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Shulman K, Baicker K, Mayes L. Reading for life-long health. Front Pediatr 2024; 12:1401739. [PMID: 39114854 PMCID: PMC11303134 DOI: 10.3389/fped.2024.1401739] [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] [Received: 03/15/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
There is a strong, positive relationship between childhood literacy and physical and mental health outcomes in adulthood. Through primary care-based literacy interventions, pediatricians reach children and their families long before they enter traditional education venues. In so doing, pediatricians play a key role in children's school readiness and in turn health outcomes. The current state of childhood literacy in United States defines an increasingly urgent platform for the healthcare profession generally, and pediatricians specifically, to embrace. Through reviewing the existing literature on the impact of childhood literacy on physical, mental, and social-emotional health outcomes, we hope to highlight the need for increased collaboration between the education and medical fields to further promote the literacy interventions in pediatric healthcare settings.
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Affiliation(s)
- Kaiulani Shulman
- Child Study Center, School of Medicine, Yale University, New Haven, CT, United States
| | | | - Linda Mayes
- Child Study Center, School of Medicine, Yale University, New Haven, CT, United States
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Simion L, Rotaru V, Cirimbei C, Gales L, Stefan DC, Ionescu SO, Luca D, Doran H, Chitoran E. Inequities in Screening and HPV Vaccination Programs and Their Impact on Cervical Cancer Statistics in Romania. Diagnostics (Basel) 2023; 13:2776. [PMID: 37685314 PMCID: PMC10486539 DOI: 10.3390/diagnostics13172776] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Introduction: A Romanian woman is diagnosed with cervical cancer every two hours; the country ranks second in Europe in terms of the mortality and incidence rate of this disease. This paper aims to identify the main reasons that have led to this situation, focusing on the measures taken by the Romanian Ministry of Health for the prevention of this type of cancer-national programs for cervical cancer screening and HPV vaccination. (2) Materials and methods: We performed a study based on the available secondary data from the National Statistics Institute, World Health Organization and Bucharest Institute of Oncology in order to assess the burden associated with cervical cancer and place it in the context of known global and European incidence and mortality rates, thus evaluating the importance of this health issue in Romania. The second component of our study was a cross-sectional study. Here, we used a 14-question questionnaire applied to the women participating in the National Screening Program for Cervical Cancer and aimed to evaluate the women's level of knowledge about screening and HPV vaccination and their access cervical-cancer-specific healthcare services. (3) Results: The results of this research show that a high percentage of women postpone routine checks due to a lack of time and financial resources and indicate that a low level of knowledge about the disease and the specific preventive methods determines the low participation in screening and HPV vaccination programs implemented in Romania, contributing to the country's cervical cancer situation. (4) Conclusions: The national programs have complicated procedures, are underfunded and do not motivate healthcare workers enough. This, combined with the lack of information for the eligible population, adds up to an extremely low number of women screened and vaccinated. Our conclusion is that the Romanian Ministry of Health must take immediate action by conducting major awareness campaigns, implementing measures to make the programs functional and ensuring coherent funding.
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Affiliation(s)
- Laurentiu Simion
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Vlad Rotaru
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Ciprian Cirimbei
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Laurentia Gales
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- Medical Oncology Department, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Daniela-Cristina Stefan
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
| | - Sinziana-Octavia Ionescu
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Dan Luca
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
| | - Horia Doran
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- Surgical Clinic I, Clinical Hospital Dr. I. Cantacuzino Bucharest, 030167 Bucharest, Romania
| | - Elena Chitoran
- “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (L.S.); (L.G.); (D.-C.S.); (D.L.); (H.D.); (E.C.)
- General Surgery and Surgical Oncology Department I, Bucharest Institute of Oncology “Prof. Dr. Al. Trestioreanu”, 022328 Bucharest, Romania
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Couture MC, Kang JE, Hemenway D, Grinshteyn E. Associations between having been threatened or injured with a weapon and substance use and mental health among high school students in the United States. Int J Inj Contr Saf Promot 2021; 29:93-102. [PMID: 34923925 DOI: 10.1080/17457300.2021.2004608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Being threatened or injured with a weapon is a serious form of physical bullying. Little is known about the effects of being threatened or injured with a weapon on substance use and mental health among adolescents. A secondary analysis of 2017 Youth Risk Behavior Survey data assessed the associations between having been threatened or injured with a weapon and substance use (binge drinking, marijuana, tobacco use, prescription medication misuse) and mental health (feeling sad or hopeless, considering suicide). Multiple logistic regression models with complex survey weights were used, controlling for potential confounders. Approximately 6.0% of students reported having been threatened/injured with a weapon. After adjusting for covariates, having been threatened/injured with a weapon was associated with binge drinking (AOR = 2.5; 95% CI: 1.9-3.4), marijuana (AOR = 2.1; 95% CI: 1.6-2.7), tobacco use (AOR = 2.6; 95% CI: 2.0-3.5), and misuse of prescription medication (AOR = 2.2; 95% CI: 1.6-3.0) compared with students who have not been threatened/injured. Having been threatened/injured with a weapon was associated with 1.6 times the odds (95% CI: 1.2-2.2) of feeling sad/hopeless and 1.7 times the odds (95% CI: 1.3-2.3) of considering suicide. Having been threatened or injured with a weapon is an important public health issue associated with negative mental health and substance use.
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Affiliation(s)
- Marie-Claude Couture
- Department of Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Jee Eun Kang
- Department of Health Professions, University of San Francisco, San Francisco, CA, USA
| | - David Hemenway
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Erin Grinshteyn
- Department of Health Professions, University of San Francisco, San Francisco, CA, USA
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4
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Vaillancourt R, Cameron JD. Health literacy for children and families. Br J Clin Pharmacol 2021; 88:4328-4336. [PMID: 34155667 DOI: 10.1111/bcp.14948] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 05/19/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022] Open
Abstract
The relationship between reading ability and health, known as health literacy, broadly reflects the skills and competencies required to operate within the healthcare environment. It is only recently that we have seen attempts to conceptualize health literacy in the context of medication use by using terms such as medication literacy. Health literacy changes over one's lifetime and is dependent on factors such as numeracy, education, income, gender and country. Low health literacy and low medication literacy have been identified as significant risk factors for poor health outcomes of adults and children. With an evaluation of common tools used to assess health literacy and medication literacy, the aim of this review is to describe the shared responsibility between patients and healthcare providers for the communication of health and medication information. Key strategies and interventions to improve two-way communication between patients and healthcare providers are highlighted, with a focus on how health literacy can impact child health outcomes.
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Taleb S, Itani L. Nutrition Literacy among Adolescents and Its Association with Eating Habits and BMI in Tripoli, Lebanon. Diseases 2021; 9:25. [PMID: 33805571 PMCID: PMC8103266 DOI: 10.3390/diseases9020025] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
(1) Background: Adolescence is a period of increased autonomy and independent decision making; it determines health behaviors that can persist into the future. Individual factors like food choices and unhealthy lifestyle have an essential role in the development and prevention of obesity among adolescents and are associated with the nutrition literacy of parents and other adults. While the association of parents' nutrition literacy with adolescent BMI has been addressed, there is still a scarcity of studies that examine the effect of adolescents' nutrition literacy on their eating habits and body mass index (BMI) status. (2) Methods: A cross-sectional study was conducted that included 189 adolescents (68 with overweight and obesity and 121 with normal weight) aged between 14-19 years from four private schools in Tripoli, Lebanon. A self-administered questionnaire that included the Nutrition Literacy Assessment Instrument (NLAI) and the Adolescent Food Habits Checklist (AFHC) was used. Anthropometrics were measured using standardized procedures. The association between nutrition literacy, food habits and BMI was assessed using a chi squared test for independence and Poisson regression analysis where suitable. (3) Results: Results indicated no association between all five components of nutrition literacy and body mass index categories. Furthermore, there was no association between the Adolescent Food Habits Checklist and overweight or obese BMI status (RR = 0.947, 95%CI: 0.629-1.426) (p = 0.796). No association was observed between nutrition literacy and food habits, except for an inverse association with macronutrients literacy. (4) Conclusions: In conclusion, the study indicated that there was no association between the components of nutrition literacy with body mass index or with food habits, except for macronutrient literacy.
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Affiliation(s)
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11–5020, Lebanon;
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Giger JT, Barnhart S, Feltner F, Slone M, Lawler MJ, Windsor L, Windsor A. Validating the eHealth Literacy Scale in Rural Adolescents. J Rural Health 2020; 37:504-516. [DOI: 10.1111/jrh.12509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Jarod T. Giger
- College of Social Work University of Kentucky Lexington Kentucky
| | - Sheila Barnhart
- College of Social Work University of Kentucky Lexington Kentucky
| | - Fran Feltner
- Center of Excellence in Rural Health Family and Community Medicine University of Kentucky Hazard Kentucky
| | - Melissa Slone
- Center of Excellence in Rural Health Family and Community Medicine University of Kentucky Hazard Kentucky
| | | | - Leah Windsor
- Institute for Intelligent Systems University of Memphis Memphis Tennessee
| | - Alistair Windsor
- Department of Mathematical Sciences University of Memphis Memphis Tennessee
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Du Y, Wang W, Washburn DJ, Lee S, Towne SD, Zhang H, Maddock JE. Violence against healthcare workers and other serious responses to medical disputes in China: surveys of patients at 12 public hospitals. BMC Health Serv Res 2020; 20:253. [PMID: 32216766 PMCID: PMC7098126 DOI: 10.1186/s12913-020-05104-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Workplace violence against healthcare workers is a global issue that is on the rise, with Chinese healthcare workers facing growing challenges with hospital violence. Attacks on medical staff have increased in recent years with no clear resolution. Prior research focused on policies to improve the doctor-patient relationship and better protect clinicians, but few studies addressed the patient perspective. This paper examines patients' choices when facing a medical dispute and identifies groups who are more likely to respond to conflict with violence or other serious actions. METHODS Patient survey responses were collected in 12 leading public hospitals in five Chinese provinces with 5556 participants. The survey asked sociodemographic information, patients' attitudes (e.g., general optimism, trust in their physicians, perceived healthcare quality), and their primary response to a medical dispute. From least to most severe, the options range from "complaining within the family" to "violence." We used t-tests and Chi-square tests to explore the relationships between reactions and patient characteristics. We also performed multivariable logistic regressions to determine the impact of sociodemographics and provider trust on the seriousness of responses. RESULTS The primary response of a third of respondents was complaining to hospital or health department officials (32.5%). Seeking legal help (26.3%) and direct negotiation with doctors (19.6%) were other frequent responses. More serious responses included 83 stating violence (1.5%), 9.7% expressing a desire to expose the issue to the news media, and 7.4% resorting to seeking third-party assistance. Patients who were more likely to report "violence" were male (OR = 1.81, p < .05), high-income earners (OR = 3.71, p < .05), or reported lower life satisfaction (OR = 1.40, p < .05). Higher trust scores were associated with a lower likelihood of a serious response, including violence (OR = 0.80, p < .01). CONCLUSION Most respondents reported mild reactions when facing a medical dispute. Among those who reported the intent of serious reactions, some sociodemographic characteristics and the trust of physicians could be predictive. To prevent future hospital violence, this work helps identify the characteristics of patients who are more likely to seek severe approaches to medical dispute resolution, including resorting to violence. From these results, hospitals will be better able to target specific groups for interventions that build patient-provider trust and improve general patient satisfaction.
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Affiliation(s)
- Yuxian Du
- Division of Public Health Sciences, Hutchinson Institute for Cancer Outcome Research (HICOR), Fred Hutchinson Cancer Research Center, Seattle, WA 98109 USA
- Data Generation and Observational Studies, Bayer Healthcare U.S. LLC, Whippany, NJ 07981 USA
| | - Wenxin Wang
- Department of Public Administration, Law School, Shantou University, Shan-Tou, 515063 People’s Republic of China
| | - David J. Washburn
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Shinduk Lee
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843 USA
| | - Samuel D. Towne
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843 USA
- Department of Health Management and Informatics, University of Central Florida, Orlando, FL 32816 USA
- Disability, Aging, and Technology Cluster Initiative, University of Central Florida, Orlando, FL 32816 USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843 USA
- Southwest Rural Health Research Center, Texas A&M University, College Station, TX 77843 USA
| | - Hao Zhang
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Jay E. Maddock
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843 USA
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Abstract
Health literacy is an important issue to consider in the provision of health-care to children. Similar to the adult population, most parents face health literacy challenges. Of particular concern, 1 in 4 parents have low health literacy, greatly affecting their ability to use health information to make health decisions for their child. High expectations are placed on parents and children to achieve effective disease management and positive health outcomes in the context of complex health-care systems and disease treatment regimens. Low health literacy affects parent acquisition of knowledge, attitudes, and behaviors, as well as child health outcomes across the domains of disease prevention, acute illness care, and chronic illness care. The effect of low health literacy is wide ranging, including 1) poor nutrition knowledge and behaviors, 2) higher obesity rates, 3) more medication errors, 4) more emergency department use, and 5) poor asthma knowledge, behaviors, and outcomes. Health-care providers can mitigate the effects of health literacy by seeking to align health-care demands with the health literacy skills of families. Effective health literacy-informed interventions provide insights into methods that can be used by providers and health systems to improve health outcomes. Health literacy-informed communication strategies should be used with all families in a "universal precautions approach" because all parents likely benefit from clear communication. As scientific advances are made in disease prevention and management, unless families understand how to follow provider recommendations, the benefit of these advances will not be realized and disparities in outcomes will be exacerbated.
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Affiliation(s)
- Andrea K Morrison
- Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | | | - H Shonna Yin
- Department of Pediatrics and.,Department of Population Health, New York University School of Medicine/NYU Langone Health, New York, NY
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Haney MO. Psychometric testing of the Turkish version of the Health Literacy for School-Aged Children Scale. J Child Health Care 2018; 22:97-107. [PMID: 29110532 DOI: 10.1177/1367493517738124] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the validity and reliability of the Turkish version of the Health Literacy for School-Aged Children (HLSAC-T) scale. This study was a cross-sectional and methodological design. The sample consisted of 563 sixth and ninth grade students in Izmir, Turkey. Data were collected with the socio-demographic characteristics questionnaire, HLSAC-T, and Turkish version of the Adolescent Lifestyle Profile. Cronbach's α for the scale was .77 and item-total correlations were between .49 and .61 ( p < .001). The model fit indices were determined to be the root mean square error of approximation at .035, the goodness of fit index at .99, and the comparative fit index at .99. The concordance validity and convergent validity were supported and the discriminant validity suggested that the scale successfully discriminated students who cared about healthy lifestyle from the students who did not. The HLSAC-T showed an adequate reliability and validity for determining the subjective health literacy of Turkish school-aged children. The results showed promise that the scale could be translated into other languages.
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Affiliation(s)
- Meryem Ozturk Haney
- Public Health Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey
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Park A, Eckert TL, Zaso MJ, Scott-Sheldon LAJ, Vanable PA, Carey KB, Ewart CK, Carey MP. Associations Between Health Literacy and Health Behaviors Among Urban High School Students. THE JOURNAL OF SCHOOL HEALTH 2017; 87:885-893. [PMID: 29096408 PMCID: PMC5669371 DOI: 10.1111/josh.12567] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/10/2016] [Accepted: 01/27/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures, and examined cross-sectional and prospective associations between health literacy and adolescent health behaviors and outcomes. METHODS We conducted a short-term prospective study of 250 adolescents (mean age = 14 years; 57% female; 48% African American) who were entering or in the ninth grade in an urban school district. Health literacy was assessed by individual interviews at baseline, and health-related behaviors and outcomes were assessed by a paper-and-pencil survey at baseline and at a 6-month follow-up. RESULTS Nearly half of the sample was reading at least 2 grades below expected levels. Lower baseline health literacy was associated with a lower self-rating of general health, unhealthier diet, heavier weight, and greater engagement in problem behaviors and sexual behaviors at baseline. Lower baseline health literacy also was associated with a greater increase in substance use over time. CONCLUSIONS Results point to the pressing need to improve health literacy in urban high school students.
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Affiliation(s)
- Aesoon Park
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244; Phone: (315) 443-2391, Fax: (315) 443-4085
| | - Tanya L. Eckert
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244;
| | - Michelle J. Zaso
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244;
| | - Lori A. J. Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Psychiatry and Human Behavior, Alpert Medical School, Brown University, Behavioral and Social Sciences, School of Public Health, Brown University, The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Coro Building, Suite 309, 164 Summit Ave, Providence RI 02906,
| | - Peter A. Vanable
- Syracuse University, Office of Research / Graduate School, 304 Lyman Hall, Syracuse, NY 13244-1200;
| | - Kate B. Carey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912;
| | - Craig K. Ewart
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244;
| | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital; Professor of Behavioral and Social Sciences, School of Public Health, and Professor of Psychiatry and Human Behavior, Alpert Medical School of Brown University; 164 Summit Avenue, Providence, RI 02906;
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Borges K, Sibbald C, Hussain-Shamsy N, Vasilevska-Ristovska J, Banh T, Patel V, Brooke J, Piekut M, Reddon M, Aitken-Menezes K, McNaughton A, Pearl RJ, Langlois V, Radhakrishnan S, Licht CPB, Piscione TD, Levin L, Noone D, Hebert D, Parekh RS. Parental Health Literacy and Outcomes of Childhood Nephrotic Syndrome. Pediatrics 2017; 139:peds.2016-1961. [PMID: 28213606 DOI: 10.1542/peds.2016-1961] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Determine the association of parental health literacy with treatment response among children with nephrotic syndrome. METHODS This was a cohort study of children aged 1-18 with nephrotic syndrome and their parent. Health literacy was measured using the validated Short Test of Functional Health Literacy in Adults assessing reading comprehension and numeracy. Outcomes included initial relapse-free period, frequently relapsing disease, relapse rate, second-line medication use, and complete remission after therapy. RESULTS Of 190 parents, 80% had adequate health literacy (score >67 of 100), and higher scores were not correlated with higher education. Almost all achieved perfect numeracy scores (>86%); numeracy was not associated with outcomes. After adjusting for immigration, education, and income, higher reading comprehension scores (tertile 3) compared with lower scores (tertile 1) were significantly associated with lower risk of first relapse (hazard ratio 0.67, 95% confidence interval [CI] 0.48-0.94, P trend = .02), lower odds of frequently relapsing disease (odds ratio [OR] 0.38, 95% CI 0.21-0.70, P trend = .002), lower relapse rate (rate ratio 0.77, 95% CI 0.73-0.80, P trend < .001), and higher odds of complete remission after both initial steroids and cyclophosphamide (OR 2.07, 95% CI 1.36-3.16, P trend = .003; OR 5.97, 95% CI 2.42-14.7, P trend < .001). CONCLUSIONS Lower parental health literacy, specifically reading comprehension, is associated with higher relapse rates among children with nephrotic syndrome and fewer achieving complete remission. This underscores the importance of assessing and targeting health literacy for chronic management of childhood-onset diseases.
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Affiliation(s)
| | - Cathryn Sibbald
- Department of Medicine, University of Toronto, Toronto, Canada
| | | | | | - Tonny Banh
- Child Health Evaluative Sciences, Research Institute
| | - Viral Patel
- Child Health Evaluative Sciences, Research Institute
| | | | | | | | | | | | - Rachel J Pearl
- Child Health Evaluative Sciences, Research Institute.,Division of Nephrology, and.,Brampton Civic Hospital, William Osler Health System, Brampton, Canada
| | - Valerie Langlois
- Child Health Evaluative Sciences, Research Institute.,Division of Nephrology, and
| | | | - Christoph P B Licht
- Child Health Evaluative Sciences, Research Institute.,Division of Nephrology, and.,Program in Cell Biology, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - Tino D Piscione
- Child Health Evaluative Sciences, Research Institute.,Division of Nephrology, and
| | - Leo Levin
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Damien Noone
- Child Health Evaluative Sciences, Research Institute.,Division of Nephrology, and
| | - Diane Hebert
- Child Health Evaluative Sciences, Research Institute.,Division of Nephrology, and
| | - Rulan S Parekh
- Child Health Evaluative Sciences, Research Institute, .,Department of Medicine, University of Toronto, Toronto, Canada.,Division of Nephrology, and.,University Health Network, Toronto, Canada; and.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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12
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Valerio MA, Peterson EL, Wittich AR, Joseph CLM. Examining health literacy among urban African-American adolescents with asthma. J Asthma 2016; 53:1041-7. [PMID: 27359106 PMCID: PMC5056364 DOI: 10.1080/02770903.2016.1175473] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 03/31/2016] [Accepted: 04/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This exploratory study assessed health literacy among urban African-American high school students to improve understanding of the association between adolescent health literacy and asthma. METHODS We conducted a secondary data analysis of the control group (n = 181) of the Puff City randomized controlled trial (2006-2010), a web-based intervention to promote asthma management among students, grades 9 through 12. A validated self-report 3-item health literacy screening instrument was completed at final online follow-up survey. Logistic regression was used to explore the association between health literacy, demographic characteristics, quality of life, asthma management, and health care utilization. RESULTS Multivariate analysis revealed that an overall inadequate health literacy score was associated with students who were more likely to be younger (OR 0.61; 95% CI 0.44-0.84), not on Medicaid (OR 0.36; 95% CI 0.17-0.76), have at least one hospitalization (OR 1.29; 95% CI 1.07-1.56); and a lower overall quality of life (OR 0.75; 95% CI 0.59-0.95). Those lacking confidence in filling out medical forms, needing help reading hospital materials, and having difficulty understanding written information were more likely to not have a rescue inhaler (OR 0.49; 95% CI 0.25-0.94), have one or more emergency visits (OR 1.21 95% CI 1.02-1.43), and one or more hospitalizations (OR 1.19; 95% CI 1.01-1.41), respectively. CONCLUSIONS The findings indicate a significant association between inadequate health literary and suboptimal asthma management. It is important to advance understanding of adolescent health literacy, especially those at-risk, as they assume asthma self-management tasks and move toward independent adult self-care.
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Affiliation(s)
- Melissa A Valerio
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Edward L Peterson
- b Department of Public Health Sciences , Henry Ford Health System , Detroit , MI , USA
| | - Angelina R Wittich
- a Health Promotion and Behavioral Science, University of Texas School of Public Health, San Antonio Regional Campus , San Antonio , TX , USA
| | - Christine L M Joseph
- c Department of Public Health Sciences , Health Disparities Research Collaborative, Henry Ford Health System , Detroit , MI , USA
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Ye XH, Yang Y, Gao YH, Chen SD, Xu Y. Status and determinants of health literacy among adolescents in Guangdong, China. Asian Pac J Cancer Prev 2015; 15:8735-40. [PMID: 25374199 DOI: 10.7314/apjcp.2014.15.20.8735] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies for non-communicable disease cotrol, including cancer, have mostly relied on health literacy in adults. However, limited studies are available for adolescents. This study aimed to assess the status and determinants of health literacy in in-school adolescents in Guangdong, China. MATERIALS AND METHODS A total of 3,821 students aged 13-25 years were selected by multi-stage cluster sampling. After the questionnaire of health literacy was answered, the total scores for health knowledge (18 questions), skills (5 questions) and behaviors (14 questions) were determined. The total scores for health literacy and each subscale were recoded into adequate and inadequate subgroups, and logistic regression models were used to identify factors associated with each outcome variable. RESULTS The prevalence of adequate health literacy was 14.4%, and the prevalences for adequate knowledge, skills and behavior were 22.4%, 64.7% and 6.6%, respectively. Students coming from prestigious schools and having parents with higher education had higher odds of having adequate knowledge, skills and behaviors. Female students had higher odds of having adequate knowledge and behaviors. Students in grade 7-8 had higher odds of having adequate knowledge and skills. The health knowledge was positive associated with health skills (odds ratio [OR]=2.1, 95% confidence interval [CI] 1.7-2.5) and behaviors (OR=3.0, 95% CI 2.3-4.0), and health skills were positive associated with health behaviors (OR=2.6, 95% CI 1.8-3.8). CONCLUSIONS Further efforts should be made to increase adolescents' health knowledge and behaviors, especially for low grade and male students in non-prestigious schools.
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Affiliation(s)
- Xiao-Hua Ye
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China E-mail : , or
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Manganello JA, DeVellis RF, Davis TC, Schottler-Thal C. Development of the Health Literacy Assessment Scale for Adolescents (HAS-A). JOURNAL OF COMMUNICATION IN HEALTHCARE 2015; 8:172-184. [PMID: 27656257 PMCID: PMC5027646 DOI: 10.1179/1753807615y.0000000016] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Health literacy has been found to be a crucial component of successful communication and navigation in health care. Various tools have been developed to measure health literacy skills, but few have been developed specifically for adolescents, and most require in-person administration. This study sought to develop a self-report health literacy scale for adolescents to assess four key health literacy domains: the ability to obtain, communicate, understand, and process health information. METHODS We collected data from 272 youth aged 12-19 recruited from a pediatrics clinic (37%) and the community (63%). We administered the Rapid Estimate of Adolescent Literacy in Medicine-Teen, Newest Vital Sign, and three surveys, and used factor analysis to identify scale items. RESULTS Using multiple health literacy assessments, it was clear that many teens struggle with low health literacy skills. When identifying items that can be used as self-report items in future research, factor analysis identified three subscales; a 5-item communication scale (alpha = 0.77), a 4-item confusion scale (alpha = 0.73), and a 6-item functional health literacy scale (alpha = 0.76). The scales performed reasonably well when compared with validation items. CONCLUSIONS Self-report items can be used to assess health literacy skills for adolescents when in-person administration is not possible or feasible. Such items will allow for greater study of how health literacy impacts communication in not only health care settings, but for all levels of health communication. The tool will also allow researchers to better understand how adolescent health literacy is related to a variety of health outcomes. Further testing of these scales with different populations is warranted.
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Affiliation(s)
- Jennifer A. Manganello
- Department of Health Policy, Management & Behavior, University at Albany School of Public Health, USA
| | - Robert F. DeVellis
- Department of Health Behavior, School of Public Health, University of North Carolina at Chapel Hill, USA
| | - Terry C. Davis
- Department of Medicine, Louisiana State University Health Sciences Center-Shreveport, USA
- Department of Pediatrics, Louisiana State University Health Sciences Center-Shreveport, USA
| | - Carrin Schottler-Thal
- Division of General Pediatrics, The Children’s Hospital at Albany Medical College, USA
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Tse CK, Bridges SM, Srinivasan DP, Cheng BS. Social media in adolescent health literacy education: a pilot study. JMIR Res Protoc 2015; 4:e18. [PMID: 25757670 PMCID: PMC4376152 DOI: 10.2196/resprot.3285] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 10/23/2014] [Accepted: 11/23/2014] [Indexed: 12/31/2022] Open
Abstract
Background While health literacy has gained notice on a global stage, the initial focus on seeking associations with medical conditions may have overlooked its impact across generations. Adolescent health literacy, specifically in dentistry, is an underexplored area despite the significance of this formative stage on an individual’s approach to healthy lifestyles and behaviors. Objective The aim is to conduct a pilot study to evaluate the efficacy of three major social media outlets - Twitter, Facebook, and YouTube - in supporting adolescents’ oral health literacy (OHL) education. Methods A random sample of 22 adolescents (aged 14-16 years) from an English-medium international school in Hong Kong provided informed consent. Sociodemographic information, including English language background, social media usage, and dental experience were collected via a questionnaire. A pre- and post-test of OHL (REALD-30) was administered by two trained, calibrated examiners. Following pre-test, participants were randomly assigned to one of three social media outlets: Twitter, Facebook, or YouTube. Participants received alerts posted daily for 5 consecutive days requiring online accessing of modified and original OHL education materials. One-way ANOVA ( analysis of variance) was used to compare the mean difference between the pre- and the post-test results among the three social media. Results No associations were found between the social media allocated and participants’ sociodemographics, including English language background, social media usage, and dental experience. Of the three social media, significant differences in literacy assessment scores were evident for participants who received oral health education messages via Facebook (P=.02) and YouTube (P=.005). Conclusions Based on the results of the pilot study, Facebook and YouTube may be more efficient media outlets for OHL promotion and education among adolescent school children when compared to Twitter. Further analyses with a larger study group is warranted.
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Affiliation(s)
- Carrie Kw Tse
- The University of Hong Kong, Hong Kong, China (Hong Kong)
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Kim S. An exploratory study of inactive health information seekers. Int J Med Inform 2014; 84:119-33. [PMID: 25453277 DOI: 10.1016/j.ijmedinf.2014.10.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 09/24/2014] [Accepted: 10/03/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE This study aims to identify people who do not actively seek out health information and the demographic characteristics of Inactive Seekers. The possible determinants of inactive seeking behaviors are also explored. DESIGN AND MEASUREMENTS A total of 14,420 survey respondents were drawn from the 2009 Annenberg National Health Communication Survey (ANHCS) data. K-means clustering was used to discriminate Inactive Seekers from Active Seekers. The inactive information seeker group was formed based on their experience with health information seeking. The potential determinants that were tested to predict inactive seeking included the following: health condition, health service use, health media exposure, and computer/Internet activities. RESULTS Within this national survey data, the respondents were more likely to be included in the Inactive Seekers (N=8312, 58.5%) compared to Active Seekers (N=5908, 41.5%). The demographic characteristics indicated that the Inactive Seekers were identified as younger, male, highly educated, White, and high household income people. The binary logistic regression results from the study model indicated that healthier people were less likely to seek out health information than their counterparts. In addition, those who were exposed to various media were almost 1.6 times more likely to seek out health information than those who were not exposed to such media. Within this study data, the statistically significant determinants identified were health condition and health media exposure while computer/Internet activities did not show strong indications in predicting inactive seeking behavior. CONCLUSION The development of more generalizable measures for health literacy or behavioral patterns will bolster advanced study on inactive seeking relating to knowledge of technology and health context. Further study should be directed at estimating the negative aspects of information seeking such as information ignorance or information avoidance.
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Affiliation(s)
- Sujin Kim
- 230G, Multidisciplinary Science Building, Division of Biomedical Informatics, College of Public Health & School of Library and Information Science, College of Communication and Information University of Kentucky, Lexington, KY 40536-0082, USA.
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Ye X, Yao Z, Liu W, Fan Y, Xu Y, Chen S. Path analysis to identify factors influencing health skills and behaviors in adolescents: a cross-sectional survey. PLoS One 2014; 9:e104406. [PMID: 25105974 PMCID: PMC4126710 DOI: 10.1371/journal.pone.0104406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 07/11/2014] [Indexed: 11/25/2022] Open
Abstract
Background Studies conducted in the past mostly rely on models of functional health literacy in adult populations. However, such models do not satisfy the need for health intervention in adolescents. The identification of key factors influencing adolescents' health literacy is essential in developing effective prevention and intervention measures. This study aimed to test a theoretical model of predictors on health skills and health behaviors in adolescents. Methods A cross-sectional survey was conducted in Guangdong using a multi-stage stratified cluster sample design. A representative random sample of 3821 students aged 13–25 years was selected using multi-stage stratified cluster sampling. The path analysis was used to test a hypothesized model of health literacy. Results The path analysis showed that knowledge of infectious disease (β = 0.26), health skills (β = 0.22), health concept (β = 0.20), general health knowledge (β = 0.15), gender (β = 0.12), and school performance (β = 0.06) had positive direct effect on health behaviors in adolescents. The explanatory variables accounted for 43% of the variance in explaining health behaviors. Knowledge of infectious disease (β = 0.30), health concept (β = 0.17), general health knowledge (β = 0.13), and school performance (β = 0.05) had positive indirect effect on health behaviors through the impacts on health skills. Conclusion This study identified several direct and indirect factors influencing health skills and health behaviors in adolescents. These findings will assist health professionals designing effective health interventions that aim to improve health skills and health behaviors in adolescents.
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Affiliation(s)
- Xiaohua Ye
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhenjiang Yao
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Weidong Liu
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Yanping Fan
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Ya Xu
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- * E-mail: (YX); (SDC)
| | - Sidong Chen
- Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
- * E-mail: (YX); (SDC)
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Stewart DW, Cano MÁ, Correa-Fernández V, Spears CA, Li Y, Waters AJ, Wetter DW, Vidrine JI. Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status. BMC Public Health 2014; 14:716. [PMID: 25018151 PMCID: PMC4226955 DOI: 10.1186/1471-2458-14-716] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 07/10/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Nearly half of U.S. adults have difficulties with health literacy (HL), which is defined as the ability to adequately obtain, process, and understand basic health information. Lower HL is associated with negative health behaviors and poor health outcomes. Racial/ethnic minorities and those with low socioeconomic status (SES) are disproportionately affected by poor HL. They also have higher smoking prevalence and more difficulty quitting smoking. Thus, lower HL may be uniquely associated with poorer cessation outcomes in this population. METHODS This study investigated the association between HL and smoking cessation outcomes among 200, low-SES, racially/ethnically diverse smokers enrolled in smoking cessation treatment. Logistic regression analyses adjusted for demographics (i.e., age, gender, race/ethnicity, relationship status), SES-related characteristics (i.e., education, income), and nicotine dependence were conducted to investigate associations between HL and smoking relapse at the end of treatment (3 weeks post quit day). RESULTS Results indicated that smokers with lower HL (score of < 64.5 on the Rapid Estimate of Adult Literacy in Medicine [REALM]) were significantly more likely than those with higher HL (score of ≥ 64.5 on the REALM) to relapse by the end of treatment, even after controlling for established predictors of cessation including demographics, SES, and nicotine dependence (OR = 3.26; 95% CI = 1.14, 9.26). CONCLUSIONS Findings suggest that lower HL may serve as an independent risk factor for smoking relapse among low-SES, racially/ethnically diverse smokers enrolled in treatment. Future research is needed to investigate longitudinal relations between HL and cessation outcomes and potential mechanisms of this relationship.
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Affiliation(s)
- Diana W Stewart
- The Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Miguel Ángel Cano
- The Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Virmarie Correa-Fernández
- The Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Claire Adams Spears
- The Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Yisheng Li
- The Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew J Waters
- The Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David W Wetter
- The Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- The Department of Psychology, Rice University, Houston, TX, USA
| | - Jennifer Irvin Vidrine
- The Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Shaw TC. Uncovering health literacy: Developing a remotely administered questionnaire for determining health literacy levels in health disparate populations. ACTA ACUST UNITED AC 2014; 3:140-156. [PMID: 25126152 DOI: 10.5430/jha.v3n4p149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Low health literacy contributes to health disparities. We sought to develop and evaluate a remotely administered tool to measure health literacy in health disparate populations. The basic research design involved asking the remotely administered questions in conjunction with an existing and valid measure of health literacy, the S-TOFHLA, to a non-representative convenience sample of individuals drawn from lower income communities. The measures of the remotely administered questions were then correlated with the results of the S-TOFHLA to determine if there was a connection between the two measures. We found a statistically significant correlation between a single question in the remotely administered survey and the validated S-TOFHLA measure. This research supports previous work that points to the importance of just a single remotely administered question in terms of correspondence with the S-TOFHLA. OBJECTIVE Develop a questionnaire that can be remotely administered to check for Health Literacy. METHODS Correlation analysis is conducted between various questions and S-TOFHLA scores to determine criterion validity. RESULTS A single question, "How confident are you in filling out medical forms by yourself?" outperforms other measures in correlating with the S-TOFHLA scores. CONCLUSIONS Further assessment of the confidence question both in isolation and in conjunction with other literacy identifiers should be conducted. Also, this question should be tested against other measures of health literacy beyond the S-TOFHLA.
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Affiliation(s)
- Thomas C Shaw
- Department of Political Science and Criminal Justice, University of South Alabama, Mobile, United States
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Holstein BA, Clifton JM, Guo JW. Health Literacy Assessment in a Juvenile Corrections Population. J Nurse Pract 2014. [DOI: 10.1016/j.nurpra.2014.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Froiland JM, Powell DR, Diamond KE, Son SHC. NEIGHBORHOOD SOCIOECONOMIC WELL-BEING, HOME LITERACY, AND EARLY LITERACY SKILLS OF AT-RISK PRESCHOOLERS. PSYCHOLOGY IN THE SCHOOLS 2013. [DOI: 10.1002/pits.21711] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ghaddar SF, Valerio MA, Garcia CM, Hansen L. Adolescent health literacy: the importance of credible sources for online health information. THE JOURNAL OF SCHOOL HEALTH 2012; 82:28-36. [PMID: 22142172 DOI: 10.1111/j.1746-1561.2011.00664.x] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Little research has examined adolescent health literacy and its relationship with online health information sources. The purpose of this study is to explore health literacy among a predominantly Hispanic adolescent population and to investigate whether exposure to a credible source of online health information, MedlinePlus(®), is associated with higher levels of health literacy. METHODS An online survey was administered to a cross-sectional random sample of high school students in South Texas. Self-reported sociodemographic characteristics and data on health-information-seeking behavior and exposure to MedlinePlus(®) were collected. Health literacy was assessed by eHEALS and the Newest Vital Sign (NVS). Linear and binary logistic regressions were completed. RESULTS Of the 261 students who completed the survey, 56% had heard of MedlinePlus(®), 52% had adequate levels of health literacy as measured by NVS, and the mean eHEALS score was 30.6 (possible range 8-40). Health literacy was positively associated with self-efficacy and seeking health information online. Exposure to MedlinePlus(®) was associated with higher eHealth literacy scores (p < .001) and increased the likelihood of having adequate health literacy (odds ratio: 2.1; 95% CI: 1.1, 4.1). CONCLUSION Exposure to a credible source of online health information is associated with higher levels of health literacy. The incorporation of a credible online health information resource into school health education curricula is a promising approach for promoting health literacy.
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Affiliation(s)
- Suad F Ghaddar
- South Texas Border Health Disparities Center, The University of Texas-Pan American, 2925 Pine Valley Drive, Harlingen, TX 78550, USA.
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Aliu O, Chung KC. Readability of ASPS and ASAPS educational web sites: an analysis of consumer impact. Plast Reconstr Surg 2010; 125:1271-1278. [PMID: 20072085 PMCID: PMC2845740 DOI: 10.1097/prs.0b013e3181d0ab9e] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients use the Internet to educate themselves about health-related topics, and learning about plastic surgery is a common activity for enthusiastic consumers in the United States. How to educate consumers regarding plastic surgical procedures is a continued concern for plastic surgeons when faced with the growing portion of the American population having relatively low health care literacy. The usefulness of health-related education materials on the Internet depends largely on their comprehensibility and understandability for all who visit the Web sites. METHODS The authors studied the readability of patient education materials related to common plastic surgery procedures from the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) Web sites and compared them with materials on similar topics from 10 popular health information-providing sites. RESULTS The authors found that all analyzed documents on the ASPS and ASAPS Web sites targeted to the consumers were rated to be more difficult than the recommended reading grade level for most American adults, and these documents were consistently among the most difficult to read when compared with the other health information Web sites. CONCLUSIONS The Internet is an increasingly popular avenue for patients to educate themselves about plastic surgery procedures. Patient education material provided on ASPS and ASAPS Web sites should be written at recommended reading grade levels to ensure that it is readable and comprehensible to the targeted audience.
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Affiliation(s)
- Oluseyi Aliu
- Plastic Surgery Resident, The University of Michigan Medical School; Ann Arbor, MI
| | - Kevin C. Chung
- Professor of Surgery, Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System; Ann Arbor, MI
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DeWalt DA, Hink A. Health literacy and child health outcomes: a systematic review of the literature. Pediatrics 2009; 124 Suppl 3:S265-74. [PMID: 19861480 DOI: 10.1542/peds.2009-1162b] [Citation(s) in RCA: 369] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To review the relationship between parent and child literacy and child health outcomes and interventions designed to improve child health outcomes for children or parents with low literacy skills. METHODS We searched Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for articles published from 1980 through 2008 and included studies that reported original data, measured literacy and >or=1 health outcome, and assessed the relationship between literacy and health outcomes. Health outcomes included health knowledge, health behaviors, use of health care resources, intermediate markers of disease status, and measures of morbidity. Two abstractors reviewed each study for inclusion. Included studies were abstracted into evidence tables and were assessed by using an 11-item quality scale. RESULTS We reviewed 4182 new titles and abstracts published since 2003. Fifty-eight articles were retained for full review, and 13 met the inclusion criteria. Eleven articles from the systematic review from 1980 to 2003 met the inclusion criteria, giving us a total of 24 articles. Children with low literacy generally had worse health behaviors. Parents with low literacy had less health knowledge and had behaviors that were less advantageous for their children's health compared with parents with higher literacy. Children whose parents had low literacy often had worse health outcomes, but we found mixed results for the relationship of literacy to the use of health care services. Interventions found that improving written materials can increase health knowledge, and combining good written materials with brief counseling can improve behaviors including adherence. The average quality of the studies was fair to good. CONCLUSIONS Child and parent literacy seems associated with important health outcomes. Future research can help us understand under what circumstances this relationship is causal, how literacy and health outcomes are related in noncausal pathways, the relative importance of parent and child literacy, and what interventions effectively reduce health literacy-related disparities.
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Affiliation(s)
- Darren A DeWalt
- Cecil G. Sheps Center for Health Services Research, Program on Health Literacy, University of North Carolina, Chapel Hill, NC 27599, USA.
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Sanders LM, Shaw JS, Guez G, Baur C, Rudd R. Health literacy and child health promotion: implications for research, clinical care, and public policy. Pediatrics 2009; 124 Suppl 3:S306-14. [PMID: 19861485 DOI: 10.1542/peds.2009-1162g] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The nation's leading sources of morbidity and health disparities (eg, preterm birth, obesity, chronic lung disease, cardiovascular disease, type 2 diabetes, mental health disorders, and cancer) require an evidence-based approach to the delivery of effective preventive care across the life course (eg, prenatal care, primary preventive care, immunizations, physical activity, nutrition, smoking cessation, and early diagnostic screening). Health literacy may be a critical and modifiable factor for improving preventive care and reducing health disparities. Recent studies among adults have established an independent association between lower health literacy and poorer understanding of preventive care information and poor access to preventive care services. Children of parents with higher literacy skills are more likely to have better outcomes in child health promotion and disease prevention. Adult studies in disease prevention have suggested that addressing health literacy would be an efficacious strategy for reducing health disparities. Future initiatives to reduce child health inequities should include health-promotion strategies that meet the health literacy needs of children, adolescents, and their caregivers.
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Affiliation(s)
- Lee M Sanders
- University of Miami, Miller School of Medicine, Jay Weiss Center for Social Medicine and Health Equity, Department of Pediatrics, 1601 NW 12th Ave, Suite 4063, Miami, FL 33136, USA.
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Wittmann M, Arce E, Santisteban C. How impulsiveness, trait anger, and extracurricular activities might affect aggression in school children. PERSONALITY AND INDIVIDUAL DIFFERENCES 2008. [DOI: 10.1016/j.paid.2008.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Manganello JA. Health literacy and adolescents: a framework and agenda for future research. HEALTH EDUCATION RESEARCH 2008; 23:840-847. [PMID: 18024979 DOI: 10.1093/her/cym069] [Citation(s) in RCA: 232] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Health literacy is an important issue in public health today, especially as patients are taking a greater role in obtaining information about their health. Health literacy is commonly defined 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'. While there is a large body of literature concerning health literacy and adults, few studies have focused on adolescents. Adolescents may have less interaction with the health care system and lower health care costs than adults, but they are increasingly involved with their health care, especially those with chronic illness. They are frequent users of mass media and other technology to access health information and are a target group for many health-related educational interventions. Adolescents are also at a crucial stage of development, learning skills they will carry with them into adulthood. The goal of this paper is to provide a summary of issues justifying the importance of studying health literacy as it relates to adolescents and to provide a framework and suggestions for future research.
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Affiliation(s)
- Jennifer A Manganello
- Department of Health Policy, Management.ehavior, University at Albany, SUNY, School of Public Health, One University Place, Rensselaer, NY 12144, USA.
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Affiliation(s)
- H Shonna Yin
- Department of Pediatrics, New York University School of Medicine and Bellevue Hospital Center, New York, NY, USA
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Betz CL. Health literacy: the missing link in the provision of health care for children and their families. J Pediatr Nurs 2007; 22:257-60. [PMID: 17645953 DOI: 10.1016/j.pedn.2007.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Evaluation of a Spanish version of the Buss and Perry aggression questionnaire: Some personal and situational factors related to the aggression scores of young subjects. PERSONALITY AND INDIVIDUAL DIFFERENCES 2007. [DOI: 10.1016/j.paid.2006.10.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Limited English and Health Proficiency. J Patient Saf 2007. [DOI: 10.1097/pts.0b013e318032392f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
OBJECTIVES Eighty million US adults have low health literacy, a risk factor for increased health care use among adults. The purpose of this work was to assess the association between caregiver health literacy and the use and cost of child health services. METHODS We conducted a cross-sectional study of caregiver-child dyads from a sample of children aged 12 months to 12 years presenting to the pediatric emergency department of an urban, public hospital. Caregiver health literacy was measured by the Short Test of Functional Health Literacy in their preferred language (English or Spanish). Child health care use was measured by a 12-month retrospective review of the public hospital system's electronic database and of state Medicaid billing records for 4 types of visits: preventive care, urgent care, emergency care, and hospital care. Cost of child health care use was provided by Medicaid billing records. Multivariate analysis included caregiver education, age, and language proficiency, as well as child age, special health care needs, ethnicity, and health-insurance coverage. RESULTS A total of 290 dyads were enrolled in the study. Twenty-two percent of caregivers had low (inadequate or marginal) health literacy. Caregivers with low health literacy were more likely to have less than a high school education, to have limited English proficiency, and to have been born outside the United States. There were no differences in health care use or cost between children of caregivers with low health literacy and children of caregivers with adequate health literacy. Three caregiver characteristics were associated with increased use of child health care services: born outside the United States, age at child's birth <24 years, and limited English proficiency. CONCLUSIONS One in 5 caregivers of young children has low health literacy. Caregiver health literacy, however, was not associated with disparities in the use of child health services in this inner-city, ethnic minority population.
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Affiliation(s)
- Lee M Sanders
- Department of Pediatrics, University of Miami School of Medicine, 1601 NW 12th Ave, Suite 4063, Miami, FL 33136, USA.
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Davis TC, Wolf MS, Arnold CL, Byrd RS, Long SW, Springer T, Kennen E, Bocchini JA. Development and validation of the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen): a tool to screen adolescents for below-grade reading in health care settings. Pediatrics 2006; 118:e1707-14. [PMID: 17142495 DOI: 10.1542/peds.2006-1139] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The magnitude and consequences of low literacy in adolescent health and health care are unknown. The purpose of this study was to validate the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen), a word-recognition test in English that can be used as a brief literacy-screening tool in health care settings. PATIENTS AND METHODS A total of 1533 adolescents aged 10 to 19 years attending 1 of 5 middle schools, 3 high schools, 1 pediatric clinic, or 2 summer programs in Louisiana and North Carolina participated in face-to-face interviews. Demographic information was solicited, and participants were administered a battery of reading tests, including the REALM-Teen, Wide Range Achievement Test-Revised (WRAT-3), and Slosson Oral Reading Test-Revised (SORT-R). Internal consistency for the REALM-Teen was determined using Cronbach's alpha, and criterion validity was established through correlations with both the WRAT-R and SORT-R. Using reading below grade level (according to SORT-R scores) as an outcome, instrument accuracy and corresponding cutoff scores were calculated by plotting receiver operating characteristic curves and stratum-specific likelihood ratios. RESULTS Participants were 50% black and 53% female; 34% were enrolled in middle school and 66% in high school. The average time required to administer the REALM-Teen was 3 minutes. Internal consistency was excellent, as was test-retest reliability. The REALM-Teen is strongly correlated with both the WRAT-R and SORT-R. Five reading level categories were identified: 3rd grade and below, 4th to 5th grade, 6th to 7th grade, 8th to 9th grade, and 10th grade and above. Forty-six percent of participants were reading below grade level according to the SORT-R and 28% had repeated at least 1 grade. CONCLUSION The REALM-Teen is a brief, reliable instrument for assessing adolescent literacy skills and reading below grade level.
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Affiliation(s)
- Terry C Davis
- Department of Pediatrics and Medicine, Louisiana State University Health Sciences Center, Shreveport, Shreveport, LA 71130, USA
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Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med 2004. [PMID: 15610334 DOI: 10.1111/j.1525–1497.2004.40153.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To review the relationship between literacy and health outcomes. DATA SOURCES We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resources Information Center (ERIC), Public Affairs Information Service (PAIS), Industrial and Labor Relations Review (ILLR), PsychInfo, and Ageline from 1980 to 2003. STUDY SELECTION We included observational studies that reported original data, measured literacy with any valid instrument, and measured one or more health outcomes. Two abstractors reviewed each study for inclusion and resolved disagreements by discussion. DATA EXTRACTION One reviewer abstracted data from each article into an evidence table; the second reviewer checked each entry. The whole study team reconciled disagreements about information in evidence tables. Both data extractors independently completed an 11-item quality scale for each article; scores were averaged to give a final measure of article quality. DATA SYNTHESIS We reviewed 3,015 titles and abstracts and pulled 684 articles for full review; 73 articles met inclusion criteria and, of those, 44 addressed the questions of this report. Patients with low literacy had poorer health outcomes, including knowledge, intermediate disease markers, measures of morbidity, general health status, and use of health resources. Patients with low literacy were generally 1.5 to 3 times more likely to experience a given poor outcome. The average quality of the articles was fair to good. Most studies were cross-sectional in design; many failed to address adequately confounding and the use of multiple comparisons. CONCLUSIONS Low literacy is associated with several adverse health outcomes. Future research, using more rigorous methods, will better define these relationships and guide developers of new interventions.
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Affiliation(s)
- Darren A Dewalt
- RTI International-University of North Carolina Evidence-based Practice Center, Research Triangle Park, NC 27599, USA.
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Abstract
OBJECTIVE To review the relationship between literacy and health outcomes. DATA SOURCES We searched MEDLINE, Cumulative Index to Nursing and Allied Health (CINAHL), Educational Resources Information Center (ERIC), Public Affairs Information Service (PAIS), Industrial and Labor Relations Review (ILLR), PsychInfo, and Ageline from 1980 to 2003. STUDY SELECTION We included observational studies that reported original data, measured literacy with any valid instrument, and measured one or more health outcomes. Two abstractors reviewed each study for inclusion and resolved disagreements by discussion. DATA EXTRACTION One reviewer abstracted data from each article into an evidence table; the second reviewer checked each entry. The whole study team reconciled disagreements about information in evidence tables. Both data extractors independently completed an 11-item quality scale for each article; scores were averaged to give a final measure of article quality. DATA SYNTHESIS We reviewed 3,015 titles and abstracts and pulled 684 articles for full review; 73 articles met inclusion criteria and, of those, 44 addressed the questions of this report. Patients with low literacy had poorer health outcomes, including knowledge, intermediate disease markers, measures of morbidity, general health status, and use of health resources. Patients with low literacy were generally 1.5 to 3 times more likely to experience a given poor outcome. The average quality of the articles was fair to good. Most studies were cross-sectional in design; many failed to address adequately confounding and the use of multiple comparisons. CONCLUSIONS Low literacy is associated with several adverse health outcomes. Future research, using more rigorous methods, will better define these relationships and guide developers of new interventions.
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Affiliation(s)
- Darren A Dewalt
- RTI International-University of North Carolina Evidence-based Practice Center, Research Triangle Park, NC 27599, USA.
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Estell DB, Farmer TW, Cairns BD, Clemmer JT. Self-report weapon possession in school and patterns of early adolescent adjustment in rural african american youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2003; 32:442-52. [PMID: 12881032 DOI: 10.1207/s15374424jccp3203_12] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Examined 345 6th-grade rural African American youth (189 boys, 156 girls) over 3 years with regard to carrying weapons in school. Recent investigations with nationally representative and urban samples have shown that carrying weapons in school fits into a larger pattern of problem behaviors, including aggression and substance use, which are supported by affiliations with other deviant youth. Very little work to date has specifically examined weapon carrying in rural African American youth. This study found that weapon carriers in the first year were primarily male, more aggressive, and had higher rates of substance use than noncarriers. Concurrent peer affiliations were not related to weapon carrying in the first year. However, among those who were not carriers in the 1st year, transitioning into weapon carrying was related to both individual marijuana use and peer-group aggression and marijuana use. Finally, over the 3 years of the study, weapon carriers tended to maintain their high levels of aggression, drinking, and marijuana use.
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Affiliation(s)
- David B Estell
- Department of Counseling and Educational Psychology, Indiana University, Bloomington, IN 4705-1006, USA.
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