 10.1016/j.sleh.2015.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONTEXT Healthy child development requires sufficient, quality sleep. Sleep problems in early childhood impair social-emotional and cognitive function and increase obesity risk. From a health literacy framework, "sleep health literacy" denotes the knowledge, motivation, and competencies to promote healthy sleep and to recognize a sleep problem. DESIGN To explore the untapped potential of early childhood education (ECE) programs to promote sleep health literacy, we surveyed staff (n=63) and parents (n=196) in Head Start about sleep-related knowledge, attitudes/beliefs, sleep hygiene, and sleep problems. Head Start is the largest ECE program in the United States. RESULTS Most parents believed that their child had healthy sleep habits (81%); few believed that he or she had a sleep problem (10%). Yet, unhealthy bedtime practices and insufficient sleep for age were reported in 50% and 33% of children, respectively. Between 10% and 12% of children had 1 or more sleep onset or awakening problems. Every unhealthy bedtime practice but one was associated with a sleep problem; parental presence at bedtime was associated with the most problems. Insufficient sleep was significantly associated with unhealthy sleep practices. More children with late vs early bedtimes (48% vs14%, P < .01) and frequent vs less frequent parental presence at bedtime (50% vs 26%-30%, P < .02) failed to obtain sufficient sleep. Staff members are more comfortable discussing healthy sleep with parents (87%) than counseling them (45%). CONCLUSION Among parents, there is a "disconnect" between actual and perceived sleep hygiene. Similarly, staff perceived a gap between their competencies to promote healthy sleep in families and their capacity to address sleep problems. US health literacy goals include the need to embed accurate, accessible, and actionable health information in ECE programs. Study findings strongly support the need to work toward sleep health literacy in ECE programs.
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Affiliation(s)
- Karen A Bonuck
- Department of Family and Social Medicine, Albert Einstein College of Medicine
| | - Barbara Schwartz
- Steinhardt School of Culture, Education, and Human Development, New York University
| | - Clyde Schechter
- Department of Family and Social Medicine, Albert Einstein College of Medicine
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93
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Rocha PC, Lemos SMA. Aspectos conceituais e fatores associados ao Letramento Funcional em Saúde: revisão de literatura. REVISTA CEFAC 2016. [DOI: 10.1590/1982-021620161819615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo é revisar as produções científicas acerca da avaliação do letramento funcional em saúde em associação com a qualidade de vida; e analisar metodologicamente os estudos observacionais sobre a temática. Trata-se de revisão integrativa de literatura produzida com base em artigos relacionados aos seguintes eixos temáticos: letramento funcional em saúde e qualidade de vida, com busca realizada nas bases de dados PubMed, Lilacs, Biblioteca Virtual em Saúde. Após a aplicação dos critérios de inclusão obteve-se 538 artigos e após a aplicação dos critérios de exclusão foram selecionados 11 artigos sendo nove estudos internacionais e dois nacionais. A revisão constou de compilação e construção de linha histórica das publicações, análise metodológica dos estudos observacionais e elaboração de nuvem de textos. A maior parte dos artigos tem análise quantitativa; público alvo adultos e idosos e medem o nível de letramento funcional em saúde. Os estudos verificaram relação positiva do letramento funcional em saúde com a baixa escolaridade, idade mais avançada, sexo masculino e baixa renda. Os principais cenários foram ambientes assistenciais. O letramento funcional em saúde apresentou associação com variáveis sócio-demográficas como sexo, idade e escolaridade. A maior parte dos estudos encontrados na busca teve como objetivo relacionar o letramento a patologias e foi realizado em ambientes clínicos (ambulatórios e hospitais). Dos oito artigos observacionais incluídos na presente revisão atenderam totalmente aos critérios metodológicos para elaboração desse tipo de estudo.
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94
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Abstract
The process of navigating through the modern American health care system is becoming progressively challenging. The range of tasks being asked of patients in the digital age is vast and complex and includes completing intricate insurance applications, signing complex consent forms, and translating medical data and prescription medication directions. Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely offered by medical providers. Mounting evidence now supports a growing awareness that general health literacy is the greatest individual factor affecting a person's health status.
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Affiliation(s)
- Mitzi Scotten
- Pediatric Medical Student Clerkship, Pediatric Cystic Fibrosis Clinic, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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95
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Anderson M, Dahllöf G, Twetman S, Jansson L, Bergenlid AC, Grindefjord M. Effectiveness of Early Preventive Intervention with Semiannual Fluoride Varnish Application in Toddlers Living in High-Risk Areas: A Stratified Cluster-Randomized Controlled Trial. Caries Res 2016; 50:17-23. [PMID: 26795957 DOI: 10.1159/000442675] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 11/16/2015] [Indexed: 11/19/2022] Open
Abstract
This study evaluated whether toddlers in an extended preventive program of semiannual fluoride varnish applications from 1 year of age had a lower incidence of caries than those undergoing a standard program. A cohort of 1-year-old children (n = 3,403) living in multicultural areas of low socioeconomic standing in Stockholm participated in a cluster-randomized controlled field trial with two parallel arms. The children attended 23 dental clinics. Using the ICDAS II criteria, the examiners recorded caries at baseline and after 1 and 2 years. The children in the reference group received a standardized oral health program once yearly between 1 and 3 years of age. The children in the test group received the same standard program supplemented with topical applications of fluoride varnish every 6 months. We compared the test group and the reference group for the prevalence and increment of caries. At baseline, 5% of the children had already developed caries (ICDAS II 1-6). We reexamined the children after 1 year (n = 2,675) and after 2 years (n = 2,536). Neither prevalence nor caries increment differed between the groups. At 3 years of age, 12% of the children had developed moderate and severe carious lesions (ICDAS II 3-6), with a mean increment of 0.5 (SD 2.4) in the test group and 0.6 (SD 2.2) in the reference group. In conclusion, semiannual professional applications of fluoride varnish, as a supplement to a standard oral health program, failed to reduce caries development in toddlers from high-risk communities.
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Affiliation(s)
- Maria Anderson
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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96
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Shields WC, McDonald EM, McKenzie LB, Gielen AC. Does Health Literacy Level Influence the Effectiveness of a Kiosk-Based Intervention Delivered in the Pediatric Emergency Department? Clin Pediatr (Phila) 2016; 55:48-55. [PMID: 26333526 DOI: 10.1177/0009922815602889] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study assesses parents' literacy skills and evaluates how literacy levels influenced the effectiveness of a health communication intervention designed to improve safety knowledge in low-income, urban families. METHODS A total of n = 450 parents of children aged 4 to 66 months completed the Rapid Estimate of Adult Literacy in Medicine (REALM) and participated in a randomized trial of an injury prevention intervention delivered via computer kiosk in a pediatric emergency department. A safety knowledge test was administered by telephone 2 to 4 weeks later. RESULTS More than one-third of parents were assessed by the REALM to have marginal (30%) or inadequate (8%) reading levels; the remaining 62% of parents had adequate reading levels. REALM scores were independently associated with knowledge gains for poison storage and smoke alarms. CONCLUSIONS Participants reading level had an independent and significant effect on safety knowledge outcomes. Literacy level should be considered in all patient education efforts.
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Affiliation(s)
- Wendy C Shields
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lara B McKenzie
- The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Andrea C Gielen
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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97
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O’Donnell K, Mansbach JM, LoVecchio F, Cheng J, Piedra PA, Clark S, Sullivan AF, Camargo CA. Use of Cough and Cold Medications in Severe Bronchiolitis before and after a Health Advisory Warning against Their Use. J Pediatr 2015; 167:196-8.e1-2. [PMID: 25888349 PMCID: PMC4485973 DOI: 10.1016/j.jpeds.2015.03.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
We compared the use of cough and cold medications in 2 multicenter studies of young children hospitalized with bronchiolitis before and after the 2008 Food and Drug Administration cough and cold medications advisory. Although cough and cold medication use decreased after the advisory, nearly 20% of children age 12-23.9 months with severe bronchiolitis received cough and cold medications.
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98
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Chisolm DJ, Sarkar M, Kelleher KJ, Sanders LM. Predictors of Health Literacy and Numeracy Concordance Among Adolescents With Special Health Care Needs and Their Parents. JOURNAL OF HEALTH COMMUNICATION 2015; 20 Suppl 2:43-49. [PMID: 26513030 PMCID: PMC4699417 DOI: 10.1080/10810730.2015.1058443] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Parent and teen health literacies (HLs) are employed as teens with chronic illnesses transition to health self-management and the adult health system. This study explores the relationships between parent and teen HL. Teens ages 12-18 with chronic conditions and their parents, sampled from a pediatric Medicaid accountable care organization, completed an interview assessing HL and self-reported competence with written and numerical health information. Rates of teen and parent HL, degree of concordance, and the relationship between concordance and teen-reported competence with health materials were measured. Half (52%) of teens had adequate HL, 62% of teens reported competence with written health materials, and 69% reported competence with numerical information. The correlation between parent and teen HL was modest but significant (ϕ = 0.13, p = .03): 47% of parent-teen dyads were concordant for adequate HL, and 10% were concordant for inadequate HL. Adequate teen HL was associated with parental adequate HL and parental education. Discordance was associated with self-reported competence with written material and numerical material. More than half of parent-teen dyads had at least 1 member with less than adequate HL, and parent-teen HL concordance was associated with teen perception of HL. These findings support the consideration of both independent and dyad HL levels in adolescent care.
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Affiliation(s)
- Deena J Chisolm
- a The Research Institute , Nationwide Children's Hospital , Columbus , Ohio , USA
- b Department of Pediatrics , The Ohio State University , Columbus , Ohio , USA
| | - Madhurima Sarkar
- a The Research Institute , Nationwide Children's Hospital , Columbus , Ohio , USA
| | - Kelly J Kelleher
- a The Research Institute , Nationwide Children's Hospital , Columbus , Ohio , USA
- b Department of Pediatrics , The Ohio State University , Columbus , Ohio , USA
| | - Lee M Sanders
- c Department of General Pediatrics , Stanford University , Stanford , California , USA
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99
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Mcluckie A, Kutcher S, Wei Y, Weaver C. Sustained improvements in students' mental health literacy with use of a mental health curriculum in Canadian schools. BMC Psychiatry 2014; 14:379. [PMID: 25551789 PMCID: PMC4300054 DOI: 10.1186/s12888-014-0379-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. METHODS We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change. RESULTS There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p < 0.001; d = 0.90) and was maintained at follow-up (p < 0.001; d = 0.73). Similarly, attitude significantly improved between pre- and post-tests (p < 0.001; d = 0.25) and was significantly higher at follow-up than base-line (p < 0.007; d = 0.18) CONCLUSIONS: The Guide, applied by usual teachers in usual classroom curriculum, may help improve student knowledge and attitudes regarding mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.
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Affiliation(s)
- Alan Mcluckie
- />Faculty of Social Work, University of Calgary, Halifax, Canada
| | - Stan Kutcher
- />Department of Psychiatry, Dalhousie University and Sun Life Financial Chair in Adolescent Mental Health, Halifax, Canada
- />IWK Health Centre, 5980 University Avenue, NS B3K 6R8 Halifax, NS Canada
| | - Yifeng Wei
- />Sun Life Financial Chair in Adolescent Mental Health team, Dalhousie University and IWK Health Centre, Halifax, Canada
| | - Cynthia Weaver
- />Adolescent Unit, Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
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100
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Chisolm DJ, Manganello JA, Kelleher KJ, Marshal MP. Health literacy, alcohol expectancies, and alcohol use behaviors in teens. PATIENT EDUCATION AND COUNSELING 2014; 97:291-296. [PMID: 25085549 PMCID: PMC4252970 DOI: 10.1016/j.pec.2014.07.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 05/28/2014] [Accepted: 07/13/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Alcohol expectancies are developed, in part, through exposure to health messages, the understanding of which may be influenced by health literacy. This study explores the relationships among health literacy, alcohol expectancies, and alcohol use behaviors in teens. METHODS We studied alcohol use behaviors in the past six months in youths aged 14-19 recruited from two adolescent medicine clinics. We assessed covariate-adjusted bivariate relationships between HL, expectancies, and four measures of alcohol use and tested health literacy as a moderator of the relationship between expectancies and use. RESULTS Of the 293 study teens, 45 percent reported use of alcohol in the past six months. Use behaviors were positively associated with higher health literacy and positive expectancies. Our moderation model suggested that health literacy moderates the relationship between expectancies and use, with the expectancy/use relationship being significantly stronger in higher literacy teens. CONCLUSION Findings suggest that health literacy can influence alcohol expectancies and behaviors. PRACTICE IMPLICATIONS Health literacy should be explicitly considered in the design of alcohol prevention messages.
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Affiliation(s)
- Deena J Chisolm
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA; The Research Institute at Nationwide Children's Hospital, Columbus, USA.
| | - Jennifer A Manganello
- Department of Health Policy, Management, and Behavior, University of Albany School of Public Health, Rensselaer, USA
| | - Kelly J Kelleher
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA; The Research Institute at Nationwide Children's Hospital, Columbus, USA
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