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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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Cheng GZ, Chen A, Xin Y, Ni QQ. Using the teach-back method to improve postpartum maternal-infant health among women with limited maternal health literacy: a randomized controlled study. BMC Pregnancy Childbirth 2023; 23:13. [PMID: 36624440 PMCID: PMC9827634 DOI: 10.1186/s12884-022-05302-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/12/2022] [Indexed: 01/10/2023] Open
Abstract
AIM This study aimed to evaluate the effects of using the teach-back method among women with limited maternal health literacy (LMHL) on maternal health literacy(MHL), postpartum health behaviours and maternal-infant health outcomes. METHODS A randomized controlled study was conducted in the obstetrics department of Anhui Provincial Hospital, China. A total of 258 pregnant women with LMHL were recruited at the point of admission to the hospital for birth and randomly assigned to the control group (n = 130), where women received routine education sessions, and the teach-back group (n = 128), where women received routine education sessions plus a teach-back intervention. The two groups were assessed in terms of MHL before and after the intervention, breastfeeding execution, uptake of 42-day postpartum check-ups, complete uptake of one-time recommended vaccines, and physical health outcomes. Statistical tests were employed for data analysis. RESULTS There was no significant difference between the two groups in terms of MHL and other social, demographic, and medical status at baseline. After the intervention, the teach-back group had a higher level of MHL (p < 0.001), better postpartum health behaviours in terms of exclusive breastfeeding within 24 hours postpartum (x2 = 22.853, p<0.001), exclusive breastfeeding within 42 days postpartum (x2 = 47.735, p<0.001), uptake of 42-day postpartum check-ups (x2 = 9.050, p = 0.003) and vaccination (x2 = 5.586, p = 0.018) and better maternal-infant health outcomes in terms of the incidence of subinvolution of the uterus (x2 = 6.499, p = 0.011), acute mastitis (x2 = 4.884, p = 0.027), postpartum constipation (x2 = 5.986, p = 0.014), overweight (x2 = 4.531, p = 0.033) and diaper dermatitis (x2 = 10.896, p = 0.001). CONCLUSIONS This study shows that the teach-back method is effective for enhancing MHL, leading to positive postpartum health behaviours, and improving postpartum maternal-infant health outcomes among women with LMHL. The teach-back method may play an important role in improving postpartum maternal-infant health and could be considered in maternal health education. TRIAL REGISTRATION NUMBER Our trial has been prospectively registered at ClinicalTrials.gov (Ref. No.: NCT04858945) and the enrollment date was 26/04/2021.
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Affiliation(s)
- Gui Zhi Cheng
- grid.59053.3a0000000121679639The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - An Chen
- grid.5373.20000000108389418Institute of Healthcare Engineering, Management and Architecture (HEMA), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, 02150 Espoo, Finland ,grid.15485.3d0000 0000 9950 5666Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland ,Nordic Healthcare Group Oy, Vattuniemenranta 2, 00210 Helsinki, Finland
| | - Youdi Xin
- grid.59053.3a0000000121679639The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - Qian Qian Ni
- grid.59053.3a0000000121679639The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
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Abstract
Rural communities are a vital segment of the US population; however, these communities are shrinking, and their population is aging. Rural women experience health disparities including increased risk of maternal morbidity and mortality. In this article, we will explore these trends and their determinants both within and external to the health care system. Health care providers, public health professionals, and policymakers should be aware of these social and structural factors that influence health outcomes and take action to reduce generational cycles of health disparity. Opportunities to improve the health and pregnancy outcomes for rural women and rural populations are highlighted.
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Chen S, Yue W, Han X, Luo J, Na L, Yang M. An integrative review on the maternal health literacy among maternal and child workers. J Nurs Manag 2022; 30:4533-4548. [PMID: 36190727 DOI: 10.1111/jonm.13830] [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: 05/25/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 12/30/2022]
Abstract
AIMS This study aim to capture the most comprehensive evidence-based dimensions of maternal health literacy, including summarizing the definitions, theoretical frameworks, measuring instruments, and the association between maternal health literacy and health behaviours. BACKGROUND Maternal health literacy has been recognized as an important approach to achieving high-quality maternal and child health; however, little is known about maternal health literacy comprehensively and scientifically. EVALUATION An integrative review retrieved articles from 11 databases, following the methodology of Whittemore and Knafl. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. KEY ISSUES A total of 5580 articles were retrieved and 23 articles were finally identified. Existing definitions and theoretical frameworks took less consideration of maternal applicability and failed to summarize maternal health literacy from a dynamic and systematic perspective. Measurement instruments were set up with many items that make it difficult to quickly screen for poor maternal health literacy. Most articles proved the association between maternal health literacy and health behaviours through correlation analysis or regression analysis but less explored the influence pathways between them. CONCLUSION The definition and theoretical framework need to focus on maternal applicability and explain the process of individual mothers acquiring and understanding health knowledge and skills from a dynamic and systematic perspective. A rapid instrument for maternal health literacy should be developed and high-quality empirical research was conducted to understand the associated mechanisms between maternal health literacy and health behaviours. IMPLICATIONS FOR NURSING MANAGEMENT It is necessary to strengthen maternal and child health education of primary health care nurses and enhance their ability to help perinatal women use maternal and child health information effectively.
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Affiliation(s)
- Shanxia Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei Yue
- Affiliated Foshan Maternal and Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Xinrui Han
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianghe Luo
- Department of Gynecology and Obstetrics, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Liu Na
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ming Yang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Meldgaard M, Gamborg M, Terkildsen Maindal H. Health literacy in the prenatal phase: a systematic review. SEXUAL & REPRODUCTIVE HEALTHCARE 2022; 34:100796. [DOI: 10.1016/j.srhc.2022.100796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/15/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
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Chen S, Yue W, Liu N, Han X, Yang M. The progression on the measurement instruments of maternal health literacy: a scoping review. Midwifery 2022; 109:103308. [DOI: 10.1016/j.midw.2022.103308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 02/10/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
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Vladutiu CJ, Mobley SC, Ji X, Thomas S, Kandasamy V, Sutherland D, Inglett S, Li R, Cox S. A Methodological Approach for Evaluating the Enterprise Community Healthy Start Program in Rural Georgia: An Analysis Using Linked PRAMS, Birth Records and Program Data. Matern Child Health J 2021; 25:1516-1525. [PMID: 34417685 PMCID: PMC10425706 DOI: 10.1007/s10995-021-03205-4] [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] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Community Healthy Start program evaluations are often limited by a lack of robust data and rigorous study designs. This study describes an enhanced methodological approach using local program data linked with existing population-level datasets for external comparison to evaluate the Enterprise Community Healthy Start (ECHS) program in two rural Georgia counties and presents results from the evaluation. METHODS ECHS program data were linked to birth records and the Pregnancy Risk Assessment Monitoring System (PRAMS) for 869 women who delivered a live birth in Burke and McDuffie counties from 2010 to 2011. Multivariate logistic regressions with and without propensity score methods modeled the association between ECHS participation and maternal health indicators and pregnancy outcomes. RESULTS 107 ECHS participants and 726 non-participants responded to PRAMS and met eligibility criteria. Compared with non-participants, ECHS participants were younger, completed fewer years of education, and were more likely to be non-Hispanic Black, unmarried, insured with Medicaid, participating in WIC, and having an unintended pregnancy. Models with and without propensity score weighting derived similar results: there was a positive association between ECHS participation and receiving adequate or adequate plus prenatal care (p < 0.05); no statistically significant associations were observed between ECHS participation and any other health behaviors, health care access and utilization measures or pregnancy outcomes. DISCUSSION Rigorous evaluation of a local Healthy Start program using linked PRAMS and birth records with a population-based external comparison group and propensity score methods is an enhanced and feasible approach that can be applied in other local and state jurisdictions.
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Affiliation(s)
- Catherine J Vladutiu
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration (HRSA), Rockville, MD, USA.
| | - Sandra C Mobley
- Department of Obstetrics & Gynecology (Retired), Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xu Ji
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA, USA
| | - Suzanne Thomas
- CSRA Nursing Associates, PC and Augusta University College of Nursing (Adjunct), Augusta, GA, USA
| | - Veni Kandasamy
- Oak Ridge Institute for Science and Education, Oak Ridge Affiliated Universities, Oak Ridge, TN, USA
| | - Don Sutherland
- Enterprise Community Healthy Start, The Perinatal Center, Augusta University, Augusta, GA, USA
| | - Sandra Inglett
- Enterprise Community Healthy Start, College of Nursing, Augusta University, Augusta, GA, USA
| | - Rui Li
- Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA, USA
| | - Shanna Cox
- Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA, USA
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Riggs E, Yelland J, Mensah FK, Gold L, Szwarc J, Kaplan I, Small R, Middleton P, Krastev A, McDonald E, East C, Homer C, Nesvadba N, Biggs L, Braithwaite J, Brown SJ. Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design. BMJ Open 2021; 11:e048271. [PMID: 34281928 PMCID: PMC8291298 DOI: 10.1136/bmjopen-2020-048271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Pregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework. METHODS AND ANALYSIS The evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation. ETHICS AND DISSEMINATION Ethics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.
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Affiliation(s)
- Elisha Riggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Yelland
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
- Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Josef Szwarc
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Ida Kaplan
- Victorian Foundation for Survivors of Torture, Melbourne, Victoria, Australia
| | - Rhonda Small
- Judith Lumely Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Philippa Middleton
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Faculty of Medical and Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ann Krastev
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Ellie McDonald
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Christine East
- School of Nursing and Midwifery/Mercy Hospital for Women, La Trobe University, Melbourne, Victoria, Australia
| | - Caroline Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Natalija Nesvadba
- Multicultural Services, Mercy Hospitals Victoria Ltd, Melbourne, Victoria, Australia
| | - Laura Biggs
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Phommachanh S, Essink DR, Wright PE, Broerse JEW, Mayxay M. Maternal health literacy on mother and child health care: A community cluster survey in two southern provinces in Laos. PLoS One 2021; 16:e0244181. [PMID: 33780460 PMCID: PMC8007003 DOI: 10.1371/journal.pone.0244181] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/04/2020] [Indexed: 11/18/2022] Open
Abstract
RATIONAL Increased maternal health literacy (MHL) has contributed considerably to maternal and child health outcomes in many countries. Malnutrition, and low coverage of child vaccination and breastfeeding are major health concerns in Laos, but there is little insight into mothers' literacy on these issues. The aim of this study was to identify the level of MHL of Lao mothers and to explore factors influencing it, in order to provide evidence that can inform policies and planning of health services. METHODS A cross-sectional survey was conducted using a questionnaire on health literacy (ability to access, understand, appraise and apply health-related information) in relation to care during pregnancy, childbirth, and the postpartum period. We interviewed 384 mothers with children aged under five years; 197 from urban and 187 from rural areas. Descriptive and inferential statistics were applied to analyze the data. RESULTS Overall, MHL of Lao mothers was very low in both urban and rural areas; 80% of mothers had either inadequate or problematic MHL, while only 17.4% had sufficient and 3.5% excellent MHL. The MHL scores were significantly higher in urban than in rural areas. One third of mothers found it very difficult to access, understand, appraise and apply information on mother and child (MCH). Health personnel were the main source of MCH information for the mothers. Years of schooling, own income, health status, and number of ANC visits significantly predicted a higher level of MHL (R square = 0.250; adjusted R square = 0.240, P = <0.001). CONCLUSIONS MHL of Lao mothers was inadequate in both urban and rural areas. Socio-demographics and key practices of the mothers were significantly associated with a better level of MHL. Health education on MHL to mothers in both urban and rural areas needs attention, and could best be done by improving the quality of health providers' provision of information.
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Affiliation(s)
- Sysavanh Phommachanh
- Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
| | - Dirk R. Essink
- Vrije Universiteit Amsterdam, Athena Institute and Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Pamela E. Wright
- Guelph International Health Consulting, Amsterdam, The Netherlands
| | - Jacqueline E. W. Broerse
- Vrije Universiteit Amsterdam, Athena Institute and Amsterdam Public Health Institute, Amsterdam, The Netherlands
| | - Mayfong Mayxay
- Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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Heizomi H, Kouzekanani K, Asghari Jafarabadi M, Allahverdipour H. Psychometric Properties of the Persian Version of Mental Health Literacy Scale. Int J Womens Health 2020; 12:513-520. [PMID: 32753978 PMCID: PMC7351619 DOI: 10.2147/ijwh.s252348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Due to the lack of an instrument to measure mental health literacy among Persian/Farsi speaking people, this study was conducted to examine the psychometric properties of the Persian version of the Mental Health Literacy Scale (P-MHLS). PARTICIPANTS AND METHODS The 2019 cross-sectional study with 992 participants was conducted in Tabriz, Iran. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to establish the construct validity of the P-MHLS. The internal consistency/reliability was estimated by computing Cronbach's coefficient alpha. Feasibility of the scale was examined and item response theory (IRT) models were applied to characterize the test items. RESULTS An exploratory factor analysis of data resulted in five factors, which included 30 of the 35 items and accounted for 42.00% of the variance. The construct validity of the 5-factor model was supported by the results of our confirmatory factor analysis. The factors were the 1) ability to recognize mental disorders, 2) confidentiality of mental health practitioners, 3) skills of mental health information seeking, 4) beliefs about mental illnesses, and 5) attitudes toward patients with mental illness. CONCLUSION The study provides initial support for the use of the MHLS among Persian/Farsi speaking adults to assess mental health literacy.
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Affiliation(s)
- Haleh Heizomi
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamiar Kouzekanani
- College of Education and Human Development, Texas A&M University-Corpus Christi, Corpus Christi, TX, USA
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences and Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
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Wideman ES, Dunnigan A, Jonson-Reid M, Kohl P, Constantino J, Tandon M, Recktenwald A, Tompkins R. Nurse home visitation with vulnerable families in rural areas: A qualitative case file review. Public Health Nurs 2019; 37:234-242. [PMID: 31860152 DOI: 10.1111/phn.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Nurse home visiting may address challenges and resource disparities that threaten maternal and infant well-being in rural areas, but little is known about United States' program implementation. This qualitative study explored how family and community characteristics affected rural nurse home visiting. SAMPLE The sample for content analysis included families beginning services in 2010-2011 living in the rural counties with the highest caseloads (433 families). DESIGN Electronic nurse home visiting case files from three rural counties were analyzed using a content analysis approach. The partner agency provided input on key constructs of interest but independent coding was also done to capture additional themes. Quantitative county level data and comments from member checking informed interpretation. Member checking included individual nurses serving the selected counties (n = 3) and input from an agency level supervisory meeting for validation. RESULTS Concerns of families served (e.g., mental health) may not be unique to rural areas, but challenges to accessing resources and constellation of needs were. Nurses adapted engagement and service strategies to meet these needs. CONCLUSION Agencies serving rural areas should allocate resources and adapt training to support nurses based on unique community profiles. More research on rural nurse home visiting practice and outcomes is needed.
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Affiliation(s)
- Ellie S Wideman
- Psychology, Maryville University of Saint Louis, Saint Louis, MO, USA
| | | | | | - Patricia Kohl
- Brown School of Social Work, Washington University, Saint Louis, MO, USA
| | - John Constantino
- Division of Child and Adolescent Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Mini Tandon
- Division of Child and Adolescent Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
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Alinejad-Naeini M, Razavi N, Sohrabi S, Heidari-Beni F. The association between health literacy, social support and self-efficacy in mothers of preterm neonates. J Matern Fetal Neonatal Med 2019; 34:1703-1710. [PMID: 31307262 DOI: 10.1080/14767058.2019.1644620] [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: 10/26/2022]
Abstract
BACKGROUND Health literacy, social support and self-efficacy are important concepts in mothers of preterm neonates. The purpose of study was to determine the association between health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit. METHODS This descriptive correlational study was conducted from November 2017 to January 2019 on 200 mothers of preterm neonates admitted to the neonatal intensive care unit of selected hospitals affiliated with Iran University of Medical Sciences, Tehran, Iran. Data were collected using demographic, maternal health literacy, maternal self-efficacy and multidimensional scale of perceived social support questionnaires. Data were analyzed by descriptive statistics (mean and standard deviation) and inferential tests (Pearson correlation coefficient) using SPSS-PC (v.23) and R software. RESULTS The data showed 23.5% of mothers had high likelihood of low health literacy, 45.5% had possibility of low health literacy and 31% had adequate with mean score 2.57 ± 1.28. Also, 9.5% of participants had low perceived social support, 62.5% moderate perceived social support and 28% high perceived social support. Maternal self-efficacy score was 52.54 ± 8.06. Pearson's correlation coefficient analyses revealed a statistically significant positive correlation between maternal health literacy and social support (r = 0.304, p < .001). Also maternal health literacy was positively correlated with the self-efficacy (r = 0.292, p < .001) and self-efficacy was positively correlated with social support (r = 0.440, p < .001). CONCLUSION Health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit in Iran are related together. Therefore, neonatal care nurses need to note this in care of this clients and adopt strategies to enhance them.
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Affiliation(s)
- Mona Alinejad-Naeini
- Department of Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Narjes Razavi
- Department of Health, Education and Health Promotion, Tehran University of Medical Sciences, Tehran, Iran
| | - Soroor Sohrabi
- Hazrat Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farshad Heidari-Beni
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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McKinn S, Linh DT, Foster K, McCaffery K. Distributed Health Literacy in the Maternal Health Context in Vietnam. Health Lit Res Pract 2019; 3:e31-e42. [PMID: 31294305 PMCID: PMC6608917 DOI: 10.3928/24748307-20190102-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/21/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous health literacy research has often focused on individual functional health literacy, ignoring the cultural contexts through which many people experience health care. OBJECTIVE We aimed to explore the nature of maternal health literacy among ethnic minority women in a low-resource setting in Vietnam. METHODS Using a qualitative approach, we conducted focus groups with 42 pregnant women, mothers, and grandmothers of children younger than age 5 years from the Thai and Hmong ethnic groups. Semi-structured interviews were conducted with key informants and thematic analysis was performed. KEY RESULTS The findings of our thematic analysis aligned well with the concept of distributed health literacy. We found that ethnic minority women drew upon family and social networks of health literacy mediators to share knowledge and understanding, assess and evaluate information, communicate with health professionals, and support decision-making. Family members were also involved in making health decisions that had the potential to negatively affect women and children's health. CONCLUSIONS Family members are an important source of information for ethnic minority women, and they influence decision-making. Relatives and husbands of pregnant women could be included in maternal health education programs to potentially strengthen the health literacy of the whole community. The distributed health literacy concept can be used to strengthen health promotion messages and to reduce the risk of negative health outcomes. [HLRP: Health Literacy Research and Practice. 2019;3(1):e31-e42.]. PLAIN LANGUAGE SUMMARY Distributed health literacy refers to how health literacy skills and practices are distributed through social networks. This concept applies well to the maternal health context in Vietnam. Older women are trusted sources of information, and family influences decision-making during pregnancy. Women's limited autonomy increases the importance of family involvement. Distributed health literacy could be used to strengthen health promotion messages.
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Affiliation(s)
| | | | | | - Kirsten McCaffery
- Address correspondence to Kirsten McCaffery, BSc (Hons), PhD, Edward Ford Building (A27), The University of Sydney, NSW 2006, Australia;
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Thomas SD, Mobley SC, Hudgins JL, Sutherland DE, Inglett SB, Ange BL. Conditions and Dynamics That Impact Maternal Health Literacy among High Risk Prenatal-Interconceptional Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1383. [PMID: 30004397 PMCID: PMC6069417 DOI: 10.3390/ijerph15071383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/21/2018] [Accepted: 06/25/2018] [Indexed: 11/16/2022]
Abstract
The purpose of the study was to describe conditions and dynamics in the lives of high-risk, low-income, Southern United States prenatal-interconceptional women (n = 37) in a home visiting program that promoted maternal health literacy progression. In the Life Course Health Development (LCHD) Model, conditions were risk and protective factors that impacted health. Dynamics drove the complex, epigenetic relationships between risk and protective factors. Maternal health literacy promotion helped participants address conditions and dynamics to create positive life changes. This research was a retrospective, mixed methods study of women's service records documenting care from prenatal admission to 24 months post-delivery. The Life Skills Progression Instrument (LSP) was scored to measure maternal health literacy progression. Ethnographic content analysis of visit notes triangulated with quantitative data enabled specificity of critical data elements. Subsequently, a complementary focus group was conducted with the Registered Nurse Case Managers (RNCM). Severe social conditions included devastating poverty, low educational achievement, transient housing, unstable relationships, incarceration, lack of continuous health insurance, and shortage of health care providers. Dynamics included severe psycho-social stressors, domestic violence, lack of employment, low income, low self-esteem and self-expectations, and social/family restraints upon women's intended positive changes. An important protective factor was the consistent, stable, evidence-informed relationship with the RNCM. Findings from the focus group discussion supported content analysis results.
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Affiliation(s)
- Suzanne D Thomas
- CSRA Nursing Associates, PC, 300 Gardners Mill Court, Augusta, GA 30907, USA.
| | - Sandra C Mobley
- Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
| | - Jodi L Hudgins
- Education and Networking, Enterprise Community Healthy Start, Augusta University, Augusta, GA 30912, USA.
| | - Donald E Sutherland
- Enterprise Community Healthy Start, The Perinatal Center, Augusta University, Augusta, GA 30912, USA.
| | - Sandra B Inglett
- Enterprise Community Healthy Start, College of Nursing, Augusta University, EC-5338, 987 St. Sebastian Way, Augusta, GA 30912, USA.
| | - Brittany L Ange
- Department of Population Health, Division of Biostatistics and Data Science, Augusta University, Augusta, GA 30912, USA.
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Thomas SD, Hudgins JL, Sutherland DE, Ange BL, Mobley SC. Perinatal program evaluations: methods, impacts, and future goals. Matern Child Health J 2016; 19:1440-6. [PMID: 25636650 DOI: 10.1007/s10995-015-1677-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this methodology note is to examine perinatal program evaluation methods as they relate to the life course health development model (LCHD) and risk reduction for poor birth outcomes. We searched PubMed, CDC, ERIC, and a list from the Association of Maternal and Child Health Programs (AMCHP) to identify sources. We included reports from theory, methodology, program reports, and instruments, as well as reviews of Healthy Start Programs and home visiting. Because our review focused upon evaluation methods we did not include reports that described the Healthy Start Program. The LCHD model demonstrates the non-linear relationships among epigenetic factors and environmental interactions, intentionality or worldview within a values framework, health practices, and observed outcomes in a lifelong developmental health trajectory. The maternal epigenetic and social environment during fetal development sets the stage for the infant's lifelong developmental arc. The LCHD model provides a framework to study challenging maternal child health problems. Research that tracks the long term maternal-infant health developmental trajectory is facilitated by multiple, linked public record systems. Two instruments, the life skills progression instrument and the prenatal risk overview are theoretically consistent with the LCHD and can be adapted for local or population-based use. A figure is included to demonstrate a method of reducing interaction among variables by sample definition. Both in-place local programs and tests of best practices in community-based research are needed to reduce unacceptably high infant mortality. Studies that follow published reporting standards strengthen evidence.
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Affiliation(s)
- Suzanne D Thomas
- College of Nursing, Georgia Regents University, Augusta, GA, USA,
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Yang SJ, Chee YK, An J, Park MH, Jung S. Analysis of Validity and Reliability of the Health Literacy Index for Female Marriage Immigrants (HLI-FMI). Asia Pac J Public Health 2016; 28:368-81. [DOI: 10.1177/1010539516645157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to obtain an independent evaluation of the factor structure of the 12-item Health Literacy Index for Female Marriage Immigrants (HLI-FMI), the first measure for assessing health literacy for FMIs in Korea. Participants were 250 Asian women who migrated from China, Vietnam, and the Philippines to marry. The HLI-FMI was originally developed and administered in Korean, and other questionnaires were translated into participants’ native languages. The HLI-FMI consisted of 2 factors: (1) Access-Understand Health Literacy (7 items) and (2) Appraise-Apply Health Literacy (5 items); Cronbach’s α = .73. Confirmatory factor analysis indicated adequate fit for the 2-factor model. HLI-FMI scores were positively associated with time since immigration and Korean proficiency. Based on classical test theory and item response theory, strong support was provided for item discrimination and item difficulty. Findings suggested that the HLI-FMI is an easily administered, reliable, and valid scale.
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Affiliation(s)
- Sook Ja Yang
- Division on Nursing Science, Ewha Womans University, Seoul, South Korea
| | - Yeon Kyung Chee
- Division on Nursing Science, Ewha Womans University, Seoul, South Korea
| | - Jisook An
- Department of Nursing, Kyungnam University, Gyeongsangnam-do, South Korea
| | - Min Hee Park
- Department of Nursing, Wonkwang University, Jeonrabuk-do, South Korea
| | - Sunok Jung
- Division on Nursing Science, Ewha Womans University, Seoul, South Korea
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Riggs E, Yelland J, Szwarc J, Wahidi S, Casey S, Chesters D, Fouladi F, Duell-Piening P, Giallo R, Brown S. Fatherhood in a New Country: A Qualitative Study Exploring the Experiences of Afghan Men and Implications for Health Services. Birth 2016; 43:86-92. [PMID: 26616739 DOI: 10.1111/birt.12208] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fathers of refugee background are dealing with multiple, interrelated stressors associated with forced migration and establishing their lives in a new country. This has implications for the role of men in promoting the health and well-being of their families. METHODS Afghan community researchers conducted interviews with 30 Afghan women and men who had recently had a baby in Australia. Interviews and focus groups were conducted with health professionals working with families of refugee background. RESULTS Fourteen men, 16 women, and 34 health professionals participated. Afghan men reported playing a major role in supporting their wives during pregnancy and postnatal care, accompanying their wives to appointments, and providing language and transport support. Although men embraced these roles, they were rarely asked by health professionals about their own concerns related to their wife's pregnancy, or about their social circumstances. Perinatal health professionals queried whether it was their role to meet the needs of men. CONCLUSION There are many challenges for families of refugee background navigating maternity services while dealing with the challenges of settlement. There is a need to move beyond a narrow conceptualization of antenatal and postnatal care to encompass a broader preventive and primary care approach to supporting refugee families through the period of pregnancy and early years of parenting. Pregnancy and postnatal care needs to be tailored to the social and psychological needs of families of refugee background, including men, and incorporate appropriate language support, in order to improve child and family health outcomes.
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Affiliation(s)
- Elisha Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Vic., Australia
| | - Jane Yelland
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Vic., Australia
| | - Josef Szwarc
- Victorian Foundation for Survivors of Torture, Brunswick, Vic., Australia
| | - Sayed Wahidi
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - Sue Casey
- Victorian Foundation for Survivors of Torture, Brunswick, Vic., Australia
| | - Donna Chesters
- Victorian Foundation for Survivors of Torture, Brunswick, Vic., Australia
| | - Fatema Fouladi
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | | | - Rebecca Giallo
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia
| | - Stephanie Brown
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, Vic., Australia.,General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Vic., Australia.,School of Population and Global Health, University of Melbourne, Parkville, Vic., Australia
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Carroll LN, Smith SA, Thomson NR. Parents as Teachers Health Literacy Demonstration Project. Health Promot Pract 2014; 16:282-90. [DOI: 10.1177/1524839914538968] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Parents as Teachers (PAT) Health Literacy Demonstration project assessed the impact of integrating data-driven reflective practices into the PAT home visitation model to promote maternal health literacy. PAT is a federally approved Maternal, Infant, Early Childhood Home Visiting program with the goal of promoting school readiness and healthy child development. This 2-year demonstration project used an open-cohort longitudinal design to promote parents’ interactive and reflective skills, enhance health education, and provide direct assistance to personalize and act on information by integrating an empowerment paradigm into PAT’s parent education model. Eight parent educators used the Life Skills Progression instrument to tailor the intervention to each of 103 parent–child dyads. Repeated-measures analysis of variance, paired t tests, and logistic regression combined with qualitative data demonstrated that mothers achieved overall significant improvements in health literacy, and that home visitors are important catalysts for these improvements. These findings support the use of an empowerment model of health education, skill building, and direct information support to enable parents to better manage personal and child health and health care.
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