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Pierce TB, Aragón MC, Auld G, Barale KV, Hughes SO, Power TG, Lanigan JD, Parker L, Baker SS. Parents Report Positive Changes in Parental Feeding Practices 12 Months After Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:489-498. [PMID: 38661626 DOI: 10.1016/j.jneb.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up. METHODS Telephone focus groups using a 2 × 2 design (English/Spanish × in-class or online) with Expanded Food and Nutrition Education Program participants (n = 37) with children 2-8 years and high exposure to the Food, Feeding, and Your Family intervention (7 lessons). Researchers (n = 3) independently identified themes. RESULTS Parental behavior changes that (1) positively influenced children's diets, (2) involved children in food-related activities, (3) eased stressful situations around food, (4) led to healthier food choices, and (5) saved money when food shopping. Commonly implemented practices included establishing structured mealtime routines, introducing new foods multiple times, and encouraging children's eating competence. Online participants noted materials were easily accessible via text messages. CONCLUSIONS AND IMPLICATIONS Incorporating parental feeding content (in-class or online) into nutrition education interventions, such as the Expanded Food and Nutrition Education Program, supports developing positive parental feeding behaviors in families with low income.
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Affiliation(s)
- Theresa B Pierce
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | | | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Karen V Barale
- Washington State University Extension, Pierce County, Tacoma, WA
| | - Sheryl O Hughes
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Jane D Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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Di Novi C, Kovacic M, Orso CE. Online health information seeking behavior, healthcare access, and health status during exceptional times. JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION 2024; 220:675-690. [PMID: 38628501 PMCID: PMC11019610 DOI: 10.1016/j.jebo.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/09/2024] [Accepted: 02/20/2024] [Indexed: 04/19/2024]
Abstract
Online health information seeking behavior (e-HISB) is becoming increasingly common and the trend has accelerated as a result of the COVID-19 pandemic when individuals strongly relied upon the Internet to stay informed by becoming exposed to a wider array of health information. Despite e-HISB having become a global trend, very few empirical investigations have analyzed its potential influence on healthcare access and individuals' health status. In this paper, we try to fill this gap. We use data from the second SHARE Corona Survey, supplemented with data from the previous 8th wave of SHARE, and estimate a recursive model of e-HISB, healthcare access, and individuals' health status that accounts for individuals' unobserved heterogeneity. Our findings suggest that e-HISB can empower individuals to better understand health concerns, facilitating improved health condition management. However, e-HISB can also trigger a chain reaction, as navigating vast amonts of online health information can heighten fear and anxiety. This increased anxiety may lead to higher utilization of medical services, adversely affecting individuals' perceptions of their health.
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Affiliation(s)
- Cinzia Di Novi
- European Commission, Joint Research Centre (JRC), Via Enrico Fermi 2749, TP 267, 21027, Ispra, VA, Italy
| | - Matija Kovacic
- European Commission, Joint Research Centre (JRC), Via Enrico Fermi 2749, TP 267, 21027, Ispra, VA, Italy
| | - Cristina Elisa Orso
- Department of Law, Economics, and Cultures, University of Insubria, Como, Italy
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Irfan B, Yasin I, Yaqoob A. The Birth of the Contextual Health Education Readability Score in an Examination of Online Influenza Patient Education Materials. Cureus 2024; 16:e56715. [PMID: 38650807 PMCID: PMC11033604 DOI: 10.7759/cureus.56715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Influenza is a major global health concern, with its rapid spread and mutation rate posing significant challenges in public health education and communication. Effective patient education materials (PEMs) are crucial for informed decision-making and improved health outcomes. This study evaluates the efficacy of online influenza PEMs using traditional readability tools and introduces the Contextual Health Education Readability Score (CHERS) to address the limitations of existing methods that do not capture the diverse array of visual and thematic means displayed. Materials and methods A comprehensive search was conducted to select relevant online influenza PEMs. This involved looking through Google's first two pages of results sorted by relevance, for a total of 20 results. These materials were evaluated using established readability tools (e.g., Flesch Reading Ease, Flesch-Kincaid Grade Level) and the Patient Education Materials Assessment Tool (PEMAT) for understandability and actionability. The study also involved the creation of CHERS, integrating factors such as semantic complexity, cultural relevance, and visual aid effectiveness. The development of CHERS included weighting each component based on its impact on readability and comprehension. Results The traditional readability tools demonstrated significant variability in the readability of the selected materials. The PEMAT analysis revealed general trends toward clarity in purpose and use of everyday language but indicated a need for improvement in summaries and visual aids. The CHERS formula was calculated as follows: CHERS = (0.4 × Average Sentence Length) + (0.3 × Average Syllables per Word) + (0.15 × Semantic Complexity Score) + (0.1 × Cultural Relevance Score) + (0.05 × Visual Aid Effectiveness Score), integrating multiple dimensions beyond traditional readability metrics. Discussion The study highlighted the limitations of traditional readability tools in assessing the complexity and cultural relevance of health information. The introduction of CHERS addressed these gaps by incorporating additional dimensions crucial for understanding in a healthcare context. The recommendations provided for creating effective influenza PEMs focused on language simplicity, cultural sensitivity, and actionability. This may enable further research into evaluating current PEMs and clarifying means of creating more effective content in the future. Conclusions The study underscores the need for comprehensive readability assessments in PEMs. The creation of CHERS marks a significant advancement in this field, providing a more holistic approach to evaluating health literacy materials. Its application could lead to the development of more inclusive and effective educational content, thereby improving public health outcomes and reducing the global burden of influenza. Future research should focus on further validating CHERS and exploring its applicability to other health conditions.
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Affiliation(s)
- Bilal Irfan
- Microbiology and Immunology, University of Michigan, Ann Arbor, USA
| | - Ihsaan Yasin
- Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, USA
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Marfo EA, Manca T, Cha E, Aylsworth L, Driedger SM, Meyer SB, Pelletier C, Dubé È, MacDonald SE. Intersecting Inequities in COVID-19 Vaccination: A Discourse Analysis of Information Use and Decision-Making Among Ethnically Diverse Parents in Canada. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01940-2. [PMID: 38409490 DOI: 10.1007/s40615-024-01940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/08/2024] [Accepted: 02/06/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Little is known about how intersecting social privilege and disadvantage contribute to inequities in COVID-19 information use and vaccine access. This study explored how social inequities intersect to shape access to and use of COVID-19 information and vaccines among parents in Canada. METHODS We conducted semi-structured interviews on COVID-19 vaccination information use with ethnically diverse parents of children ages 11 to 18 years from April to August 2022. We purposefully invited parents from respondents to a national online survey to ensure representation across diverse intersecting social identities. Five researchers coded transcripts in NVivo using a discourse analysis approach informed by intersectionality. Our analysis focused on use of vaccine information and intersecting privileges and oppressions, including identifying with equity-denied group(s). RESULTS Interview participants (N = 48) identified as ethnically diverse non-Indigenous (n = 40) and Indigenous (n = 8) Peoples from seven Canadian provinces. Racialized minority or Indigenous participants reflected on historical and contemporary events of racism from government and medical institutions as barriers to trust and access to COVID-19 information, vaccines, and the Canadian healthcare system. Participants with privileged social locations showed greater comfort in resisting public health measures. Despite the urgency to receive COVID-19 vaccines, information gaps and transportation barriers delayed vaccination among some participants living with chronic medical conditions. CONCLUSION Historicization of colonialism and ongoing events of racism are a major barrier to trusting public health information. Fostering partnerships with trusted leaders and/or healthcare workers from racialized communities may help rebuild trust. Healthcare systems need to continuously implement strategies to restore trust with Indigenous and racialized populations.
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Affiliation(s)
| | - Terra Manca
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Eunah Cha
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Laura Aylsworth
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - S Michelle Driedger
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Samantha B Meyer
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Catherine Pelletier
- Centre de Recherche du CHU de Quebec- Université Laval, Quebec City, QC, Canada
| | - Ève Dubé
- Department of Anthropology, Université Laval, Quebec City, QC, Canada
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Donelle L, Hiebert B, Hall J. An investigation of mHealth and digital health literacy among new parents during COVID-19. Front Digit Health 2024; 5:1212694. [PMID: 38333052 PMCID: PMC10850289 DOI: 10.3389/fdgth.2023.1212694] [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: 04/26/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Especially during the COVID-19 pandemic, parents were expected to understand increasingly sophisticated information about health issues and healthcare systems and access online resources as a part of their caregiving role. Yet little is known about parents' online digital technology use and digital health literacy skill. This study aimed to investigate parents' digital technology use, their self-reported digital health literacy skill, and demographic information as potential factors influencing their use of digital technologies. Methods An online survey utilizing convenience sampling was administered to new parents during the COVID-19 pandemic that inquired about their demographic information, digital technology use, and digital health literacy skills within Ontario, Canada. Results A total of 151 individuals responded to the survey; these were primarily mothers (80%) who self-reported as white (72%), well-educated 86%), heterosexual (86%) females (85%) with incomes over $100,00 per year (48%). Participants reported consistent and persistent online activity related to their parenting role and mostly via mobile smartphone devices (92%). Participants had moderate to high digital health literacy skills, greater than the Canadian national average. Almost half of participants reported negative health and well-being consequences from their digital online behaviours. There were no significant relationships between technology use, digital health literacy skill, and demographic variables. Discussion The COVID-19 pandemic has reinforced the need for and importance of effective and equitable digital health services. Important opportunities exist within clinical practice and among parenting groups to proactively address the physical and mental health implications of digital parenting practices. Equally important are opportunities to insert into clinical workflow the inquiry into parents' online information-seeking behaviours, and to include digital health literacy as part of prenatal/postnatal health education initiatives.
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Affiliation(s)
- Lorie Donelle
- College of Nursing, University of South Carolina, Columbia, SC, United States
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Brad Hiebert
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Jodi Hall
- School of Nursing, Fanshawe College, London, ON, Canada
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Luong N, Barnett I, Aledavood T. The impact of the COVID-19 pandemic on daily rhythms. J Am Med Inform Assoc 2023; 30:1943-1953. [PMID: 37550242 PMCID: PMC10654873 DOI: 10.1093/jamia/ocad140] [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: 03/17/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic has significantly impacted daily activity rhythms and life routines with people adjusting to new work schedules, exercise routines, and other everyday life activities. This study examines temporal changes in daily activity rhythms and routines during the COVID-19 pandemic, emphasizing disproportionate changes among working adult subgroups. MATERIALS AND METHODS In June 2021, we conducted a year-long study to collect high-resolution fitness tracker data and questionnaire responses from 128 working adults. Questionnaire data were analyzed to explore changes in exercise and work routines during the pandemic. We build temporal distributions of daily step counts to quantify their daily movement rhythms, then measure their consistency over time using the inverse of the Earth mover's distance. Linear mixed-effects models were employed to compare movement rhythm variability among subpopulations. RESULTS During the pandemic, our cohort exhibited a shift in exercise routines, with a decrease in nonwalking physical exercises, while walking remained unchanged. Migrants and those living alone had less consistent daily movement rhythms compared to others. Those preferring on-site work maintained more consistent daily movement rhythms. Men and migrants returned to work more quickly after pandemic restriction measures were eased. DISCUSSION Our findings quantitatively show the pandemic's unequal impact on different subpopulations. This study opens new research avenues to explore why certain groups return to on-site work, exercise levels, or daily movement rhythms more slowly compared to prepandemic times. CONCLUSIONS Considering the pandemic's unequal impact on subpopulations, organizations and policymakers should address diverse needs and offer tailored support during future crises.
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Affiliation(s)
- Nguyen Luong
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Ian Barnett
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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