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Sætre LMS, Raasthøj I, Lauridsen GB, Balasubramaniam K, Haastrup P, Rasmussen S, Eilerskov N, Søndergaard J, Storsveen MM, Wehberg S, Jarbøl DE. Revisiting the symptom iceberg based on the Danish symptom cohort - Symptom experiences and healthcare-seeking behaviour in the general Danish population in 2022. Heliyon 2024; 10:e31090. [PMID: 38803940 PMCID: PMC11128908 DOI: 10.1016/j.heliyon.2024.e31090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Healthcare-seeking behaviour may change over time, and some groups are more likely to avoid relevant help seeking, which possibly contributes to social inequity in health. Thus, we developed an expansion of and follow-up to the Danish Symptom Cohort (DaSC) from 2012 and formed the DaSC II, which encompassed a population-based questionnaire study investigating symptoms and healthcare-seeking behaviour. In this paper, we describe the conceptual framework, development and content validity of the questionnaire and a responder analysis of the participants in the DaSC II. We present the symptom iceberg in the Danish general population by estimating the prevalence of symptoms and proportion of contacts to general practitioners (GPs) in 2022. Moreover, we discuss differences in healthcare-seeking behaviour with reference to the 2012 DaSC. Methods 100,000 randomly selected Danish citizens aged ≥20 years, along with the 44,713 respondents from the 2012 cohort, were invited to participate in a survey. The questionnaire was pilot and field tested prior to distribution. Descriptive statistics were used to estimate symptom prevalence and proportion of GP contacts, and to execute the respondent analysis. Results Nine out of ten respondents reported at least one symptom within the preceding four weeks and reported an average of 4.6 symptoms. One in four symptoms were presented to a GP. The highest proportion of GP contacts was found for haematuria (63.3 %) and shortness of breath (51.8 %). For several symptoms, differences between the sexes were found in relation to both prevalence and GP contacts. The proportion of GP contacts was higher in 2022 than in 2012 and was most pronounced for general, frequently experienced symptoms and to a lesser extent for cancer alarm symptoms. Conclusion Many symptoms go unreported, which may delay relevant diagnosis; more research on certain symptom categories and population subgroups is needed. Future studies based on the DaSC II form a basis for interventions targeting symptom awareness, healthcare-seeking behaviour and social equity in society and health.
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Affiliation(s)
- Lisa Maria Sele Sætre
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Isabella Raasthøj
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Gitte Bruun Lauridsen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Kirubakaran Balasubramaniam
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Peter Haastrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Sanne Rasmussen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Natasja Eilerskov
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Maria Munch Storsveen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Sonja Wehberg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Campusej 55, 5230, Odense M, Denmark
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Mavedatnia D, Wang L, Kiss A, Monteiro E, Lin V. Health literacy of patients eligible for cochlear implants. Cochlear Implants Int 2024:1-9. [PMID: 38810103 DOI: 10.1080/14670100.2024.2341208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Hearing loss is known to be an independent risk factor for inadequate health literacy. The objective of this study was to assess the level of health literacy among patients undergoing cochlear implantation to determine areas for improvement in delivery of patient information. METHODS A cross-sectional survey was conducted at the otology-neurotology clinic at Sunnybrook Health Sciences Centre. Patients eligible for cochlear implantation completed two health literacy screening tools: The Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Brief Health Literacy Screen (BHLS). RESULTS Thirty seven patients were included (41% female, 59% male, mean age: 55 years). Most patients had adequate health literacy through BHLS (76%) and S-TOFHLA (98%) scoring. Over 80% of patients were not able to correctly recount all the operative risks associated with cochlear implant surgery and one third of patients did not correctly recount any risks associated with a cochlear implant surgery. Female sex was associated with higher scores (p=0.03) and low income (<$35,000) was associated with lower scores (p=0.05). CONCLUSION Patients eligible for cochlear implants have adequate health literacy, but most are not able to recount operative risks. Educational tools are required to improve patient retention, understand, and perioperative health information delivery.
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Affiliation(s)
- Dorsa Mavedatnia
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Lily Wang
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Lin
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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Zaki-Metias KM, Ogunde B, Carruthers H, Deptula L, Allen LS, Hakim BH. A multimodality review of gynecologic devices in the pelvis. Abdom Radiol (NY) 2024:10.1007/s00261-024-04367-9. [PMID: 38805098 DOI: 10.1007/s00261-024-04367-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024]
Abstract
There are a wide variety of gynecologic devices encountered on pelvic imaging which may not be the focus or primary reason for imaging. Such devices include pessaries, menstrual products, radiation therapy devices, tubal occlusion devices, and contraceptive devices, including intrauterine devices and intravaginal rings. This manuscript offers a comprehensive review of multimodality imaging appearances of gynecologic devices encountered on pelvic imaging and discusses device indications, positioning, and complications.
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Affiliation(s)
- Kaitlin M Zaki-Metias
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA.
| | - Barakat Ogunde
- Department of Medical Imaging, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Hailey Carruthers
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA
| | - Lisa Deptula
- Ross University School of Medicine, Bridgetown, Barbados
| | - Leslie S Allen
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA
- Huron Valley Radiology, Ypsilanti, MI, USA
| | - Bashir H Hakim
- Department of Radiology, Trinity Health Oakland Hospital/Wayne State University School of Medicine, Pontiac, MI, USA
- Huron Valley Radiology, Ypsilanti, MI, USA
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Sheng Z, Kuang J, Yang L, Wang G, Gu C, Qi Y, Wang R, Han Y, Li J, Wang X. Predictive models for delay in medical decision-making among older patients with acute ischemic stroke: a comparative study using logistic regression analysis and lightGBM algorithm. BMC Public Health 2024; 24:1413. [PMID: 38802838 PMCID: PMC11129384 DOI: 10.1186/s12889-024-18855-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To explore the factors affecting delayed medical decision-making in older patients with acute ischemic stroke (AIS) using logistic regression analysis and the Light Gradient Boosting Machine (LightGBM) algorithm, and compare the two predictive models. METHODS A cross-sectional study was conducted among 309 older patients aged ≥ 60 who underwent AIS. Demographic characteristics, stroke onset characteristics, previous stroke knowledge level, health literacy, and social network were recorded. These data were separately inputted into logistic regression analysis and the LightGBM algorithm to build the predictive models for delay in medical decision-making among older patients with AIS. Five parameters of Accuracy, Recall, F1 Score, AUC and Precision were compared between the two models. RESULTS The medical decision-making delay rate in older patients with AIS was 74.76%. The factors affecting medical decision-making delay, identified through logistic regression and LightGBM algorithm, were as follows: stroke severity, stroke recognition, previous stroke knowledge, health literacy, social network (common factors), mode of onset (logistic regression model only), and reaction from others (LightGBM algorithm only). The LightGBM model demonstrated the more superior performance, achieving the higher AUC of 0.909. CONCLUSIONS This study used advanced LightGBM algorithm to enable early identification of delay in medical decision-making groups in the older patients with AIS. The identified influencing factors can provide critical insights for the development of early prevention and intervention strategies to reduce delay in medical decisions-making among older patients with AIS and promote patients' health. The LightGBM algorithm is the optimal model for predicting the delay in medical decision-making among older patients with AIS.
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Affiliation(s)
- Zhenwen Sheng
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Jinke Kuang
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Li Yang
- Qingdao University, Qingdao City, Shandong Province, China.
| | - Guiyun Wang
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Cuihong Gu
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Yanxia Qi
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Ruowei Wang
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Yuehua Han
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Jiaojiao Li
- Shandong Xiehe University, Jinan City, Shandong Province, China
| | - Xia Wang
- Qilu Hospital of Shandong University, Jinan City, Shandong Province, China
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Keles A, Arikan O, Hamid-Zada İ, Somun UF, Baydili KN, Yildirim A. Exploring the impact of digital health literacy on quality of life in patients undergoing retrograde intrarenal surgery for kidney stone treatment: a prospective, single-center study. Urolithiasis 2024; 52:77. [PMID: 38780763 PMCID: PMC11116255 DOI: 10.1007/s00240-024-01576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
Retrograde intrarenal surgery (RIRS) is the recommended treatment for renal stones up to two cm in size. As digital health literacy (e-HL) has become increasingly important in promoting informed health decisions and healthy behaviors, it is necessary to investigate its impact on RIRS treatment outcomes. We aimed to explore the influence of patients' e-HL level on their postoperative quality of life (QoL). We conducted an observational prospective study of 111 patients who underwent RIRS for renal pelvis stones. Before RIRS, we evaluated patients' e-HL using the electronic health literacy scale (eHEALS). QoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) one month after RIRS. SFR was determined by a negative CT scan or asymptomatic patients with stone fragments < 3 mm. Adult individuals aged 18 years or older with typical calyceal anatomy met the eligibility criteria for enrollment. Exclusion criteria for the study included patients with ureteric stones, anomalous kidneys, or bilateral renal stones. The relationship between patients' QoL and stone-free rate was explored using Spearman's rank correlation coefficient. The mean stone burden was 14 ± 3 mm (6-19 mm). The overall SFR was 83.3% after one month. The median EQ-5D-5L utility index and VAS score were 0.826 (0.41-1) and 70 (20-100) respectively, for the overall population. We found that poorer e-HL was associated with being older (p = 0.035), having less education (p = 0.005), and not having access to the internet (p < 0.001). A significant difference was observed between patients with sufficient e-HL and patients with limited e-HL in the self-care (p = 0.02) and anxiety/depression (p = 0.021) dimensions. To date, no study has examined the impact of patients' e-HL levels on postoperative QoL in patients undergoing RIRS. This study also revealed that e-HL levels in patients undergoing RIRS were related to postoperative QoL, especially self-care and anxiety/depression dimensions, whereas there was no relationship between them and SFR.
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Affiliation(s)
- Ahmet Keles
- Department of Urology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
| | - Ozgur Arikan
- Department of Urology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - İlkin Hamid-Zada
- Department of Urology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Umit Furkan Somun
- Department of Urology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Kursad Nuri Baydili
- Department of Biostatistics, School of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
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James TG, McKee KS, Moore Simas TA, Smith LD, McKee MM, Mitra M. Cesarean birth and adverse birth outcomes among sub-populations of deaf and hard-of-hearing people. Disabil Health J 2024:101639. [PMID: 38811248 DOI: 10.1016/j.dhjo.2024.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/24/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Deaf and hard-of-hearing (DHH) people are at higher risk than their non-DHH counterparts of experiencing adverse birth outcomes. There is a lack of research focusing on social, linguistic, and medical factors related to being DHH which may identify groups of DHH people who experience more inequity. OBJECTIVE Examine difference in prevalence of cesarean and adverse birth outcomes among diverse sub-groups of DHH people. METHODS We conducted a cross-sectional survey of DHH birthing people in the U.S. who gave birth within the past 10 years. The sample was predominantly white, college educated, and married. We assessed cesarean birth and three adverse birth outcomes: preterm birth, low birthweight, and NICU admission post-delivery. DHH-specific variables were genetic etiology of hearing loss, preferred language (i.e., American Sign Language, English, or bilingual), severity of hearing loss, age of onset of hearing loss, and self-reported quality of perinatal care communication. We estimated prevalence, 95 % confidence intervals, and unadjusted prevalence ratios. RESULTS Thirty-one percent of our sample reported a cesarean birth. Overall, there were no significant differences in prevalence across the outcome variables with respect to preferred language, genetic etiology, severity, and age of onset. Poorer perinatal care communication quality was associated with higher prevalence of preterm birth (PR = 2.37) and NICU admission (PR = 1.91). CONCLUSIONS Our study found no evidence supporting differences in obstetric outcomes among DHH birthing people across medical factors related to deafness. Findings support the important role of communication access for DHH people in healthcare environments.
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Affiliation(s)
- Tyler G James
- Department of Family Medicine, University of Michigan, USA.
| | | | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, UMass Chan Medical School, Worcester, MA, USA
| | - Lauren D Smith
- Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, USA
| | | | - Monika Mitra
- Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, USA
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Shi X, Shi Y, Wang J, Wang H, Li Y. Knowledge, attitude, and practice toward sleep disorders and sleep hygiene among perimenopausal women. Sci Rep 2024; 14:11663. [PMID: 38777871 PMCID: PMC11111451 DOI: 10.1038/s41598-024-62502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024] Open
Abstract
This cross-sectional study aimed to explore the knowledge, attitude and practice (KAP) toward sleep disorders and sleep hygiene among perimenopausal women, who were enrolled in Dezhou region of Shandong Province between July and September 2023. A total of 720 valid questionnaires were collected (mean age: 51.28 ± 4.32 years old), and 344 (47.78%) reported experiencing insomnia. The mean scores for knowledge, attitude, practice, and Dysfunctional Beliefs and Attitudes about Sleep (DBAS) were 15.73 ± 7.60 (possible range: 0-36), 29.35 ± 3.15 (possible range: 10-50), 28.54 ± 4.03 (possible range: 10-50), and 6.79 ± 1.90 (possible range: 0-10), respectively. Path analysis showed that knowledge had direct effects on attitude (β = 0.04, 95% CI 0.01-0.07, P = 0.001), and DBAS (β = 0.04, 95% CI 0.02-0.05, P < 0.001). Knowledge had direct effects (β = 0.11, 95% CI 0.08-0.15, P < 0.001) and indirect (β = 0.02, 95% CI 0.00-0.03, P = 0.002) effect on practice. Moreover, attitude also had a direct impact on practice (β = 0.34, 95% CI 0.25-0.43, P < 0.001). In conclusion, perimenopausal women exhibited insufficient knowledge, negative attitude, inactive practice toward sleep disorders and sleep hygiene, and unfavorable DBAS, emphasizing the need for targeted healthcare interventions.
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Affiliation(s)
- Xiaomin Shi
- Ningjin TCM Hospital, Shandong, 253400, China
| | - Yi Shi
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Jie Wang
- Ningjin TCM Hospital, Shandong, 253400, China
| | - Hui Wang
- Ningjin TCM Hospital, Shandong, 253400, China
| | - Yunru Li
- Beijing University of Chinese Medicine, Beijing, 100105, China
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Naal H, Alaeddine R, Brome D, Daou T, Hudroj L, el Sayed I, Soubra R, Hokayem J, Ghalayini M, Slim W, Saleh S. Capacity building and community of practice for women community health workers in low-resource settings: long-term evaluation of the Mobile University For Health (MUH). Front Glob Womens Health 2024; 5:1304954. [PMID: 38832109 PMCID: PMC11144904 DOI: 10.3389/fgwh.2024.1304954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 05/01/2024] [Indexed: 06/05/2024] Open
Abstract
Background Lebanon has been facing a series of crises, significantly increasing health challenges, and straining its healthcare infrastructure. This caused deficiencies in the system's ability to attend to population health needs, and it profoundly impacted vulnerable and refugee communities who face additional challenges accessing healthcare services. In response, the Global Health Institute at the American University of Beirut designed and implemented the Mobile University for Health (MUH), which promotes task-shifting through capacity building complemented by communities of practice (CoP). The program aimed to prepare vulnerable women to assume the role of community health workers (CHW) within their communities, and to promote positive health knowledge and behaviours. Methods A mixed-methods approach was used to evaluate MUHs' three certificates (women's health, mental health and psychosocial support, and non-communicable diseases). Implementation took place between 2019 and 2022, with 83 CHWs graduating from the program. Short-term data including knowledge assessments, course evaluations, and community member feedback surveys were collected. 93 semi-structured interviews with CHWs and 14 focus group discussions with community members were conducted to evaluate the long-term impact of the capacity building and CoP components. Results Data revealed multiple strengths of the initiative, including increased access to education for the community, effectiveness of blended learning modality, successful planning and delivery of CoP sessions, and improved knowledge, skills, and health behaviours over time. The supplementary CoP sessions fostered trust in CHWs, increased community empowerment, and increased leadership skills among CHWs. However, some challenges persisted, including limited access to healthcare services, implementation logistical issues, difficulties with some aspects of the learning modality, and some resistance within the communities. Conclusion MUH promoted and improved positive health knowledge and behaviours within targeted vulnerable populations in Lebanon. The supplementary CoP component proved instrumental in empowering CHWs and enhancing their impact within their communities. The study highlights the need for ongoing training and support for CHWs and underscores the importance of continued investment and adaptation of such initiatives through a gendered lens. This evaluation provides evidence on the successes of a capacity building model that has strong potential for scale and replication across health topics in conflict-affected contexts.
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Affiliation(s)
- Hady Naal
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Reem Alaeddine
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Dayana Brome
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Tracy Daou
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Laura Hudroj
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Israa el Sayed
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Racha Soubra
- Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC, Canada
| | - Joanne Hokayem
- School of Public Health, Harvard University, Cambridge, MA, United States
| | - Mohamad Ghalayini
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Waed Slim
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Shadi Saleh
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Bardelle J, Abady H, Paulussen M, Lampen-Eberle P, Kalhoff H, Pizzulli A, Parasher K, Brzoska P, Aydin M, Kiessling C. Study protocol of a prospective, interventional non-randomised trial investigating the impact of asthma education on specific disease understanding, health literacy and therapy outcome in childhood. BMJ Open 2024; 14:e083180. [PMID: 38749686 PMCID: PMC11097816 DOI: 10.1136/bmjopen-2023-083180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/26/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Childhood asthma is a highly prevalent chronic disease. A failure to implement patient education programmes may result in increased morbidity, despite the availability of distinct diagnostic and therapeutic approaches. Patients with lower socioeconomic status (SES) tend to have a higher asthma prevalence. Moreover, the progression of asthma is significantly influenced by factors such as health literacy and the children's specific knowledge about the condition. With this trial, the primary objective is to evaluate whether asthma education enhances specific disease understanding in children with asthma (primary outcome). Secondary objectives include evaluating training effects on health literacy, retention rates of information, 'Children Asthma Control Test' (C-ACT) score, frequency of emergency room and physician visits (secondary outcomes) and whether SES influences training effects. METHODS AND ANALYSIS To address the research objectives, this study comprises two projects. The first subproject will investigate the influence of asthma training on the development of disease understanding and health literacy. The second subproject will analyse the influence of SES on the outcome of children participating in asthma training. This research is designed as a comparative, non-randomised study involving two paediatric groups between the ages of ≥7 and < 14 years. After being diagnosed with asthma, the intervention group undergoes standardised psychoeducational asthma training at a certified centre associated with paediatricians in private practice in Germany, following the recommendations of the 'Arbeitsgruppe Asthmaschulung im Kindes- und Jugendalter e.V.', a national association aiming to establish uniform and guideline-based standards for patient education in children and adolescents. The comparison group receives a significantly shorter period of education and instruction on the usage of asthma medication at outpatient clinics. Data will be collected from patients and their parents at three specific survey time points, based on standardised tools.To describe mean differences between the intervention and control group over time (subproject 1), a repeated-measures analysis of variance (ANOVA) will be conducted. In subproject 2, multivariate linear regression analysis will be used to analyse the variables determining the changes in specific disease understanding and health literacy, including SES. The sample size calculation is based on a mixed ANOVA model with two groups and two measurements resulting in a total of 126 participants. ETHICS AND DISSEMINATION All protocols and a positive ethics approval were obtained from the Witten/Herdecke University, Germany (S-159, 2023; application submission: 24 June 2023, final vote: 10 July 2023). Furthermore, the study was registered at the German Clinical Trials Register (DRKS), DRKS00032423. The application submission was on 3 August 2023, and the final approval was on 4 August 2023. The results will be disseminated among experts and participants and will be published in peer-reviewed, international journal with open access. TRIAL REGISTRATION NUMBER DRKS00032423.
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Affiliation(s)
| | | | | | | | | | - Antje Pizzulli
- Praxis für Kinderpneumologie und Allergologie, Berlin, Germany
| | - Kirn Parasher
- Schwerpunktpraxis für Kinderpneumologie und Allergologie sowie Kinderkardiologie, Berlin, Germany
| | - Patrick Brzoska
- Health Services Research, Witten/Herdecke University, Witten, Germany
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Bhidayasiri R, Sringean J, Phumphid S, Anan C, Thanawattano C, Deoisres S, Panyakaew P, Phokaewvarangkul O, Maytharakcheep S, Buranasrikul V, Prasertpan T, Khontong R, Jagota P, Chaisongkram A, Jankate W, Meesri J, Chantadunga A, Rattanajun P, Sutaphan P, Jitpugdee W, Chokpatcharavate M, Avihingsanon Y, Sittipunt C, Sittitrai W, Boonrach G, Phonsrithong A, Suvanprakorn P, Vichitcholchai J, Bunnag T. The rise of Parkinson's disease is a global challenge, but efforts to tackle this must begin at a national level: a protocol for national digital screening and "eat, move, sleep" lifestyle interventions to prevent or slow the rise of non-communicable diseases in Thailand. Front Neurol 2024; 15:1386608. [PMID: 38803644 PMCID: PMC11129688 DOI: 10.3389/fneur.2024.1386608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
The rising prevalence of Parkinson's disease (PD) globally presents a significant public health challenge for national healthcare systems, particularly in low-to-middle income countries, such as Thailand, which may have insufficient resources to meet these escalating healthcare needs. There are also many undiagnosed cases of early-stage PD, a period when therapeutic interventions would have the most value and least cost. The traditional "passive" approach, whereby clinicians wait for patients with symptomatic PD to seek treatment, is inadequate. Proactive, early identification of PD will allow timely therapeutic interventions, and digital health technologies can be scaled up in the identification and early diagnosis of cases. The Parkinson's disease risk survey (TCTR20231025005) aims to evaluate a digital population screening platform to identify undiagnosed PD cases in the Thai population. Recognizing the long prodromal phase of PD, the target demographic for screening is people aged ≥ 40 years, approximately 20 years before the usual emergence of motor symptoms. Thailand has a highly rated healthcare system with an established universal healthcare program for citizens, making it ideal for deploying a national screening program using digital technology. Designed by a multidisciplinary group of PD experts, the digital platform comprises a 20-item questionnaire about PD symptoms along with objective tests of eight digital markers: voice vowel, voice sentences, resting and postural tremor, alternate finger tapping, a "pinch-to-size" test, gait and balance, with performance recorded using a mobile application and smartphone's sensors. Machine learning tools use the collected data to identify subjects at risk of developing, or with early signs of, PD. This article describes the selection and validation of questionnaire items and digital markers, with results showing the chosen parameters and data analysis methods to be robust, reliable, and reproducible. This digital platform could serve as a model for similar screening strategies for other non-communicable diseases in Thailand.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand
| | - Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Saisamorn Phumphid
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Chanawat Anan
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | | | - Suwijak Deoisres
- National Electronics and Computer Technology Centre, Pathum Thani, Thailand
| | - Pattamon Panyakaew
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Suppata Maytharakcheep
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Vijittra Buranasrikul
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Tittaya Prasertpan
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Sawanpracharak Hospital, Nakhon Sawan, Thailand
| | | | - Priya Jagota
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Araya Chaisongkram
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Worawit Jankate
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Jeeranun Meesri
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Araya Chantadunga
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Piyaporn Rattanajun
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Phantakarn Sutaphan
- Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Weerachai Jitpugdee
- Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Marisa Chokpatcharavate
- Chulalongkorn Parkinson's Disease Support Group, Department of Medicine, Faculty of Medicine, Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Yingyos Avihingsanon
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thai Red Cross Society, Bangkok, Thailand
| | - Chanchai Sittipunt
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thai Red Cross Society, Bangkok, Thailand
| | | | | | | | | | | | - Tej Bunnag
- Thai Red Cross Society, Bangkok, Thailand
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Zhou X, Du F, Peng W, Bai L, Peng L, Hou X. Building Medication Profiles in the Elderly: a Qualitative Study Based on Medication Information Literacy in a Long-Term Care Facility. Clin Interv Aging 2024; 19:779-793. [PMID: 38751855 PMCID: PMC11095403 DOI: 10.2147/cia.s454620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose Long-term care facilities are increasingly challenged with meeting the diverse healthcare needs of the elderly population, particularly concerning medication management. Understanding medication information literacy and behavior among this demographic is imperative. Therefore, this qualitative study aims to explore medication information literacy and develop distinct medication profiles among elderly long-term care residents. Material and Methods In this study, we conducted in-depth semi-structured interviews with 32 participants aged 65 or older residing in a long-term care facility. The interviews were designed to explore participants' understanding of medication information, medication management practices, and experiences with healthcare providers. Thematic analysis was employed to analyze the interview data, allowing for the identification of common patterns and themes related to medication-taking behavior among the elderly residents. Results The thematic analysis revealed four distinct medication behavior profiles among the elderly long-term care residents: (1) Proactive Health Self-Managers, (2) Medication Information Adherents, (3) Experience-Based Medication Users, and (4) Nonadherent Medication Users. These findings provide valuable insights into the diverse approaches to medication management within long-term care facilities and underscore the importance of tailored interventions to support the specific needs of each profile. Conclusion This study highlights the necessity for tailored medication education and support to optimize medication management for the elderly. With the aging population expansion, addressing the unique medication challenges within long-term care facilities becomes increasingly critical. This research contributes to ongoing endeavors to enhance healthcare services for the elderly, striving for safer and more effective medication-taking behavior.
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Affiliation(s)
- Xiaoyu Zhou
- College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, 400016, People’s Republic of China
| | - Fei Du
- College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, 400016, People’s Republic of China
| | - Wei Peng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, People’s Republic of China
| | - Li Bai
- Hospital of Zigong Mental Health Central, Sichuan, 643021, People’s Republic of China
| | - Leyi Peng
- College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, 400016, People’s Republic of China
| | - Xiaorong Hou
- College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Chongqing Engineering Research Center for Clinical Big Data and Drug Evaluation, Chongqing, 400016, People’s Republic of China
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Chen J, Wen L, Fu G, Bai C, Lei X, Zhang Y. The relationship between health literacy and blood sugar control in rural areas among diabetes patients. Front Endocrinol (Lausanne) 2024; 15:1334100. [PMID: 38800475 PMCID: PMC11116642 DOI: 10.3389/fendo.2024.1334100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
Background Although the relationship between health literacy and glycemic control has been explored in patients with diabetes, little is known about the relationship between different categories of diabetes health literacy and glycemic control in rural areas. Therefore, this study focused on the relationship between different categories of health literacy and glycemic control among diabetic patients in rural areas of Guangxi, China. Objective To explore the potential profiles of health literacy among rural diabetes patients in Guangxi and investigate their relationship with blood sugar control. Methods A health literacy questionnaire was administered to 2280 rural diabetes patients in five cities in the Guangxi Zhuang Autonomous Region. Latent profile analysis was conducted to identify potential health literacy profiles. Results Health literacy among rural diabetes patients in Guangxi could be categorized into high literacy-high functionality and low literacy-low criticality groups. The latent categories of health literacy were associated with blood sugar control, with diabetes patients in the high literacy-high functionality group demonstrating better blood sugar control than those in the low literacy-low criticality group (P < 0.05). Conclusion Health literacy among rural diabetes patients in Guangxi exhibits heterogeneity. Healthcare professionals should pay attention to patients with low literacy and low criticality in rural areas and develop interventions to enhance their health literacy, thereby improving their blood sugar control.
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Affiliation(s)
- Jingfeng Chen
- Department of Geriatric Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Lina Wen
- Cardiovascular Medicine Cadre Ward and Geriatric Cardiovascular Medicine Department, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guifen Fu
- Department of Nursing, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Chaoqun Bai
- Department of Geriatric Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaoxue Lei
- Department of Geriatric Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yanping Zhang
- Department of Geriatric Endocrinology and Metabolism, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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FarzanehRad A, Allahbakhshian A, Gholizadeh L, Khalili AF, Hasankhani H. Randomized comparison of the effects of tailored text messaging versus pillbox organizers on medication adherence of heart failure patients. BMC Cardiovasc Disord 2024; 24:244. [PMID: 38724943 PMCID: PMC11080170 DOI: 10.1186/s12872-024-03884-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/09/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a major public health issue worldwide, affecting approximately 64.3 million people in 2017. Non-adherence to medication is a common and serious issue in the management of HF. However, new reminder systems utilizing mobile technology, such as text messaging, have shown promise in improving medication adherence. The purpose of this study was to compare the impact of tailored text messaging (TTM) and pillbox organizers on medication adherence in individuals with HF. METHODS A randomized controlled trial was conducted, involving 189 eligible patients with HF who were randomly assigned to either the TTM, pillbox organizer, or control group. Medication adherence was evaluated using pill counting and the Medication Adherence Rating Scale (MARS) over a period of three months and compared across the groups. The data were analyzed using Kruskal-Wallis, Analysis of Variance (ANOVA), and Repeated Measures ANOVA tests. RESULTS The results indicate that both the TTM and pillbox organizers groups had significantly higher medication adherence compared to the control group, as measured by pill counting (MD = 0.05, 95%CI = 0.03-0.06; p < 0.001 for TTM group, MD = 0.04, 95%CI = 0.03-0.06; p < 0.001 for pillbox organizers group) and the MARS (MD = 1.32, 95%CI = 0.93 to 1.72; p < 0.001 for TTM group, MD = 1.33, 95%CI = 0.95 to 1.72; p < 0.001 for pillbox organizers group). However, there was no statistically significant difference in medication adherence between the two intervention groups using either measurement method. The TTM group exhibited a lower hospitalization rate than the other groups in the first follow up (p = 0.016). CONCLUSIONS Both the TTM and pillbox organizers were shown to be effective in enhancing medication adherence among patients with HF. Therefore, healthcare providers should take into account the patient's condition and preferences when selecting one of these methods to promote medication adherence. Future research should aim to address the limitations of this study, such as controlling for confounding variables, considering long-term effects, and comparing the effectiveness of different interventions.
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Affiliation(s)
- Ameneh FarzanehRad
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, Tabriz, East Azerbaijan, Iran
| | - Atefeh Allahbakhshian
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, Tabriz, East Azerbaijan, Iran.
- School of Nursing & Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Azizeh Farshbaf Khalili
- Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran
| | - Hadi Hasankhani
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences Tabriz, Tabriz, East Azerbaijan, Iran
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Zou D, Liu Y, Gong Y, Zhang X, Liu J, Shen J. Self-Efficacy's Mediating Role in the Relationship Between Self-Perceived Burden and Health-Related Quality of Life Among Older-Adult Inpatients in China: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2157-2163. [PMID: 38736537 PMCID: PMC11088387 DOI: 10.2147/jmdh.s460151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose This study investigated the current state of self-efficacy and the association between self-perceived burden (SPB) and health-related quality of life (HRQoL) among Chinese older-adult inpatients. Methods A cross-sectional study was conducted using convenience sampling to survey Chinese older-adult inpatients. Data regarding demographic characteristics, self-efficacy, SPB, and HRQoL were collected. Pearson's correlation analysis was used to examine the correlations among the research variables. SPSS® Statistics V26.0, and SPSS® PROCESS Macro Model 4 were used to analyze the available data. The bootstrap method was used to analyze the mediating role of self-efficacy. Results Survey participants included 514 older-adult inpatients, with a mean age of 72.28±5.58 years. Self-efficacy (r=0.471, p<0.01) was positively correlated with HRQoL, whereas self-efficacy (r=-0.891, p<0.01) and HRQoL (r=-0.516, p<0.01) were negatively correlated with SPB. The mediating effect analysis revealed that self-efficacy either completely or partially mediated the effect of SPB on HRQoL, with the indirect effect accounting for 30.2% of the total. Conclusion This study provides a mediating model suggesting that SPB exerts both direct and indirect effects on the HRQoL of older-adult inpatients through self-efficacy.
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Affiliation(s)
- Dongmei Zou
- Department of Cardiovascular Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde city), Changde, People’s Republic of China
| | - Yanqiong Liu
- Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Youwen Gong
- Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Xueqing Zhang
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jieqiong Liu
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jinhua Shen
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
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Burus T, VanHelene AD, Rooney MK, Lang Kuhs KA, Christian WJ, McNair C, Mishra S, Paulino AC, Smith GL, Frank SJ, Warner JL. Travel-Time Disparities in Access to Proton Beam Therapy for Cancer Treatment. JAMA Netw Open 2024; 7:e2410670. [PMID: 38758559 PMCID: PMC11102024 DOI: 10.1001/jamanetworkopen.2024.10670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/11/2024] [Indexed: 05/18/2024] Open
Abstract
Importance Proton beam therapy is an emerging radiotherapy treatment for patients with cancer that may produce similar outcomes as traditional photon-based therapy for many cancers while delivering lower amounts of toxic radiation to surrounding tissue. Geographic proximity to a proton facility is a critical component of ensuring equitable access both for indicated diagnoses and ongoing clinical trials. Objective To characterize the distribution of proton facilities in the US, quantify drive-time access for the population, and investigate the likelihood of long commutes for certain population subgroups. Design, Setting, and Participants This population-based cross-sectional study analyzed travel times to proton facilities in the US. Census tract variables in the contiguous US were measured between January 1, 2017, and December 31, 2021. Statistical analysis was performed from September to November 2023. Exposures Drive time in minutes to nearest proton facility. Population totals and prevalence of specific factors measured from the American Community Survey: age; race and ethnicity; insurance, disability, and income status; vehicle availability; broadband access; and urbanicity. Main Outcomes and Measures Poor access to proton facilities was defined as having a drive-time commute of at least 4 hours to the nearest location. Median drive time and percentage of population with poor access were calculated for the entire population and by population subgroups. Univariable and multivariable odds of poor access were also calculated for certain population subgroups. Results Geographic access was considered for 327 536 032 residents of the contiguous US (60 594 624 [18.5%] Hispanic, 17 974 186 [5.5%] non-Hispanic Asian, 40 146 994 [12.3%] non-Hispanic Black, and 195 265 639 [59.6%] non-Hispanic White; 282 031 819 [86.1%] resided in urban counties). The median (IQR) drive time to the nearest proton facility was 96.1 (39.6-195.3) minutes; 119.8 million US residents (36.6%) lived within a 1-hour drive of the nearest proton facility, and 53.6 million (16.4%) required a commute of at least 4 hours. Persons identifying as non-Hispanic White had the longest median (IQR) commute time at 109.8 (48.0-197.6) minutes. Multivariable analysis identified rurality (odds ratio [OR], 2.45 [95% CI, 2.27-2.64]), age 65 years or older (OR, 1.09 [95% CI, 1.06-1.11]), and living below the federal poverty line (OR, 1.22 [1.20-1.25]) as factors associated with commute times of at least 4 hours. Conclusions and Relevance This cross-sectional study of drive-time access to proton beam therapy found that disparities in access existed among certain populations in the US. These results suggest that such disparities present a barrier to an emerging technology in cancer treatment and inhibit equitable access to ongoing clinical trials.
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Affiliation(s)
- Todd Burus
- Markey Cancer Center, University of Kentucky, Lexington
| | | | - Michael K. Rooney
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Krystle A. Lang Kuhs
- Markey Cancer Center, University of Kentucky, Lexington
- Department of Epidemiology & Environmental Health, College of Public Health, University of Kentucky, Lexington
| | - W. Jay Christian
- Department of Epidemiology & Environmental Health, College of Public Health, University of Kentucky, Lexington
| | - Christopher McNair
- Department of Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sanjay Mishra
- Lifespan Cancer Institute, Rhode Island Hospital, Providence
- Center for Clinical Cancer Informatics and Data Science, Legorreta Cancer Center, Brown University, Providence, Rhode Island
| | - Arnold C. Paulino
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Grace L. Smith
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Steven J. Frank
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - Jeremy L. Warner
- Lifespan Cancer Institute, Rhode Island Hospital, Providence
- Center for Clinical Cancer Informatics and Data Science, Legorreta Cancer Center, Brown University, Providence, Rhode Island
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Romanova A, Rubinelli S, Diviani N. Improving health and scientific literacy in disadvantaged groups: A scoping review of interventions. PATIENT EDUCATION AND COUNSELING 2024; 122:108168. [PMID: 38301598 DOI: 10.1016/j.pec.2024.108168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/05/2023] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To explore approaches for developing and implementing interventions aimed at improving health literacy and health-related scientific literacy in disadvantaged groups. METHODS A scoping review of literature published in 2012-2022 was conducted, followed by quality appraisal of eligible studies. RESULTS Interventions were conducted mainly in community settings, where the most popular venues were adult education facilities. The primary target groups were those with limited income or education, ethnic minorities, or immigrants. Programs were often held in-person using interactive and culturally appropriate methods. They were predominantly focused on functional and interactive health literacy dimensions rather than on critical and scientific ones. Evaluations measured knowledge, health literacy, behavioral and psychological outcomes using various quantitative and qualitative instruments. CONCLUSIONS The findings offer a comprehensive overview of the ways to design and evaluate health and scientific literacy interventions tailored to disadvantaged groups. PRACTICE IMPLICATIONS Future interventions should prioritize participatory designs, culturally appropriate materials, and shift focus to critical and scientific health literacy, as well as to program scalability in less controlled conditions.
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Affiliation(s)
- Anna Romanova
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland
| | - Sara Rubinelli
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland
| | - Nicola Diviani
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland; Swiss Paraplegic Research, Person-Centered Healthcare & Health Communication Group, Guido A, Zäch-Strasse 4, 6207 Nottwil, Switzerland.
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Liu D, Ge P, Li X, Hong W, Huang M, Zhu L, Kaierdebieke A, Yu W, Qi J, Pu K, Ling R, Pan L, Sun X, Wu Y, Feng Q. Status of self-medication and the relevant factors regarding drug efficacy and safety as important considerations among adolescents aged 12-18 in China: a cross-sectional study. Sci Rep 2024; 14:9982. [PMID: 38693178 PMCID: PMC11063147 DOI: 10.1038/s41598-024-59204-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 04/08/2024] [Indexed: 05/03/2024] Open
Abstract
The objective of this study was to investigate self-medication behavior among Chinese adolescents aged 12-18 years and explore the factors associated with whether adolescents prioritize drug efficacy or safety when engaging in self-medication behavior. In 2021, a questionnaire investigation was conducted in the Chinese mainland using a multi-stage sampling approach. After a statistical description, logistic regression was used to analyze the factors associated with considering drug efficacy and safety. The self-medication rate among Chinese adolescents aged 12-18 years was 96.61%. Of these, 65.84% considered drug safety to be essential, while 58.72% prioritized drug efficacy. Regression analysis showed that individuals with better healthcare were more likely to consider drug efficacy an important factor. Additionally, those with a healthier family lifestyle were more likely to prioritize efficacy. When individuals engage in self-medication, those residing in urban areas and possessing advanced preventive health literacy and ample family health resources tend to prioritize drug safety to a greater extent. Conversely, those with higher monthly household incomes and only children exhibit a decreased inclination towards prioritizing safety during self-medication. Self-medication is a frequently observed practice among Chinese adolescents aged 12-18. Several factors, such as demographic and sociological characteristics, health literacy, and family health status, have been found to be associated with the extent to which adolescents prioritize medication safety and efficacy when engaging in self-medication practices. Higher levels of health literacy and better family health status were positively correlated with considering both the efficacy and safety of drugs as important factors when self-medicating.
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Affiliation(s)
- Diyue Liu
- International School of Public Health and One Health, Hainan Medical University, Hiaikou, China
| | - Pu Ge
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xialei Li
- School of Pharmaceutical Sciences, Shandong University, Jinan, China
| | | | - Mengjie Huang
- School of Public Health, ShanDong University, Jinan, China
| | - Lijun Zhu
- College of Communication and Art Design, University of Shanghai for Science and Technology, Shanghai, China
| | | | - Wenbian Yu
- Zhuhai Institute of Social Development, Zhuhai, China
| | - Jiale Qi
- International School of Journalism and Communication, Zhengzhou University, Zhengzhou, China
| | - Keping Pu
- Institute of School of Nursing, China Medical University, Shenyang, China
| | - Rong Ling
- Jilin University School of Pharmaceutical Sciences, Jilin University, Changchun, China
| | - LuTong Pan
- School of Public Health, Shandong University, Beijing, China
| | - Xinying Sun
- School of Public Health, Peking University, Beijing, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
| | - Qiqin Feng
- International School of Public Health and One Health, Hainan Medical University, Hiaikou, China.
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Bjørnsen HN, Bjørnebekk G, Brandmo C. Schools as a Source of Mental Health Literacy: Adjusting and Validating a Mental Health Literacy Scale. Health Promot Pract 2024; 25:391-398. [PMID: 36942353 PMCID: PMC11064467 DOI: 10.1177/15248399231161090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents' positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents' positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s' CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents' learning about the factors promoting good mental health.
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Ewen AM, Hawkins JM, Kloss KA, Nwankwo R, Funnell MM, Sengupta S, Jean Francois N, Piatt G. The Michigan Men's Diabetes Project Randomized Clinical Control Trial: A Pilot/Feasibility Study of a Peer-Led Diabetes Self-Management and Support Intervention for Black Men With Type 2 Diabetes. Am J Mens Health 2024; 18:15579883241258318. [PMID: 38879823 PMCID: PMC11181889 DOI: 10.1177/15579883241258318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/19/2024] Open
Abstract
Black men are disproportionately affected by type 2 diabetes (T2D) and experience higher diabetes-related complications than non-Hispanic White men. To address the complex barriers in diabetes self-management for Black men, we implemented a 3-month peer-led and empowerment-based Diabetes Self-Management Education (DSME) and Support (DSMS) intervention in Metro Detroit. Twenty-five Black men ≥55 years of age with self-reported T2D were randomized to the intervention group (n=12)-10 hr of DSME and 9 hr of DSMS-or enhanced usual care (EUC) group (n=13)-10 hr of DSME. Peer leaders (n = 3) were trained by certified diabetes care and education specialists (CDCESs) to cofacilitate the support sessions. Outcomes (hemoglobin A1c [HbA1c], diabetes self-care activities, and diabetes distress) were assessed preintervention and postintervention. In the intervention and EUC groups, mean HbA1c decreased by 0.20% (p = .52, SD = 0.99) and 0.13% (p = .68), respectively. General diet (p = .03, M change: 1.32, SD = 1.71) and blood glucose monitoring (p < .05, M change: 0.50, SD = 0.74) scores improved among those in the intervention group. General diet scores also improved in the EUC group: mean change: 1.77, p = .08, although changes were not statistically significant. Changes in diabetes distress scores differed based on the number of sessions attended, with a significant decrease in those attending 7 to 12 sessions (n = 7), >50%, (p = .003, M change: -5.71, SD = 3.20). Implementing a peer-led DSMS program for Black men was feasible, adopted, and led to positive changes in outcomes. Scaling up the intervention and assessing sustainability is warranted.
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Affiliation(s)
- Alana M. Ewen
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Robin Nwankwo
- Department of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Martha M. Funnell
- Department of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Srijani Sengupta
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | | | - Gretchen Piatt
- Department of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, MI, USA
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Posawang P, Vatcharavongvan P. Development of health literacy assessment scale for Thai stroke patients. Top Stroke Rehabil 2024; 31:336-344. [PMID: 37880193 DOI: 10.1080/10749357.2023.2275091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND One important factor influencing the treatment and rehabilitation results for stroke patients is their level of health literacy. In order to acquire comprehensive information for appropriate treatment and rehabilitation programs that will promote the optimal possible health outcomes, health literacy assessment should be done in stroke patients from the earliest stages of stroke onset. OBJECTIVES This research aimed to develop a health literacy assessment scale for Thai stroke patients and to evaluate the HL levels of those patients using that assessment scale. METHODS A draft version of the scale has been developed based on the literature review and focus group discussions. After tryout, content validity, corrected item-total correlation and internal consistency were examined. A confirmatory factor analysis (CFA) was conducted in 400 patients with stroke to test the construct validity. RESULTS The Health Literacy Assessment Scale for Thai Stroke Patients was successfully developed. The complete version featured 50 health literacy-related questions, along with seven demographic-related questions. This tool demonstrated good psychometric properties, including content validity (Item-objective congruence; IOC > 0.50), internal consistency (Cronbach's alpha = 0.951 to 0.955, overall = 0.94). Confirmatory factor analysis (CFA) also revealed good construct validity. CONCLUSIONS The Health Literacy Assessment Scale for Thai Stroke Patients (HLS-Th) is measuring five components cover all health literacy aspects necessary for Thai stroke patient. This novel measurement scale is an accurate psychometric tool for assessing the level of health literacy among Thai stroke survivors.
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Affiliation(s)
- Pornsawan Posawang
- Department of Community and Family Medicine, Faculty of Medicine, Thammasat University, Klong Nueng, Thailand
- Sirindhorn National Medical Rehabilitation Institute, Soi Bamrasnaradura, Nonthaburi, Thailand
| | - Pasitpon Vatcharavongvan
- Department of Community and Family Medicine, Faculty of Medicine, Thammasat University, Klong Nueng, Thailand
- Research Unit in Physical Anthropology and Health Sciences, Faculty of Medicine, Thammasat University, Klong Nueng, Thailand
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Xiao Y, Fulda KG, Young RA, Hendrix ZN, Daniel KM, Chen KY, Zhou Y, Roye JL, Kosmari L, Wilson J, Espinoza AM, Sutcliffe KM, Pitts SI, Arbaje AI, Chui MA, Blair S, Sloan D, Jackson M, Gurses AP. Patient Partnership Tools to Support Medication Safety in Community-Dwelling Older Adults: Protocol for a Nonrandomized Stepped Wedge Clinical Trial. JMIR Res Protoc 2024; 13:e57878. [PMID: 38684080 PMCID: PMC11091807 DOI: 10.2196/57878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Preventable harms from medications are significant threats to patient safety in community settings, especially among ambulatory older adults on multiple prescription medications. Patients may partner with primary care professionals by taking on active roles in decisions, learning the basics of medication self-management, and working with community resources. OBJECTIVE This study aims to assess the impact of a set of patient partnership tools that redesign primary care encounters to encourage and empower patients to make more effective use of those encounters to improve medication safety. METHODS The study is a nonrandomized, cross-sectional stepped wedge cluster-controlled trial with 1 private family medicine clinic and 2 public safety-net primary care clinics each composing their own cluster. There are 2 intervention sequences with 1 cluster per sequence and 1 control sequence with 1 cluster. Cross-sectional surveys will be taken immediately at the conclusion of visits to the clinics during 6 time periods of 6 weeks each, with a transition period of no data collection during intervention implementation. The number of visits to be surveyed will vary by period and cluster. We plan to recruit patients and professionals for surveys during 405 visits. In the experimental periods, visits will be conducted with two partnership tools and associated clinic process changes: (1) a 1-page visit preparation guide given to relevant patients by clinic staff before seeing the provider, with the intention to improve communication and shared decision-making, and (2) a library of short educational videos that clinic staff encourage patients to watch on medication safety. In the control periods, visits will be conducted with usual care. The primary outcome will be patients' self-efficacy in medication use. The secondary outcomes are medication-related issues such as duplicate therapies identified by primary care providers and assessment of collaborative work during visits. RESULTS The study was funded in September 2019. Data collection started in April 2023 and ended in December 2023. Data was collected for 405 primary care encounters during that period. As of February 15, 2024, initial descriptive statistics were calculated. Full data analysis is expected to be completed and published in the summer of 2024. CONCLUSIONS This study will assess the impact of patient partnership tools and associated process changes in primary care on medication use self-efficacy and medication-related issues. The study is powered to identify types of patients who may benefit most from patient engagement tools in primary care visits. TRIAL REGISTRATION ClinicalTrials.gov NCT05880368; https://clinicaltrials.gov/study/NCT05880368. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57878.
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Affiliation(s)
- Yan Xiao
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
- College of Engineering, University of Texas at Arlington, Arlington, TX, United States
| | - Kimberley G Fulda
- Department of Family Medicine and Osteopathic Manipulative Medicine and North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Richard A Young
- Family Medicine Residency Program, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Z Noah Hendrix
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Kathryn M Daniel
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Kay Yut Chen
- College of Business, University of Texas at Arlington, Arlington, TX, United States
| | - Yuan Zhou
- College of Engineering, University of Texas at Arlington, Arlington, TX, United States
| | - Jennifer L Roye
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Ludmila Kosmari
- College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Joshua Wilson
- College of Liberal Arts, University of Texas at Arlington, Arlington, TX, United States
| | - Anna M Espinoza
- Department of Family Medicine and Osteopathic Manipulative Medicine and North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Kathleen M Sutcliffe
- Carey Business School, Johns Hopkins University, Baltimore, MD, United States
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Samantha I Pitts
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Alicia I Arbaje
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Michelle A Chui
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, United States
| | - Somer Blair
- Office of Clinical Research, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Dawn Sloan
- Family Medicine Residency Program, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Masheika Jackson
- Family Medicine Residency Program, John Peter Smith Health Network, Fort Worth, TX, United States
| | - Ayse P Gurses
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
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Berete F, Gisle L, Demarest S, Charafeddine R, Bruyère O, Van den Broucke S, Van der Heyden J. Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population? BMC Public Health 2024; 24:1182. [PMID: 38678179 PMCID: PMC11055376 DOI: 10.1186/s12889-024-18676-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Health literacy (HL) has been put forward as a potential mediator through which socioeconomic status (SES) affects health. This study explores whether HL mediates the relation between SES and a selection of health or health-related outcomes. METHODS Data from the participants of the Belgian health interview survey 2018 aged 18 years or older were individually linked with data from the Belgian compulsory health insurance (n = 8080). HL was assessed with the HLS-EU-Q6. Mediation analyses were performed with health behaviour (physical activity, diet, alcohol and tobacco consumption), health status (perceived health status, mental health status), use of medicine (purchase of antibiotics), and use of preventive care (preventive dental care, influenza vaccination, breast cancer screening) as dependent outcome variables, educational attainment and income as independent variables of interest, age and sex as potential confounders and HL as mediating variable. RESULTS The study showed that unhealthy behaviours (except alcohol consumption), poorer health status, higher use of medicine and lower use of preventive care (except flu vaccination) were associated with low SES (i.e., low education and low income) and with insufficient HL. HL partially mediated the relationship between education and health behaviour, perceived health status and mental health status, accounting for 3.8-16.0% of the total effect. HL also constituted a pathway by which income influences health behaviour, perceived health status, mental health status and preventive dental care, with the mediation effects accounting for 2.1-10.8% of the total effect. CONCLUSIONS Although the influence of HL in the pathway is limited, our findings suggest that strategies for improving various health-related outcomes among low SES groups should include initiatives to enhance HL in these population groups. Further research is needed to confirm our results and to better explore the mediating effects of HL.
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Affiliation(s)
- Finaba Berete
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium.
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
| | - Lydia Gisle
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Stefaan Demarest
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing Research Unit in Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
| | | | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
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Marie P, Romain-Scelle N, Potinet V, Schott AM, Douplat M. Assessment of health literacy in a French emergency department. BMC Health Serv Res 2024; 24:493. [PMID: 38649979 PMCID: PMC11034065 DOI: 10.1186/s12913-024-11003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Health literacy (HL) has become a subject of major interest in public health worldwide. It is known to be linked to self-efficacy in care use and to global health status, and a non-negligible frequency of problematic or inadequate levels of HL in populations worldwide is reported. As this has yet to be evaluated in France, the present study aimed to evaluate the HL level of patients in a French emergency department (ED). METHODS We conducted a descriptive, cross-sectional observational, single center study in the ED of the Lyon Sud hospital (Hospices civils de Lyon, Lyon, France). The primary endpoint was the HL level of the patients determined according to the score obtained using the 16-item European Health Literacy Survey Questionnaire. The secondary endpoint was the identification of sociodemographic factors associated with the HL level. RESULTS A total of 189 patients were included for analysis. 10% (95% CI [3%; 17%]) of the patients had an inadequate HL, 38% (95% CI [31%; 45%]) had a problematic HL, and 53% (95% CI [46%; 61%] had an adequate HL. In multivariate analysis, age and perceived health status were independent predictors of the HL level; OR =0.82 (95% CI [0.69; 0.97]; p=0.026) for a 10-year increase in age, and OR =1.84 (95% CI [1.22; 2.82]; p=0.004]). CONCLUSIONS The HL level of the patients in the ED studied herein was similar to that found in the population of France and other European countries and was influenced by age and perceived health status, which are both associated with care needs. It may be therefore interesting to explore in future studies how taking into consideration HL in the general population may lead to a better self-efficacy in care and optimize the use of the healthcare system.
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Affiliation(s)
- Pauline Marie
- Hospices Civils of Lyon, Hôpital Lyon Sud, Emergency department, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
| | - Nicolas Romain-Scelle
- Hospices Civils of Lyon, Hôpital Lyon Sud, Emergency department, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
- CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR, 5558, Villeurbanne, France
| | - Veronique Potinet
- Hospices Civils of Lyon, Hôpital Lyon Sud, Emergency department, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France
| | - Anne Marie Schott
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM, U1290, Lyon, France
| | - Marion Douplat
- Hospices Civils of Lyon, Hôpital Lyon Sud, Emergency department, Université Claude Bernard Lyon 1, 69495, Pierre-Bénite, France.
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM, U1290, Lyon, France.
- UMR ADéS 7268, Aix-Marseille Université/ EFS / CNRS, Espace éthique méditerranéen, Marseille, France.
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沈 鹤, 侍 崇, 郑 清, 黄 玉, 景 涛. [Investigation on the current situation and influencing factors of sitting time and health literacy among high school students in China]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2024; 56:239-246. [PMID: 38595239 PMCID: PMC11004951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Indexed: 04/11/2024]
Abstract
OBJECTIVE To investigate the current situation of sitting time and health literacy among high school students in China, in order to provide a basis for improving their physical and mental health levels. METHODS A stratified random cluster sampling method was used to investigate the length of sitting time and health literacy of first and second grade high school students from 31 provinces, cities, and autonomous regions in China(data did not include that of Hong Kong and Macao Special Administrative Region, and Taiwan Province of China). The Kruskal-Wallis H method, independent sample Mann-Whitney U test, and regression model were used to analyze the influencing factors of sitting time and total health literacy score. RESULTS (1) The total score of health literacy was statistically significant (P < 0.01) in different regions, urban and rural distribution, annual family income, parents' educational background, age, and gender. (2) The length of sitting was statistically significant (P < 0.01) among multiple groups in different regions, family annual income, parental education, and gender. However, there was no statistically significant difference between groups of different ages and urban-rural distribution (P>0.05). (3) The analysis of multiple linear regression model showed that the total score of health literacy was positively correlated with the family' s annual income and the mother' s education, and negatively correlated with the father' s education and the length of sitting. Standardized regression coefficient β comparison: Father' s education (-0.32) > family annual income (0.15) > mother' s education (0.09) > average daily sitting time (-0.02), with father' s education having the greatest impact, followed by family annual income. The length of sitting was positively related to the family' s annual income and the mother' s educational background, and negatively related to the total score of health literacy. Standardized regression coefficient β comparison: Annual family income (0.14) > education background of mother (0.13)> total score of health literacy (-0.02), with the impact of annual family income the largest, followed by education background of mother. CONCLUSION China' s first and second grade high school students generally spend a long time sitting every day, and the level of health literacy is generally low. The level of health literacy and sitting time are negatively correlated with each other, and are most influenced by the educational background of high school students' parents and their family economic levels.
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Affiliation(s)
- 鹤军 沈
- 南京体育学院体育教育与人文学院,南京 210014School of Physical Education and Humanities, Nanjing Sport Institute, Nanjing 210014, China
| | - 崇艳 侍
- 南京体育学院体育教育与人文学院,南京 210014School of Physical Education and Humanities, Nanjing Sport Institute, Nanjing 210014, China
| | - 清 郑
- 江苏省邗江中学体育教研组,江苏扬州 225009Physical Education Teaching and Research Group, Hanjiang Middle School of Jiangsu Province, Yangzhou 225009, Jiangsu, China
| | - 玉 黄
- 江苏省溧阳中学体育教研组,江苏溧阳 213300Physical Education Teaching and Research Group, Liyang Middle School of Jiangsu Province, Liyang 213300, Jiangsu, China
| | - 涛 景
- 南京体育学院运动健康学院康复治疗学系,南京 210014Department of Rehabilitation Therapy, School of Exercise and Health, Nanjing Sport Institute, Nanjing 210014, China
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Yi J, Yoon JY, Won CW, Kim M, Lee KS. The roles of health literacy and social support in the association between smartphone ownership and frailty in older adults: a moderated mediation model. BMC Public Health 2024; 24:1064. [PMID: 38632509 PMCID: PMC11037091 DOI: 10.1186/s12889-024-18163-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/20/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Understanding the role of smartphones to promote the health status of older adults is important in the digital society. Little is known about the effects of having smartphones on physical frailty despite its positive effect on the well-being of older adults. This study aimed to explore the association between smartphone ownership and frailty in community-dwelling older adults and its underlying mechanism. METHODS We used data from the Korean Frailty and Aging Cohort Study and analyzed 2,469 older adults aged 72-86 years. Frailty, health literacy, and social support were assessed by Fried's frailty phenotype, the Behavioral Risk Factor Surveillance System health literacy module, and the Enhancing Recovery in Coronary Heart Disease (ENRICHD) Social Support Instrument, respectively. The mediation model and moderated mediation model were estimated, where the mediator was health literacy and the moderator was social support, to explore the relationship between smartphone ownership and frailty. RESULTS Of our study participants, 58.9% owned smartphones, and 10.9% were classified as frail. Smartphone ownership was negatively associated with frailty (β = -0.623, p < 0.001). Health literacy mediated the relationship between smartphone ownership and frailty (β = -0.154, boot confidence interval [CI] = - 0.222, - 0.096), and social support moderated the mediation effect (β = -0.010, Boot CI = - 0.016, - 0.004). CONCLUSIONS Owning smartphones among older adults could reduce the risk of frailty. Promoting health literacy and social support among older adults with smartphones would be effective to prevent frailty.
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Affiliation(s)
- Jinseon Yi
- College of Nursing, Seoul National University, Seoul, Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Kyoung Suk Lee
- College of Nursing, Seoul National University, Seoul, Korea.
- Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, Korea.
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Domínguez-Martín G, Tárraga-López PJ, López-Gil JF. Relationship between perceived physical literacy and obesity-related outcomes in adolescents: the EHDLA study. Front Public Health 2024; 12:1321361. [PMID: 38694986 PMCID: PMC11062133 DOI: 10.3389/fpubh.2024.1321361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/27/2024] [Indexed: 05/04/2024] Open
Abstract
Purpose The aim of the present study was to examine the relationship between perceived physical literacy and obesity-related outcomes among adolescents from Spain. Methods This is a secondary cross-sectional analysis including a total sample of 845 Spanish adolescents (55.3% girls) aged 12-17 years from the Valle de Ricote (Region of Murcia) from the Eating Healthy and Daily Life Activities (EHDLA) project. Physical literacy was evaluated using the Spanish Perceived Physical Literacy Instrument for adolescents (S-PPLI). Body mass index was computed by taking the participants' body weight in kilograms and dividing it by the square of their height in meters, and body mass index (z score) and overweight/obesity and obesity were computed by the World Health Organization age- and sex-specific thresholds. Waist circumference was measured using a constant tension tape. Moreover, the waist-to-height ratio was calculated, and therefore, abdominal obesity was determined. Skinfold measurements were taken at the triceps and medial calf using calibrated steel calipers. Results In general, the overall trend was downward (i.e., the higher the PPLI score the lower the obesity-related indicators), with the approximate significance of smooth terms being statistically significant for all models examined (p < 0.001). Adolescents with lower perceived physical literacy (PPL) showed the highest estimated marginal means of body mass index, body mass index z score, waist circumference, waist-to-height ratio, and skinfold (triceps and calf) and predictive probabilities of having excess weight, obesity, and abdominal obesity, while their counterparts with high PPL had the lowest. In addition, significant differences were observed for all the obesity-related indications between adolescents with low PPL and those with medium PPL (p-adjusted < 0.05 for all indicators), as well as with those with high PPL (p-adjusted < 0.05 for all indicators). Moreover, these significant differences were also shown for most indicators between adolescents with medium PPL and those with high PPL (except for obesity). Conclusion Physical literacy could play a crucial role in maintaining more desirable obesity-related outcomes in adolescents. Adolescents with high perceived physical literacy showed lower obesity-related indicators (i.e., body mass index, body mass index z score, waist circumference, waist-to-height ratio, skinfolds), as well as a lower probability of having excess weight, obesity, and abdominal obesity.
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Affiliation(s)
| | - Pedro J Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Castilla-La Mancha, Albacete, Spain
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Shea S, Nguyen T, Kim DH, Gee GC, Wang MC, Umemoto K. Lessons Learned From TranslateCovid, a Multilingual Online Resource Hub for Asian American and Pacific Islander Communities and Beyond. Public Health Rep 2024:333549241236092. [PMID: 38584484 DOI: 10.1177/00333549241236092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
The COVID-19 pandemic exacerbated health disparities among immigrant communities. Delivering accurate information and addressing misinformation on protective measures and vaccination to linguistically disadvantaged groups was critical for mitigating the effects of the pandemic. One group that was especially vulnerable to miscommunication about COVID-19 was non-native English-speaking immigrants. To address these disparities, the Asian American Studies Center and the Fielding School of Public Health at the University of California, Los Angeles, partnered to create a multilingual resource hub, TranslateCovid.org, to disseminate credible and reliable information about COVID-19 safety measures, the science behind the vaccines, and vaccine safety. We identified >1300 verified resources in 60 languages from government, academic, and nonprofit organizations and reposted them on the TranslateCovid website. We also developed public service announcement videos on handwashing, use of face masks, and social distancing in 10 languages and a fact sheet for frequently asked questions in 20 languages. We used a participatory approach to develop strategies for disseminating these resources. We discuss lessons learned, including strategies for forming government, community, and academic partnerships to support the timely development and dissemination of information. We conclude with a discussion on the unique role of universities in promoting equitable access to public health resources among immigrant communities in times of crisis.
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Affiliation(s)
- Sheila Shea
- Asian American Studies Center, University of California Los Angeles, Los Angeles, CA, USA
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Tom Nguyen
- Asian American Studies Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Daniel H Kim
- Asian American Studies Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Gilbert C Gee
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - May C Wang
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Karen Umemoto
- Asian American Studies Center, University of California Los Angeles, Los Angeles, CA, USA
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Rohde G, Helseth S, Hagen M, Mikkelsen HT, Skarstein S, Haraldstad K. The relationship between gender, psychosocial factors, pain, health literacy and health-related quality of life in parents of Norwegian adolescents one year into the COVID-19 pandemic. BMC Public Health 2024; 24:980. [PMID: 38589853 PMCID: PMC11000350 DOI: 10.1186/s12889-024-18525-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/04/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Stress impacts healthy behaviours and may influence life and health-related quality of life (HRQOL). A stressful event occurred when the COVID-19 pandemic hit in March 2020. The present study aims to explore possible gender differences in stress, psychosocial factors (self-efficacy, self-esteem, loneliness), pain, HL, and HRQOL in parents of adolescents one year into the COVID-19 pandemic, and to explore possible associations between gender, demographic and psychosocial factors, pain, HL, and HRQOL. METHODS Parents of adolescents aged 16-17 took part in the study from January to February 2021, when the COVID-19 pandemic was ongoing. Data on socio-demographics, stress, self-efficacy, self-esteem, pain, HL, loneliness, and HRQOL were collected. HRQOL was assessed using RAND-36. RESULTS Among the 320 parents from the general population, the mean age was 47.6 (standard deviation (SD) = 4.6) years, 81% were mothers, 79% were married or cohabiting, 81% had a university degree, and the majority worked full time (78%) or part time (13%). The average pain score was low, 0.48 (95% CI [0.43-0.54]). However, 50% of the parents reported persistent pain and more mothers reported persistent pain compared to fathers (53% vs. 37%). The parents' mean (SD) score for RAND-36 was 52.1 (95% CI [51.2-53.0]) for the physical component summary (PCS) score and 51.0 (95% CI [50.0-52.1]) for the mental component summary (MCS) score. Mothers reported significantly lower scores for all the eight RAND-36 domains and the PCS and MCS scores. Adjusting for gender, age, living condition, education, pain, HL, self-efficacy and loneliness, we revealed no associations between stress and RAND-36-PCS. University education of four years or more was positively associated (B = 3.29, 95% CI: [0.78-5.80]) with RAND-36-PCS, while persistent pain was negatively associated (B = -7.13, CI: [-9.20- -5.06]). We identified a strong negative association between RAND-36-MCS and stress (B = -43.11, CI: [-48.83- -37.38]) and a positive association with older age (B = 0.21, CI: [ 0.04, 0.39)]. CONCLUSION One year into the COVID-19 pandemic, we identified a strong negative association between stress and mental HRQOL, while pain was strongly negatively associated with physical HRQOL.
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Affiliation(s)
- Gudrun Rohde
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway.
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway.
| | - Sølvi Helseth
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Milada Hagen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Hilde Timenes Mikkelsen
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
| | - Siv Skarstein
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing, Faculty of Health and Sport Sciences, University of Agder, Postbox 422, 4604, Kristiansand, Norway
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Muller R, Bilich L, Jones M. Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees. J Immigr Minor Health 2024:10.1007/s10903-024-01594-6. [PMID: 38589753 DOI: 10.1007/s10903-024-01594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
Inadequate comprehension of healthcare information contributes to poor health outcomes. Ethnic minorities are one of the populations most affected by low health and oral health literacy (OHL). The hypothesis of the current study was that an oral health education program (OHEP) can improve the OHL, oral health awareness and behaviors of refugees. We also hypothesized that there will be a difference between OHL in English and native language in the Pre-intervention phase. Fifty-two adult refugees participated in an educational program that included a comprehensive and culturally sensitive PowerPoint presentation and hands-on learning activities on oral health topics. The study used a cross-sectional pre-post study design. Before the program (Pre-intervention group), participants completed 2 surveys: Sociodemographic Survey and Oral Health Perceptions of Refugees in a bilingual format, and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English, and in the participants' native language. Immediately after an OHEP (Post-intervention group), participants completed the EOHL-BL40 survey in English only. Two weeks after OHEP (Follow-up intervention), participants completed again the Sociodemographic Survey and Oral Health Perceptions of Refugees and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English only. The mean percentage of words understood on Pre-intervention EOHL-BL40 survey were significantly higher in native languages (47.3% ±3.7%) compared with survey in English (15.3% ±1.2%, P < 0.001). Post-intervention scores, immediately after educational program, were higher (28.6% ±2.4%), P < 0.001) for survey in English compared with the Pre-intervention (15.3% ±1.2%). The follow-up (2 weeks later) scores (25.5% ±2.4) were slightly lower than Post-intervention but still significantly higher (P < 0.001) than Pre-intervention. Results for both Sociodemographic Survey and Oral Health Perceptions of Refugees surveys were similar: the OHEP positively affected oral health awareness and oral health behaviors. Results of the study suggested that OHEP may improve oral health literacy, oral health awareness, and personal oral hygiene practices of refugees.
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Affiliation(s)
- Romana Muller
- Missouri School of Dentistry & Oral Health, St. Louis Dental Center, A.T. Still University1500 Park Ave, St. Louis, MO, 63104, USA.
| | - Lisa Bilich
- Eastern Washington University, 310 N. Riverpoint Blvd. Box E, Spokane, WA, 99202, USA
| | - Merri Jones
- Eastern Washington University, 310 N. Riverpoint Blvd. Box E, Spokane, WA, 99202, USA
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Peleg O, Hadar E, Boniel-Nissim M. A novel questionnaire for evaluating digital tool use (DTUQ-D) among individuals with type 2 diabetes: exploring the digital landscape. Front Public Health 2024; 12:1374848. [PMID: 38645461 PMCID: PMC11026855 DOI: 10.3389/fpubh.2024.1374848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/25/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Effective healthcare currently incorporates a patient-centric system and accessible technology for patient self-management. This study aimed to develop and validate a novel questionnaire titled the Digital Tool Use Questionnaire for Diabetes (DTUQ-D) - a screening tool identifying the type, number, and frequency of digital tools used by Type 2 Diabetes Mellitus (T2DM) patients with within HMOs, online, and via applications. Methods The questionnaire was administered to two ethnic groups and both genders. A mixed-methods approach was used. In the qualitative phase, the questionnaire was developed through phone surveys of 29 T2DM patients, two endocrinologists and two technology experts. In the quantitative phase, involving 367 participants, convergent validity, construct validity, and reliability were examined. Results Findings indicated that the DTUQ-D is valid and reliable, successfully identifying digital tools utilized by T2DM patients, notwithstanding variations in factor structures between ethnic groups. This questionnaire provides a foundation for future research, offering a standardized approach to evaluating digital tool usage. Discussion The study enhances understanding of the role of digital tools in healthcare, especially for T2DM self-management. It also can be easily adapted to assess digital tool use for other illnesses by adjusting instructions and the wording of certain items.
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Affiliation(s)
- Ora Peleg
- Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
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Alabri A. Compliance with COVID-19 Physical Distancing Mandates in Oman: The Role of Health Literacy and Internal Health Locus of Control. Health Lit Res Pract 2024; 8:e69-e78. [PMID: 38713898 PMCID: PMC11075997 DOI: 10.3928/24748307-20240424-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/12/2023] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Research indicates that the effectiveness of coronavirus disease 2019 (COVID-19) physical distancing mandates is influenced by several individual factors, including health literacy; internal health locus of control (IHLOC), the belief that physical distancing can reduce COVID-19 risk; social norms; self-efficacy; and perceptions of the benefits and barriers associated with distancing. However, further investigation is needed to understand the links between these factors and compliance intentions. OBJECTIVE This study investigates the mechanism linking these factors with the intentions to comply with physical distancing mandates. METHODS A total of 759 participants (Mean age = 29.13, standard deviation [SD] = 8.33; 68.5% women) were surveyed online from September 2020 to October 2020. Data were analyzed using ANOVA (analysis of variance) and structural equation modeling. KEY RESULTS Health literacy was associated with more perceived benefits (β = .175, p = .001), greater self-efficacy (β = .193, p < .001), and less perceived barriers (β = -.391, p < .001). IHLOC was significantly associated with greater perceived benefits (β = .156, p = .007) and self-efficacy (β = .294, p < .001). Family descriptive norms were significantly associated with fewer perceived barriers (β = -.276, p < .001), while injunctive norms were associated with more perceived benefits (β = .202, p = .001) and higher self-efficacy (β = .299, p < .001). Intentions to adhere to physical distancing mandates were significantly associated with past compliance (β = .427, p < .001) and perceived barriers (β = -.205, p < .001) and benefits (β = .295, p < .001). Post-hoc mediation analyses revealed several small yet significant indirect effects, highlighting the complex pathways shaping adherence intentions. CONCLUSIONS This study identifies how health literacy, IHLOC, social norms, perceived benefits and barriers, and self-efficacy intricately shape intentions to comply with physical distancing mandates. These findings offer valuable implications for public health policy and interventions. [HLRP: Health Literacy Research and Practice. 2024;8(2):e69-e78.].
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Affiliation(s)
- Amna Alabri
- Address correspondence to Amna Alabri, PhD, Department of Mass Communication, University of Technology and Applied Sciences, P. O. Box 699, Nizwa, Postal Code 611, Nizwa;
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Efthymiou A, Kalaitzaki A, Kondilis B, Rovithis M. Health literacy continuing education courses and tools for healthcare professionals: A scoping review. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:212-247. [PMID: 36545846 DOI: 10.1080/02701960.2022.2156865] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Strengthening the health literacy (HL) skills of the healthcare users is a multicomponent process involving the users, the healthcare professionals, the stakeholders, and the environment. Health organizations, universities, private initiatives, and funded projects focused on developing and implementing continuing education courses target at increasing healthcare professionals' HL. This scoping review aimed at reporting the HL continuing education courses for healthcare professionals to enhance their knowledge and skills in identifying and supporting healthcare users with limited HL, and particularly, older people. This review followed the five stages by Arksey and O'Malley framework and the guidelines by Joanna Briggs Institute for scoping reviews. Peer-reviewed papers and gray literature published between years 2000 to 2020 were included in this bibliometric search utilizing four electronic databases (PUBMED, MEDLINE, CINAHL, PSYCHINFO, and Opengrey). Twenty-seven (27) papers met the criteria, including twenty-one (21) full-texts and six (6) other records (website contents, eLearning, and funded projects). There is a lack of HL tools that address the training needs of healthcare professionals working with older adults. Tailored HL tools could benefit healthcare professionals' clinical work by improving their communication with older adults.
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Affiliation(s)
- Areti Efthymiou
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University (HMU), Heraklion, Crete, Greece
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
| | - Argyroula Kalaitzaki
- Department of Social Work, School of Health Sciences, Hellenic Mediterranean University (HMU), Heraklion, Crete, Greece
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
- University Centre of Research and Innovation 'Institute of AgriFood and Life Sciences, HMU
| | - Barbara Kondilis
- Department of Art & Sciences, Hellenic American University, Nashua, Greece
| | - Michael Rovithis
- Laboratory of Interdisciplinary Approaches to the Enhancement of Quality of Life (Quality of Life Lab), HMUb
- Department of Business Administration and Tourism, Hellenic Mediterranean University, Heraklion, Crete
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Borkar S, Chakole S, Prasad R, Bansod S. Revolutionizing Oncology: A Comprehensive Review of Digital Health Applications. Cureus 2024; 16:e59203. [PMID: 38807819 PMCID: PMC11131437 DOI: 10.7759/cureus.59203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/14/2024] [Indexed: 05/30/2024] Open
Abstract
Digital health is poised to revolutionize the field of oncology, offering innovative solutions that enhance diagnostics, treatment, and patient care. This comprehensive review delves into the multifaceted landscape of digital health in oncology, encompassing its definition, significance, applications, benefits, challenges, ethical considerations, and future trends. Key findings highlight the potential for early detection, personalized treatment, enhanced care coordination, patient empowerment, accelerated research, and cost efficiency. Ethical concerns surrounding privacy, equitable access, and responsible data use are discussed. Looking ahead, the future of digital health in oncology is bright, driven by advancements in artificial intelligence, virtual and augmented reality, predictive analytics, global collaboration, and evolving regulations. This review underscores the need for collaboration among stakeholders and a patient-centered approach to harness the transformative power of digital health, promising a future where the burden of cancer is lessened through innovation and compassionate care.
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Affiliation(s)
- Samidha Borkar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Roshan Prasad
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Spandan Bansod
- Obstetrics and Gynecological Nursing, Srimati Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Hogan A, Hughes L, Coyne E. Nurses' assessment of health literacy requirements for adult inpatients: An integrative review. Health Promot J Austr 2024; 35:504-517. [PMID: 37443427 DOI: 10.1002/hpja.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
ISSUE ADDRESSED This paper reviews current research which examines nurses' assessment of patient's health literacy in the acute hospital setting. Research highlights, that patients with low health literacy have more frequent hospitalisations and are more likely to be re-admitted. Within the healthcare team, nurses are primarily responsible for teaching patients and deciphering health communication, to enhance understanding. Within the acute care setting, there remains a disparity in patient understanding of information, despite nurse-led education. The health literacy assessment and tailoring of information by nurses, is becoming more important with shorter stays, plus limited family visits and the wearing of masks with COVID-19 related changes. METHODS An integrative review across four nursing databases, from 2010 and June 2022 was conducted. The integrative framework included problem identification, literature search, data evaluation, data analysis with thematic analysis, and results presentation. RESULTS Nine studies were included. Common themes were nurses' overestimation of patients' health literacy, the use of universal precautions, and adapting communication techniques to improve education moments. CONCLUSION The findings of this review indicate a tendency among nurses to overestimate their patients' health literacy levels, which can result in ineffective health education and inadequate discharge planning. SO WHAT Nurses decipher health communication for their patients. Designing tailored patient communication and education could potentially be a cost saving measure for hospitals by reducing length of stay and reducing readmissions. Health literacy training should be incorporated into nursing practice.
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Affiliation(s)
- Alana Hogan
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Caboolture Hospital, Caboolture, Queensland, Australia
| | - Lynda Hughes
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
| | - Elisabeth Coyne
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- School of Nursing and Midwifery, University of Southern Denmark, Odense, Denmark
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Wong AWK, Tomazin R, Walker K, Heeb Desai R, Hollingsworth H, Newland PK, Morgan KA. Text messaging intervention for fatigue self-management in people with stroke, spinal cord injury, and multiple sclerosis: A pilot study. Disabil Health J 2024; 17:101549. [PMID: 38001005 DOI: 10.1016/j.dhjo.2023.101549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Fatigue negatively impacts the function and quality of life of people with disabilities (PwD). Mobile health (mHealth) platforms are recognized as effective and accessible approaches to delivering health interventions and may show higher satisfaction by tailoring the information toward personalized needs for PwD. OBJECTIVE To evaluate the acceptability, feasibility, and participant engagement with a Short Message Service (SMS) text messaging intervention for fatigue self-management and to explore the pre- and post-score health changes in PwD. METHODS A total of 27 PwD (multiple sclerosis = 9, spinal cord injury = 9, or stroke = 9) experiencing fatigue in their daily lives participated in a 12-week self-management text messaging intervention. Participants completed a demographic survey and health outcome measures, including patient activation, self-efficacy for managing symptoms, fatigue, sleep, and satisfaction with participation in social roles before and after the intervention. Participants also completed a client satisfaction questionnaire after the intervention. We also tracked the program retention and SMS response rates over the 12-week intervention period. RESULTS Twenty-five participants completed the entire intervention (93% retention rate), and the overall SMS response rate was 84.67%, indicating high acceptability and adherence to the intervention. The mean satisfaction score was 3.18, indicating high satisfaction with the intervention. Despite finding a negligible effect on patient activation, we found a small intervention effect on self-efficacy for managing symptoms (η2 = 0.04) and moderate effects on fatigue (η2 = 0.06-0.12), sleep (η2 = 0.11), and satisfaction with participation in social roles (η2 = 0.08). CONCLUSIONS This study provides initial feasibility and health outcome change evidence to support an SMS text messaging intervention to manage fatigue in PwD.
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Affiliation(s)
- Alex W K Wong
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, 60611, USA; Department of Physical Medicine and Rehabilitation and Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Rachel Tomazin
- Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA
| | - Kim Walker
- Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA
| | - Rachel Heeb Desai
- Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA.
| | - Holly Hollingsworth
- Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA
| | - Pamela K Newland
- Goldfarb School of Nursing at Barnes Jewish College, St. Louis, MO, USA.
| | - Kerri A Morgan
- Washington University in St. Louis, School of Medicine, Program in Occupational Therapy, St. Louis, MO, USA
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Murugan Y, Parmar A, Hirani MM, Babaria DL, Damor NC. Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study. Cureus 2024; 16:e58800. [PMID: 38784325 PMCID: PMC11112451 DOI: 10.7759/cureus.58800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Background Effective self-care is crucial for maintaining health among older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in urban slums in India. Materials and methods A mixed methods study was conducted among 432 adults aged ≥65 years. Participants were selected through multistage random sampling from five slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data was explored through in-depth interviews with 30 participants. Results Inadequate health literacy (194, 45%) and low self-efficacy (162, 37.5%) were common. While 324 (75%) had an adequate diet and 378 (87.5%) took medications properly, only 86 (20%) monitored diabetes complications. Only 194 (45%) of the patients underwent recommended cancer screening, and 324 (75%) of the patients saw doctors ≥twice a year. Age, sex, education, income, comorbidities, self-efficacy, and health literacy had significant associations. Alongside facilitators such as social support, barriers such as limited healthcare access and suboptimal prevention orientation emerged. Conclusion Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.
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Affiliation(s)
- Yogesh Murugan
- Family Medicine, Guru Gobind Singh Government Hospital, Jamnagar, IND
| | - Alpesh Parmar
- Public Health, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Mehjabin M Hirani
- General Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Dhruvam L Babaria
- Internal Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Naresh C Damor
- Community Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
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Fleary SA. Linking Childhood Cultural Health Capital Factors with Adult Health Literacy. Health Lit Res Pract 2024; 8:e79-e88. [PMID: 38713899 PMCID: PMC11075993 DOI: 10.3928/24748307-20240422-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 12/01/2023] [Indexed: 05/09/2024] Open
Abstract
Adult health outcomes are linked to childhood factors such as socioeconomic status via cultural health capital (CHC). Specifically, these factors shape opportunities for developing skills for navigating health environments via experience and the intergenerational transfer of health-related knowledge and skills. Health literacy (HL) is considered a part of and/or result of CHC. HL develops similarly to CHC via opportunities and experiences. Most research to date has ignored the effect of childhood factors on adult HL. The purpose of this study was to explore how childhood factors are related to adult HL. Data were collected from adults (N = 736, mean age = 40.65 years, standard deviation [SD] = 15.39; 52% female; 53.8% White, 31.3% Hispanic and Latino/a/e) in the United States using Qualtrics Panel. Multivariate ordinal and binary logistic regressions predicting HL (as measured by the Newest Vital Sign and Single-Item Literacy Scale) from childhood factors and accounting for demographic covariates were estimated. After accounting for covariates, such as the presence of an employed adult in a white-collar (odds ratio [OR] = 3.34) or blue-collar (OR = 3.68) occupation (versus unknown/not employed) increased the odds of being categorized as possible limited literacy and adequate literacy (versus limited literacy) as measured by the Newest Vital Sign. Similarly, having an employed adult during childhood who had a blue-collar occupation (vs. unknown/not employed) increased the odds of being categorized as adequate literacy (OR = 2.06) as measured by the Single-Item Literacy Scale. Because the adult's employment played a role in the child's adult HL after accounting for other factors and demographics, these findings support using a lifespan approach to assess and identify risk factors for lower HL. This study contributes to the growing body of evidence of how HL is interconnected with social determinants of health across the lifespan and the need to address HL skills in those with poor social determinants of health. [HLRP: Health Literacy Research and Practice. 2024;8(2):e79-e88.].
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Affiliation(s)
- Sasha A. Fleary
- Address correspondence to Sasha A. Fleary, PhD, Department of Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, 55 W. 125th Street; New York, NY 10027;
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Rodriguez AK, Akram S, Colverson AJ, Hack G, Golden TL, Sonke J. Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:315-322. [PMID: 37196338 DOI: 10.1177/2752535x231175072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.
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Affiliation(s)
- Alexandra K Rodriguez
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Seher Akram
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Aaron J Colverson
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- University of Florida Musicology/Ethnomusicology Program, Gainesville, FL, USA
| | - George Hack
- University of Florida College of Public Health and Health Professions, Gainesville, FL, USA
| | - Tasha L Golden
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
- International Arts + Mind Lab, Brain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jill Sonke
- University of Florida Center for Arts in Medicine, Gainesville, FL, USA
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van den Besselaar BN, Sewnaik A, Hoesseini A, Dorr MC, Baatenburg de Jong RJ, Offerman MPJ. Causes and Ways of Death in Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2024; 150:303-310. [PMID: 38358760 PMCID: PMC10870226 DOI: 10.1001/jamaoto.2023.4694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/15/2023] [Indexed: 02/16/2024]
Abstract
Importance There is limited literature on the exact causes and ways of death in patients with head and neck cancer. To provide optimal care, especially in the palliative phase, more information on this is needed. Objective To provide insights into the causes and ways of death among patients with head and neck cancer. Design, Setting, and Participants This retrospective cohort study included a consecutive population of patients who received a diagnosis of primary squamous cell carcinoma of the head and neck between January 2006 and December 2013 who were treated in the Erasmus MC. Patient data were merged with nonpublic microdata from Statistics Netherlands. Follow-up time was specified as the date of diagnosis until death or December 3, 2019, whichever came first. The data were checked and reanalyzed in November 2023. Main outcomes and Measures Causes (eg, head and neck cancer, other cancer) and ways (eg, natural death, suicide) of death. Results A total of 1291 patients (59.2%; 342 women [26.5%]) died during follow-up (median [IQR] follow-up, 2.7 [1.2-5.6] years). The main cause of death was head and neck cancer (557 [43.1%]), followed by the competing cause of other cancers (344 [26.6%]). In total, 240 patients (18.6%) received palliative sedation and 70 patients (5.4%) euthanasia. Compared with patients with head and neck cancer as the underlying cause of death, lower odds ratios (ORs) were observed for receiving palliative sedation (OR, 0.32 vs 0.07; 95% CI, 0.22-0.46 vs 0.03-0.12) and euthanasia (OR, 0.22 vs 0.01; 95% CI, 0.11-0.41 vs 0-0.107) in patients with other causes of death. Patients with a middle and high income had higher ORs for receiving palliative sedation (OR, 1.46 vs 1.86; 95% CI, 1.05-2.04 vs 1.22-2.85) or euthanasia (OR, 2.25 vs 3.37; 95% CI, 1.18-4.3, 1.6-7.12) compared with low-income patients. Retired patients had lower ORs for receiving palliative sedation or euthanasia compared with employed patients (OR, 0.56 vs 0.44; 95% CI, 0.39-0.8 vs 0.24-0.82). Conclusion and Relevance The results of this cohort study suggest that more than half of the patients died of competing causes and palliative sedation and euthanasia were more common in patients with head and neck cancer as the underlying cause of death. Patients with a higher socioeconomic status had higher odds of receiving palliative sedation and euthanasia. These insights may support health care professionals in providing patient-centered care, especially for patients in the palliative phase.
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Affiliation(s)
- Boyd N. van den Besselaar
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Arta Hoesseini
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Maarten C. Dorr
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Robert. J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
| | - Marinella P. J. Offerman
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, the Netherlands
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Hazewinkel MHJ, Gfrerer L, Ashina S, Austen WG, Klassen AF, Pusic A, Kaur MN. Readability analysis and concept mapping of PROMs used for headache disorders. Headache 2024; 64:410-423. [PMID: 38525832 DOI: 10.1111/head.14706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To assess the readability and the comprehensiveness of patient-reported outcome measures (PROMs) utilized in primary headache disorders literature. BACKGROUND As the health-care landscape has evolved toward a patient-centric model, numerous PROMs have been developed to capture treatment outcomes in patients with headache disorders. For these PROMs to advance our understanding of headache disorders and their treatment impact, they must be easy to understand (i.e., reading grade level 6 or less) and comprehensively capture what matters to patients with headache. The aim of this study was to (a) assess the readability of PROMs utilized in headache disorders literature, and (b) assess the comprehensiveness of PROMs by mapping their content to a health-related quality of life framework. METHODS In this scoping review, recently published systematic reviews were used to identify PROMs used in primary headache disorders literature. Readability analysis was performed at the level of individual items and full PROM using established readability metrics. The content of the PROMs was mapped against a health-related quality-of-life framework by two independent reviewers. RESULTS In total, 22 PROMs (15 headache disorders related, 7 generic) were included. The median reading grade level varied between 7.1 (interquartile range [IQR] 6.3-7.8) and 12.7 (IQR 11.8-13.2). None of the PROMs were below the recommended reading grade level for patient-facing material (grade 6). Three PROMs, the Migraine-Treatment Assessment Questionnaire, the Eurolight, and the European Quality of Life 5 Dimensions 3 Level Version, were between reading grade levels 7 and 8; the remaining 19 PROMs were above reading grade level 8. In total, the PROMs included 425 items. Most items (n = 134, 32%) assessed physical function (e.g., work, activities of daily living). The remaining items assessed physical symptoms (n = 127, 30%; e.g., pain, nausea), treatment effects on symptoms (n = 65, 15%; e.g., accompanying symptoms relief, headache relief), treatment impact (n = 56, 13%; e.g., function, side effects), psychological well-being (n = 41, 10%; e.g., anger, frustration), social well-being (n = 29, 7%; e.g., missing out on social activities, relationships), psychological impact (n = 14, 3%; e.g., feeling [not] in control, feeling like a burden), and sexual well-being (n = 3, 1%; e.g., sexual activity, sexual interest). Some of the items pertained to treatment (n = 27, 6%), of which most were about treatment type and use (n = 12, 3%; e.g., medication, botulinum toxin), treatment access (n = 10, 2%; e.g., health-care utilization, cost of medication), and treatment experience (n = 9, 2%; e.g., treatment satisfaction, confidence in treatment). CONCLUSION The PROMs used in studies of headache disorders may be challenging for some patients to understand, leading to inaccurate or missing data. Furthermore, no available PROM comprehensively measures the health-related quality-of-life impact of headache disorders or their treatment, resulting in a limited understanding of patient-reported outcomes. The development of an easy-to-understand, comprehensive, and validated headache disorders-specific PROM is warranted.
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Affiliation(s)
- Merel H J Hazewinkel
- Department of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Lisa Gfrerer
- Department of Plastic and Reconstructive Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Sait Ashina
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesia, Critical Care, Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - William G Austen
- Department of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Pusic
- Patient Reported Outcomes, Value and Experience Center (PROVE), Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Manraj N Kaur
- Patient Reported Outcomes, Value and Experience Center (PROVE), Brigham and Women's Hospital, Boston, Massachusetts, USA
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von Sommoggy J, Skiba EM, Lander J, Apfelbacher C, Curbach J, Brandstetter S. Health Literacy in Pediatric Consultations on Allergy Prevention. Health Lit Res Pract 2024; 8:e47-e61. [PMID: 38599576 PMCID: PMC11006282 DOI: 10.3928/24748307-20240320-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/31/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The first 3 years of life offer an opportunity to prevent allergic diseases. Pediatricians are an important source of health information for parents. However, a certain degree of health literacy is necessary to understand, appraise, and apply preventive behavior, which can be supported by health literacy (HL) sensitive consultations and a HL friendly environment. OBJECTIVE In this study, we want to shed light on how pediatricians in outpatient care in Germany advise on early childhood allergy prevention (ECAP) and how they consider parental HL. METHODS We conducted 19 semi-standardized telephone interviews with pediatricians from North-Rhine-Westphalia and Bavaria. The interviews were audio-recorded, transcribed, pseudonymized, and subjected to content analysis. KEY RESULTS Current ECAP recommendations were well known among our sample. Despite the shift of evidence from avoidance of allergens toward early exposure, providing advice on ECAP was considered non-controversial and it was widely assumed that recommendations were easy to understand and apply for parents. However, ECAP was treated as an implicit topic resonating among others like infant nutrition and hygiene. Regarding HL, our interview partners were not aware of HL as a concept. However, they deemed it necessary to somehow assess parental information level and ability to understand provided information. Formal HL screening was not applied, but implicit strategies based on intuition and experience. Concerning effective HL-sensitive communication techniques, interviewees named the adaptation of language and visual support of explanations. More advanced techniques like Teach Back were considered too time-consuming. Medical assistants were considered important in providing an HL-sensitive environment. Time constraints and the high amount of information were considered major barriers regarding HL-sensitive ECAP counseling. CONCLUSION It seems warranted to enhance professional education and training for pediatricians in HL and HL-sensitive communication, to reach all parents with HL-sensitive ECAP counseling. [HLRP: Health Literacy Research and Practice. 2024;8(2):e47-e61.].
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Affiliation(s)
- Julia von Sommoggy
- Address correspondence to Julia von Sommoggy, Ph.D., University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, Steinmetzstr. 1–3, 93049 Regensburg;
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Al Saffar H, Thomson A, Tan JS, Wang Q, Birch E, Koschel S, Medhurst E, Jobson D, Ong S, Moon DA, Murphy D, Lawrentschuk N. Patient-centred pathology reporting improves patient experience and understanding of disease in prostate cancer care. BJUI COMPASS 2024; 5:497-505. [PMID: 38633832 PMCID: PMC11019249 DOI: 10.1002/bco2.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/16/2023] [Accepted: 12/23/2023] [Indexed: 04/19/2024] Open
Abstract
Introduction and Objectives Patient-centred (PC) and holistic care improves patient satisfaction and health outcomes. We sought to investigate the benefit of utilising a PC pathology report in patients undergoing radical prostatectomy (RP) for prostate cancer (PCa). Our study aimed to evaluate and compare patient understanding of their PCa diagnosis after RP, upon receiving either a standard histopathology report or a personalised and PC report (PCR). Moreover, we evaluated knowledge retention at 4 weeks after the initial consultation. Methods We invited patients undergoing RP at three metropolitan Urology clinics to participate in our randomised controlled study. Patients were randomised to receive either a PCR or standard pathology report. Patient satisfaction questionnaires (Perceived Efficacy in Patient-Physician Interactions [PEPPI], Consultation and Relational Empathy [CARE] and Communication Assessment Tool [CAT]) and a knowledge test were conducted within 72 h of the initial appointment and again at 4 weeks. Accurate recollection of Gleason grade group (GGG) and extracapsular extension (ECE) were classified as 'correct'. Baseline demographic data included age, education, marital and employment status, pre-op prostate specific antigen (PSA) and clinical stage. Baseline data were tested for differences between groups using the Student's t test, chi-squared test or Fisher's exact test depending on whether data were continuous, categorical or sparse. Comparison of correctly answered 'knowledge' questions was analysed using chi-squared test. A significance level of p ≤ 0.05 was used. Results Data from 62 patients were analysed (30 standard vs. 32 PCR). No significant differences in baseline demographics were found between groups. Both groups reported high levels of satisfaction with their healthcare experiences in all domains of patient-physician rapport, empathy and communication. There were no significant differences between groups in PEPPI (p = 0.68), CAT (p = 0.39) and CARE (p = 0.66) scores, at baseline and 4 weeks. Ninety-three per cent of patients who received the PCR understood the report while 90% felt the report added to their understanding of their PCa. Regarding patient knowledge, the PCR group had significantly more correct answers on GGG and ECE as compared with the standard report group at baseline and 4 weeks (p < 0.001 and 0.001, respectively). Conclusions Our findings demonstrate that PC pathology reports improve patient knowledge and understanding of their PCa that is retained for at least 4 weeks after initial receipt of results.
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Affiliation(s)
- Haidar Al Saffar
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Alice Thomson
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Jo‐Lynn S. Tan
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- St Vincent's Hospital, MelbourneFitzroyVictoriaAustralia
| | - Qiwei Wang
- St Vincent's Hospital, MelbourneFitzroyVictoriaAustralia
- Melbourne Medical School, St Vincent's Hospital, MelbourneUniversity of MelbourneFitzroyVictoriaAustralia
| | - Emma Birch
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Samantha Koschel
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Elizabeth Medhurst
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Dale Jobson
- St Vincent's Hospital, MelbourneFitzroyVictoriaAustralia
- School of Public Health and Preventative MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Sean Ong
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- EJ Whitten Prostate Cancer Research CentreEpworth HospitalRichmondVictoriaAustralia
| | - Daniel A. Moon
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Surgery (Urology)Epworth Hospital RichmondRichmondVictoriaAustralia
| | - Declan Murphy
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Department of Surgery (Urology)Epworth Hospital RichmondRichmondVictoriaAustralia
| | - Nathan Lawrentschuk
- Department of Genitourinary Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- EJ Whitten Prostate Cancer Research CentreEpworth HospitalRichmondVictoriaAustralia
- Department of Surgery (Urology)Epworth Hospital RichmondRichmondVictoriaAustralia
- Department of Surgery (Urology)Royal Melbourne HospitalMelbourneVictoriaAustralia
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Pagán CR, Schmitter-Edgecombe M. Health literacy in older adults: The newest vital sign and its relation to cognition and healthy lifestyle behaviors. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-8. [PMID: 38552259 DOI: 10.1080/23279095.2024.2334348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Health literacy tends to decrease with age, and lower health literacy has been associated with lower levels of physical function, mental health, and medication adherence. The present study examined health literacy in relation to cognition in a sample of community-dwelling older adults. The study also examined the impact of health literacy on engagement in healthy aging lifestyle behaviors. Participants included 128 older adults (age: M = 72.07, SD = 6.71; education: M = 16.34, SD = 2.56; 74% female) who completed a health literacy measure (Newest Vital Sign; NVS), a lifestyle behavior questionnaire (Healthy Aging Activity Engagement scale; HAAE), and several neuropsychological tests. The cognitive domains assessed included memory, executive function, and attention/working memory. Two variables were computed from the NVS to represent the health literacy factors of document and numeracy literacy; these factors demonstrated a small correlation (r = .18). Results revealed that attention/working memory, executive function, and memory were all significantly related to numeracy literacy and overall health literacy. Only memory was significantly related to document literacy. After accounting for age, education, and cognition, a hierarchical regression revealed that health literacy significantly predicted engagement in healthy aging lifestyle behaviors. Multiple cognitive abilities are necessary for searching, finding, and processing information to make health-related decisions. Health literacy accounted for a significant amount of variance in older adults' engagement in everyday lifestyle behaviors. Health literacy skills may be an area of focus for intervention efforts to improve brain health in older adults.
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Affiliation(s)
- Carolyn R Pagán
- Department of Psychology, Washington State University, Pullman, WA, USA
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Bindhu S, Nattam A, Xu C, Vithala T, Grant T, Dariotis JK, Liu H, Wu DTY. Roles of Health Literacy in Relation to Social Determinants of Health and Recommendations for Informatics-Based Interventions: Systematic Review. Online J Public Health Inform 2024; 16:e50898. [PMID: 38506914 PMCID: PMC10993137 DOI: 10.2196/50898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Health literacy (HL) is the ability to make informed decisions using health information. As health data and information availability increase due to online clinic notes and patient portals, it is important to understand how HL relates to social determinants of health (SDoH) and the place of informatics in mitigating disparities. OBJECTIVE This systematic literature review aims to examine the role of HL in interactions with SDoH and to identify feasible HL-based interventions that address low patient understanding of health information to improve clinic note-sharing efficacy. METHODS The review examined 2 databases, Scopus and PubMed, for English-language articles relating to HL and SDoH. We conducted a quantitative analysis of study characteristics and qualitative synthesis to determine the roles of HL and interventions. RESULTS The results (n=43) were analyzed quantitatively and qualitatively for study characteristics, the role of HL, and interventions. Most articles (n=23) noted that HL was a result of SDoH, but other articles noted that it could also be a mediator for SdoH (n=6) or a modifiable SdoH (n=14) itself. CONCLUSIONS The multivariable nature of HL indicates that it could form the basis for many interventions to combat low patient understandability, including 4 interventions using informatics-based solutions. HL is a crucial, multidimensional skill in supporting patient understanding of health materials. Designing interventions aimed at improving HL or addressing poor HL in patients can help increase comprehension of health information, including the information contained in clinic notes shared with patients.
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Affiliation(s)
- Shwetha Bindhu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Anunita Nattam
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Catherine Xu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Tripura Vithala
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Tiffany Grant
- University of Cincinnati Libraries Research and Data Services, University of Cincinnati, Cincinnati, OH, United States
| | - Jacinda K Dariotis
- Department of Human Development and Family Studies, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
- The Family Resiliency Center, College of Agricultural, Consumer and Environmental Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Biomedical and Translational Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Hexuan Liu
- School of Criminal Justice, University of Cincinnati, Cincinnati, OH, United States
| | - Danny T Y Wu
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Khanal SP, Budhathoki CB, Devkota B, Bollweg TM, Okan O. Adolescents' understanding of the Nepalese version of HLS-CHILD-Q15: qualitative pre-testing in ninth-graders. BMC Public Health 2024; 24:851. [PMID: 38504195 PMCID: PMC10949603 DOI: 10.1186/s12889-024-18329-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/11/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Research on health literacy is still at an early stage, lacking a dedicated measurement instrument for assessing children's and adolescents' health literacy. Such tools are necessary to generate the evidence required for informed intervention development. This study translated the validated German HLS-Child-Q15 into the Nepalese context, creating the HLS-Child-Q22-NEP. METHODS The research team initially created the HLS-Child-Q22-NEP using an additional item pool. We conducted thirteen one-on-one cognitive interviews with adolescent students from community schools in three districts of Nepal during the pre-test. We employed verbal probing techniques and deductively analysed the interviews based on Tourneau's model, uncovering four main themes: (1) comprehension (with the two sub-categories: a) item comprehension and b) word comprehension); (2) retrieval; (3) judgement; and (4) response. RESULTS Overall, participants responded positively to the HLS-Child-Q22-NEP. However, this study revealed comprehension challenges such as unfamiliarity, misunderstandings, and translation issues. Additionally, the study identified retrieval challenges and poor judgement, indicating limitations in the assessment. Participants experienced varying levels of difficulty with some items, emphasising the need for revised instructions. Subsequent revisions, guided by pretest insights, led to the development of the HLS-Child-Q24-NEP. CONCLUSION The development of the HLS-Child-Q22-NEP is a significant step in addressing Nepali adolescents' lack of health literacy measurement. Despite its generally positive reception, this study encountered challenges in comprehending the scale, prompting enhancements, and developing the HLS-Child-Q24-NEP. Further research, both qualitative and quantitative, is necessary to evaluate the validity and reliability of the modified items.
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Affiliation(s)
| | | | - Bhimsen Devkota
- Faculty of Education, Tribhuvan University, Kathmandu, Nepal
- Bournemouth University, St Paul's Lane, Poole, UK
| | - Torsten Michael Bollweg
- TUM School of Medicine and Health, Technical University of Munich, Professorship of Health Literacy, München, Germany
| | - Orkan Okan
- TUM School of Medicine and Health, Department of Sport and Health Sciences, Technical University of Munich, WHO Collaborating Centre for Health Literacy, Munich, Germany
- School of Medicine and Health, Center for Health and Medicine in Society, Technical University, Munich, Germany
- School of Medicine and Health, Center for Health Promotion in Childhood and Adolescence, Technical University, Munich, Germany
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Nam HJ, Yoon JY. Pathways linking health literacy to self-care in diabetic patients with physical disabilities: A moderated mediation model. PLoS One 2024; 19:e0299971. [PMID: 38484001 PMCID: PMC10939260 DOI: 10.1371/journal.pone.0299971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Health literacy is widely considered to be a determinant of self-care behavior in people with diabetes. However, the mechanisms underlying how health literacy is linked to self-care behaviors have not been clearly elucidated. The aim of the present study was to explore the mediating roles of access to healthcare, provider-patient interaction, motivation, self-efficacy in the effect of health literacy on diabetes self-care behaviors among diabetic patients with physical disabilities and investigate the moderating effect of age in a moderated mediation model. METHODS The online survey was participated by a total of 214 diabetic patients with physical disabilities from November to December 2021. The moderated mediation analysis was examined using the Hayes' PROCESS macro modeling tool based on the bias-corrected bootstrapping method. RESULTS After controlling for education, the results yielded a significant indirect effect of health literacy on diabetes self-care through motivation and self-efficacy. A partially mediating relationship also was confirmed, as there is a positive direct effect of health literacy on diabetes self-care. Furthermore, age groups (i.e., age <40 and ≥ 40) functioned as a moderator of the mediating effects of motivation and self-efficacy between health literacy and diabetes self-care. CONCLUSION This study emphasized the important role of motivation and self-efficacy which play in linking health literacy and self-care behavior, especially for younger diabetic patients with physical disabilities. In the light of these findings, a health-literacy tailored motivation and self-efficacy enhancing program may be key targets for interventions promoting diabetes self-care behaviors in people with physical disabilities.
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Affiliation(s)
- Hye Jin Nam
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, South Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, South Korea
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97
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Ling E, de Pieri D, Loh E, Scott KM, Li SCH, Medbury HJ. Evaluation of the Accuracy, Credibility, and Readability of Statin-Related Websites: Cross-Sectional Study. Interact J Med Res 2024; 13:e42849. [PMID: 38483461 PMCID: PMC10979333 DOI: 10.2196/42849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/13/2023] [Accepted: 11/17/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) represents the greatest burden of mortality worldwide, and statins are the most commonly prescribed drug in its management. A wealth of information pertaining to statins and their side effects is on the internet; however, to date, no assessment of the accuracy, credibility, and readability of this information has been undertaken. OBJECTIVE This study aimed to evaluate the quality (accuracy, credibility, and readability) of websites likely to be visited by the general public undertaking a Google search of the side effects and use of statin medications. METHODS Following a Google web search, we reviewed the top 20 consumer-focused websites with statin information. Website accuracy, credibility, and readability were assessed based on website category (commercial, not-for-profit, and media), website rank, and the presence or absence of the Health on the Net Code of Conduct (HONcode) seal. Accuracy and credibility were assessed following the development of checklists (with 20 and 13 items, respectively). Readability was assessed using the Simple Measure of Gobbledegook scores. RESULTS Overall, the accuracy score was low (mean 14.35 out of 20). While side effects were comprehensively covered by 18 websites, there was little information about statin use in primary and secondary prevention. None of the websites met all criteria on the credibility checklist (mean 7.8 out of 13). The median Simple Measure of Gobbledegook score was 9.65 (IQR 8.825-10.85), with none of the websites meeting the recommended reading grade of 6, even the media websites. A website bearing the HONcode seal did not mean that the website was more comprehensive or readable. CONCLUSIONS The quality of statin-related websites tended to be poor. Although the information contained was accurate, it was not comprehensive and was presented at a reading level that was too difficult for an average reader to fully comprehend. As such, consumers risk being uninformed about this pharmacotherapy.
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Affiliation(s)
- Eunice Ling
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Domenico de Pieri
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Evenne Loh
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen M Scott
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Stephen C H Li
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, Australia
| | - Heather J Medbury
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Vascular Biology Research Centre, Surgery, Westmead Hospital, Westmead, Australia
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98
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Chow BC, Jiao J, Duong TV, Hassel H, Kwok TCY, Nguyen MH, Liu H. Health literacy mediates the relationships of cognitive and physical functions with health-related quality of life in older adults. Front Public Health 2024; 12:1355392. [PMID: 38550320 PMCID: PMC10976439 DOI: 10.3389/fpubh.2024.1355392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/16/2024] [Indexed: 04/02/2024] Open
Abstract
Background Declining cognitive function (CF) and physical function (PF) relate to poorer health-related quality of life (HRQoL) in older adults. As health literacy (HL) facilitates health information utilization, it may mediate links between functionality and HRQoL appraisals. This study examined HL as an intermediary between joint CF and PF contributions and HRQoL in Hong Kong older adults. Methods 490 older adults aged 50-80 years completed assessments from March to July 2021. Health Literacy Survey Questionnaire Short Form 12 questions (HLS-SF12), Montreal Cognitive Assessment (MoCA), Senior Fitness Test (SFT) and 12-Item Short-Form Health Survey version 2 (SF-12v2) were used to assess HL, CF, PF and HRQoL, respectively. Path analysis tested a model with HL mediating CF/PF predictors and HRQoL outcome. Results Results for direct effects indicated that CF significantly associated with PF (β = 0.115, SE = 0.012, p < 0.001), PF significantly connected to HL (β = 0.101, SE = 0.022, p < 0.001), and HL significantly related to HRQoL (β = 0.457, SE = 0.049, p < 0.001). Meanwhile, PF significantly linked to HRQoL directly (β = 0.156, SE = 0.025, p < 0.001) as well as indirectly (β = 0.046, 95% CI [0.028, 0.067]). Significant mediating effect of HL was found on the relationship of PF and HRQoL. Conclusion Findings confirm CF and PF joint impacts on HL and HRQoL in older adults, elucidating HL's mediating role in translating functionality levels into HRQoL. Fostering enduring health knowledge access may thus buffer effects of age-related declines on well-being. Results can inform interventions leveraging this pathway to promote resilient trajectories.
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Affiliation(s)
- Bik C. Chow
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
- Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Jiao Jiao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
- Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Tuyen V. Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
- International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Holger Hassel
- Institute for Applied Health Sciences, Coburg University of Applied Sciences and Arts, Coburg, Germany
- Berlin Institute for Health and Social Affairs, Berlin, Germany
| | - Timothy C. Y. Kwok
- Department of Medicine & Therapeutic and School of Public Health, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Minh H. Nguyen
- International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huaxuan Liu
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, Fujian, China
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99
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Van Boxtel W, Jerković-Ćosić K, Schoonmade LJ, Chinapaw MJM. Health literacy in the context of child health promotion: a scoping review of conceptualizations and descriptions. BMC Public Health 2024; 24:808. [PMID: 38486202 PMCID: PMC10941366 DOI: 10.1186/s12889-024-17955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/01/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Increasing health literacy (HL) in children could be an opportunity for a more health literate future generation. The aim of this scoping review is to provide an overview of how HL is conceptualized and described in the context of health promotion in 9-12-year-old children. METHODS A systematic and comprehensive search for 'health literacy' and 'children' and 'measure' was performed in accordance with PRISMA ScR in PubMed, Embase.com and via Ebsco in CINAHL, APA PsycInfo and ERIC. Two reviewers independently screened titles and abstracts and evaluated full-text publications regarding eligibility. Data was extracted systematically, and the extracted descriptions of HL were analyzed qualitatively using deductive analysis based on previously published HL definitions. RESULTS The search provided 5,401 original titles, of which 26 eligible publications were included. We found a wide variation of descriptions of learning outcomes as well as competencies for HL. Most HL descriptions could be linked to commonly used definitions of HL in the literature, and some combined several HL dimensions. The descriptions varied between HL dimensions and were not always relevant to health promotion. The educational setting plays a prominent role in HL regarding health promotion. CONCLUSION The description of HL is truly diverse and complex encompassing a wide range of topics. We recommend adopting a comprehensive and integrated approach to describe HL dimensions, particularly in the context of health promotion for children. By considering the diverse dimensions of HL and its integration within educational programs, children can learn HL skills and competencies from an early age.
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Affiliation(s)
- Wieke Van Boxtel
- Research group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands.
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands.
- Health Behaviour and Chronic Diseases, Methodology, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Katarina Jerković-Ćosić
- Research group Innovation in Preventive Healthcare, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Utrecht, 3584 CS, The Netherlands
| | - Linda J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, 1007 MB, The Netherlands
| | - Mai J M Chinapaw
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
- Health Behaviour and Chronic Diseases, Methodology, Amsterdam Public Health, Amsterdam, The Netherlands
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100
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Poletti B, Stringer G, Furness K. Patient Experience Pre-Implementation of an Enhanced Recovery After Surgery Protocol: A Qualitative Investigation. J Multidiscip Healthc 2024; 17:1147-1158. [PMID: 38500482 PMCID: PMC10946404 DOI: 10.2147/jmdh.s453467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/19/2024] [Indexed: 03/20/2024] Open
Abstract
Objective This study explores the experience of adults undergoing major abdominal surgery pre-implementation of an Enhanced Recovery after Surgery program at a tertiary hospital in Melbourne, Australia, to enhance health promotion in Australian hospitals. Methodology Patients who were undergoing major abdominal surgery and who consented to participate were recruited in this study. Patients were chosen based on an inclusion-exclusion criterion. In-depth, semi-structured qualitative interviews were conducted by telephone and transcribed verbatim by the primary researcher. Thematic analysis was used and synthesised into five inductive themes. Eighteen participants aged between 51 and 82 years were interviewed. Codes were categorised into inductive themes: 1) preparedness for surgery; 2) communication; 3) aftercare; 4) expectations of surgery; and 5) overall experience utilising an iterative process. The following themes and subthemes emerged from the qualitative synthesis. Results Patients undergo a variety of experiences throughout the perioperative care period. Patient care and experience may be improved through increased access to patient engagement, information and communication, use of multimedia and teach-back method, optimization of the hospital environment and through providing adequate planning and support on discharge. Conclusion Evidence of barriers to enhancing patient surgical experience can be used to guide the implementation of Enhanced Recovery after Surgery protocols in Australian hospitals and therefore may limit its generalizability. This will improve health promotion as these findings provide valuable insights into integrative methods that can be considered to be important for achieving person-centred care. This knowledge can be useful in clinical practice, implementation and education programs for ERAS.
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Affiliation(s)
- Bianca Poletti
- Faculty of Health Science (Biomedical Science), Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia
| | - Georgia Stringer
- Department of Nutrition and Dietetics, Eastern Health, Melbourne, Australia
| | - Kate Furness
- Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Victoria, 3122, Australia
- Department Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, 3086, Australia
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