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Sethares KA, Westlake C, Viveiros JD, Elliott K. Correlation of health literacy and learning style preference in persons with heart failure. PATIENT EDUCATION AND COUNSELING 2024; 127:108367. [PMID: 38981405 DOI: 10.1016/j.pec.2024.108367] [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: 01/31/2024] [Revised: 06/13/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVE The purpose of the study was to describe demographic and health literacy correlates of learning style in older adults with heart failure (HF). METHODS Cross sectional data on learning styles (VARK Questionnaire, 16 items) and health literacy (S-TOFHLA, 36 items) were collected. Preferred learning style was determined and correlated to health literacy and demographic measures. RESULTS 116 participants with heart failure (M age = 75.1 (SD 12.5) years, M health literacy of 19 (SD 11.5). Most identified as male (59 %); with inadequate health literacy (67 %). Thirty percent reported a multimodal learning style preference with a kinesthetic (r = .33, p = .03) and not a visual preference (r = -.49, p < .001). Among unimodal learning styles, the most frequent was kinesthetic (26.7 %). Those with lower literacy levels were older (r = -.44, p = <.001), had less education (r = .48, p < .001) and reported a kinesthetic learning preference (r = .37, p = .001). CONCLUSION Older individuals identifying as male, with low health literacy, preferred a kinesthetic approach to HF education. Future research should consider the linkage between education tailored to learning style, health literacy and outcomes. PRACTICE IMPLICATIONS Assessment of learning style should be completed prior to an educational encounter.
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Affiliation(s)
- Kristen A Sethares
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, USA.
| | - Cheryl Westlake
- Memorial Care, 17360 Brookhurst Street, Fountain Valley, CA 92708, USA; Azusa Pacific University, 606 E Huntington Drive, Monrovia, CA 91016, USA
| | - Jennifer D Viveiros
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, USA
| | - Kathleen Elliott
- Department of Adult Nursing, College of Nursing and Health Sciences, University of Massachusetts Dartmouth, 285 Old Westport Rd., North Dartmouth, MA 02747, USA
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Kincaid H, Coyne CA, Hamadani R, Friel T. Validation of three health literacy screening questions compared with S-TOFHLA in a low-income diverse English- and Spanish-Speaking population. J Public Health (Oxf) 2024; 46:383-391. [PMID: 38609184 DOI: 10.1093/pubmed/fdae035] [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: 06/13/2023] [Revised: 12/26/2023] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Clinicians need a tool to gauge patients' ability to understand health conditions and treatment options. The Short-form Test of Functional Health Literacy in Adults (S-TOFHLA) is the gold standard for this, but its length is prohibitive for use in clinical settings. This study seeks to validate a novel three-item question set for predicting health literacy. METHODS This cross-sectional study utilized an in-person questionnaire alongside the S-TOFHLA. The sample included 2027 English- and Spanish-speaking adults (≥18 years) recruited from primary care practices serving a low-income eastern Pennsylvania community. Most patients (57.7%) identified as Hispanic. Diagnostic accuracy of each question and aggregated scores were assessed against the validated survey by calculating the area under the receiver operating characteristic (AUROC) curve. RESULTS Questions in the 'Problems Learning' and 'Help Reading' domains (AUROC 0.66 for each) performed better than the 'Confident Forms' question (AUROC 0.64). Summing all three scores resulted in an even higher AUROC curve (0.71). Cronbach's alpha of the combined items was 0.696. CONCLUSIONS Study results suggest that any of the three questions are viable options for screening health literacy levels of diverse patients in primary care clinical settings. However, they perform better as a summed score than when used individually.
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Affiliation(s)
- Hope Kincaid
- Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, PA 18103, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620 USA
| | - Cathy A Coyne
- Department of Nursing and Public Health, Moravian University, Bethlehem, PA 18018, USA
| | - Roya Hamadani
- Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA 18101, USA
| | - Timothy Friel
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620 USA
- Department of Medicine, Lehigh Valley Health Network, Allentown, PA 18102, USA
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Draughon Moret J, Wilson M, Humphrey-Staub J, Porter T, Wellington J, Anderson JC. Readiness for HIV Postexposure Prophylaxis (PEP) Decision Making Following Sexual Violence. Issues Ment Health Nurs 2024:1-11. [PMID: 39173124 DOI: 10.1080/01612840.2024.2366324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
HIV post-exposure prophylaxis (PEP) can reduce the risk of acquiring HIV infection following sexual assault. However, only about half of people offered HIV PEP will initiate the medication. Factors associated with patient readiness for HIV PEP following sexual assault have been attributed to structural and clinical barriers. This study utilized the Theory of Reasoned Action and Planned Behavior to better understand how personal factors, cognitive factors, mental health, barriers and facilitators that could influence a patient's decision to start HIV PEP post sexual assault. A web-based cross sectional survey was conducted from October 2017 to January 2020 and a total of 228 responses were included from participants that had experienced sexual assault in the previous 3 months. Using linear regression modeling fear of HIV, post-traumatic stress symptoms, validating social responses to disclosure, and having someone else pay for HIV PEP were all associated with feeling better prepared for HIV PEP decision making. Results indicate that structural, social, and individual factors impact patient decision making. These findings highlight opportunities for health systems and providers to improve HIV education and the importance of initiating HIV PEP following sexual assault.
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Affiliation(s)
| | - Machelle Wilson
- Clinical and Translational Science Center Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis, CA, USA
| | - Jacke Humphrey-Staub
- Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA, USA
| | - Tequila Porter
- Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA, USA
| | - Jessica Wellington
- Nese College of Nursing, Penn State University, University Park, PA, USA
| | - Jocelyn C Anderson
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Maheswaranathan M, Boan AD, Ramakrishnan V, Johnson H, Rose J, Dismuke-Greer CL, Oates JC, Egede LE, Williams E. Association of Limited Health Literacy With Clinical and Patient-Reported Outcomes in Individuals With Systemic Lupus Erythematosus. ACR Open Rheumatol 2024. [PMID: 39155276 DOI: 10.1002/acr2.11719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/19/2024] [Accepted: 06/18/2024] [Indexed: 08/20/2024] Open
Abstract
OBJECTIVE Health literacy is an important social determinant of health, with limited health literacy associated with worse health outcomes. This study examined the associations between limited health literacy with patient-reported outcomes and disease activity/damage among 267 Black women with active systemic lupus erythematosus (SLE) enrolled in the Peer Approaches to Lupus Self-Management (PALS) program. METHODS The three-item Chew Health Literacy Screening was used to dichotomize those reporting in the "limited" range on any item with outcomes compared via generalized linear models. Baseline surveys and assessments obtained at study entry as part of the PALS study were used. Primary outcomes included disease activity and lupus damage; other secondary outcomes included patient activation, self-efficacy, physician/patient communication, and quality of life. RESULTS The study included 267 Black women with SLE. In covariate-adjusted analyses, participants with limited health literacy (88 [33%]) were more likely to have lower patient activation (Patient Activation Measure P < 0.0001), lower self-efficacy (Lupus Self-Efficacy P < 0.0001), higher lupus damage (self-administered Brief Index of Lupus Damage P = .016), higher disease activity (Systemic Lupus Activity Questionnaire symptom severity P = 0.006), and worse physician/patient communication (patient-centered care P < 0.0001) compared to those with adequate health literacy. Those with limited health literacy also reported worse lupus quality of life (P = 0.0004) and greater levels of stress (Perceived Stress Scale-4 P < 0.0001) and were 2.4 times more likely to have probable major depression (Patient Health Questionnaire Depression Scale-8 of ≥10 P = 0.004) and probable anxiety disorder (General Anxiety Disorder-7 of ≥10 P = 0.007) compared to those with adequate health literacy. CONCLUSION Black women with SLE and limited health literacy have worse clinical outcomes and represent a particularly vulnerable population with significantly disparate health outcomes. These findings suggest health literacy and complexities of managing SLE may impair clinical care in multiple domains, ultimately contributing to higher disease activity and death/damage, and are important to address in clinical care and future interventions in patients with SLE.
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Affiliation(s)
| | | | | | | | - Jillian Rose
- Hospital for Special Surgery, New York City, New York
| | - Clara L Dismuke-Greer
- Health Economics Resource Center, Veterans Affairs Palo Alto Health System, Menlo Park, California
| | - Jim C Oates
- Medical University of South Carolina, Charleston
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von Ash T, Dunsiger SI, Williams DM, Larsen BA, Bohlen LC, Pekmezi D, Mendoza-Vasconez AS, Benitez TJ, Bock BC, Hartman SJ, Marquez B, Marcus BH. Pasos Hacia La Salud II: A Superiority RCT Utilizing Technology to Promote Physical Activity in Latinas. Am J Prev Med 2024; 67:220-230. [PMID: 38490284 DOI: 10.1016/j.amepre.2024.03.006] [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: 10/24/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION Latinas face an increased risk for chronic diseases associated with insufficient physical activity (PA). The researchers previously showed that a website-based intervention could increase PA among insufficiently active Latinas, yet rates of meeting national PA guidelines were low. The original intervention was enhanced by adding additional features, content, and points of contact, including via text messaging. This study tests the efficacy of the enhanced intervention compared with the original, aimed at maximizing and sustaining PA gains across 24 months. It also examines if increases in PA differed by baseline PA. STUDY DESIGN The researchers conducted a superiority randomized controlled trial (data collected 2018-2022, analyzed 2023). SETTING/PARTICIPANTS Participants were 195 Spanish-speaking Latinas ages 18-65 in the Providence, RI area. INTERVENTION The original intervention is an empirically supported Spanish-language, individually-tailored, website-delivered PA intervention. The enhanced intervention includes text messaging and additional data-driven content and interactive features. MAIN OUTCOME MEASURES Total weekly minutes of moderate to vigorous PA (MVPA) was measured via accelerometry and self-report at 6, 12, 18, and 24 months. RESULTS Participants in both groups increased their MVPA over 24 months. There were no significant between-group differences at 6 or 12 months; at 18 months the enhanced intervention group had higher levels of self-reported (mean (sd): 90.35 (43.55) vs 70.18 [9.99]) and accelerometer-measured (66.21 [18.26] vs 60.27 [16.00]) MVPA compared to the original intervention group. They also had higher levels of self-reported (111.17 [23.35] vs 81.44 [1.82]) and accelerometer-measured (63.76 [15.12] vs 54.86 [14.59]) MVPA at 24 months. Baseline PA moderated the intervention effect. CONCLUSIONS This study demonstrates the potential to enhance the efficacy of website-based PA interventions by utilizing text messaging, and adding more interactive features, content, and phone support. These enhancements may be particularly beneficial in supporting long-term PA maintenance. TRIAL REGISTRATION This study is registered at www. CLINICALTRIAL gov (NCT03491592).
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Affiliation(s)
- Tayla von Ash
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island.
| | - Shira I Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Britta A Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Lauren Connell Bohlen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Dori Pekmezi
- Department of Health Behavior, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama
| | - Andrea S Mendoza-Vasconez
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Tanya J Benitez
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
| | - Beth C Bock
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Becky Marquez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island; Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, Rhode Island
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Gutierrez-Wu JC, Ritter V, McMahon EL, Heerman WJ, Rothman RL, Perrin EM, Shonna Yin H, Sanders LM, Delamater AM, Flower KB. Language Disparities in Caregiver Satisfaction with Physician Communication at Well Visits from 0-2 Years. Acad Pediatr 2024; 24:930-939. [PMID: 38458488 PMCID: PMC11283991 DOI: 10.1016/j.acap.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE This study aimed to describe caregiver satisfaction with physician communication over the first two years of life and examine differences by preferred language and the relationship to physician continuity. METHODS Longitudinal data were collected at well visits (2 months to 2 years) from participants in a randomized controlled trial to prevent childhood obesity. Satisfaction with communication was assessed using the validated Communication Assessment Tool (CAT) questionnaire. Changes in the odds of optimal scores were estimated in mixed-effects logistic regression models to evaluate the associations between satisfaction over time and language, interpreter use, and physician continuity. RESULTS Of 865 caregivers, 35% were Spanish-speaking. Spanish-speaking caregivers without interpreters had lower odds of an optimal satisfaction score compared with English speakers during the first 2 years, beginning at 2 months [OR 0.64 (95% CI: 0.43, 0.95)]. There was no significant difference in satisfaction between English-speaking caregivers and Spanish-speaking caregivers with an interpreter. The odds of optimal satisfaction scores increased over time for both language groups. For both language groups, odds of an optimal satisfaction score decreased each time a new physician was seen for a visit [OR 0.82 (95% CI: 0.69, 0.97)]. CONCLUSION Caregiver satisfaction with physician communication improves over the first two years of well-child visits for both English- and Spanish-speakers. A loss of physician continuity over time was also associated with lower satisfaction. Future interventions to ameliorate communication disparities should ensure adequate interpreter use for primarily Spanish-speaking patients and address continuity issues to improve communication satisfaction.
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Affiliation(s)
- Jennifer C Gutierrez-Wu
- Division of General Pediatrics and Adolescent Medicine (JC Gutierrez-Wu, V Ritter, and KB Flower), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research (JC Gutierrez-Wu), University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Victor Ritter
- Division of General Pediatrics and Adolescent Medicine (JC Gutierrez-Wu, V Ritter, and KB Flower), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Division of General Pediatrics (V Ritter and LM Sanders), Stanford University School of Medicine, Palo Alto, Calif
| | - Ellen L McMahon
- Division of General Pediatrics (EL McMahon, WJ Heerman, and RL Rothman), Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - William J Heerman
- Division of General Pediatrics (EL McMahon, WJ Heerman, and RL Rothman), Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Russell L Rothman
- Division of General Pediatrics (EL McMahon, WJ Heerman, and RL Rothman), Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn
| | - Eliana M Perrin
- Division of General Pediatrics (EM Perrin), Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md; Johns Hopkins University School of Nursing (EM Perrin), Baltimore, Md; Department of Population, Family, and Reproductive Health (EM Perrin), Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
| | - H Shonna Yin
- Departments of Pediatrics and Population Health (H Shonna Yin), New York University School of Medicine, New York City, NY
| | - Lee M Sanders
- Division of General Pediatrics (V Ritter and LM Sanders), Stanford University School of Medicine, Palo Alto, Calif
| | - Alan M Delamater
- Department of Pediatrics (AM Delamater), University of Miami Miller School of Medicine, Miami, Fla
| | - Kori B Flower
- Division of General Pediatrics and Adolescent Medicine (JC Gutierrez-Wu, V Ritter, and KB Flower), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Christ A, Bamer O, Seilern Und Aspang J, Aldrian S, Herold J, Haider T. Health literacy in physical trauma patients : Evaluation of the general understanding of patients in an outpatient clinic using the German Short Test of Functional Health Literacy. Wien Klin Wochenschr 2024:10.1007/s00508-024-02389-3. [PMID: 39085647 DOI: 10.1007/s00508-024-02389-3] [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: 12/22/2023] [Accepted: 05/31/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Health literacy (HL) refers to the ability to understand and process information provided by the healthcare system and depends on various factors, such as language comprehension, education, and social environment. Low HL was recently associated with increased readmission, morbidity, and mortality. Little is known about HL levels in physical trauma patients. The aim of this study was to determine general HL in physical trauma patients in an outpatient setting and to evaluate possible differences based on demographic characteristics. MATERIAL AND METHODS A total of 100 physical trauma patients were recruited in the outpatient trauma facility of the Medical University of Vienna. All recruited patients completed the German Short Test of Functional Health Literacy (S-TOFHLA). RESULTS The evaluated HL index ranged between 20 and 36 points (highest achievable score: 36 points), with the mean value calculated at 34.3 (adequate). Out of 100 participants, 97 patients (97%) showed adequate HL and 3 patients (3%) reached a score corresponding to a marginal understanding. No patient showed inadequate HL utilizing the S‑TOFHLA tool. No significant differences were found between different demographic categories, including age, education level, native language, and injury location. CONCLUSION In this study, included outpatient trauma patients demonstrated an overall adequate understanding of healthcare related information. Age, sociodemographic background, and/or educational status did not influence performance, which leads to the question as to whether the German version of the S‑TOFHLA is valid to representatively measure HL in these patients. Furthermore, regarding the obvious shortcomings of the S‑TOFHLA, the education standard of the respective population should be taken into consideration when choosing an appropriate testing tool.
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Affiliation(s)
- Alexandra Christ
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria
| | - Oskar Bamer
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Silke Aldrian
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Johannes Herold
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Haider
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
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Egede LE, Walker RJ, Linde S, Williams JS. Identifying Individuals with Highest Social Risk in Adults with Type 2 Diabetes Using Item Response Theory. J Gen Intern Med 2024; 39:1642-1648. [PMID: 38565767 PMCID: PMC11255170 DOI: 10.1007/s11606-024-08742-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE The aim of this analysis was to create a parsimonious tool to screen for high social risk using item response theory to discriminate across social risk factors in adults with type 2 diabetes. METHODS Cross-sectional data of 615 adults with diabetes recruited from two primary care clinics were used. Participants completed assessments including validated scales on economic instability (financial hardship), neighborhood and built environment (crime, violence, neighborhood rating), education (highest education, health literacy), food environment (food insecurity), social and community context (social isolation), and psychological risk factors (perceived stress, depression, serious psychological distress, diabetes distress). Item response theory (IRT) models were used to understand the association between a participant's underlying level of a particular social risk factor and the probability of that response. A two-parameter logistic IRT model was used with each of the 12 social determinant factors being added as a separate parameter in the model. Higher values in item discrimination indicate better ability of a specific social risk factor in differentiating participants from each other. RESULTS Rate of crime reported in a neighborhood (discrimination 3.13, SE 0.50; item difficulty - 0.68, SE 0.07) and neighborhood rating (discrimination 4.02, SE 0.87; item difficulty - 1.04, SE 0.08) had the highest discrimination. CONCLUSIONS Based on these findings, crime and neighborhood rating discriminate best between individuals with type 2 diabetes who have high social risk and those with low social risk. These two questions can be used as a parsimonious social risk screening tool to identify high social risk.
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Affiliation(s)
- Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA.
| | - Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
| | - Sebastian Linde
- Department of Health Policy & Management, Texas A&M School of Public Health, 212 Adriance Lab Rd, College Station, TX, 77843, USA
| | - Joni S Williams
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI, 53226, USA
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McGrew SJ, Thai JM, Woller SJ, Smit T, Rogers AH, Vujanovic AA, Zvolensky MJ. Posttraumatic Stress and Opioid Use and Pain among Individuals with Probable Posttraumatic Stress Disorder and Self-Reported Chronic Pain: The Role of Health Literacy. Subst Use Misuse 2024:1-8. [PMID: 38914534 DOI: 10.1080/10826084.2024.2369164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Chronic pain and opioid misuse are a prevalent comorbidity with deleterious health outcomes. Growing work indicates that posttraumatic stress disorder (PTSD) can increase the risk for chronic pain and opioid misuse and dependence. However, there is little understanding of social determinants of health (SDoH) that may account for interrelations of PTSD with chronic pain and opioid misuse and dependence. Health literacy is one relevant SDoH construct, reflecting the ability to gather, process, and comprehend health-related information required to engage in a healthcare setting. OBJECTIVE The purpose of the present cross-sectional study was to examine the indirect effect of health literacy in the association between PTSD and opioid misuse, opioid dependence, pain intensity, and pain disability. METHOD The sample included 142 adults (Mage = 35.2, SD = 9.9; 67.4% female; 70.1% White/Caucasian) with self-reported chronic pain and probable PTSD who were using opioid medication. RESULTS Results demonstrated that PTSD symptom severity had a small indirect effect on opioid misuse and opioid dependence via health literacy; no indirect effects were evident for pain intensity and disability. CONCLUSION The present investigation provides evidence that health literacy may serve as an important explanatory factor in associations between PTSD symptom severity and opioid misuse and dependence among adults with co-occurring probable PTSD and chronic pain.
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Affiliation(s)
- Shelby J McGrew
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Jessica M Thai
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Savannah J Woller
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H Rogers
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Seattle Children's Hospital, Seattle Children's Research Institute, Seattle, WA, USA
| | - Anka A Vujanovic
- Department of Psychological & Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas Maryland Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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Connell Bohlen L, Dunsiger SI, von Ash T, Larsen BA, Pekmezi D, Marquez B, Benitez TJ, Mendoza-Vasconez A, Hartman SJ, Williams DM, Marcus BH. Six-Month Outcomes of a Theory- and Technology-Enhanced Physical Activity Intervention for Latina Women (Pasos Hacia La Salud II): Randomized Controlled Trial. J Med Internet Res 2024; 26:e51708. [PMID: 38842930 PMCID: PMC11190618 DOI: 10.2196/51708] [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: 08/09/2023] [Revised: 11/10/2023] [Accepted: 03/01/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND More than half (55%) of Latina women do not meet aerobic physical activity (PA) guidelines, and frequently cite time, childcare, and transportation as barriers to PA. In addition to linguistic adaptations for this population, successful PA interventions for Latina women addressed these barriers through remote intervention delivery approaches (eg, mail, phone, or web delivery). OBJECTIVE We aimed to evaluate 6-month outcomes of a randomized trial comparing a Spanish-language, individually tailored, web-delivered PA intervention (original) to an enhanced version with text messages and additional features (enhanced). Further, we evaluated if increases in PA at 6 months were moderated by baseline activity status. METHODS In total, 195 Latina women aged 18-65 years participated in a trial comparing the efficacy of the enhanced versus original interventions at initiating PA behavior change. We examined minutes per week of accelerometer-measured PA in the enhanced versus original arms, and the proportion of each arm meeting aerobic PA guidelines (150 min/wk at 6 mo). For moderator analyses, participants were classified as inactive (0 min/wk) or low active (1-90 min/wk) at baseline, measured via the 7 Day Physical Activity Recall interview. RESULTS PA increased from 19.7 (SD 47.9) minutes per week at baseline to 46.9 (SD 66.2) minutes per week at 6 months in the enhanced arm versus 20.6 (SD 42.7) minutes per week to 42.9 (SD 78.2) minutes per week in the original arm (P=.78). Overall, 30% (31/103) of the enhanced group met aerobic PA guidelines at 6 months, compared to 21% (19/92) of the original group (odds ratio [OR] 1.75, 95% CI 0.87-3.55). Baseline PA (inactive vs low active) moderated treatment effects on PA. For inactive participants, there were no group differences at 6 months (b=7.1; SE 22.8; P=.75), while low-active participants increased more in enhanced than original (b=72.5; SE 27.9; P=.01). For low-active participants, 45% (46/103) of the enhanced group met PA guidelines at 6 months, versus 20% (18/92) of the original arm (OR 3.29, 95% CI 1.05-11.31). For inactive participants, there were no group differences (25/103, 24% vs n=19/92, 21% for enhanced vs original, respectively; OR 1.28, 95% CI 0.54-3.06). CONCLUSIONS Intervention effects were conditional on baseline PA. For low-active Latina women, the enhanced intervention was more effective at increasing PA. Additional tailored intervention enhancements may be necessary to increase PA for inactive Latina women. TRIAL REGISTRATION ClinicalTrials.gov NCT03491592; https://www.clinicaltrials.gov/study/NCT03491592. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-022-06575-4.
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Affiliation(s)
- Lauren Connell Bohlen
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Shira I Dunsiger
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Tayla von Ash
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Britta A Larsen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Dori Pekmezi
- Department of Health Behavior, The University of Alabama at Birmingham School of Public Health, Birmingham, AL, United States
| | - Becky Marquez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Tanya J Benitez
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Andrea Mendoza-Vasconez
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| | - David M Williams
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Bess H Marcus
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
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11
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Ryman C, Warnicke C, Hugosson S, Zakrisson AB, Dahlberg K. Health literacy in cancer care: A systematic review. Eur J Oncol Nurs 2024; 70:102582. [PMID: 38608377 DOI: 10.1016/j.ejon.2024.102582] [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: 12/22/2023] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE Health literacy (HL) is a set of knowledge and skills that enables individuals to interpret and act upon health information, which is essential for health equity. There is a growing body of evidence in the field of HL in cancer care but there is, to our knowledge, no systematic review that explores the association between sociodemographic factors and HL among patients with cancer. The aim of this study was therefore to conduct a systematic review of the existing literature that assesses HL levels and the relationship between HL and sociodemographic factors in an adult cancer population. METHODS This is a systematic review and its protocol was registered in PROSPERO (ID: CRD42021164071). The study was conducted in accordance with the PRISMA statement. The literature search, from December 2009 to September 2023, was made in six databases, AMED, CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science Core Collection. RESULTS Fifteen studies were included in the review. The included studies used nine different measurement tools for assessing HL. In the included studies between 11.9 % and 86 % had limited HL. We identified a relationship between limited HL and annual income, education level, ethnicity, living in rural areas and multiple comorbidities. CONCLUSION The results indicate that limited HL is prevalent in the cancer population and should be acknowledge in everyday practice to meet health equity. Our awareness about sociodemographic factors and its association with HL, may enhance adherence to cancer treatment and quality of life, and lower physical and emotional distress.
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Affiliation(s)
- C Ryman
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - C Warnicke
- Department of University Health Care Research Center, Faculty of Humanities and Social Sciences, Örebro, Sweden
| | - S Hugosson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - A-B Zakrisson
- Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - K Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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12
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Csima M, Podráczky J, Keresztes V, Soós E, Fináncz J. The Role of Parental Health Literacy in Establishing Health-Promoting Habits in Early Childhood. CHILDREN (BASEL, SWITZERLAND) 2024; 11:576. [PMID: 38790571 PMCID: PMC11119361 DOI: 10.3390/children11050576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/14/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
In early childhood, children are extremely susceptible to the acquisition of habits and the establishment of health-promoting habits. Therefore, the patterns, routines, and rules transmitted and expected by the adults surrounding the child are of paramount importance and can correlate with the level of their health literacy. Our cross-sectional, quantitative, exploratory study aimed to examine the relationships between parental health literacy and preschool children's health-related habits, using simple, non-random sampling (n = 598). In addition to the sociodemographic characteristics, the measuring tool we compiled included the standardized European Health Literacy Survey Questionnaire (HLS-EU-Q16), as well as a set of questions containing 30 statements suitable for exploring children's habit systems. The health literacy of the parents involved in our study proved to be more favorable than that of the general population. Regarding children's habit systems, we found significant differences in several areas by age group (p < 0.05) and gender (p < 0.05). The levels of parental health literacy (0.003 ≤ p ≤ 0.048) and parents' education (p < 0.05) show a correlation with the children's health-related habit systems: the indicators of children with parents who have a higher level of health literacy and a higher level of education are more favorable in terms of established habits. In the long term, the formation of health-promoting habits may facilitate the internalization of favorable health behavior motives for the future, contributing to the establishment of positive physical, mental, and social health in adulthood.
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Affiliation(s)
- Melinda Csima
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (J.P.); (J.F.)
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
| | - Judit Podráczky
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (J.P.); (J.F.)
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
| | - Viktória Keresztes
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
- Education and Society Doctoral School of Education, University of Pécs, H-7624 Pécs, Hungary
| | - Evelin Soós
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
- Education and Society Doctoral School of Education, University of Pécs, H-7624 Pécs, Hungary
| | - Judit Fináncz
- Institute of Education, Hungarian University of Agriculture and Life Sciences, H-7400 Kaposvár, Hungary; (J.P.); (J.F.)
- MTA-MATE Early Childhood Research Group, H-7400 Kaposvár, Hungary; (V.K.); (E.S.)
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13
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Han YY, Gutwein A, Apter A, Celedón JC. Health literacy and asthma: An update. J Allergy Clin Immunol 2024; 153:1241-1251. [PMID: 38135010 PMCID: PMC11070295 DOI: 10.1016/j.jaci.2023.12.007] [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: 10/10/2023] [Revised: 12/09/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
The US Department of Health and Human Services has defined health literacy (HL) as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Structural and social determinants of health lead to low HL in approximately 36% of adults in the United States, where this condition is most prevalent in racial and ethnic minorities, economically disadvantaged communities, and immigrants with limited English proficiency. In turn, low HL can worsen asthma outcomes through direct effects (eg, nonadherence to or incorrect use of medications) and indirect effects (eg, an unhealthy diet leading to obesity, a risk factor for asthma morbidity). The purpose of this update is to examine evidence from studies on low HL and health and asthma outcomes published in the last 12 years, identify approaches to improve HL and reduce health disparities in asthma, and discuss future directions for research in this area under the conceptual framework of a socioecological model that illustrates the multifactorial and interconnected complexity of this public health issue at different levels.
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Affiliation(s)
- Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Amanda Gutwein
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Andrea Apter
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pa
| | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa.
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14
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Nishio Lucar AG, Patel A, Mehta S, Yadav A, Doshi M, Urbanski MA, Concepcion BP, Singh N, Sanders ML, Basu A, Harding JL, Rossi A, Adebiyi OO, Samaniego-Picota M, Woodside KJ, Parsons RF. Expanding the access to kidney transplantation: Strategies for kidney transplant programs. Clin Transplant 2024; 38:e15315. [PMID: 38686443 DOI: 10.1111/ctr.15315] [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: 11/14/2023] [Revised: 03/05/2024] [Accepted: 03/28/2024] [Indexed: 05/02/2024]
Abstract
Kidney transplantation is the most successful kidney replacement therapy available, resulting in improved recipient survival and societal cost savings. Yet, nearly 70 years after the first successful kidney transplant, there are still numerous barriers and untapped opportunities that constrain the access to transplant. The literature describing these barriers is extensive, but the practices and processes to solve them are less clear. Solutions must be multidisciplinary and be the product of strong partnerships among patients, their networks, health care providers, and transplant programs. Transparency in the referral, evaluation, and listing process as well as organ selection are paramount to build such partnerships. Providing early culturally congruent and patient-centered education as well as maximizing the use of local resources to facilitate the transplant work up should be prioritized. Every opportunity to facilitate pre-emptive kidney transplantation and living donation must be taken. Promoting the use of telemedicine and kidney paired donation as standards of care can positively impact the work up completion and maximize the chances of a living donor kidney transplant.
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Affiliation(s)
- Angie G Nishio Lucar
- Department of Medicine, University of Virginia Health, Charlottesville, Virginia, USA
| | - Ankita Patel
- Recanati-Miller Transplantation Institute, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Shikha Mehta
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anju Yadav
- Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mona Doshi
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan A Urbanski
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Neeraj Singh
- Willis Knighton Health System, Shreveport, Louisiana, USA
| | - M Lee Sanders
- Department of Internal Medicine, Division of Nephrology, Organ Transplant Center, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Arpita Basu
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jessica L Harding
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ana Rossi
- Piedmont Transplant Institute, Atlanta, Georgia, USA
| | - Oluwafisayo O Adebiyi
- Department of Medicine, Indiana University Health Hospital, Indianapolis, Indiana, USA
| | | | | | - Ronald F Parsons
- Department of Surgery, University of Pennsylvannia, Philadelphia, Pennsylvania, USA
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15
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Hawley CE, Wagner C, Venegas MD, Genovese N, Triantafylidis LK, McCullough MB, Beizer JL, Hung WW, Moo LR. Connecting the disconnected: Leveraging an in-home team member for video visits for older adults. J Am Geriatr Soc 2024; 72:1408-1419. [PMID: 37960887 PMCID: PMC11188997 DOI: 10.1111/jgs.18663] [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: 07/07/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Older adults are interested and able to complete video visits, but often require coaching and practice to succeed. Data show a widening digital divide between older and younger adults using video visits. We conducted a qualitative feasibility study to investigate these gaps via ethnographic methods, including a team member in older participants' homes. METHODS This ethnographic feasibility study included a virtual medication reconciliation visit with a clinical pharmacist for Veterans aged 65 and older taking 5 or more medications. An in-home study team member joined the participant and recorded observations in structured fieldnotes derived from the Updated Consolidated Framework for Implementation Research and Age-Friendly Health Systems. Fieldnotes included behind-the-scenes facilitators, barriers, and solutions to challenges before and during the visits. We conducted a thematic analysis of these observations and matched themes to implementation solutions from the Expert Recommendations for Implementing Change. RESULTS Twenty participants completed a video visit. Participants were 74 years old (range 68-80) taking 12 daily medications (range 7-24). Challenges occurred in half of the visits and took the in-home team member and/or pharmacist an average of 10 minutes to troubleshoot. Challenges included notable new findings, such as that half of the participants required technology assistance for challenges that would not have been able to be solved by the pharmacist virtually. Furthermore, although many participants had a device or had used video visits before, some did not have a single device with video, audio, Internet, and access to their email username and password. CONCLUSIONS Clinicians may apply these evidence-based implementation solutions to their approach to video visits with older adults, including having a team member join the visit before the clinician, involving tech-savvy family members, ensuring the device works with the visit platform ahead of time, and creating a troubleshooting guide from our common challenges.
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Affiliation(s)
- Chelsea E. Hawley
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Medicine, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Caroline Wagner
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Pharmacy Department, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Maria D. Venegas
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Medicine, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, Massachusetts, USA
| | - Nicole Genovese
- Pain Management, Opioid Safety, and Prescription Drug Monitoring Program, Veterans Affairs New Jersey Healthcare System, East Orange, New Jersey, USA
| | | | - Megan B. McCullough
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Judith L. Beizer
- College of Pharmacy and Health Sciences, St. John’s University, New York, New York, USA
| | - William W. Hung
- Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lauren R. Moo
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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16
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Smith B, Smith BP, Hollis RH, Jones BA, Shao C, Katta M, Wood L, Bateman LB, Oates GR, Chu DI. Development of a comprehensive survey to assess key socioecological determinants of health. Surgery 2024; 175:991-999. [PMID: 38158309 PMCID: PMC10947950 DOI: 10.1016/j.surg.2023.11.011] [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: 06/20/2023] [Revised: 10/22/2023] [Accepted: 11/07/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Although disparities in surgical outcomes are well-documented, our understanding of how socioecological factors drive these disparities remains limited. Comprehensive and efficient assessment tools are needed. This study's objective was to develop and assess the acceptability and feasibility of a comprehensive tool evaluating socioecological determinants of health in patients requiring colorectal surgery. METHODS In the first phase, a comprehensive socioecological determinant of health assessment tool was developed. A review of validated socioecological health evaluation instruments was conducted, and a 2-step modified Delphi method addressed the length, clarity, appropriateness, and redundancy of each instrument. A comprehensive tool was then finalized. In the second phase, the tool was tested for acceptability and feasibility in adult patients requiring colorectal surgery using a theory-guided framework at 3 Alabama hospitals. Relationships between survey responses and measures of acceptability and feasibility were evaluated using results from initial pilot tests of the survey. RESULTS In Phase 1, a modified Delphi process led to the development of a comprehensive tool that included 31 socioecological determinants of health (88 questions). Results of acceptability and feasibility were globally positive (>65%) for all domains. Overall, 83% of participants agreed that others would have no trouble completing the survey, 90.4% of respondents reported the survey was not burdensome, 97.6% of patients reported having enough time to complete the survey, and 80.9% agreed the survey was well-integrated into their appointment. CONCLUSION An 88-item assessment tool measuring 31 socioecological determinants of health was developed with high acceptability and feasibility for patients who required colorectal surgery. This work aids in the development of research needed to understand and address surgical disparities.
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Affiliation(s)
- Baker Smith
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Burkely P Smith
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Robert H Hollis
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Bayley A Jones
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Connie Shao
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Meghna Katta
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Lauren Wood
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL
| | - Lori B Bateman
- Division of Preventive Medicine and O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Gabriela R Oates
- University of Alabama at Birmingham, Department of Pediatrics, Birmingham, AL
| | - Daniel I Chu
- University of Alabama at Birmingham, Department of Surgery, Division of Gastrointestinal Surgery, Birmingham, AL.
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Lin Y, Chen M, Lee SY, Yi SH, Chen Y, Tandoc EC, Goh ZH, Salmon CT. Understanding the Effects of News-Finds-Me Perception on Health Knowledge and Information Seeking During Public Health Crises. HEALTH COMMUNICATION 2024; 39:352-362. [PMID: 36628501 DOI: 10.1080/10410236.2023.2165750] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
News-finds-me (NFM) perception is a belief that, in the era of social media, individuals can remain adequately well-informed about current events even if they do not actively seek news. While it has been examined in the context of general and political news, NFM perception has not been explored in the context of other genres of news. Through an online survey involving 1,001 Singaporeans, with the Planned Risk Information Seeking Model, this study examines how NFM perception is related to information seeking and COVID-19 knowledge. An issue-specific NFM perception was also proposed and tested in order to determine whether NFM perception and its associated effects differ when operationalized as general news exposure or issue-specific news relating to COVID-19. The negative relationship between general NFM perception and knowledge and the mediating role of information seeking on social media in this relationship are detected. It is also found that when the NFM perception is issue-specific (i.e. COVID-NFM perception), information insufficiency and intentions of information seeking on social media fully mediated the relationship between NFM perception and knowledge. Theoretical and practical implications are discussed.
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Affiliation(s)
- Yumin Lin
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Minyi Chen
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Si Yu Lee
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Sue Hyon Yi
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Yingting Chen
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Edson C Tandoc
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Zhang Hao Goh
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
| | - Charles T Salmon
- Wee Kim Wee School of Communication and Information, Nanyang Technological University
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Rivera E, Tintle N, Townsend RR, Rahman M, Schrauben SJ, Clark-Cutaia MN, Hannan M, Lash JP, Wolfrum K, Missikpode C, Hirschman KB. Characterization of CKD illness representation profiles using patient-level factors. J Nephrol 2024; 37:671-679. [PMID: 38727894 DOI: 10.1007/s40620-024-01955-2] [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: 11/07/2023] [Accepted: 04/01/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Illness perceptions are the unique perspective individuals have on their illness, based on their context and experiences, and are associated with patient outcomes including coping and adherence. The purpose of this study was to explore characteristics that may be driving membership in illness perceptions cluster groups for adults with chronic kidney disease (CKD). METHODS This study was conducted within the multicenter longitudinal Chronic Renal Insufficiency Cohort (CRIC) Study. Cross-sectional data were collected and combined with CRIC data. Illness perceptions were measured using the Revised Illness Perception Questionnaire. Clustering analysis was conducted in R, and bivariate analysis including linear regression was performed in STATA 16. RESULTS The sample (n = 197) had a mean age of 68, was 52% women, 53% non-White, and mean estimated glomerular filtration rate (eGFR) 56 ml/min/1.73 m2. Three cluster groups were identified, labeled as "Disengaged" (n = 20), "Well-Resourced" (n = 108), and "Distressed" (n = 69). The "Disengaged" group was characterized by low CKD knowledge, many recent hospitalization days, and the lowest perceived CKD burden. The "Well-Resourced" group was characterized by the highest levels of education, CKD knowledge, optimism, and medication adherence. The "Distressed" group was characterized by the highest levels of depression scores, comorbidity burden, CKD burden, CKD symptoms, and lowest optimism. Group membership significantly predicted the number of hospitalization days in adjusted analyses. CONCLUSIONS Illness perceptions groups are associated with number of hospitalization days but are independent of many patient characteristics. Illness perceptions data could be used to tailor care for specific patients at risk for poor health outcomes.
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Affiliation(s)
| | | | | | | | | | | | - Mary Hannan
- University of Illinois Chicago, Chicago, IL, USA
| | - James P Lash
- University of Illinois Chicago, Chicago, IL, USA
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Reagan L, Laguerre R, Todd S, Gallagher C. The Feasibility and Acceptability of a Diabetes Survival Skills Intervention for Persons Transitioning from Prison to the Community. J Racial Ethn Health Disparities 2024; 11:1014-1023. [PMID: 37154888 PMCID: PMC10166023 DOI: 10.1007/s40615-023-01581-x] [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: 11/01/2022] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
Community evidenced-based diabetes self-management education (DSME) models have not been examined for feasibility, acceptability, or effectiveness among persons transitioning from prison to the community to independent diabetes self-management (DSM). In a non-equivalent control group design with repeated measures, we examined the feasibility, acceptability, and preliminary effect of a 6-week, 1-h per week Diabetes Survival Skills (DSS) intervention on diabetes knowledge, distress, self-efficacy, and outcome expectancy for transitioning incarcerated males. Of the 92 participants (84% T2D, 83% using insulin, 40% Black, 20% White, 30% Latino, 66% high school or less, mean age 47.3 years, 84% length of incarceration ≤4 years ), 41 completed the study (22 control/19 intervention [TX]). One-way repeated measures ANOVAs revealed significant changes in diabetes knowledge within each group (C, p = .002; TX, p = .027) at all time points; however, a two-way repeated measures ANOVA showed no differences between groups. Additionally, both groups showed improvement in diabetes-related distress and outcome expectancy with the treatment group experiencing greater and sustained improvement at the 12-week time point. Analysis of focus group data (Krippendorf) revealed acceptance of and enthusiasm for the DSS training and low literacy education materials, the need for skill demonstration, and ongoing support throughout incarceration and before release. Our results highlight the complexity of working with incarcerated populations. After most of the sessions, we observed some information sharing between the intervention and the control groups on what they did in their respective sessions. Due to high attrition, the power to detect effects was limited. Yet, results suggest that the intervention is feasible and acceptable with an increased sample size and refined recruitment procedure. NCT05510531, 8/19/2022, retrospectively, registered.
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Affiliation(s)
- Louise Reagan
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, U-4026, USA.
| | - Rick Laguerre
- Department of Psychological Sciences, University of Connecticut, Storrs, USA
- Department of Psychology, Montclair State University, Montclair, NJ, USA
| | - Sarah Todd
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT, U-4026, USA
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20
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Wood I, Song R, Zhang Y, Jacobsen E, Hughes T, Chang CCH, Ganguli M. Ethnoracial Identity and Cognitive Impairment: A Community Study. Alzheimer Dis Assoc Disord 2024; 38:152-159. [PMID: 38748688 DOI: 10.1097/wad.0000000000000617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/02/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Identifying potentially modifiable risk factors associated with MCI in different ethnoracial groups could reduce MCI burden and health inequity in the population. METHODS Among 2845 adults aged 65+ years, we investigated potential risk exposures including education, physical and mental health, lifestyle, and sensory function, and their cross-sectional associations with MCI. We compared proportions of exposures between Black and White participants and explored relationships among race, MCI, and exposures. Logistic regression modeled MCI as a function of each exposure in the overall sample adjusting for age, sex, educational level, and race, and investigating race*exposure interactions. RESULTS Compared with White participants, Black participants had greater odds of MCI (OR 1.53; 95% CI, 1.13 to 2.06) and were more likely to report depressive symptoms, diabetes, and stroke, to have high blood pressure and BMI, and to be APOE - 4 carriers. Exposures associated with higher odds of MCI were diabetes, stroke, lifetime smoking, sleep disturbances, social isolation, loneliness, depression and anxiety symptoms, and vision and hearing loss. There were no significant interactions between race and any exposure. CONCLUSIONS Black participants had 53% higher odds of MCI adjusting for age, sex, and education. The same exposures were associated with MCI in Black and White participants.
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Affiliation(s)
- Isabella Wood
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Ruopu Song
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Yingjin Zhang
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Tiffany Hughes
- Master of Public Health Program, Midwestern University College of Graduate Studies, Glendale, AZ
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA
- Department of Medicine
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Department of Neurology, University of Pittsburgh School of Medicine
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
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21
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Baby B, McKinnon A, Patterson K, Patel H, Sharma R, Carter C, Griffin R, Burns C, Chang F, Guilcher SJ, Lee L, Fadaleh SA, Patel T. Tools to measure barriers to medication management capacity in older adults: a scoping review. BMC Geriatr 2024; 24:285. [PMID: 38532328 PMCID: PMC10967066 DOI: 10.1186/s12877-024-04893-7] [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: 09/18/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Medication management capacity is a crucial component of medication adherence, particularly among older adults. Various factors, including physical abilities, cognitive functions, sensory capabilities, motivational, and environmental factors, influence older adults' ability to manage medications. It is, therefore, crucial to identify appropriate tools that allow clinicians to determine which factors may impact medication management capacity and, consequently, nonadherence to medications. PURPOSE 1)To identify tools that measure physical, cognitive, sensory (vision, hearing, touch), motivational, and environmental barriers to medication self-management in older adults, and 2) to understand the extent to which these tools assess various barriers. METHODS The scoping review was conducted using Arksey and O'Malley's scoping review framework and the PRISMA Extension for Scoping Reviews checklist. In June 2022, the relevant literature was identified by searching PubMed (MEDLINE), Ovid Embase, Ovid IPA, EBSCOhost CINAHL, APA PsycINFO, and Scopus. RESULTS AND DISCUSSION In total, 7235 studies were identified. Following the removal of duplicates, 4607 articles were screened by title and abstract, of which 4253 did not meet the inclusion criteria. Three reviewers reviewed the full texts of the remaining 354 articles; among them, 41 articles, 4 theses and 1 conference abstract met the inclusion criteria. From the included studies, 44 tools were identified that measured a combination of physical, cognitive, sensory, motivational, and environmental barriers (n=19) or only cognition (n=13), vision (n=5), environmental factors (n=3), auditory (n=1), and motivational factors (n=1). The review also examined the psychometric properties of the identified tools and found that most of them had reported validity and reliability data. Several tools have demonstrated promise in assessing a combination of barriers with validity and reliability. These tools include the Self-Medication Assessment Tool (SMAT), ManageMed Screening (MMS), Self-Medication Risk Assessment Tool (RAT), HOME-Rx revised, and Medication Management Ability Assessment (MMAA). CONCLUSION This scoping review identified 44 validated tools to measure various challenges that older adults encounter with medication management. However, no tool measures all five barriers (physical, cognitive, sensory, motivational, and environmental) to medication-taking at home. Therefore, utilizing a combination of tools would be most appropriate to measure these different aspects comprehensively. Further research is needed to develop a new comprehensive tool that simultaneously measures various barriers to medication self-management.
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Affiliation(s)
- Bincy Baby
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | | | | | - Hawa Patel
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Rishabh Sharma
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Caitlin Carter
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Ryan Griffin
- National Research Council Canada, Ottawa, ON, Canada
| | - Catherine Burns
- Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Feng Chang
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Sara Jt Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Linda Lee
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Sara Abu Fadaleh
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada.
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22
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Sutthiworapon S, Vichitkunakorn P, Choomalee K, Ngamchaliew P. Effect of online infographics for enhancing health literacy among patients with type 2 diabetes in primary care unit during the COVID-19 pandemic: a randomized controlled trial. BMC PRIMARY CARE 2024; 25:87. [PMID: 38491433 PMCID: PMC10941353 DOI: 10.1186/s12875-024-02335-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Health literacy (HL) in patients with type 2 diabetes mellitus (DM) can help control disease and prevent complications. However, most patients with type 2 DM have inadequate HL; therefore, their HL must be further improved. This study aimed to determine the effects of online infographics on improving HL among patients with type 2 DM. METHODS This randomized controlled trial was conducted from July 2022 to September 2022, at the primary care unit of Songklanagarind Hospital, Thailand; 30 patients with type 2 DM were randomly assigned to the experimental (n = 15; three types of infographics) and control (n = 15; three types of pamphlets) groups. Infographics and pamphlets were distributed weekly via social media platforms. The S-TOFHLA Thai version and Thai-FCCHL were used to evaluate HL. Chi-square, Fisher's exact, Wilcoxon rank-sum, t-test, paired t-test, and McNemar's chi-square tests were used. RESULTS The median age of 30 participants was 56 years. The mean duration of DM was 9.6 years, with a median HbA1c level of 7.5 mg%. Most participants (80%) had adequate HL in S-TOFHLA, whereas 63.3% had adequate HL in FCCHL. All participants in the infographic group who had inadequate HL in the S-TOFHLA pre-test achieved adequate HL. Meanwhile, only 50% of patients in the pamphlet group achieved adequate HL. Regarding FCCHL, 50% of patients in the infographic group and 60% in the pamphlet group who had inadequate HL in the pretest achieved adequate HL. However, no statistical significance in achieving adequate HL was found in either group. The mean differences (SD) in S-TOFHLA between before and after intervention were 12.53 (8.77; p = 0.0007) and 10.13 (9.88; p = 0.001) in the infographic and pamphlet groups, respectively. Regarding FCCHL, the mean differences (SD) were 3.47 (4.29) and 3.20 (2.91) in the infographic group (p = 0.003) and pamphlet (p = 0.002) groups, respectively. No statistical significance in the mean difference was found between both groups. CONCLUSIONS Novel online infographics and pamphlets did not significantly differ in achieving adequate HL among patients with type 2 DM who should receive health education about disease control and complication prevention. However, both interventions can increase and maintain HL levels. Online educational media can be appropriate during the COVID-19 pandemic. Nevertheless, further larger-scale studies should be performed to examine the impact of other DM educational media on HL promotion. TRIAL REGISTRATION The Thai Clinical Trials Registry (TCTR) with registry ID TCTR20230425001 (date of registration 25/04/2023).
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Affiliation(s)
- Suchada Sutthiworapon
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Polathep Vichitkunakorn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Kittisakdi Choomalee
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Pitchayanont Ngamchaliew
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
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23
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Yuen E, Wilson C, Adams J, Kangutkar T, Livingston PM, White VM, Ockerby C, Hutchinson A. Health literacy interventions for informal caregivers: systematic review. BMJ Support Palliat Care 2024:spcare-2023-004513. [PMID: 38326015 DOI: 10.1136/spcare-2023-004513] [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: 07/24/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
AIM The aim of the systematic review was to identify conceptual models and interventions designed to improve health literacy in caregivers of adults with a chronic disease/disability. METHODS MEDLINE, CINAHL, PsycINFO and Embase were searched for relevant literature. Articles were included if they focused on adults who provided informal care to someone aged 18+ with a chronic disease/disability. Quantitative studies were included if they reported an intervention designed to improve caregiver health literacy (CHL) and assessed outcomes using a validated measure of health literacy. Qualitative and mixed method studies were included if they described a conceptual model or framework of CHL or developed/assessed the feasibility of an intervention. Study quality was appraised using the Mixed Methods Assessment Tool. RESULTS Eleven studies were included. Five studies used pre-post design to assess outcomes of an intervention; four described intervention development and/or pilot testing; two described conceptual models. Two of five studies reported pre-post intervention improvements in CHL; one reported an improvement in one of nine health literacy domains; two reported no improvements following intervention. Interventions predominantly aimed to improve: caregiver understanding of the disease, treatment and potential outcomes, day-to-day care, self-care and health provider engagement. Few interventions targeted broader interpersonal and health service factors identified as influencing CHL. DISCUSSION Evidence on the development and assessment of comprehensive CHL interventions is scarce. Recommendations include the development of interventions that are guided by a CHL framework to ensure they address individual, interpersonal and health service/provider factors that influence CHL.
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Affiliation(s)
- Eva Yuen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Monash Health, Clayton, Victoria, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton-John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Joanne Adams
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University, Bendigo, Victoria, Australia
| | - Tejashree Kangutkar
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Alison Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
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24
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Jones PR, Santiago J, Pearsall BM, Chu DM, Wolff C, Kearsley A. A survey on perceived medication guide reading and comprehension ease among US adults. Health Promot Int 2024; 39:daad190. [PMID: 38386901 DOI: 10.1093/heapro/daad190] [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] [Indexed: 02/24/2024] Open
Abstract
Medication guides (MGs) provide patients with important information about certain prescription drugs to help them take these drugs safely. We surveyed US residents about their perceptions of MG readability and understandability. We randomly sampled 5204 US residents (age 18+) from Ipsos's KnowledgePanel to complete a two-part survey. Only respondents who reported receiving an MG with their prescription drugs (n = 3852) completed part 2, which included two key items: How easy to [(1)read/(2)understand] are the MGs that you have received from a pharmacy along with your prescription medicines? (1 = Very easy, 5 = Very difficult; reverse-coded). Health literacy (HL) and demographic data were also collected. After weighting our data, we found that 85% of respondents who reported receiving an MG perceived this information as 'very easy' (27.3%), 'somewhat easy' (28.3%) or 'about average' (29.3%) to read. Eighty-seven percent of respondents who reported receiving an MG perceived it as 'very easy' (27.6%), 'somewhat easy' (30.2%) or 'about average' (29.5%) to understand. ANOVAs revealed higher average perceived MG reading and comprehension ease scores among respondents presumed to have adequate versus inadequate HL (ps ≤ 0.0006). Younger or less-educated respondents and non-Hispanic Blacks perceived MGs as easier to read and understand, on average, than their counterparts (ps ≤ 0.0001). Many of these relationships remained intact in models predicting perceived MG reading and comprehension ease (ps ≤ 0.001). Adjusted R2 values across models were small, however (≤0.06). Our findings suggest most US residents (18+) who received MGs perceived them to be 'about average' to 'very easy' to read and understand.
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Affiliation(s)
- Paul R Jones
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Jonas Santiago
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Bryon M Pearsall
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Dan-My Chu
- Division of Medical Policy Programs, Office of Medical Policy Initiatives, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Carolyn Wolff
- Office of Economics and Analysis, Office of Policy, Legislation, and International Affairs, Office of the Commissioner, FDA, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Aaron Kearsley
- Office of Economics and Analysis, Office of Policy, Legislation, and International Affairs, Office of the Commissioner, FDA, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
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25
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McKenna VB, Gilheaney Ó. Health literacy interventions in adult speech and language therapy: A scoping review. Health Expect 2024; 27:e13878. [PMID: 37746677 PMCID: PMC10726155 DOI: 10.1111/hex.13878] [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: 07/06/2023] [Revised: 08/29/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Reduced health literacy can negatively impact care seeking, satisfaction with care and overall health outcomes. These issues are particularly common among people living with communication difficulties who are seeking care from speech and language therapists (SLTs). As such, the SLT must be aware of and sensitive to health literacy needs within their clinical practice, proactively adapting materials and resources to the health literacy needs of their patients. Despite this required core competency, little is known about the health literacy interventions used by SLTs when working with adult patients, and as such, there is limited and unclear guidance for the practicing clinician, leading to potentially suboptimal care delivery. OBJECTIVES To explore the characteristics of health literacy interventions discussed in the literature for use by SLTs with adult patients. SEARCH STRATEGY PubMed, CINAHL, Web of Science and The Cochrane Database of Systematic Reviews were searched. Conference proceedings of the annual scientific meetings of the European Society for Swallowing Disorders and the Dysphagia Research Society were also searched. Grey literature was searched via the Open Grey database and, hand-searches of reference lists from included studies were conducted by both authors. INCLUSION CRITERIA Published and unpublished research investigating health literacy interventions provided by qualified SLTs providing care to adult patients in any setting for any speech and language related concerns. No language, geographic, study design or publication date limitations applied. Eligible participants in these studies were classified as: (1) patients and (2) professionals. DATA EXTRACTION AND SYNTHESIS Data were charted in accordance with guidelines from the Joanna Briggs Institute and the PRISMA ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) independently by both authors. MAIN RESULTS A total of 1112 potentially eligible studies were identified in the initial search, with 15 studies ultimately included in the synthesis. Study design and quality varied significantly. Most explored basic functional health literacy or narratively described core components of health literacy, which an SLT should understand, without employing an investigative research design. DISCUSSION Limited research has been conducted on the use of health literacy interventions within adult speech and language therapy practices. This finding is significant as SLTs regularly work with people living with communication problems, and therefore, addressing health literacy should be a core tenet of service delivery. CONCLUSION There is a need for valid, reliable and rigorous investigations of health literacy interventions within speech and language therapy to ultimately improve future patient access to and benefit from the care provided. PATIENT OR PUBLIC CONTRIBUTION Patient public involvement in review studies is an emerging area. Due to resource issues, it was not possible to include this element in this study.
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Affiliation(s)
- Verna B. McKenna
- Discipline of Health Promotion, School of Health SciencesUniversity of GalwayGalwayIreland
| | - Órla Gilheaney
- School of Linguistic, Speech & Communication SciencesTrinity College DublinDublinIreland
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26
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Hezer B, Massey EK, Reinders ME, Tielen M, van de Wetering J, Hesselink DA, van den Hoogen MW. Telemedicine for Kidney Transplant Recipients: Current State, Advantages, and Barriers. Transplantation 2024; 108:409-420. [PMID: 37264512 PMCID: PMC10798592 DOI: 10.1097/tp.0000000000004660] [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: 03/06/2022] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 06/03/2023]
Abstract
Telemedicine is defined as the use of electronic information and communication technologies to provide and support healthcare at a distance. In kidney transplantation, telemedicine is limited but is expected to grow markedly in the coming y. Current experience shows that it is possible to provide transplant care at a distance, with benefits for patients like reduced travel time and costs, better adherence to medication and appointment visits, more self-sufficiency, and more reliable blood pressure values. However, multiple barriers in different areas need to be overcome for successful implementation, such as recipients' preferences, willingness, skills, and digital literacy. Moreover, in many countries, limited digital infrastructure, legislation, local policy, costs, and reimbursement issues could be barriers to the implementation of telemedicine. Finally, telemedicine changes the way transplant professionals provide care, and this transition needs time, training, willingness, and acceptance. This review discusses the current state and benefits of telemedicine in kidney transplantation, with the aforementioned barriers, and provides an overview of future directions on telemedicine in kidney transplantation.
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Affiliation(s)
- Bartu Hezer
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
| | - Emma K. Massey
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
| | - Marlies E.J. Reinders
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
| | - Mirjam Tielen
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
| | - Jacqueline van de Wetering
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
| | - Dennis A. Hesselink
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
| | - Martijn W.F. van den Hoogen
- Erasmus MC Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, the Netherlands
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Al-Bitar KM, Garcia JM, Han S, Guentsch A. Association between periodontal health status and quality of life: a cross-sectional study. FRONTIERS IN ORAL HEALTH 2024; 5:1346814. [PMID: 38333564 PMCID: PMC10850382 DOI: 10.3389/froh.2024.1346814] [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: 11/30/2023] [Accepted: 01/03/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Attachment loss due to periodontal diseases is associated with functional limitations as well as physical pain and psychological discomfort, which may lead to a reduced quality of life. The purpose of this study is to determine if the oral health status, specifically the periodontal status, influences oral health-related quality of life. Materials and methods Survey data were collected in a US dental school clinical setting in a cross-sectional study. Quality of life related to oral health was assessed with the Oral Health Impact Profile-49 (OHIP-49). In addition, DMFT index, periodontal status, and health literacy scores (dental and medical health literacy) were recorded, and the data of n = 97 subjects were statistically analyzed. Results The DMFT index of the study population was 14.98 ± 6.21 (D: 4.72 ± 4.77; M: 3.19 ± 3.46; F: 7.12 ± 4.62). Of the subjects, 44% were identified as periodontitis cases. These periodontitis cases demonstrated significantly higher OHIP-49 scores (66.93 ± 30.72) than subjects without signs of periodontal diseases (NP) (32.40 ± 19.27, p < 0.05). There was also a significant difference between NP patients and patients with gingivitis (66.24 ± 46.12, p < 0.05). It was found that there was a statistically significant difference between Stage 3 (severe) periodontitis and periodontal health (p = 0.003). Pearson correlations were completed, and positive relationships were found with OHIP-49 and DMFT (0.206, p < 0.05), and periodontal risk self-assessment (0.237, p < 0.05). Age [odds ratio (OR) 4.46], smoking (OR 2.67), and the presence of mobile teeth (OR 2.96) are associated with periodontitis. Conclusions Periodontal diseases may negatively impact the oral health-related quality of life. Patients suffering from periodontitis also showed more missing teeth, which might influence function. Age and smoking are associated with a higher prevalence of periodontitis. A good general health literacy was no guarantee for having an adequate oral literacy.
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Affiliation(s)
- Kinan M. Al-Bitar
- Private Practitioner, Waukesha, WI, United States
- Department of Surgical and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, WI, United States
| | | | - Shengtong Han
- Department of General Dental Sciences, Marquette University School of Dentistry, Milwaukee, WI, United States
| | - Arndt Guentsch
- Department of Surgical and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, WI, United States
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Bai L, Tang H, Wang M. Dietary behaviors of rural residents in northeastern China: implications for designing intervention information and targeting high-risk population. Front Public Health 2024; 12:1239449. [PMID: 38389950 PMCID: PMC10883159 DOI: 10.3389/fpubh.2024.1239449] [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: 06/13/2023] [Accepted: 01/02/2024] [Indexed: 02/24/2024] Open
Abstract
Background Dietary behavior is a pivotal modifiable determinant in reducing the occurrence of obesity/overweight and chronic non-communicable diseases. Improving the dietary behavior of rural residents in China is imminent due to the poor performance of their dietary behavior. Nutrition knowledge and health literacy are considered as elements that are linked intimately to healthy dietary behaviors but lack research in the Chinese setting. Purpose The study is designed to explore the relationship between nutritional knowledge, health literacy and dietary behaviors and to analyze the performance under different demographic characteristics. Methods A face-to-face survey of 400 rural residents on their nutrition knowledge, functional health literacy and dietary intake of five food categories consisting of 32 items was conducted based on a validated questionnaire. Descriptive analysis, difference test including ANOVA, t-test and non-parametric test, and multivariate linear regression were used for data analysis. Results The results indicate that declarative nutrition knowledge, individuals' information application capacity, and dietary behaviors, especially the intake of fruits, dairy and beans, and vegetable are not ideal and requires improvement. Male, elder, low-income, unmarried, and low-education populations performed significantly worse and were the high-risk group. Procedural nutrition knowledge, information access capacity, information understanding capacity, and information application capacity have remarkable effects on better dietary behavior. Conclusion This study provides evidence-based guidance for prioritizing information and populations for healthy dietary interventions.
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Affiliation(s)
- Li Bai
- School of Biological and Agricultural Engineering, Jilin University, Changchun, China
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Haiheng Tang
- School of Biological and Agricultural Engineering, Jilin University, Changchun, China
| | - Mingliang Wang
- School of Business and Management, Jilin University, Changchun, China
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Nwachokor J, Rochlin EK, Gevelinger M, Yadav M, Adams W, Fitzgerald C, Acevedo-Alvarez M, Mueller ER, Pham TT. Physician awareness of patients' preferred level of involvement in decision-making at the initial urogynecology visit: a randomized trial. Am J Obstet Gynecol 2024; 230:81.e1-81.e9. [PMID: 37330125 DOI: 10.1016/j.ajog.2023.06.024] [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: 01/02/2023] [Revised: 05/28/2023] [Accepted: 06/11/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Studies have shown up to a 40% discordance between patients' preferred roles in decision-making before and their perceived roles after their visit. This can negatively affect patients' experiences; interventions to minimize this discordance may significantly improve patient satisfaction. OBJECTIVE We aimed to determine whether physicians' awareness of patients' preferred involvement in decision-making before their initial urogynecology visit affects patients' perceived level of involvement after their visit. STUDY DESIGN This randomized controlled trial enrolled adult English-speaking women presenting for their initial visit at an academic urogynecology clinic from June 2022 to September 2022. Before the visit, participants completed the Control Preference Scale to determine the patient's preferred level of decision-making: active, collaborative, or passive. The participants were randomized to either the physician team being aware of their decision-making preference before the visit or usual care. The participants were blinded. After the visit, participants again completed a Control Preference Scale and the Patient Global Impression of Improvement, CollaboRATE, patient satisfaction, and health literacy questionnaires. Fisher exact, logistic regression, and generalized estimating equations were used. Based on a 21% difference in preferred and perceived discordance, we calculated the sample size to be 50 patients in each arm to achieve 80% power. RESULTS Women (n=100) with a mean age of 52.9 years (standard deviation=15.8) participated in the study. Most participants identified as White (73%) and non-Hispanic (70%). Before the visit, most women preferred an active role (61%) and few preferred a passive role (7%). There was no significant difference between the 2 cohorts in the discordance between their pre- and post-Control Preference Scale responses (27% vs 37%; P=.39) or whether their symptoms were much better or very much better following the visit (18% vs 37%; P=.06). However, when asked whether they were completely satisfied with the visit, those assigned to the physician awareness cohort reported higher satisfaction than those in the treatment as usual cohort (100% vs 90%; P=.03). CONCLUSION Although there was no significant decrease in discordance between the patient's desired and perceived level of decision-making following physician awareness, it had a significant effect on patient satisfaction. All patients whose physicians were aware of their preferences reported complete satisfaction with their visit. Although patient-centered care does not always entail meeting all of the patients' expectations, the mere understanding of their preferences in decision-making can lead to complete patient satisfaction.
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Affiliation(s)
- Jasmin Nwachokor
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL.
| | - Emma K Rochlin
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
| | - Matthew Gevelinger
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
| | - Menaka Yadav
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
| | - William Adams
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
| | - Colleen Fitzgerald
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
| | | | - Elizabeth R Mueller
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
| | - Thythy T Pham
- Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, IL
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Wu C, Lin K, Fan Q, Bai J, Tang L. The effect of health literacy on early postoperative recovery of patients undergoing outpatient surgery. Technol Health Care 2024; 32:1091-1097. [PMID: 38073342 DOI: 10.3233/thc-230592] [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: 03/23/2024]
Abstract
BACKGROUND The measurement of the health literacy level of patients undergoing outpatient surgery has become a major challenge in perioperative nursing of outpatient surgery. OBJECTIVE To analyze the effect of health literacy on early postoperative recovery of patients undergoing outpatient surgery by developing a health literacy assessment tool for this population. METHODS A scale for the assessment of health literacy was established based on Nutbeam's health literacy model. From April to September 2021, 264 patients were selected in the daytime operating rooms of six Class A tertiary hospitals in Kunming, Yunnan Province to investigate health literacy and early postoperative rehabilitation quality, and the influencing factors of the two variables were analyzed. RESULTS An assessment scale of health literacy of patients undergoing outpatient surgery was developed, including 3 dimensions and 24 items. The Cronbach's α coefficient of the total scale was 0.944, the split-half reliability was 0.902, and the content validity was 0.920. Exploratory factor analysis showed that the cumulative variance contribution rate was 66.37%, and the scale had good structural validity. Multiple linear regression analysis showed that age, functional health literacy, interactive health literacy, and critical health literacy could explain 60.4% of the variation (adjusted R2= 0.583) of postoperative recovery quality of patients undergoing outpatient surgery. CONCLUSION Health literacy of patients undergoing outpatient surgery is an important factor that affects the quality of early postoperative recovery. The health literacy assessment scale can assist medical staff in implementing personalized perioperative nursing and health education.
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Affiliation(s)
- Chuntao Wu
- Nursing Faculty, Kunming Medical University, Kunming, Yunnan, China
| | - Ke Lin
- Operating Room, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Qi Fan
- Operating Room, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jing Bai
- Operating Room, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Li Tang
- Operating Room, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Louizou E, Panagiotou N, Dafli E, Smyrnakis E, Bamidis PD. Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review. Cureus 2024; 16:e51448. [PMID: 38298293 PMCID: PMC10829061 DOI: 10.7759/cureus.51448] [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] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
A physician's role is critical in fostering patient health literacy (HL) and influencing various aspects, including patient-physician communication and treatment effectiveness. The purpose of this systematic literature review is to analyze physicians' perspectives, comprehension, and management of HL. The focus of this review is on physicians' views, opinions, experiences, and strategies related to HL. We conducted comprehensive searches across seven databases, including PubMed, Scopus, ProQuest, Science Direct, Web of Science, The Cochrane Library, and Google Scholar. Original research articles published between January 1, 2009, and July 31, 2020, were considered for inclusion. This literature review incorporates qualitative studies and mixed-methods studies, with a focus on extracting qualitative data. Among the 22 articles included in our review, we employed the method of inductive thematic analysis for data analysis. A detailed description of the review methodology can be found in a previously published protocol available through PROSPERO (CRD42020212599). The themes that emerged from the thematic analysis include: (a) physicians' perception and management of HL; and (b) barriers. The results of the systematic review reveal that healthcare professionals exhibit varying perceptions of patients' HL levels and ascribe different meanings to it. However, none of them employ a specific measuring tool. While there appears to be no uniform approach to managing patients with low HL, some prioritize certain communication strategies, such as repetition, simplified language, and providing written instructions, among others. Most physicians cited multiple barriers that impede the development of patients' HL, including dysfunctions within the healthcare system, staff shortages, managing a large number of patients, limited time, work-related stress, cultural and socio-economic barriers, medical jargon, and language barriers. Considering the pivotal role of physicians in fostering patient HL, it is crucial to enhance medical education in addressing and managing HL, both within academic curricula and through continuing education seminars. Furthermore, there is a pressing need to improve healthcare professionals' working conditions, ensuring that each physician can allocate the necessary time to each patient based on their individual needs, without being hindered by stress-inducing work environments.
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Affiliation(s)
- Eleni Louizou
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Nikolaos Panagiotou
- School of Journalism & Mass Communications, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Eleni Dafli
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Emmanouil Smyrnakis
- Primary Health Care, General Practice and Health Services Research, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Panagiotis D Bamidis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Dijkman EM, ter Brake WWM, Drossaert CHC, Doggen CJM. Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review. Healthcare (Basel) 2023; 12:11. [PMID: 38200917 PMCID: PMC10778720 DOI: 10.3390/healthcare12010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Assessment of (digital) health literacy in the hospital can raise staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools should ideally address multiple domains of health literacy, fit to the complex hospital context and have a short administration time, to enable routine assessment. This review aims to create an overview of tools for measuring (digital) health literacy in hospitals. A search in Scopus, PubMed, WoS and CINAHL, following PRISMA guidelines, generated 7252 hits; 251 studies were included in which 44 assessment tools were used. Most tools (57%) were self-reported and 27% reported an administration time of <5 min. Almost all tools addressed the domain 'understanding' (98%), followed by 'access' (52%), 'apply' (50%), 'appraise' (32%), 'numeracy' (18%), and 'digital' (18%). Only four tools were frequently used: the Newest Vital Sign (NVS), the Short Test of Functional Health Literacy for Adults ((S)TOFHLA), the Brief Health Literacy Screener (BHLS), and the Health Literacy Questionnaire (HLQ). While the NVS and BHLS have a low administration time, they cover only two domains. HLQ covers the most domains: access, understanding, appraise, and apply. None of these four most frequently used tools measured digital skills. This review can guide health professionals in choosing an instrument that is feasible in their daily practice, and measures the required domains.
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Affiliation(s)
- Eline M. Dijkman
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Department of Surgery, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Wouter W. M. ter Brake
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
| | | | - Carine J. M. Doggen
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
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Hasan S, AlZubaidi H, Palaian S, AlOmar M, Kheir N, Al Hariri Y, Shanableh S, Gaili A, Kahaleh A. A Telehealth Module and Virtual Objective Structured Clinical Examination of Health Literacy in Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100555. [PMID: 37399897 DOI: 10.1016/j.ajpe.2023.100555] [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: 04/08/2023] [Revised: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To implement an online health literacy (HL) module and evaluate its impact through virtual Objective Structured Clinical Examination (OSCE) on students' abilities to manage patients with low HL. METHODS Students virtually engaged in several learning activities related to HL, including practicing using HL assessment tools, designing an information booklet suitable for low HL patients, using readability formulas to lower text readability level to ≤ sixth grade, role-playing scenarios related to HL, and undergoing a virtual OSCE. Student performance on course assessments was tested using Spearman's rank-order. Students evaluated their OSCE experience in terms of case content, virtual assessment, and logistics; and effectiveness of the HL module and confidence related to HL. RESULTS A total of 90 students completed the virtual OSCE; the mean score was 8.8 out of 10 (88%), which correlated with similar course assessments. The average score was 3.46 out of 3.7 for the "gathering information" domain (recognizing risk factors and behaviors, assessing HL and adherence, etc.), and 4.06 out of 4.9 for the "patient management" domain (counseling patients on taking medications, focusing on repeating key messages, offering adherence interventions, etc.). Students responded positively regarding case content and virtual assessment, but less favorably regarding logistics. Feedback on effectiveness of the HL module and confidence in managing patients with low HL was positive. CONCLUSION An HL module delivered online was effective in improving student knowledge, abilities, and confidence related to HL. Students achieved high scores in all items in the virtual OSCE, and considered it a measure of communication and clinical skills that is comparable to traditional in-room assessments.
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Affiliation(s)
- Sanah Hasan
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates.
| | - Hamzah AlZubaidi
- University of Sharjah, Department of Pharmacy practice and Pharmacotherapeutics, Sharjah, United Arab Emirates
| | - Subish Palaian
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Muaed AlOmar
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Nadir Kheir
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Yassin Al Hariri
- Department of Pharmacy, Fatima College of Health Sciences, P.O. Box 42162, Al Maqam, Al Ain, United Arab Emirates
| | - Sawsan Shanableh
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Ahmed Gaili
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Abby Kahaleh
- Roosevelt University, College of Pharmacy, Schaumburg, IL, USA; American Journal of Pharmaceutical Education, USA
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Louizou E, Panagiotou N, Smyrnakis Ε, Anastasiadis S, Diamantis KG, Papamalis F, Bamidis PD. Greek medical professionals approaches and understanding of health literacy: a qualitative study. BMC Health Serv Res 2023; 23:1209. [PMID: 37932722 PMCID: PMC10626757 DOI: 10.1186/s12913-023-10226-y] [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: 01/22/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Health literacy holds significant importance for medical professionals, as it is widely acknowledged as a key element in enhancing health promotion and overall well-being. The primary objective of this study is to explore Greek physicians' comprehension of health literacy, the significance they attribute to it, their strategies for addressing patients with low health literacy, and the potential barriers they face while striving to enhance a patient's health literacy. In this context, we examine the communication methods employed by physicians as an integral part of their approach to improving a patient's health literacy. METHODS A qualitative study was conducted between April 29, 2021, and February 17, 2022, utilizing in-depth, semi-structured interviews with 30 Greek medical professionals, of whom 15 were university professors. The research sample selection methodology employed in this study was purposive sampling. Data analysis was conducted using inductive thematic analysis. RESULTS The majority of physicians were not familiar with the concept of health literacy. The most significant barriers to the development of health literacy among physicians are a lack of time, issues within the healthcare system, and interference from third parties, although they acknowledge that a significant portion of the responsibility lies with them. Effective communication with patients is important for all physicians, as it plays a crucial role in the therapeutic process. When they realize that their patients are not understanding them, they employ communication methods such as using plain language, providing numerous examples, incorporating visuals like pictures and even using drawings. CONCLUSIONS The findings of this study underscore the importance of implementing targeted initiatives to promote health literacy within the Greek medical and academic community. Integrating health literacy training for physicians into the educational and training curriculum is essential. To accomplish this goal, it is imperative to first address the shortcomings within the healthcare system and improve the working conditions for physicians.
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Affiliation(s)
- Eleni Louizou
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece.
| | - Nikolaos Panagiotou
- Faculty of Economic and Political Sciences, School of Journalism & Mass Communications, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Εmmanouil Smyrnakis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Savvas Anastasiadis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Konstantinos G Diamantis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Foivos Papamalis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Panagiotis D Bamidis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
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Choi S, Nanda P, Yuen K, Ong K. Bridging the gap in health literacy research: The inclusion of individuals with visual impairments. PATIENT EDUCATION AND COUNSELING 2023; 116:107932. [PMID: 37566948 DOI: 10.1016/j.pec.2023.107932] [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: 01/14/2023] [Revised: 07/09/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES Patient education and health literacy aim to enhance understanding of health and self-care for optimal health outcomes. However, the attention towards populations with visual impairments requiring specialized accommodations for improved health literacy and healthcare access appears to be insufficient METHODS: In an effort to bridge this gap, we conducted a scoping review focusing on health literacy studies undertaken specifically for individuals with visual impairments. RESULTS We encapsulate the main findings and constraints of preceding studies and deliberate on the influence of health literacy research for individuals with visual impairments on healthcare inequalities and health disparities. CONCLUSIONS A health-literate approach, combined with an accessible healthcare environment, can serve as a catalyst to motivate individuals with visual impairments to actively engage in their self-care practices. PRACTICE IMPLICATIONS It is of utmost urgency to develop and validate a health literacy assessment tool for visually impaired individuals, and to utilize it for providing healthcare interventions as well as health education.
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Affiliation(s)
- Soyoung Choi
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA.
| | - Pearl Nanda
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA
| | - Kelly Yuen
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA
| | - Kristel Ong
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA
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Alick CL, Braxton D, Skinner H, Alexander R, Ammerman AS, Keyserling TC, Samuel-Hodge CD. Rural African American Women With Severe Obesity: A Cross-Sectional Analysis of Lifestyle Behaviors and Psychosocial Characteristics. Am J Health Promot 2023; 37:1060-1069. [PMID: 37505193 PMCID: PMC10631280 DOI: 10.1177/08901171231190597] [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] [Indexed: 07/29/2023]
Abstract
PURPOSE To examine differences in lifestyle behavioral and psychosocial factors between rural African American women with Class 3 obesity and those with overweight, and Class 1-2 obesity. DESIGN Cross-sectional study. SETTING Rural Southeastern United States. SUBJECTS Participants included 289 African American women with a mean age of 56 years, 66% with a high school education or less, and a mean body mass index (BMI) of 38.6 kg/m2; 35% (n = 102) were classified with Class 3 obesity. MEASURES We objectively measured height, weight, and physical activity steps/day. Self-reported dietary and physical activity behaviors, general health-related quality of life, mental health, and social support were measured with validated surveys. ANALYSIS Chi-Square analysis for categorical variables and analysis of variance (ANOVA) - via multiple linear regression - for continuous variables. RESULTS There were no significant demographic differences between BMI groups, except for age, where women with Class 3 obesity were on average younger (51 vs 58 y, P < .001). Although dietary behaviors did not differ significantly between groups, we observed significant group differences in self-reported and objective measures of physical activity. The age-adjusted difference in means for self-reported total physical activity minutes/wk. was 91 minutes, with women categorized with Class 3 obesity reporting significantly fewer weekly minutes than those with overweight/Class 1-2 obesity (64.3 vs 156.4 min/wk. respectively, P < .01). Among psychosocial variables, only in the physical component scores of health-related quality of life did we find significant group differences - lower physical well-being among women with Class 3 obesity compared to those with overweight/Class 1-2 obesity (P = .02). CONCLUSION For African American women with Class 3 obesity living in rural setting, these findings suggest behavioral weight loss interventions may need to target physical activity strategies that address physical, psychosocial, and environmental barriers.
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Affiliation(s)
- Candice L. Alick
- Center for Health Promotion & Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Danielle Braxton
- Department of Health Promotion, North Carolina Wesleyan College, Rocky Mount, NC, USA
| | - Harlyn Skinner
- Department of Biological Science, Center for Human Health and the Environment, North Carolina State University, Chapel Hill, NC, USA
| | - Ramine Alexander
- Department of Family and Consumer Sciences, Food and Nutritional Sciences, North Carolina Agricultural & Technical State University, Greensboro, NC, USA
| | - Alice S. Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C. Keyserling
- Internal Medicine, UNC School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Carmen D. Samuel-Hodge
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC, USA
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Adam HS, Merkin SS, Anderson MD, Seeman T, Kershaw KN, Magnani JW, Everson-Rose SA, Lutsey PL. Personal Health Literacy and Life Simple 7: The Multi-Ethnic Study of Atherosclerosis. AMERICAN JOURNAL OF HEALTH EDUCATION 2023; 54:451-462. [PMID: 38486878 PMCID: PMC10939068 DOI: 10.1080/19325037.2023.2254354] [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: 12/23/2022] [Accepted: 07/14/2023] [Indexed: 03/17/2024]
Abstract
Background Personal Health literacy (PHL) is essential in cardiovascular risk management. Hindrances in PHL can lead to poor cardiovascular outcomes. Purpose To investigate whether limited PHL is associated with lower likelihoods of i) overall cardiovascular health and ii) individual cardiovascular health components as defined by the American Heart Association's Life Simple (LS7). Methods Multi-Ethnic Study of Atherosclerosis participants (N=3719; median age[range]: 59[45-84]) completed a PHL questionnaire in 2016-2018. PHL was classified as limited (score ≥10) or adequate (score <10). LS7 components were measured in 2000-2002. Robust Poisson regression was employed to compute prevalence ratios and 95% confidence intervals (PR[95%CI]) of LS7 measures. Results 14.7% of participants had limited PHL. Limited PHL was associated with lower likelihoods of optimal LS7 (0.69[0.50, 0.95], p=0.02) and average LS7 (0.95[0.88, 1.02], p=0.15) after adjustment. Limited PHL was significantly associated with a 7% lower likelihood of ideal fasting blood glucose level after adjustment (0.93[0.89, 0.98], p<0.01). Discussion Limited PHL was modestly associated with suboptimal cardiovascular health and elevated blood glucose, independent of income and education. Translation to Health Education Practice Health educators and providers should equitably address PHL barriers to improve cardiovascular management and quality of care for patients and communities.
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Gelfman LP, Barnes DE, Goldstein N, Volow AM, Shi Y, Li B, Sudore RL. Quality and Satisfaction With Advance Care Planning Conversations Among English- and Spanish-Speaking Older Adults. J Palliat Med 2023; 26:1380-1385. [PMID: 37335910 PMCID: PMC10551762 DOI: 10.1089/jpm.2022.0565] [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: 04/17/2023] [Indexed: 06/21/2023] Open
Abstract
Background: Little is known about the patient-reported quality of and satisfaction with advance care planning (ACP) conversations with surrogates and clinicians among English- and Spanish-speaking older adults, or the potential disparities associated with ACP communication satisfaction. Objectives: To determine patients' perceived quality of and satisfaction with ACP surrogate/clinician conversations and associated patient characteristics. Design: Cross-sectional baseline data were used from two ACP trials, 2013-2017. Outcomes included self-reported ACP conversation quality ("general" vs. "detailed") and communication satisfaction (5-point Likert scale). Associations were determined by chi-squared and t-tests. Setting/Subjects: Subjects were primary care patients ≥55 years with chronic/serious illness in the United States. Results: Of 1398 patients, mean age was 65.6 years (±7.7), 46% women, 32% Spanish speaking, 34% had limited health literacy, and 589 (42%) reported conversations with surrogates and 216 (15%) with clinicians. Of these, less than half rated the conversations as detailed high quality (clinician: 43%; surrogate: 37%). Five-point communication satisfaction scores were higher with detailed versus general conversations (e.g., surrogates: 4.4 vs. 4.1, p = 0.001; clinicians: 4.4 vs. 4.2, p = 0.18) and more often reported by men versus women [(4.4 (0.8) vs. 4.0 (1.0), p = 0.003]; those with adequate versus limited health literacy [4.4 (0.8) vs. 4.0 (0.9), p = 0.002]; and English versus Spanish speakers [4.5 (0.7) vs. 3.5 (0.9), p < 0.001]. Conclusions: Among English- and Spanish-speaking older adults, ACP conversations were infrequent and most were general in quality. Higher quality detailed conversations resulted in greater communication satisfaction. Interventions are needed to improve conversation quality, particularly for Spanish-speaking patients and those with limited health literacy. Trial Registrations: ClinicalTrials.gov identifiers: "Improving Advance Care Planning by Preparing Diverse Seniors for Decision Making (PREPARE)" NCT01990235 and "Preparing Spanish-Speaking Older Adults for Advance Care Planning and Medical Decision Making (PREPARE)" NCT02072941.
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Affiliation(s)
- Laura P. Gelfman
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
| | - Deborah E. Barnes
- Department of Psychiatry and University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Innovation and Implementation Center for Aging and Palliative Care, Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Nathan Goldstein
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Aiesha M. Volow
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Ying Shi
- San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Brookelle Li
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Rebecca L. Sudore
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Innovation and Implementation Center for Aging and Palliative Care, Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, California, USA
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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Todd S, Reagan L, Laguerre R. Health Literacy, Cognitive Impairment, and Diabetes Knowledge Among Incarcerated Persons Transitioning to the Community: Considerations for Intervention Development. JOURNAL OF FORENSIC NURSING 2023; 19:262-270. [PMID: 35482339 DOI: 10.1097/jfn.0000000000000396] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the relationships of health literacy (HL; Short Test of Functional Health Literacy), cognitive impairment (CI), and diabetes knowledge (DK) among incarcerated persons transitioning to the community. METHODS Using preintervention data from a quasi-experimental nonequivalent control group study evaluating the feasibility of a six-session literacy-tailored Diabetes Survival Skills intervention for incarcerated men transitioning to the community, we conducted correlational analyses among the Short Test of Functional Health Literacy, Montreal Cognitive Assessment, and Spoken Knowledge in Low Literacy in Diabetes Scale using the SPSS PROCESS macro and bias-corrected bootstrapping to test the meditational hypothesis: HL mediates the relationship between CI and DK. RESULTS Participants ( N = 73) were incarcerated for 1-30 years with a mean age of 47 (9.9) years, 40% Black, 19% White, and 30% Hispanic, with 78% having high school/GED or less education. Most (70%) screened positive for CI and had low DK, and 20% had marginal or inadequate HL. HL, CI, and DK were positively associated with each other. Controlling for race, age, and group (control/experimental), cognitive function had a significant direct effect on HL ( b = 0.866, p = 0.0003) but not on DK ( b = 0.119, p = 0.076). Results indicated a significant indirect effect of cognitive functioning on DK via HL, 95% confidence interval [0.300, 0.1882]. CONCLUSION Intervention approaches aimed at increasing HL or tailored to low HL in the presence of CI may be effective in increasing DK in this population. IMPLICATIONS Given the low risk to high benefit of implementing literacy-tailored approaches to persons in prison and the population demographics from studies supporting a high degree of CI, nurses should consider implementing literacy-tailored approaches and screening for CI before participation in all educational programs.
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Affiliation(s)
| | | | - Rick Laguerre
- Department of Psychological Sciences, University of Connecticut
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Shaw SJ, Huebner Torres C, Lee JK, Gavrilyuk D, Korchmaros JD. Cultural and translation challenges in assessing health literacy among immigrants from the former Soviet Union. Health Promot Int 2023; 38:daad103. [PMID: 37796105 DOI: 10.1093/heapro/daad103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
Health literacy is an important foundation for health promotion and an under-recognized risk factor for immigrant and refugee groups. Yet measuring health literacy among diverse ethnic and linguistic populations presents complex challenges. We describe cultural and translation challenges encountered in measuring health literacy among Russian-speaking immigrants to the USA and offer a mixed-methods approach to understanding them. The Rx-Health Literacy (RxHL) study used cross-sectional quantitative and qualitative data to examine health literacy and medication adherence among five cultural and four language groups (Latinx, Vietnamese, African-American, Russian-speaking immigrant and White American) who are patients at Caring Health Center, a federally qualified health center in Springfield, MA. We translated an existing health literacy scale into Russian and Vietnamese and examined item difficulty across cultural groups. We conducted qualitative cognitive interviews to learn more about Russian speakers' understandings of the scale. Health literacy scores varied by cultural group, and the range of correct responses was much greater among Russian speakers than in other groups. Percentage correct varied by 69.7% for Russian speakers, compared with 25.0-44.0% for other groups. These findings indicate greater variability in health literacy levels among this group compared with others. Cognitive interviews with Russian-speaking participants revealed multiple interpretations of several items, suggesting that the English version of the scale contained embedded meanings associated with an American health care context that were not captured in the translated instrument. Combining qualitative and quantitative research methods allows for greater insight into contextual and translation factors that may shape the results of translated instruments in unanticipated ways.
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Affiliation(s)
- Susan J Shaw
- Department of Health Promotion and Policy, University of Massachusetts, 715 N. Pleasant St., Amherst, MA, USA
| | | | - Jeannie K Lee
- Department of Pharmacy Practice and Science, University of Arizona, 1295 N. Martin St., Tucson, AZ, USA
| | - Dina Gavrilyuk
- Caring Health Center, 1049 Main St., Springfield, MA 01103, USA
| | - Josephine D Korchmaros
- Southwest Institute for Research on Women, University of Arizona, 915 N. Tyndall Ave., Tucson, AZ, USA
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Toapanta N, Salas-Gama K, Pantoja PE, Soler MJ. The role of low health literacy in shared treatment decision-making in patients with kidney failure. Clin Kidney J 2023; 16:i4-i11. [PMID: 37711638 PMCID: PMC10497376 DOI: 10.1093/ckj/sfad061] [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: 11/23/2022] [Indexed: 09/16/2023] Open
Abstract
The classic paternalist medicine in nephrology has been modified to a shared decision-making model that clearly offers a benefit in patients with kidney disease. One of the cornerstones of shared treatment decision in patients with kidney failure is the understanding of kidney disease. As kidney disease is silent until advanced stages and is also an entity with a complex pathophysiology with little knowledge in the general population, its presence and understanding are difficult for most people. Health literacy (HL) plays a crucial role in the care of patients with kidney disease and the shared treatment decision. Limited HL has been associated with inefficient use of health services, non-compliance of medications, worse quality of life and increased mortality. In this review, we will address the importance of low HL in nephrology in terms of diagnosis, measurement, its effect on shared decision-making and how to increase it in people with kidney disease.
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Affiliation(s)
- Néstor Toapanta
- Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Karla Salas-Gama
- Quality, Process and Innovation Direction, Vall d'Hebron University Hospital, Barcelona, Spain
- Health Services Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital University, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- PhD candidate at the Methodology of Biomedical Research and Public Health program, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Percy Efrain Pantoja
- Quality, Process and Innovation Direction, Vall d'Hebron University Hospital, Barcelona, Spain
- Health Services Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital University, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - María José Soler
- Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain
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Liu J, Pan Y, Nelson MC, Gooden LK, Metsch LR, Rodriguez AE, Tross S, Del Rio C, Mandler RN, Feaster DJ. Strategies of Managing Repeated Measures: Using Synthetic Random Forest to Predict HIV Viral Suppression Status Among Hospitalized Persons with HIV. AIDS Behav 2023; 27:2915-2931. [PMID: 36739589 PMCID: PMC10403627 DOI: 10.1007/s10461-023-04015-1] [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] [Accepted: 01/28/2023] [Indexed: 02/06/2023]
Abstract
The HIV/AIDS epidemic remains a major public health concern since the 1980s; untreated HIV infection has numerous consequences on quality of life. To optimize patients' health outcomes and to reduce HIV transmission, this study focused on vulnerable populations of people living with HIV (PLWH) and compared different predictive strategies for viral suppression using longitudinal or repeated measures. The four methods of predicting viral suppression are (1) including the repeated measures of each feature as predictors, (2) utilizing only the initial (baseline) value of the feature as predictor, (3) using the last observed value as the predictors and (4) using a growth curve estimated from the features to create individual-specific prediction of growth curves as features. This study suggested the individual-specific prediction of the growth curve performed the best in terms of lowest error rate on an independent set of test data.
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Affiliation(s)
- Jingxin Liu
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA.
- Soffer Clinical Research Ctr, 1120 NW 14th St, Room 1059, Miami, FL, 33136-2107, USA.
| | - Yue Pan
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA
| | - Mindy C Nelson
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA
| | - Lauren K Gooden
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | | | - Susan Tross
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Irving Medical Center, New York, NY, USA
| | - Carlos Del Rio
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine and Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Raul N Mandler
- Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Daniel J Feaster
- Department of Public Health, Miller School of Medicine, University of Miami, Coral Gables, USA
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Alobaidi A, Yan CH, Kopfman M, Naveed M, Sharp LK, Nutescu EA. The Relationship Between Signature Time and Functional Health Literacy: Results from a Prospective Study of an Urban Low-Income Population Receiving Long-Term Anticoagulation. Adv Ther 2023; 40:3926-3936. [PMID: 37389731 PMCID: PMC10427553 DOI: 10.1007/s12325-023-02556-4] [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: 03/02/2023] [Accepted: 05/16/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Low health literacy (HL) is consistently associated with worse health outcomes. Routine clinical screening with available instruments is impractical because of added time and effort. Prior findings suggested that signature time may be a reliable alternative measure of HL among general medicine patients. METHODS Our aim was to assess the screening performance of signature time and explore optimal thresholds for identifying patients with limited HL in a chronically anticoagulated population. English-speaking patients receiving long-term anticoagulation therapy were recruited. HL was assessed using the Short Test of Functional Health Literacy in Adults (STOFHLA). Signature time was measured using a stopwatch. Logistic regression models and receiver-operating characteristic (ROC) curves were used to evaluate the association and accuracy of signature time compared to HL, respectively. RESULTS Of 139 enrolled patients, mean age was 60.1 years, 70.5% were African-American, 48.9% reported < $25,000 income, and 27.3% had marginal or inadequate HL. Overall, median time to sign was 6.1 s. Signature time was longest with inadequate HL (median 9.5 s) compared to adequate HL (5.7 s; p < 0.01). Longer signature time was significantly associated with lower HL after adjusting for age and education (aOR 0.77, 95% CI: 0.68-0.88, p < 0.01). Signature time demonstrated high accuracy (area under the curve [AUC] > 0.8) in identifying HL levels. Thresholds of 5.1 s and 9.0 s showed appropriate screening performance in distinguishing patients with adequate vs. marginal and marginal vs. inadequate HL, respectively. CONCLUSION Signature time demonstrated strong screening performance and may offer a quick and practical approach to assessing HL among patients receiving long-term anticoagulation management.
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Affiliation(s)
- Ali Alobaidi
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA.
| | - Connie H Yan
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
| | - Miranda Kopfman
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
| | - Maryam Naveed
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
- Center for Pharmacoepidemiology & Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Edith A Nutescu
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
- Center for Pharmacoepidemiology & Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
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Bittencourt JV, de Souza PAC, Corrêa LA, Volotão AN, Mathieson S, Nogueira LAC. Health literacy, pain-related interference and pain-related distress of patients with musculoskeletal pain. Health Promot Int 2023; 38:daab183. [PMID: 34718561 DOI: 10.1093/heapro/daab183] [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] [Indexed: 11/14/2022] Open
Abstract
The present study aimed to compare pain-related interference and pain-related distress in patients with musculoskeletal pain and differing levels of health literacy. A cross-sectional study was conducted among 243 patients with chronic musculoskeletal pain. Short Test of Functional Health Literacy in Adults classified the level of health literacy. Outcome measures included pain-related interference (pain intensity and functional limitation) and pain-related distress (psychosocial factors). Analysis of variance methods were used. One hundred twenty-three (50.62%) participants were classified as adequate, 24 (9.88%) as marginal and 96 (39.50%) as inadequate health literacy. Patients with inadequate health literacy had higher values of pain severity compared to the other groups, when controlled for age. The group adequate health literacy showed less kinesiophobia compared to their counterparts. Functional limitations and other psychosocial factors were similar among groups. Pain severity and kinesiophobia had disadvantageous findings in participants with inadequate health literacy. Still, the results of pain severity must be approached cautiously because the differences were observed when controlled for age solely.
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Affiliation(s)
- Juliana Valentim Bittencourt
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Avenida Paris, 84, Bonsucesso, CEP 21041-020 Rio de Janeiro, Brazil
| | - Patrick Anderson Chaves de Souza
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343, Realengo, CEP 21710-240 Rio de Janeiro, Brazil
| | - Leticia Amaral Corrêa
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Avenida Paris, 84, Bonsucesso, CEP 21041-020 Rio de Janeiro, Brazil
| | - Andresa Narcizo Volotão
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343, Realengo, CEP 21710-240 Rio de Janeiro, Brazil
| | - Stephanie Mathieson
- Institute for Musculoskeletal Health, Sydney School of Public Health, Edward Ford Building, A27 Fisher Rd, University of Sydney NSW 2006, Austrália
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Avenida Paris, 84, Bonsucesso, CEP 21041-020 Rio de Janeiro, Brazil
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343, Realengo, CEP 21710-240 Rio de Janeiro, Brazil
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Teixeira-Poit SM, Sawicki K, O'Kelley W, Hardin M, Jenkins M, Gudena V. Efficacy of a Patient Education Session for Cancer Patients Receiving Immunotherapy. Semin Oncol Nurs 2023; 39:151445. [PMID: 37179177 DOI: 10.1016/j.soncn.2023.151445] [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: 10/05/2022] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES Our research questions include: What are gaps in cancer patients' knowledge about immunotherapy? What is the efficacy of an education session in improving cancer patients' knowledge about immunotherapy and reducing inappropriate emergency department (ED) visits? DATA SOURCES From July 2020 to September 2021, we invited cancer patients receiving immunotherapy to participate in a one-on-one patient education session and pre-test/post-test surveys. The patient education session included an oral presentation following National Comprehensive Cancer Network guidelines, video on immunotherapy mechanisms of action, and review of written materials and alert cards. The surveys assessed patient knowledge of immunotherapies' mechanisms of action, adverse effects and their management, and health literacy. Survey data were paired with data abstracted from the electronic health record on patient ED utilization and demographic characteristics. CONCLUSION Before the education session, knowledge gaps about immunotherapy included understanding the medical term "itis," side effects of immunotherapy, and treatment for side effects of immunotherapy. Overall, the education session significantly improved cancer patients' knowledge about immunotherapy. The education session addressed knowledge gaps by significantly increasing patients' knowledge of immunotherapy mechanisms of action, recognition of side effects, and ability to define the medical term "itis". Because our sample had low inappropriate ED utilization, we could not assess the impact of the education session on inappropriate ED utilization. IMPLICATIONS FOR NURSING PRACTICE A multicomponent strategy for patient education was effective in improving overall knowledge uptake, especially among patients who initially had the least knowledge. Future studies should continue to explore whether patient education decreases inappropriate ED utilization.
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Affiliation(s)
- Stephanie M Teixeira-Poit
- Associate Professor, Hairston College of Health and Human Sciences, North Carolina A&T State University, Greensboro, North Carolina.
| | - Katelin Sawicki
- Radiation Oncology Nurse, Cone Health Cancer Center at Wesley Long, Greensboro, North Carolina
| | - Wendy O'Kelley
- Nurse Navigator, Cone Health Cancer Center at Drawbridge Parkway, Greensboro, North Carolina
| | - Myrtle Hardin
- Medical Oncology/Nurse Educator, Cone Health Cancer Center at Wesley Long, Greensboro, North Carolina
| | - Marjorie Jenkins
- System-Wide Director for Nursing Research, Cone Health System, Greensboro, North Carolina
| | - Vinay Gudena
- Medical Oncologist, Hematology/Oncology, Cone Health Cancer Center at Wesley Long, Greensboro, North Carolina
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Hæsum LKE, Cichosz SL, Hejlesen OK. Using machine learning to design a short test from a full-length test of functional health literacy in adults-The development of a short form of the Danish TOFHLA. PLoS One 2023; 18:e0280613. [PMID: 37498890 PMCID: PMC10373996 DOI: 10.1371/journal.pone.0280613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Patients are compelled to become more involved in shared decision making with healthcare professionals in the self-management of chronic disease and general adherence to treatment. Therefore, it is valuable to be able to identify patients with low functional health literacy so they can be given special instructions about the management of chronic disease and medications. However, time spent by both patients and clinicians is a concern when introducing a screening instrument in the clinical setting, which raises the need for short instruments for assessing health literacy that can be used by patients without the involvement of healthcare personnel. This paper describes the development of a short version of the full-length Danish TOFHLA (DS-TOFHLA) that is easily applicable in the clinical context and where the use does not require a trained interviewer. MATERIALS AND METHODS Data were collected as a part of a large-scale telehomecare project (TeleCare North), which was a randomized controlled trial that included 1225 patients with chronic obstructive pulmonary disease. The DS-TOFHLA was developed solely using an algorithm-based selection of variables and multiple linear regression. A multiple linear regression model was developed using an exhaustive search strategy. RESULTS The exhaustive search showed that the number of items in the full-length TOFHLA could be reduced from 17 numeracy items and 50 reading comprehension items to 20 reading comprehension items while maintaining a correlation of r = 0.90 between the scores from full-length and short versions. A generic model-based approach was developed, which is suitable for development of short versions of the TOFHLA in other languages, including the original American version. CONCLUSIONS This study demonstrated how a generic model-based approach could be applied in the development of a short version of the TOFHLA, thereby reducing the 67 items to 20 items in the short version. Furthermore, this study showed that the inclusion of numeracy items was not necessary. The development of the DS-TOFHLA presents an opportunity to reliably identify patients with inadequate functional health literacy in approximately 5 minutes without involvement of healthcare personnel. The approach may be used in the development of short versions of any scaling questionnaire.
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Affiliation(s)
- Lisa Korsbakke Emtekær Hæsum
- Department of Nursing, University College of Northern Denmark, Aalborg, Denmark
- Faculty of Medicine, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Simon Lebech Cichosz
- Faculty of Medicine, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Ole Kristian Hejlesen
- Faculty of Medicine, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Chen P, Callisaya M, Wills K, Greenaway T, Winzenberg T. Health Literacy predicts incident foot ulcers after 4 years - the SHELLED cohort study. J Foot Ankle Res 2023; 16:45. [PMID: 37501178 PMCID: PMC10373326 DOI: 10.1186/s13047-023-00644-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
AIMS/HYPOTHESIS To determine whether health literacy is associated with an index diabetes-related foot ulcer (DFU). METHODS The SHELLED Study is a 4-year prospective study of people with diabetes aged over 40 with no history of DFU. The primary outcome was development of a first foot ulcer. Health Literacy was measured using the short form Test of Functional Health Literacy in Adults (s-TOFHLA) and nine domains of the Health Literacy Questionnaire (HLQ). RESULTS Of 222 participants, 191 (86.0%) completed the study, of whom 13 (5.9%) developed an incident ulcer. In multivariable models, every unit increase in S-TOFHLA was associated with a reduced odds of foot ulcer development by 6% (OR 0.94, 95% CI 0.88 to 0.99). Better scores on two HLQ domains reduced the odds of foot ulcer (actively managing my health (OR 0.23, 95% CI 0.08 to 0.65) and understanding health information well enough to know what to do (OR 0.39, 95% CI 0.19 to 0.78). This was independent of baseline risk for foot disease. CONCLUSIONS/INTERPRETATION These data provide novel evidence that health literacy is an important clinical risk factor for index foot ulceration. This is an area of potential focus for research and development of educational programs or policy aimed at reducing development of incident foot ulceration.
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Affiliation(s)
- Pamela Chen
- School of Medicine, Faculty of Health, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia.
- Present Address: Joondalup Health Campus, Ramsay Healthcare Australia, Corner Shenton Ave and Grand Boulevard, Joondalup, WA, 6027, Australia.
| | - Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
| | - Timothy Greenaway
- School of Medicine, Faculty of Health, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia
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Vidrine JI, Fennell BS, Simmons VN, Sutton SK, Jones SR, Woodward HW, Hoogland CE, Vidrine DJ. Enhancing long-term smoking abstinence among individuals with a history of cervical intraepithelial neoplasia or cervical cancer (Project ACCESS): protocol for a randomized clinical trial. BMC Public Health 2023; 23:1284. [PMID: 37403057 DOI: 10.1186/s12889-023-16189-3] [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: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial (RCT) designed to evaluate the efficacy of a novel, personally tailored SMS-delivered text-based digital treatment adjuvant designed to enhance the long-term efficacy of a "Motivation And Problem-Solving" (MAPS) approach for smoking cessation among individuals with a history of cervical intraepithelial neoplasia (CIN) or cervical cancer. MAPS is a phone counseling approach designed to facilitate long-term abstinence that comprises 6 counseling calls over 12 months. The current trial is evaluating the efficacy of MAPS+, which comprises all MAPS components plus a 24-month digital treatment adjuvant. This trial represents a logical extension of our previous RCT, which compared the efficacy of MAPS to a quitline control condition and found that MAPS resulted in greater than a 2-fold increase in smoking abstinence at 12 months (i.e., 26.4% vs. 11.9%). This treatment effect was no longer significant at 18 months, suggesting that efficacy dissipated as time from the end of treatment increased. The primary aim of the current trial is to compare the efficacy of MAPS + and ST in facilitating long-term abstinence. METHODS Individuals who smoke and have a history of cervical cancer or CIN (N = 340) are recruited throughout Florida and randomly assigned to Standard Treatment [ST] or MAPS+. ST participants are electronically connected with the Florida Quitline. MAPS + consists of 6 proactive MAPS-based counseling calls over 12 months plus the novel, personally tailored, text message-based treatment adjuvant delivered over 24 months. All participants receive 12 weeks of combination nicotine replacement therapy (patch and lozenge) and are followed for 24 months. Participant recruitment commenced in December 2022 and is ongoing. DISCUSSION This study builds on promising results from our recent trial which found that MAPS was associated with substantially higher abstinence from smoking at the end of the 12-month treatment period. Finding that this low-burden, personally tailored digital treatment adjuvant improves the long-term efficacy of MAPS would have important clinical and public health implications. TRIAL REGISTRATION Clinical Trials Registry NCT05645146; https://clinicaltrials.gov/ct2/show/NCT05645146 ; Registered on December 9, 2022.
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Grants
- 22K02, Principal Investigator JIV James and Esther King Florida Biomedical Research Program
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- T32CA090314-18, MPIs: Vadaparampil, Simmons National Institutes of Health Training Grant in Behavioral Oncology
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Affiliation(s)
- Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA.
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Bethany Shorey Fennell
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Sarah R Jones
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Honor W Woodward
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Charles E Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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49
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Keith KE, Wadhwa A, York J, Fazeli PL, Bhatia S, Landier W. Health Literacy in Parents of Children Newly Diagnosed With Cancer and Comprehension of Key Concepts Related to Their Child's Care. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:235-244. [PMID: 37063061 DOI: 10.1177/27527530221140076] [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: 04/18/2023]
Abstract
Background: There is a paucity of literature regarding health literacy in pediatric oncology. We sought to understand the relationship between health literacy and comprehension of key new diagnosis education concepts in parents of children newly diagnosed with cancer. Methods: Using data from a study evaluating a structured new diagnosis discharge teaching intervention, we performed a secondary analysis to understand the relationship between parental health literacy (Brief Health Literacy Screener: BHLS) and comprehension of six key concepts (child's diagnosis, primary oncologist, and treatment plan; seeking emergent care; fever definition; re-dosing medication). We also evaluated the association between parents self-reported sociodemographic characteristics, preferred learning style (one-item ordinal assessment) and health literacy. We tested relationships using Fisher's exact tests, independent samples t-tests, and Pearson correlations. Results: Fifty parents participated (age 35.4 ± 8.2 years [M ± SD]; 86% female; 60% non-Hispanic white; 24% with ≤high school education); nine parents (18%) scored in the BHLS low literacy range; 80% correctly responded to all six items on the key concepts questionnaire (100% comprehension). Health literacy was not significantly related to 100% comprehension or to individual key concept responses, with the exception of "child's treatment plan" (correct responses: 55.6% in low vs. 100% in adequate literacy groups; p < .001). Parental sociodemographic characteristics and preferred learning styles were not significantly related to health literacy. Discussion:Despite variability in health literacy levels, 80% of the parents comprehended all key concepts, suggesting that the intervention was effective for most parents, regardless of health literacy level.
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Affiliation(s)
- K Elizabeth Keith
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Aman Wadhwa
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jocelyn York
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wendy Landier
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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50
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Perumalswami PV, Belemkoabga A, Joseph L, Erblich J, Jandorf L. HBV screening among West Africans living in the US: Influences of stigma, health literacy, and self-efficacy. Hepatol Commun 2023; 7:02009842-202306010-00030. [PMID: 37267200 DOI: 10.1097/hc9.0000000000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/13/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Applying theoretically informed constructs using an adaptation of the "Theory of Planned Behavior," this study assessed social-cognitive and sociocultural determinants of HBV screening among West Africans living in the US to inform solutions to testing gaps. METHODS We developed and administered a theory-based survey in both English (41%) and French (59%) from September 2021 to April 2022 to a sample of West African-born individuals (n = 162). Predictors of HBV screening included: attitudes, perceived behavioral control or self-efficacy, and subjective norms along with health literacy (HL), language proficiency, and stigma of HBV infection. We hypothesized that these constructs would predict HBV testing. We also conducted path analytic modeling to better understand both direct and indirect effects of key factors on HBV screening status. RESULTS West Africans who completed the survey in English were younger with less education and lower income, whereas those who completed the survey in French reported higher HBV-related stigma. In a bivariate analysis of factors associated with HBV screening by language, less education was associated with lower HBV screening in English speakers. Adequate HL, higher self-efficacy, and higher English language proficiency were independently associated with HBV screening. Path analysis to better understand the interplay between social-cognitive and sociocultural factors revealed HL and stigma both had indirect effects on screening, mediated by differences in self-efficacy. CONCLUSIONS This study identified HL and stigma as key indirect factors that influence HBV screening by way of self-efficacy in West Africans in the US. This work is a first step to identifying barriers that can lead to the development of an evidence-based intervention aimed at increasing HBV screening of West Africans to address health disparities.
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Affiliation(s)
- Ponni V Perumalswami
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Assita Belemkoabga
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lovely Joseph
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Joel Erblich
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychology, Hunter College and The Graduate Center, City University of New York, New York, USA
| | - Lina Jandorf
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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