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Hiefner AR, Raman S, Woods SB. Family Support and Type 2 Diabetes Self-management Behaviors in Underserved Latino/a/x Patients. Ann Behav Med 2024; 58:477-487. [PMID: 38795386 DOI: 10.1093/abm/kaae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2024] Open
Abstract
BACKGROUND Latino/a/x families experience persistent Type 2 diabetes mellitus (T2DM) disparities, including higher rates of diagnosis and mortality due to disease complications than their non-Hispanic White counterparts. Though greater social support is associated with improved disease outcomes for Latino/a/x patients with diabetes, research has yet to identify the specific pathways through which social support, and specifically family support, influences self-management. PURPOSE This study tested a theoretical model highlighting the mechanisms and pathways linking social support and physical health. Specifically, self-efficacy and depression were tested as psychological pathways connecting family support to diabetes self-management behaviors and diabetes morbidity in Latino/a/x patients with T2DM. METHODS Data from 177 patients were analyzed using structural equation modeling. Measures included diabetes-specific family support needed and received, depressive symptoms, self-efficacy in diabetes management, diabetes self-management behaviors, health appraisal, and hemoglobin A1c. RESULTS Greater diabetes-specific family support was significantly associated with more frequent engagement in diabetes self-management behaviors, both directly (p < .001) and through diabetes self-efficacy's partial mediation of this relationship (p = .013). Depression was not significantly associated with either family support (support received, p = .281; support needed, p = .428) or self-management behaviors (p = .349). CONCLUSIONS Family support and diabetes self-efficacy may be important modifiable psychosocial factors to target via integrated care interventions aimed at supporting Latino/a/x patients with T2DM. Future research is needed to test empirically based, culturally adapted interventions to reduce T2DM-related health disparities in this population.
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Affiliation(s)
- Angela R Hiefner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Shivani Raman
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sarah B Woods
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Alemany-Pagès M, Tavares R, Azul AM, Ramalho-Santos J. A Healthy Liver Will Always Deliver: Impact Study of a Non-Alcoholic Fatty Liver Disease (NAFLD) Awareness Comic. HEALTH COMMUNICATION 2024; 39:1412-1417. [PMID: 37248695 DOI: 10.1080/10410236.2023.2215908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Based on previous work, we developed the comic "A healthy liver will always deliver!" to raise awareness about Non-Alcoholic Fatty Liver Disease (NAFLD) and promote healthy lifestyles. An online pre-post questionnaire design demonstrated an increase in health-threat beliefs regarding NAFLD among the general public, as well as response efficacy and self-efficacy beliefs, normative and control beliefs regarding the maintenance of preventive strategies involving healthy diets and active lifestyles, after interaction with the comic's narrative. This effect was more evident in women. Furthermore, although we could not perform all the ideal controls during the COVID-19 pandemic, and the online strategy attracted mostly university education-level subjects, the comic seemed relatable and engaging. However, more work will have to be performed to ensure its usefulness in terms of acquired knowledge and behavior changes, especially in at-risk segments of the population.
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Affiliation(s)
- Mireia Alemany-Pagès
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra
- Programme in Experimental Biology and Biomedicine (PDBEB), IIIUC-Institute for Interdisciplinary Research, University of Coimbra
| | - Rui Tavares
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra
- Programme in Experimental Biology and Biomedicine (PDBEB), IIIUC-Institute for Interdisciplinary Research, University of Coimbra
| | - Anabela Marisa Azul
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra
- IIIUC-Institute for Interdisciplinary Research, University of Coimbra
| | - João Ramalho-Santos
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra
- DCV-Department of Life Sciences, University of Coimbra
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Panagiotidis P, Kalokairinou A, Tzavara C, Michailidou A, Velonaki VS. Health Literacy, Self-Efficacy and Glycemic Control in Patients With Diabetes Type 2 in a Greek Population. Cureus 2024; 16:e55691. [PMID: 38586620 PMCID: PMC10997967 DOI: 10.7759/cureus.55691] [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: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Aim To investigate the relationship between health literacy (HL), self-efficacy (SE), and achievement of treatment goals in patients with type 2 diabetes mellitus (T2DM). Method The cross-sectional study was conducted with a random sample of patients with T2DM attending the diabetology clinic and the Home Care department of the General Hospital of Drama, Greece. They completed two questionnaires: the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) to measure HL and the Diabetes Management Self-Efficacy Scale (DMSES) for people with T2DM to measure SE. Medical history, demographic characteristics, and values related to glycemic control were also recorded. Linear regression analysis was used to search for the dependence of glycosylated hemoglobin (A1C) values with HL and SE and the dependence between them. Result About 120 patients with T2DM (response rate of 92.3%) were enrolled in the study. The mean age of the participants was 62.5 years [standard deviation (SD) = 10.6 years] and most of them were female (53.3%). A1C was found to be significantly negatively associated with diet, physical activity, and SE score. Also, a statistically significant positive correlation was found between HL and SE. HL was correlated with age, gender, education level, and A1C, with women and older people having lower HL, while conversely higher education level was significantly associated with higher HL. Higher A1C was significantly associated with lower HL. Also, SE partially mediates the relationship between HL and A1C, in a significant way. Conclusion The results of the study confirm the important role of HL and SE in the successful management of T2DM. Multi-level educational interventions for diabetic patients could improve HL and SE and promote diabetes self-management.
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Affiliation(s)
- Panagiotis Panagiotidis
- Nursing, National and Kapodistrian University of Athens, Athens, GRC
- Outpatient Diabetes Clinic, General Hospital of Drama, Drama, GRC
| | | | - Chara Tzavara
- Biostatistician, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC
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Mesinovic J, Fyfe JJ, Talevski J, Wheeler MJ, Leung GK, George ES, Hunegnaw MT, Glavas C, Jansons P, Daly RM, Scott D. Type 2 Diabetes Mellitus and Sarcopenia as Comorbid Chronic Diseases in Older Adults: Established and Emerging Treatments and Therapies. Diabetes Metab J 2023; 47:719-742. [PMID: 37709502 PMCID: PMC10695715 DOI: 10.4093/dmj.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/16/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
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Affiliation(s)
- Jakub Mesinovic
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Jackson J. Fyfe
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jason Talevski
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia
- School of Rural Health, Monash University, Warragul, Australia
| | - Michael J. Wheeler
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Gloria K.W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Elena S. George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Melkamu T. Hunegnaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Costas Glavas
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Paul Jansons
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Robin M. Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - David Scott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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Karki A, Vandelanotte C, Khalesi S, Dahal P, Rawal LB. The effect of health behavior interventions to manage Type 2 diabetes on the quality of life in low-and middle-income countries: A systematic review and meta-analysis. PLoS One 2023; 18:e0293028. [PMID: 37844107 PMCID: PMC10578590 DOI: 10.1371/journal.pone.0293028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Behavioral interventions targeted at managing Type 2 diabetes mellitus (T2DM) may have a positive effect on quality of life (QOL). Limited reviews have synthesized this effect in low- and middle-income countries (LMICs). This review and meta-analysis synthesised available evidence on the effect of behavioral interventions to manage T2DM on the QOL of people with T2DM in LMICs. METHODS Electronic databases PUBMED/MEDLINE, SCOPUS, CINAHL, Embase, Web of Science and PsycINFO were searched from May to June 2022. Studies published between January 2000 and May 2022, conducted in LMICs using randomized controlled trial design, using a health behavior intervention for T2DM management, and reporting QOL outcomes were included. Difference in QOL change scores between the intervention and control group was calculated as the standardized mean difference (SMD) of QOL scores observed between the intervention and control groups. Random-effects model was used for meta-analysis. RESULTS Of 6122 studies identified initially, 45 studies met the inclusion criteria (n = 8336). Of them, 31 involved diabetes self-management education and 14 included dietary and/or physical activity intervention. There was moderate quality evidence from the meta-analysis of mean QOL (n = 25) that health behavior intervention improved the QOL of people with T2DM (SMD = 1.62, 95%CI = 0.65-2.60 I2 = 0.96, p = 0.001). However, no significant improvements were found for studies (n = 7) separately assessing the physical component summary (SMD = 0.76, 95%CI = -0.03-1.56 I2 = 0.94, p = 0.060) and mental component summary (SMD = 0.43, 95%CI = -0.30-1.16 I2 = 0.94, p = 0.249) scores. High heterogeneity and imprecise results across studies resulted in low to moderate quality of evidence. CONCLUSION The findings suggest that health behavior interventions to manage T2DM may substantially improve the QOL of individuals with T2DM over short term. However, due to low to moderate quality of evidence, further research is required to corroborate our findings. Results of this review may guide future research and have policy implications for T2DM management in LMICs.
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Affiliation(s)
- Ashmita Karki
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Saman Khalesi
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Padam Dahal
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Lal B. Rawal
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Rockhampton, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney Australia
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Lim ML, van Schooten KS, Radford KA, Hadjistavropoulos T, Everett B, Zijlstra R, Delbaere K. Theoretical framework of concerns about falling in older people: the role of health literacy. Health Promot Int 2023; 38:daad122. [PMID: 37804516 DOI: 10.1093/heapro/daad122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/09/2023] Open
Abstract
Adherence and participation can be improved in health programs for older people with concerns about falling. While health literacy empowers older people to have greater control over their health, little is known about the extent to which health literacy influences health behaviours associated with concerns about falling in older people. This study aimed to synthesise current findings on health literacy, concerns about falling and falls to propose a multicomponent theoretical model on health literacy and concerns about falling. The model was developed based on a review of the literature, existing frameworks and models on health literacy and concerns about falling. Existing evidence on the relationship between health literacy and concerns about falling in older people is limited. Evidence from other research areas, however, shows that health literacy is closely related to many of the determinants of concerns about falling. More research is needed to clarify the impact of health literacy on intervention adherence and decision-making processes of older people with concerns about falling. Our model offers a novel perspective on the role of health literacy in health behaviours associated with concerns about falling, suggesting new research directions and providing insights for clinicians to consider health literacy when managing older patients with concerns about falling.
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Affiliation(s)
- Mei Ling Lim
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Kimberley S van Schooten
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Kylie A Radford
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | | | - Bronwyn Everett
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Australia
| | - Rixt Zijlstra
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Public Health Service Flevoland (GGD Flevoland), Department of Health Policy and Research, Lelystad, The Netherlands
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
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Pienkowska A, Ang CS, Mammadova M, Mahadzir MDA, Car J. A Diabetes Education App for People Living With Type 2 Diabetes: Co-Design Study. JMIR Form Res 2023; 7:e45490. [PMID: 37721799 PMCID: PMC10546275 DOI: 10.2196/45490] [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: 01/04/2023] [Revised: 06/30/2023] [Accepted: 07/19/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a growing global health concern, including in Singapore. Diabetes education programs have been shown to be effective in improving health outcomes and diabetes self-management skills. Mobile health apps have emerged as useful tools for diabetes education; however, their use and acceptance by the target population remain inconsistent. Therefore, end-user participation in the design and development of a mobile health app is crucial for designing an acceptable app that can improve outcomes for populations with a chronic disease. OBJECTIVE The objective of this study was to apply an end-user participatory approach to co-design a diabetes education app prototype for people living with T2D by exploring their perceptions, acceptance, and usability of an app prototype, as well as their diabetes experience and perspectives on digital diabetes education. METHODS A total of 8 people with T2D, who were recruited from diabetes management Facebook groups, participated in 4 web-based surveys via Qualtrics and 2 structured interviews via Zoom (Zoom Video Communications, Inc) between August 20, 2021, and January 28, 2022. Descriptive statistics and thematic analyses of the discussion and iterative feedback on the app prototype were used to assess the participants' perceptions of living with T2D, attitudes toward digital diabetes education, and acceptance of the prototype. RESULTS Analyses of the surveys and interview data revealed 3 themes: challenges of living with T2D; validation, acceptability, and usability of the diabetes education app prototype; and perspectives on digital diabetes education. In the first theme, participants highlighted the importance of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second theme indicated that the diabetes education app prototype was acceptable, with information and appearance being key; revealed ambivalent and polarized opinions toward the chatbot; and confirmed potential impact of the app on diabetes self-management skills and practice. The third theme comprised the necessity of using a variety of information-seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based design and content, gamification, guidance, integration, personalization, and up-to-date content. The findings were used to reiterate the app design. CONCLUSIONS Despite a small sample size, the study demonstrated the feasibility of engaging and empowering people living with T2D to consider digital therapeutics for diabetes self-management skills and practice. Participants gave rather positive feedback on the design and content of the app prototype, with some recommendations for improvements. The findings suggest that incorporating end-user feedback into app design can lead to the creation of feasible and acceptable tools for diabetes education, potentially improving outcomes for populations with a chronic disease. Further research is needed to test the impact of the refined diabetes education app prototype on diabetes self-management skills and practice and quality of life.
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Affiliation(s)
- Anita Pienkowska
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Chin-Siang Ang
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Maleyka Mammadova
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Muhammad Daniel Azlan Mahadzir
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Center for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Litchfield I, Barrett T, Hamilton-Shield J, Moore T, Narendran P, Redwood S, Searle A, Uday S, Wheeler J, Greenfield S. Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes. Int J Equity Health 2023; 22:188. [PMID: 37697302 PMCID: PMC10496394 DOI: 10.1186/s12939-023-01976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/26/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, its important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes. METHODS We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context - the influence and mitigation of a range of individual, socio-cultural, and environmental factors. RESULTS We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities. CONCLUSIONS A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Tim Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
| | - Julian Hamilton-Shield
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 2NT, UK
- The Royal Hospital for Children in Bristol, Bristol, BS2 8BJ, UK
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
- Queen Elizabeth Hospital, Birmingham, B15 2GW, UK
| | - Sabi Redwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Aidan Searle
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Suma Uday
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Jess Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
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Seangpraw K, Ong-Artborirak P, Boonyathee S, Bootsikeaw S, Kantow S, Panta P, Winaiprasert P. Effect of Health Literacy Intervention on Glycemic Control and Renal Function Among Thai Older Adults at Risk of Type 2 Diabetes Mellitus. Clin Interv Aging 2023; 18:1465-1476. [PMID: 37700781 PMCID: PMC10494859 DOI: 10.2147/cia.s413456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose Diabetes patients with low health literacy often have poor health and clinical outcomes. The study aimed to assess the effectiveness of a health literacy intervention on glycemic control and renal function among Thai older adults at risk of type 2 diabetes mellitus (T2DM). Methods A quasi-experimental study was carried out in rural areas of Phayao Province in northern Thailand. The participants were older adults with T2DM who recorded blood glucose levels ranging from 140 to 180 mg/dL and who were not receiving prescribed medication. The intervention lasted 12 weeks, and data were collected at three points: baseline, post-intervention, and at 3 months' follow-up. The study outcomes included the measurement of fasting blood sugar (FBS), hemoglobin A1C (HbA1c), and glomerular filtration rate (eGFR) levels after the intervention. A linear mixed model and generalized estimating equations model were used to assess the intervention effect for continuous and binary outcomes, respectively. Results From baseline to post-intervention, FBS and HbA1c decreased more in the intervention group than in the control group by 8.2 mg/dL (p < 0.001) and 0.1% (p = 0.029), respectively, whereas eGFR increased by 8.0 mL/min/1.73m2 (p < 0.001). The absolute effect of the intervention at follow-up was -9.8 units for FBS, -0.4 units for HbA1c, and 14.0 units for eGFR. Abnormal HbA1c level (≥6.5%) of the intervention group was reported as 70.3% at baseline, 31.3% at post-intervention, and 9.4% at follow-up. Compared to baseline levels, the T2DM patients who received the intervention were 0.31 times less likely to have abnormal HbA1c levels than the control subjects at follow-up (p = 0.003) who received no intervention. Conclusion Our findings suggest that this intervention may potentially improve diabetes self-management and prevention behaviors, thereby reducing the diabetes burden in rural communities in northern Thailand.
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Affiliation(s)
| | | | | | | | - Supakan Kantow
- School of Public Health, University of Phayao, Phayao, 56000, Thailand
| | - Pitakpong Panta
- School of Nursing, University of Phayao, Phayao, 56000, Thailand
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Arnardóttir E, Sigurðardóttir ÁK, Graue M, Kolltveit BCH, Skinner T. Can Waist-to-Height Ratio and Health Literacy Be Used in Primary Care for Prioritizing Further Assessment of People at T2DM Risk? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6606. [PMID: 37623189 PMCID: PMC10454465 DOI: 10.3390/ijerph20166606] [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: 06/16/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND To identify people at risk of type 2 diabetes. Primary health care needs efficient and noninvasive screening tools to detect individuals in need of follow-up to promote health and well-being. Previous research has shown people with lower levels of health literacy and/or well-being scores are vulnerable but may benefit from intervention and follow-up care. AIMS This cross-sectional study, aimed to identify people at risk for type 2 diabetes by comparing the Finnish Diabetes Risk instrument with the waist-to-height ratio. Further, the difference was examined in health literacy and well-being scale scores in the countryside versus town areas, respectively. RESULTS In total, 220, aged 18-75 years, participated. Thereof, 13.2% displayed biomarkers at prediabetes level of HbA1c (39-47 mmol/mol); none had undiagnosed diabetes. Of the participants, 73% were overweight or obese. Waist-to-height ratio demonstrated 93.1% of the prediabetes group at moderate to high health risk and 64.4% of the normal group, with an area under the curve of 0.759, sensitivity of 93.3%, and specificity of 63.1%. Residency did not influence prediabetes prevalence, health literacy, or well-being. CONCLUSION Waist-to-height ratio and the Finnish Diabetes Risk instrument may be suitable for identifying who need further tests and follow-up care for health promotion in primary care.
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Affiliation(s)
- Elín Arnardóttir
- School of Health, Business and Natural Sciences, University of Akureyri, 600 Akureyri, Iceland
- Health Care Institution of North Iceland, 580 Siglufjordur, Iceland
| | - Árún K. Sigurðardóttir
- School of Health, Business and Natural Sciences, University of Akureyri, 600 Akureyri, Iceland
- Akureyri Hospital, 600 Akureyri, Iceland
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, 5063 Bergen, Norway
| | | | - Timothy Skinner
- Institute of Psychology, University of Copenhagen, 1017 Copenhagen K, Denmark
- Australian Centre for Behavioral Research in Diabetes, Melbourne, VIC 3053, Australia
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Doğan AG, Uzeli Ü. The Relationship Between Health Literacy Level and Neuropathic Pain Level in Patients With Diabetic Neuropathy. Cureus 2023; 15:e41490. [PMID: 37426407 PMCID: PMC10326641 DOI: 10.7759/cureus.41490] [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: 07/05/2023] [Indexed: 07/11/2023] Open
Abstract
Background This study aimed to analyze the current situation of health literacy (HL), neuropathic pain, and Neuropathic Pain Impact on Quality of Life (NePIQoL) questionnaire in patients with diabetic neuropathy (DN). Methodology This study was conducted among 60 patients with diabetic peripheral distal neuropathy on electroneuromyography (ENMG) and 47 patients without diabetic peripheral distal neuropathy on ENMG. The Turkish version of the European Health Literacy Scale (EHLS-TR) for HL levels, Visual Analog Scale (VAS) and Douleur Neuropathique 4 Questions (DN4) for pain level, and NePIQoL for health-related quality of life were used in participants. Results A total of 107 type 2 diabetes mellitus patients were included in the study with a mean age of 57.12 ± 4.12 years. The EHLS-TR significantly decreased in the DN group compared to the control group (p = 0.004). There was a significant difference between the two groups in the EHLS-TR classification (p = 0.024). Glycosylated hemoglobin (HbA1c), VAS, and DN4 values were found to be significantly higher in the DN group compared to the control group (p = 0.001). While there was a negative correlation between EHLS-TR scores and DN4 and HbA1c in the DN group, a positive correlation was found between EHLS-TR and NePIQoL. Conclusions HL has an effect on HbA1c, neuropathic pain level, and quality of life in DN patients. By increasing the level of HL, glycemic control can be achieved in this patient population, while the level of neuropathic pain decreases and the quality of life increases.
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Affiliation(s)
- Ayşe G Doğan
- Physical Medicine and Rehabilitation, Hitit University Erol Olçok Training and Research Hospital, Çorum, TUR
| | - Ülkem Uzeli
- Internal Medicine, Osmancık State Hospital, Çorum, TUR
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Yous ML, Ganann R, Ploeg J, Markle-Reid M, Northwood M, Fisher K, Valaitis R, Chambers T, Montelpare W, Légaré F, Beleno R, Gaudet G, Giacometti L, Levely D, Lindsay C, Morrison A, Tang F. Older adults' experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for diabetes self-management in Canada: a qualitative descriptive study. BMJ Open 2023; 13:e068694. [PMID: 37019487 PMCID: PMC10083734 DOI: 10.1136/bmjopen-2022-068694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES To assess the experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) from the perspectives of older adults with diabetes and other chronic conditions. The ACHRU-CPP is a complex 6-month self-management evidence-based intervention for community-living older adults aged 65 years or older with type 1 or type 2 diabetes and at least one other chronic condition. It includes home and phone visits, care coordination, system navigation support, caregiver support and group wellness sessions delivered by a nurse, dietitian or nutritionist, and community programme coordinator. DESIGN Qualitative descriptive design embedded within a randomised controlled trial was used. SETTING Six trial sites offering primary care services from three Canadian provinces (ie, Ontario, Quebec and Prince Edward Island) were included. PARTICIPANTS The sample was 45 community-living older adults aged 65 years or older with diabetes and at least one other chronic condition. METHODS Participants completed semistructured postintervention interviews by phone in English or French. The analytical process followed Braun and Clarke's experiential thematic analysis framework. Patient partners informed study design and interpretation. RESULTS The mean age of older adults was 71.7 years, and the mean length of time living with diabetes was 18.8 years. Older adults reported positive experiences with the ACHRU-CPP that supported diabetes self-management, such as improved knowledge in managing diabetes and other chronic conditions, enhanced physical activity and function, improved eating habits, and opportunities for socialisation. They reported being connected to community resources by the intervention team to address social determinants of health and support self-management. CONCLUSIONS Older adults perceived that a 6-month person-centred intervention collaboratively delivered by a team of health and social care providers helped support chronic disease self-management. There is a need for providers to help older adults connect with available health and social services in the community. TRIAL REGISTRATION NUMBER ClinicalTrials.gov ID: NCT03664583; Results.
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Affiliation(s)
- Marie-Lee Yous
- School of Nursing, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Rebecca Ganann
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Maureen Markle-Reid
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Melissa Northwood
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Kathryn Fisher
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Ruta Valaitis
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Tracey Chambers
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - William Montelpare
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - France Légaré
- VITAM Centre de recherche en santé durable, Université Laval, Quebec, Quebec, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Ron Beleno
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Gary Gaudet
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Luisa Giacometti
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Deborah Levely
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Craig Lindsay
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Allan Morrison
- Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Frank Tang
- School of Nursing, Aging, Community and Health Research Unit, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
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Sertkaya Z, Koyuncu E, Nakipoğlu Yüzer GF, Özgirgin N. Investigation of health literacy level and its effect on quality of life in patients with spinal cord injury. J Spinal Cord Med 2023; 46:62-67. [PMID: 34726584 PMCID: PMC9897774 DOI: 10.1080/10790268.2021.1991162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine the health literacy (HL) level in patients with traumatic spinal cord injury (SCI) and evaluate the relationship between HL and the quality of life (QoL). STUDY DESIGN Cross-sectional study. SETTING Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Turkey. PARTICIPANTS A total of 77 patients with traumatic SCI aged 15-65 years where the trauma had occurred at least a month ago before data collection and who were attending the rehabilitation program at the hospital as inpatients we included in the study. OUTCOME MEASURES The European Health Literacy Questionnaire Turkish Adaptation (HLS-TR) was used for the evaluation of the HL level, and the Short Form-36 was used for the evaluation of the QoL. RESULTS The HL level was inadequate in 32.5%, problematic-limited in 40.3%, sufficient in 19.5%, and excellent in 7.8% of the patients. The vitality and mental health subdimensions of the QoL were found to be statistically significantly better in participants with excellent, sufficient or problematic-limited HL compared to those with an inadequate level. CONCLUSIONS According to our results, the HL level of the majority of patients with SCI who are hospitalized in our hospital is low, and there is a relationship between HL and QoL. In conclusion, steps need to be taken to increase the HL levels of patients to improve their QoL, taking into account the important effect of HL on the QoL.
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Affiliation(s)
- Zilan Sertkaya
- Department of Physical Medicine and Rehabilitation, Soma State Hospital, Soma/Manisa, Turkey
| | - Engin Koyuncu
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Turkey,Department of Physical Medicine and Rehabilitation, University of Medical Sciences, Ankara, Turkey,Correspondence to: Engin Koyuncu, Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, University of Medical Sciences, Ankara, Turkey; Ph: 05052553671.
| | - Güldal Funda Nakipoğlu Yüzer
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Turkey,Department of Physical Medicine and Rehabilitation, University of Medical Sciences, Ankara, Turkey
| | - Neşe Özgirgin
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital Physical Medicine and Rehabilitation Hospital, Ankara, Turkey,Department of Physical Medicine and Rehabilitation, University of Medical Sciences, Ankara, Turkey
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Chen J, Tian Y, Yin M, Lin W, Tuersun Y, Li L, Yang J, Wu F, Kan Y, Li X, Gan Y, Sun X, Wu Y, He F. Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: A multicentre cross-sectional study. J Psychosom Res 2023; 164:111105. [PMID: 36495756 DOI: 10.1016/j.jpsychores.2022.111105] [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: 06/06/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE This study aimed to explore the effects of self-efficacy on adherence to self-management and medication among patients with chronic diseases in China. METHODS A cross-sectional survey of 2047 patients with chronic diseases in 120 cities across China was conducted between May and September 2021 using a multi-stage sampling method. Self-efficacy was measured using the New General Self-Efficacy Scale. The adherence to self-management was measured using the item response theory based self-management adherence scale, and the medication adherence was assessed using the Medication Adherence Scale for the Chronically Ill. The adherence to self-management and medication were evaluated by linear regression and logistic regression models, respectively. RESULTS After adjusting for all covariates, self-efficacy was significantly associated with adherence to self-management (β =0.207, 95% CI =0.064-0.350, P = 0.005), but not with medication adherence (for[middle/low]: OR = 1.119, 95% CI =0.828-1.511, P = 0.47; for[high/low]: OR = 1.281, 95% CI =0.935-1.754, P = 0.12). In subgroup analysis, self-efficacy positively correlated with adherence to self-management in patients with multiple chronic diseases (β =0.286, 95% CI =0.037-0.535, P = 0.03), but not in those with only one chronic disease (P = 0.12). Self-efficacy was not significantly associated with medication adherence in any of the subgroups. CONCLUSION Self-efficacy was positively associated with adherence to self-management in patients with chronic diseases, but not with medication adherence. Enhanced health education in patients with one chronic disease alone may have an association with better adherence to self-management and medication in daily life.
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Affiliation(s)
- Jiangyun Chen
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China; Institute of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yaoming Tian
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Minggang Yin
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Wei Lin
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yusupujiang Tuersun
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Lehuan Li
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Jiao Yang
- School of Health Management, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Fangjing Wu
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Yifan Kan
- School of Public Health, Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China
| | - Xialei Li
- School of Pharmaceutical Sciences, Shandong University, No.44 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China
| | - Yong Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan City, Hubei Province, China
| | - Xinying Sun
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing City, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing City, China.
| | - Feiying He
- Southern Medical University, No.1023-1063 Shatai Road, Baiyun District, Guangzhou City, Guangdong Province, China.
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15
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Anand VV, Goh RSJ, Nah B, Koh SWC, Lim J, Neo NWS, Chew J, Lee YY, Chin YH, Chong B, Kong G, Tan B, Low Z, Khoo CM, Goh LH, Loh PH, Chai P, Dalakoti M, Chan M, Foo R, Muthiah M, Chew NWS. General Public's knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population. Front Med (Lausanne) 2023; 10:1193829. [PMID: 37168269 PMCID: PMC10165106 DOI: 10.3389/fmed.2023.1193829] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
Background Health literacy and illness perception play crucial roles in tackling the cardiometabolic disease epidemic. We aim to compare the attitudes, knowledge, self-perceived risks and actions taken, between individuals with and without metabolic risk factors (MFs). Methods From 5 June to 5 October 2022, participants of the general public were invited to complete a self-administered questionnaire. MF status was defined as the presence of hypertension, hyperlipidemia, diabetes mellitus and/or current/previous smoking. Participants were assessed based on four categories (knowledge-based, attitude-based, perceived risk, and action-based) of questions pertaining to four cardiometabolic diseases - diabetes mellitus, hypertension, hyperlipidemia, and non-alcoholic fatty liver disease. Results A total of 345 participants were enrolled, of whom 34.5% had at least one MF. Compared to those without MFs, participants with MFs had lower knowledge scores, but higher perceived risk scores across all cardiometabolic diseases. The largest knowledge gap pertained to hypertension-related questions. After adjustment, linear regression demonstrated that the presence of MFs (β:2.752, 95%CI: 0.772-4.733, p = 0.007) and higher knowledge scores (β:0.418, 95%CI: 0.236-0.600, p < 0.001) were associated with higher perceived risk. Despite increased perceived risk in those with MFs, this translated to only few increased self-reported preventive actions, when compared to those without MFs, namely the reduction in red meat/processed food consumption (p = 0.045) and increase in fruits/vegetables consumption (p = 0.009). Conclusion This study identified a vulnerable subpopulation living with MFs, with high perceived risks, and discordant levels of knowledge and preventive actions taken. Nationwide efforts should be channeled into addressing the knowledge-to-action gap.
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Affiliation(s)
- Vickram Vijay Anand
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rachel Sze Jen Goh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Benjamin Nah
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Sky Wei Chee Koh
- National University Polyclinics, National University Health System, Singapore, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jieyu Lim
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Nicholas W. S. Neo
- Nursing Department, National University Heart Centre, Singapore, Singapore
| | - Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Yuan Ying Lee
- Nursing Department, National University Heart Centre, Singapore, Singapore
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Bryan Chong
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Bryan Tan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Zhiwen Low
- Faculty of Science, Monash University, Melbourne, VIC, Australia
| | - Chin Meng Khoo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Department of Endocrinology, National University Hospital, Singapore, Singapore
| | - Lay Hoon Goh
- National University Polyclinics, National University Health System, Singapore, Singapore
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Poay Huan Loh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
- Division of Cardiology, Department of Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Ping Chai
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Mayank Dalakoti
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Mark Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Roger Foo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Nicholas W. S. Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
- *Correspondence: Nicholas W. S. Chew,
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Gao Y, Yan K, Yan X, Xi N, Gao J, Ren H. Correlation between health literacy and health‐related quality of life in patients with diabetic peripheral neuropathy: The mediating role of self‐management. Nurs Open 2022; 10:3164-3177. [PMID: 36572957 PMCID: PMC10077377 DOI: 10.1002/nop2.1566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/25/2022] [Accepted: 12/10/2022] [Indexed: 12/28/2022] Open
Abstract
AIM The aims of the study were to analyse the current situation of health literacy (HL), self-management and health-related quality of life (HRQOL) in patients with diabetic peripheral neuropathy (DPN), to explore the correlation between the three and to verify the mediating role of self-management in HL and HRQOL. DESIGN A cross-sectional survey. METHODS The convenience sampling method was used to select 401 DPN patients attending the First Hospital of Jinzhou Medical University in Liaoning Province, China, from December 2020 to December 2021 as the study population. The research instrument included socio-demographic characteristics questionnaire, Health Literacy Management Scale (HeLMS), Summary of Diabetes Self-Care Activities (SDSCA) and Short-Form 12-item Health Survey (SF-12). SPSS 25.0 was applied to the data for descriptive analysis, Pearson correlation analysis and stratified multiple regression analysis. Mediating effects were tested using SPSS PROCESS macro 4.0 software. RESULTS HL and self-management of DPN patients correlated positively with HRQOL. The mediation role of self-management was significant in the relationship between HL and physical and mental HRQOL (physical component summary: β = 0.26, P < 0.01; mental component summary: β = 0.18, P < 0.01), with mediating effects accounting for 35.62% and 34.62% of the total effect. CONCLUSIONS There was a positive correlation between HL, self-management and HRQOL in patients with DPN. Self-management plays a partially mediating role in the relationship between HL and HRQOL in DPN patients. It means that HRQOL in this population can be improved by increasing HL and thus self-management in DPN patients. PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Yuqi Gao
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Keshu Yan
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Xiangru Yan
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Na Xi
- School of Nursing Jinzhou Medical University Jinzhou City Liaoning Province China
| | - Jia Gao
- Tie Coal General Hospital of Liaoning Health Industry Group Tieling City Liaoning Province China
| | - Hengjie Ren
- First Affiliated Hospital of Jinzhou Medical University Jinzhou City Liaoning Province China
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Verma I, Gopaldasani V, Jain V, Chauhan S, Chawla R, Verma PK, Hosseinzadeh H. The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis. Prim Care Diabetes 2022; 16:719-735. [PMID: 36307372 DOI: 10.1016/j.pcd.2022.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 09/12/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is a major health risk and dominant cause of global mortality and morbidity. Disease-specific support from peers with similar chronic condition has shown to improve chronic disease self-management outcomes. The purpose of this systematic review is to summarise the existing evidence on the impact of peer coach-led type 2 diabetes mellitus self-management interventions on glycaemic control and self-management outcomes. Databases including MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest Central, ScienceDirect, web of science, Wiley Online Library and UOW Library were searched for eligible papers. Thirteen randomised controlled trials (RCTs) published between 2008 and 2021 were included in this review. Random-effects meta-analyses found that there were statistically significant changes in Haemoglobin A1c HbA1c) after the interventions. However, the meta-analyses showed no significant changes in LDL (low-density lipoprotein), BMI (Body mass index), systolic BP (Blood Pressure), and HRQoL (Health-related quality of life) among intervention and control groups after the intervention. The identified studies mainly recruited patients with suboptimal glucose levels; majority of them belonging to low-income population. Our findings showed that peer coaching was helpful in improving HbA1c levels, quality of life, self-efficacy, diabetes distress and patient activation. Moreover, peer coaching associations with medication adherence, hypoglycaemic symptoms, diabetes specific social support and depression were inconclusive. This review concludes that peer-led community-based interventions with longer follow up, using a mixed method of delivery among patients with suboptimal levels of HbA1c were more efficient compared to usual care for improving T2DM self-management.
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Affiliation(s)
- Iksheta Verma
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia.
| | - Vinod Gopaldasani
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia
| | - Vishesh Jain
- Data & Analytics, RMIT Building 106, Level 7, 222 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Saroj Chauhan
- Employees State Insurance, Faridabad, Haryana 121002, India
| | - Rajeev Chawla
- North Delhi Diabetes Centre, 180, Jai Apartment, Rohini Sector 9, New Delhi 110085, India
| | | | - Hassan Hosseinzadeh
- School of Health and Society, University of Wollongong, Building 29, Room 315, NSW 2522, Australia
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Khatiwada B, Rajbhandari B, Mistry SK, Parsekar S, Yadav UN. Prevalence of and factors associated with health literacy among people with Noncommunicable diseases (NCDs) in South Asian countries: A systematic review. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Beasant B, Lee G, Vaughan V, Lotfaliany M, Hosking S. Health literacy and cardiovascular disease prevention: a systematic scoping review protocol. BMJ Open 2022; 12:e054977. [PMID: 35676010 PMCID: PMC9185497 DOI: 10.1136/bmjopen-2021-054977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Health literacy is 'The skills and resources of a person to access, understand and use information to make decisions, and take action on their own health and healthcare'. Literature investigating cardiovascular disease (CVD) prevention and health literacy often exist in silos, only exploring one element of prevention. This protocol aims to establish a scoping method of articles investigating health literacy and CVD preventive practices or knowledge in lay populations. METHODS AND ANALYSIS A scoping review was deemed the most appropriate study design. The topic was conceptualised, with preliminary searching informing subsequent development of search strings. A search of the following databases will be conducted on 31 January 2022: MEDLINE, Global Health, PubMed, Embase, PsycINFO and CINAHL. Studies included will be published in English, of appropriate design, measuring health literacy and some aspect of primary CVD prevention in lay-populations. These criteria will be tested against 25 'pilot' articles from the results, undergoing necessary review before screening commences. A secondary author will screen 10% of abstracts, with a third subject-matter expert reviewing conflicts. ETHICS AND DISSEMINATION This review will be disseminated through peer-reviewed scholarly networks, most likely including journal publication and conference presentation. ARTICLE SUMMARY CVD is the leading cause of death around the world. This paper proposes an exploration of health literacy's relationship with CVD prevention as a whole, contrasting with the more segmented reviews currently published.
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Affiliation(s)
- Bonnie Beasant
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Georgie Lee
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Vanessa Vaughan
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Mojtaba Lotfaliany
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Sarah Hosking
- Institute for Mental and Physical Health and Clinical Translation, Deakin University School of Medicine, Geelong, Victoria, Australia
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van der Gaag M, Heijmans M, Spoiala C, Rademakers J. The importance of health literacy for self-management: A scoping review of reviews. Chronic Illn 2022; 18:234-254. [PMID: 34402309 DOI: 10.1177/17423953211035472] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Self-management of chronic diseases is rather complex, especially for patients with limited health literacy. In this review, we aim to disentangle the specific difficulties patients with limited health literacy face in relation to self-management and their associated needs with respect to self-management support. METHODS We performed a literature search in five databases. We used a broad definition of health literacy and self-management was categorized into four types of activities: medical management, changing lifestyle, communicating and navigating through the health care system and coping. Included reviews described the relationship between health literacy and different domains of self-management and were published after 2010. RESULTS A total of 28 reviews were included. Some clear difficulties of patients with limited health literacy emerged, predominantly in the area of medical management (especially adherence), communication and knowledge. Other associations between health literacy and self-management were inconclusive. Barriers from the patients' perspective described mainly medical management and the communication and navigation of the health care system. DISCUSSION Patients with limited health literacy experience difficulties with specific domains of self-management. For a better understanding of the relationship between health literacy and self-management, a broader conceptualization of health literacy is warranted, including both cognitive and behavioural aspects.
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Affiliation(s)
| | - Monique Heijmans
- 8123Nivel, Netherlands Institute for Health Services Research, the Netherlands
| | - Cristina Spoiala
- 8123Nivel, Netherlands Institute for Health Services Research, the Netherlands
| | - Jany Rademakers
- 8123Nivel, Netherlands Institute for Health Services Research, the Netherlands.,Department of Family Medicine, 168092Maastricht University, CAPHRI Care and Public Health Research Institute, the Netherlands
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Kim K, Yang Y, Wang Z, Chen J, Barandouzi ZA, Hong H, Han HR, Starkweather A. A systematic review of the association between health literacy and pain self-management. PATIENT EDUCATION AND COUNSELING 2022; 105:1427-1440. [PMID: 34629232 DOI: 10.1016/j.pec.2021.09.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/03/2021] [Accepted: 09/28/2021] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To synthesize the impact of health literacy on pain self-management contexts, processes, and outcomes. METHODS This systematic review employed a narrative synthesis. We used databases, including PubMed and PsycINFO, and handsearching of the reference lists to identify articles published before December 2020. Pain self-management variables were chosen based on the Individual and Family Self-Management Theory. Quality was assessed using the National Institute of Health quality assessment tool for observational and cross-sectional studies. RESULTS Twenty studies that included 6173 participants were used. Most studies measured functional domains of the health literacy concept. Twelve studies reported small to large associations between health literacy and pain knowledge, medication regimen adherence, or pain. Thirteen studies considered health literacy clinical risks in tailoring education, while seven viewed it as personal assets developed via education. CONCLUSIONS Limited information on the contribution of health literacy to pain self-management context factors and processes exists. Current evidence was limited by a lack of temporality, theoretical basis, and a priori sample estimation. PRACTICE IMPLICATIONS Using brief functional literacy scales in the clinical environment can be more practical. Identifying patients' literacy levels helps clinicians personalize education, which then promotes patients' knowledge of pain, medication regimen adherence, and pain control.
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Affiliation(s)
- Kyounghae Kim
- College of Nursing, Korea University, Seoul, South Korea; Institute of Nursing Research, Korea University, Seoul, South Korea; Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, South Korea.
| | - Yuxuan Yang
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | - Zequan Wang
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | - Jie Chen
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | | | - Hyejeong Hong
- School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Angela Starkweather
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
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22
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Evaluating the impact of the Understanding Multiple Sclerosis online course on participant MS knowledge, health literacy, resilience, self-efficacy, quality of life, and MS symptom severity. Mult Scler Relat Disord 2022; 60:103717. [DOI: 10.1016/j.msard.2022.103717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 11/19/2022]
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Downie S, Shnaigat M, Hosseinzadeh H. Effectiveness of health literacy- and patient activation-targeted interventions on chronic disease self-management outcomes in outpatient settings: a systematic review. Aust J Prim Health 2022; 28:83-96. [PMID: 35131029 DOI: 10.1071/py21176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022]
Abstract
Chronic diseases are the leading causes of morbidity and mortality and account for approximately 60% of all deaths worldwide. Self-management is a key strategy to manage chronic diseases, and there is emerging evidence recommending targeting both health literacy (HL) and patient activation (PA) to improve chronic disease self-management outcomes. The aim of this systematic review is to summarise the current evidence on the impact of HL- and PA-led interventions on self-management outcomes using randomised control trials (RCTs). Six well known databases (MEDLINE, Web of Science, Scopus, Science Citation Index, EMBASE and Academic Search Complete) were searched for RCTs of chronic disease self-management interventions targeting both HL and PA and published between 2004 and June 2021. The search terms included chronic disease, self-management, patient activation/engagement and health literacy/education. Ten studies were eligible for inclusion. We found that patients with low HL and PA levels are most likely to benefit from the interventions. The moderate improvements in PA and HL in the reviewed studies were translated into some improvements in physical activity and mental health outcomes but failed to improve patients' quality of life and healthcare utilisation outcomes. Patients with low HL were more likely to have higher PA levels after the interventions. This review suggests that both HL and PA are essential pillars for improving chronic disease self-management outcomes. However, more studies are needed to explore the long-term impacts of a combination of HL and PA on chronic disease self-management outcomes.
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Affiliation(s)
- S Downie
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - M Shnaigat
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; and Corresponding author
| | - H Hosseinzadeh
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
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Rawal LB, Sun Y, Dahal PK, Baral SC, Khanal S, Arjyal A, Manandhar S, Abdullah AS. Engaging Female Community Health Volunteers (FCHVs) for cardiovascular diseases risk screening in Nepal. PLoS One 2022; 17:e0261518. [PMID: 34990481 PMCID: PMC8735630 DOI: 10.1371/journal.pone.0261518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/05/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction
Non-Communicable Diseases (NCDs) have become the leading public health problems worldwide and the cardiovascular diseases (CVDs) is one of the major NCDs. Female Community Health Volunteers (FCHVs) in Nepal are the key drivers to implementing frontline health services. We explored the potential for engaging FCHVs for CVD risk screening at the community level in Nepal.
Methods
We used multiple approaches (quantitative and qualitative) for data collection. The trained FCHVs administered CVD risk screening questionnaire among 491 adults in rural and urban areas and calculated the CVD risk scores. To maintain consistency and quality, a registered medical doctor also, using the same risk scoring chart, independently calculated the CVD risk scores. Kappa statistics and concordance coefficient were used to compare these two sets of risk screening results. Sensitivity and specificity analyses were conducted. Two focus group discussions among the FCHVs were conducted to determine their experiences with CVD risk screening and willingness to engage with CVD prevention and control efforts.
Results
The mean level of agreement between two sets of risk screening results was 94.5% (Kappa = 0.77, P<0.05). Sensitivity of FCHV screening was 90.3% (95% CI: 0.801–0.964); and the specificity was 97% (95% CI: 0.948, 0.984). FCHVs who participated in the FGDs expressed a strong enthusiasm and readiness to using the CVD risk screening tools. Despite their busy workload, all FCHVs showed high level of motivation and willingness in using CVD risk screening tools and contribute to the prevention and control efforts of NCDs. The FCHVs recommended needs for providing additional training and capacity building opportunities.
Conclusion
We conclude that there is a potential for engaging FCHVs to use simple CVD risk screening tools at the community level. The findings are promising, however, further studies engaging larger number of FCHVs and larger population would warrant feasibility of such tools within the existing healthcare systems in Nepal.
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Affiliation(s)
- Lal B. Rawal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Rockhampton, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, Australia
- Translational Health Research Institute, and School of Social Sciences, Western Sydney University, Penrith, Australia
- * E-mail: , (LBR); (ASA)
| | - Yuewen Sun
- Global Health Institute, Duke Kunshan University, Jiangsu, China
| | - Padam K. Dahal
- School of Health, Medical and Applied Sciences, College of Science and Sustainability, Central Queensland University, Rockhampton, Australia
| | | | - Sudeepa Khanal
- HERD International, Kathmandu, Nepal
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | | | | | - Abu S. Abdullah
- Global Health Institute, Duke Kunshan University, Jiangsu, China
- Duke Global Health Institute, Duke University, Durban, NC, United States of America
- Boston University School of Medicine, Boston Medical Center, Boston, MA, United States of America
- * E-mail: , (LBR); (ASA)
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Hsieh MH, Chen YC, Ho CH, Lin CY. Validation of Diabetes Knowledge Questionnaire (DKQ) in the Taiwanese Population - Concurrent Validity with Diabetes-Specific Quality of Life Questionnaire Module. Diabetes Metab Syndr Obes 2022; 15:2391-2403. [PMID: 35971522 PMCID: PMC9375556 DOI: 10.2147/dmso.s369552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/16/2022] [Indexed: 04/20/2023] Open
Abstract
PURPOSE Diabetes knowledge is important for people with type 2 diabetes mellitus (DM) to improve their health. Therefore, it is important to validate an instrument for assessing diabetes knowledge. The present study aimed to validate the 24-item Diabetes Knowledge Questionnaire (DKQ). PATIENTS AND METHODS The 24-item DKQ and Diabetes-specific Quality of Life Module (DMQoL) were administered to 425 patients (mean±SD age=58.4±11.6) with type 2 DM. RESULTS The 24-item DKQ was first examined for its factor structure using exploratory factor analysis (EFA). Items with low factors loadings were removed and 18 items were retained to make a DKQ-18. In DKQ-18, five factors were identified, which were named as diabetes etiology and symptoms (F1), intermediate nursing (F2), complications (F3), diet and treatment (F4), and elementary nursing (F5). The DKQ-18 had satisfactory internal consistency (Cronbach's α= 0.732 and McDonald's ω=0.748), good known-group validity (participants with a higher level of education showed better score in DKQ-18; participants with HbA1c ≤7 had better score in DKQ-18 compared to group of HbA1c level >8.5), acceptable test-retest reliability (r=0.69), adequate responsiveness (DKQ-18 can detect knowledge change), and concurrent validity with DMQoL. CONCLUSION The DKQ-18 is a valid measure for assessing diabetes knowledge. The DKQ-18 could evaluate participants' diabetes knowledge and improve their diabetes knowledge and self-care through a diabetes team and serve as a tool to evaluate the knowledge of participants with type 2 DM.
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Affiliation(s)
- Meng-Hsueh Hsieh
- Department of Industrial Design, College of Planning and Design, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ching Chen
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Heng Ho
- Department of Industrial Design, College of Planning and Design, National Cheng Kung University, Tainan, Taiwan
- Chun-Heng Ho, Department of Industrial Design, College of Planning and Design, National Cheng Kung University, Tainan, Taiwan, Email
| | - Chung-Ying Lin
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Correspondence: Chung-Ying Lin, Institute of Allied Health Sciences, Department of Public Health, Department of Occupational Therapy, Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Email
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White A, Buschur E, Harris C, Pennell ML, Soliman A, Wyne K, Dungan KM. Influence of Literacy, Self-Efficacy, and Social Support on Diabetes-Related Outcomes Following Hospital Discharge. Diabetes Metab Syndr Obes 2022; 15:2323-2334. [PMID: 35958875 PMCID: PMC9359168 DOI: 10.2147/dmso.s327158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/13/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between health literacy, social support, and self-efficacy as predictors of change in A1c and readmission among hospitalized patients with type 2 diabetes (T2D). METHODS This is a secondary analysis of patients with T2D (A1c >8.5%) enrolled in a randomized trial in which health literacy (Newest Vital Sign), social support (Multidimensional Scale of Perceived Social Support), and empowerment (Diabetes Empowerment Scale-Short Form) was assessed at baseline. Multivariable models evaluated whether these concepts were associated with A1c reduction at 12 weeks (absolute change, % with >1% reduction, % reaching individualized target) and readmission (14 and 30 days). RESULTS A1c (N=108) decreased >1% in 60%, while individualized A1c target was achieved in 31%. After adjustment for baseline A1c and potential confounders, health literacy was associated with significant reduction in A1c (Estimate -0.21, 95% CI -0.40, -0.01, p=0.041) and >1% decrease in A1c (OR 1.37, 95% CI 1.08, 1.73, p=0.009). However, higher social support was associated with greater adjusted odds of reaching the individualized A1c target (OR 1.63, 95% CI 1.04, 2.55, p=0.32). Both higher empowerment (OR 0.23, 95% CI 0.08, 0.64, p=0.005) and social support (OR 0.57, 95% CI 0.36, 0.91, p=0.018) were associated with fewer readmissions by 14 days, but not 30 days. CONCLUSION The study indicates that health literacy and social support may be important predictors of A1c reduction post-discharge among hospitalized patients with T2D. Social support and diabetes self-management skills should be addressed and early follow-up may be critical for avoiding readmissions. CLINICAL TRIAL NCT03455985.
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Affiliation(s)
- Audrey White
- Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Elizabeth Buschur
- Division of Endocrinology, Diabetes & Metabolism, The Ohio State University, Columbus, OH, 43220, USA
| | - Cara Harris
- Division of Endocrinology, Diabetes & Metabolism, The Ohio State University, Columbus, OH, 43220, USA
| | - Michael L Pennell
- The Ohio State University College of Public Health, Division of Biostatistics, Columbus, OH, 43210, USA
| | - Adam Soliman
- Division of Endocrinology, Diabetes & Metabolism, The Ohio State University, Columbus, OH, 43220, USA
| | - Kathleen Wyne
- Division of Endocrinology, Diabetes & Metabolism, The Ohio State University, Columbus, OH, 43220, USA
| | - Kathleen M Dungan
- Division of Endocrinology, Diabetes & Metabolism, The Ohio State University, Columbus, OH, 43220, USA
- Correspondence: Kathleen M Dungan, The Ohio State University, Division of Endocrinology, Diabetes and Metabolism, 5th Floor McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210-1296, USA, Email
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27
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Gea Cabrera A, Caballero P, Wanden-Berghe C, Sanz-Lorente M, López-Pintor E. Effectiveness of Workplace-Based Diet and Lifestyle Interventions on Risk Factors in Workers with Metabolic Syndrome: A Systematic Review, Meta-Analysis and Meta-Regression. Nutrients 2021; 13:nu13124560. [PMID: 34960112 PMCID: PMC8704618 DOI: 10.3390/nu13124560] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022] Open
Abstract
Workplace health interventions are essential to improve the health and well-being of workers and promote healthy lifestyle behaviours. We carried out a systematic review, meta-analysis and meta-regression of articles measuring the association between workplace dietary interventions and MetS risk. We recovered potentially eligible studies by searching MEDLINE, the Cochrane Library, Embase, Scopus and Web of Science, using the terms “Metabolic syndrome” and “Occupational Health”. A total of 311 references were retrieved and 13 documents were selected after applying the inclusion and exclusion criteria. Dietary interventions were grouped into six main types: basic education/counselling; specific diet/changes in diet and food intake; behavioural change/coaching; physical exercise; stress management; and internet/social networks. Most programmes included several components. The interventions considered together are beneficial, but the clinical results reflect only a minimal impact on MetS risk. According to the metaregression, the interventions with the greatest impact were those that used coaching techniques and those that promoted physical activity, leading to increased HDL (effect size = 1.58, sig = 0.043; and 2.02, 0.015, respectively) and decreased BMI (effect size = −0.79, sig = −0.009; and −0.77, 0.034, respectively). In contrast, interventions offering information on healthy habits and lifestyle had the contrary effect, leading to increased BMI (effect size = 0.78, sig = 0.006), systolic blood pressure (effect size = 4.85, sig = 0.038) and diastolic blood pressure (effect size = 3.34, sig = 0.001). It is necessary to improve the efficiency of dietary interventions aimed at lowering MetS risk in workers.
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Affiliation(s)
- Alicia Gea Cabrera
- Department of Engineering, Area of Pharmacy and Pharmaceutical Technology, Universidad Miguel Hernández, 03550 Alicante, Spain;
| | - Pablo Caballero
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science (Spain), University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - Carmina Wanden-Berghe
- Grupo de Nutrición Clínica y HAD del Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-Fundación FISABIO), Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - María Sanz-Lorente
- Department of Public Health and History of Science, Universidad Miguel Hernández, 03550 Alicante, Spain;
| | - Elsa López-Pintor
- Department of Engineering, Area of Pharmacy and Pharmaceutical Technology, Universidad Miguel Hernández, 03550 Alicante, Spain;
- CIBER of Epidemiology and Public Health, CIBERESP, 28029 Madrid, Spain
- Correspondence:
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Asharani PV, Lau JH, Roystonn K, Devi F, Peizhi W, Shafie S, Chang S, Jeyagurunathan A, Yiang CB, Abdin E, Vaingankar JA, Sum CF, Lee ES, Dam RV, Chong SA, Subramaniam M. Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9316. [PMID: 34501905 PMCID: PMC8431510 DOI: 10.3390/ijerph18179316] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.
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Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Wang Peizhi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chua Boon Yiang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore 730676, Singapore;
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics 3 Fusionopolis Link, Singapore 138543, Singapore;
| | - Rob Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
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Rheault H, Coyer F, Bonner A. Chronic disease health literacy in First Nations people: A mixed methods study. J Clin Nurs 2021; 30:2683-2695. [PMID: 34180097 DOI: 10.1111/jocn.15757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 03/05/2021] [Indexed: 01/29/2023]
Abstract
AIM To explore chronic disease education, self-management and health literacy abilities from First Nations Australian adults with chronic disease through the integration of qualitative and quantitative findings. BACKGROUND Chronic disease management requires good health literacy abilities to manage long-term health needs. First Nations people have a higher burden of chronic disease although little is known regarding chronic disease health literacy of First Nations people. DESIGN A concurrent embedded mixed methods study reported using the Consolidated Criteria for Reporting Qualitative Research guidelines. METHODS Data were collected from First Nations people with one or more chronic diseases living in remote Australia between February-November 2017. Quantitative data (n = 200) were collected using the Health Literacy Questionnaire along with demographic and health data. Qualitative data (n = 20) were collected via face-to-face interviews to examine chronic disease education and self-management experiences. Data were analysed separately then integrated to develop meta-inferences. RESULTS Poor communication from healthcare providers coupled with low health literacy abilities is a major barrier to both active and successful management of chronic disease. Communicating in medical jargon resulted in individuals being placed in a power differential causing lack of trust and relationship breakdowns with healthcare providers affecting active chronic disease self-management. The perception of inevitability and ambivalence towards chronic disease and the notion of futility towards self-management were concurred with the low level of active engagement in health care. CONCLUSIONS Yarning is an important strategy used by First Nations people for communication. For nurses, understanding and developing skills in yarning will facilitate cultural safety, communication and understanding about chronic disease self-management in contexts where health literacy abilities are challenged. RELEVANCE TO CLINICAL PRACTICE Using yarning, and plain language visual aids, and teach-back will readdress the power differential experienced by First Nations people and may also improve understanding of chronic disease self-management.
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Affiliation(s)
- Haunnah Rheault
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.,NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Herston, Queensland, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Herston, Queensland, Australia
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Shnaigat M, Downie S, Hosseinzadeh H. Effectiveness of Health Literacy Interventions on COPD Self-Management Outcomes in Outpatient Settings: A Systematic Review. COPD 2021; 18:367-373. [PMID: 33902367 DOI: 10.1080/15412555.2021.1872061] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic progressive lung disease which imposes significant health and economic burdens on societies. Self-management is beneficial in controlling and managing COPD and health literacy (HL) is a major driver of COPD self-management. This review aims to summarize the most recent evidence on the effectiveness of HL driven COPD self-management interventions using randomized controlled trials (RCTs). Eight data bases including Science Citation Index, Academic Search Complete, Social Sciences Citation Index, CINAHL Plus, APA PsycInfo, MEDLINE, Scopus and ScienceDirect were searched to find eligible RCTs assessing the effectiveness of HL interventions on COPD self-management outcomes in outpatient settings between 2008 and February 2020. Ten RCTs met the eligibility criteria. The review found that HL interventions led to moderate improvements in physical activity levels (four out of seven trials) and COPD knowledge (three out of six trials). Surprisingly, none of the RCTs led to significant improvement in medication adherence, which warrants further studies. Furthermore, there were inconclusive findings regarding other COPD self-management outcomes such as smoking cessation, medication adherence, dyspnea, mental health, hospital admissions and health related quality of life.
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Affiliation(s)
- Mahmmoud Shnaigat
- School of Health & Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Sue Downie
- Discipline of Medical and Exercise Science, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Hassan Hosseinzadeh
- School of Health & Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia
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Sharp LK, Biggers A, Perez R, Henkins J, Tilton J, Gerber BS. A Pharmacist and Health Coach-Delivered Mobile Health Intervention for Type 2 Diabetes: Protocol for a Randomized Controlled Crossover Study. JMIR Res Protoc 2021; 10:e17170. [PMID: 33688847 PMCID: PMC7991981 DOI: 10.2196/17170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 07/17/2020] [Accepted: 01/21/2021] [Indexed: 01/17/2023] Open
Abstract
Background Aggressive management of blood glucose, blood pressure, and cholesterol through medication and lifestyle adherence is necessary to minimize the adverse health outcomes of type 2 diabetes. However, numerous psychosocial and environmental barriers to adherence prevent low-income, urban, and ethnic minority populations from achieving their management goals, resulting in diabetes complications. Health coaches working with clinical pharmacists represent a promising strategy for addressing common diabetes management barriers. Mobile health (mHealth) tools may further enhance their ability to support vulnerable minority populations in diabetes management. Objective The aim of this study is to evaluate the impact of an mHealth clinical pharmacist and health coach–delivered intervention on hemoglobin A1c (HbA1c, primary outcome), blood pressure, and low-density lipoprotein (secondary outcomes) in African-Americans and Latinos with poorly controlled type 2 diabetes. Methods A 2-year, randomized controlled crossover study will evaluate the effectiveness of an mHealth diabetes intervention delivered by a health coach and clinical pharmacist team compared with usual care. All patients will receive 1 year of team intervention, including lifestyle and medication support delivered in the home with videoconferencing and text messages. All patients will also receive 1 year of usual care without team intervention and no home visits. The order of the conditions received will be randomized. Our recruitment goal is 220 urban African-American or Latino adults with uncontrolled type 2 diabetes (HbA1c ≥8%) receiving care from a largely minority-serving, urban academic medical center. The intervention includes the following: health coaches supporting patients through home visits, phone calls, and text messaging and clinical pharmacists supporting patients through videoconferences facilitated by health coaches. Data collection includes physiologic (HbA1c, blood pressure, weight, and lipid profile) and survey measures (medication adherence, diabetes-related behaviors, and quality of life). Data collection during the second year of study will determine the maintenance of any physiological improvement among participants receiving the intervention during the first year. Results Participant enrollment began in March 2017. We have recruited 221 patients. Intervention delivery and data collection will continue until November 2021. The results are expected to be published by May 2022. Conclusions This is among the first trials to incorporate health coaches, clinical pharmacists, and mHealth technologies to increase access to diabetes support among urban African-Americans and Latinos to achieve therapeutic goals. International Registered Report Identifier (IRRID) DERR1-10.2196/17170
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Affiliation(s)
- Lisa Kay Sharp
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Alana Biggers
- Department of Medicine, Section of Academic Internal Medicine & Geriatrics, University of Illinois at Chicago, Chicago, IL, United States
| | - Rosanne Perez
- Department of Medicine, Section of Academic Internal Medicine & Geriatrics, University of Illinois at Chicago, Chicago, IL, United States
| | - Julia Henkins
- Department of Medicine, Section of Academic Internal Medicine & Geriatrics, University of Illinois at Chicago, Chicago, IL, United States
| | - Jessica Tilton
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Ben S Gerber
- Department of Medicine, Section of Academic Internal Medicine & Geriatrics, University of Illinois at Chicago, Chicago, IL, United States
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Shah JM, Ramsbotham J, Seib C, Muir R, Bonner A. A scoping review of the role of health literacy in chronic kidney disease self-management. J Ren Care 2021; 47:221-233. [PMID: 33533199 DOI: 10.1111/jorc.12364] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/02/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic kidney disease is a serious health condition and is increasing globally. Effective self-management could slow disease progression and improve health outcomes, although the contribution of health literacy and knowledge for self-management is not well known. AIM To investigate the recent evidence of health literacy and the relationship between health literacy, knowledge and self-management of chronic kidney disease. METHODS Arksey and O'Malley's framework informed this scoping review. Eligible studies involving adults with any grade of chronic kidney disease, measuring all dimensions of health literacy (i.e., functional, communicative, and critical), disease-specific knowledge and self-management, published in English between January 2005 and March 2020, were included. RESULTS The scoping review found 12 eligible studies, with 11 assessing all dimensions of health literacy. No study examined health literacy, knowledge and self-management. When individuals had greater health literacy, this was associated with greater knowledge about the disease. Communicative health literacy was a significant predictor of medication, diet and fluid adherence, and overall self-management behaviours. CONCLUSION This scoping review shows that disease-specific knowledge is important for health literacy and that health literacy is essential for effective self-management of chronic kidney disease. The implications of these relationships can inform strategies for the development of evidence-based patient education to support increased self-management. There is also a need for further research to explore these associations.
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Affiliation(s)
- Jennifer M Shah
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Joanne Ramsbotham
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Rachel Muir
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Health Groups, Griffith University, Brisbane, Queensland, Australia.,Kidney Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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İlhan N, Telli S, Temel B, Aştı T. Health literacy and diabetes self-care in individuals with type 2 diabetes in Turkey. Prim Care Diabetes 2021; 15:74-79. [PMID: 32646764 DOI: 10.1016/j.pcd.2020.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 12/30/2022]
Abstract
AIM The aim of this study was to examine the relationship between health literacy and diabetes self-care in individuals with type 2 diabetes. METHODS This cross-sectional study was conducted with 207 individuals with Type 2 diabetes at a diabetes outpatient clinic of a foundation university hospital in Istanbul, Turkey. The data were collected using a sociodemographic and illness characteristics questionnaire, the Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q-TR), and the Diabetes Self-Care Scale (DSCS). Data were analyzed using descriptive statistics, one-way ANOVA, Student's t-test, Pearson correlation test, and multiple regression analysis. RESULTS It was found that 81.5% of individuals with type 2 diabetes were at an inadequate or limited and problematic level of health literacy. The DSCS mean scores of patients with an inadequate health literacy level were significantly lower than that of patients at other levels of health literacy. It was determined that education level, exercise status, and HLS-EU-Q-TR scores were significantly related to diabetes self-care (R² = 0.245, p < 0.001). CONCLUSION The study found that individuals with type 2 diabetes had higher diabetes self-care if they had a high education level, regularly exercised, or had high HLS-EU-Q-TR mean scores.
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Affiliation(s)
- Nesrin İlhan
- Department of Nursing, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey.
| | - Safiye Telli
- Bezmialem Vakif University Hospital, Istanbul, Turkey.
| | - Betül Temel
- Acıbadem Atakent Hospital, Istanbul, Turkey.
| | - Türkinaz Aştı
- Department of Nursing, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey.
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Gaffari-Fam S, Lotfi Y, Daemi A, Babazadeh T, Sarbazi E, Dargahi-Abbasabad G, Abri H. Impact of health literacy and self-care behaviors on health-related quality of life in Iranians with type 2 diabetes: a cross-sectional study. Health Qual Life Outcomes 2020; 18:357. [PMID: 33148266 PMCID: PMC7640476 DOI: 10.1186/s12955-020-01613-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/29/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Regarding the importance of health literacy as a key factor in self-care, appropriate understanding of health information by patients with type 2 diabetes mellitus (T2DM) is fundamental for better management of risk factors, which can also benefit their quality of life. This study aimed to describe the relationship between health literacy (HL), and self-care behaviors with health-related quality of life (HRQL) in patients with T2DM. METHODS A cross-sectional survey was done in Iran in 2019. Patients were recruited randomly from health centers by medical records (n = 192, 55.2% male, mean age 58.12 years). The data collection included demographic form, health literacy questionnaire, diabetes self-care behavior questionnaire, and world health organization's Quality of Life-BREF (WHOQOL-BREF). Analyses were adjusted for confounders using hierarchical regression analysis. RESULTS HL as predictor variables explained 47.5% of variance in overall HRQL (p value < 0.001), reading health information was the strongest HL dimension (β = 0.478). Self-care behaviors explained an additional 13.6% of the HRQL variance. In total, 65.5% of the variation in the HRQL is explained by the HL, self-care behavior, and the demographic variables. CONCLUSION We found that more almost two-third of the HRQL explained by the HL and self-care behaviors. Given the importance of health literacy and self-care behaviors in the quality of life in patients with T2DM, adoption of health-promoting behaviors and increasing health literacy can be beneficial for promoting quality of life among these patients.
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Affiliation(s)
- Saber Gaffari-Fam
- School of Nursing of Miandoab City, Urmia University of Medical Sciences, Urmia, Iran
| | - Yosef Lotfi
- MSc in Nursing Education, Islamic Azad University, Sarab Branch, Sarab, Iran
| | - Amin Daemi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Towhid Babazadeh
- Department of Public Health, Sarab Faculty of Medical Science, Sarab, Iran.
| | - Ehsan Sarbazi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ghader Dargahi-Abbasabad
- MSc of Epidemiology, Research Center of Psychiatry and Behavioral Science, Razi Hospital, Tabriz University of Medical Science, Tabriz, Iran
| | - Hamed Abri
- Department of Public Health, Sarab Faculty of Medical Science, Sarab, Iran
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Dika Q, Duli M, Burazeri G, Toci D, Brand H, Toci E. Health Literacy and Blood Glucose Level in Transitional Albania. Front Public Health 2020; 8:405. [PMID: 33014957 PMCID: PMC7461777 DOI: 10.3389/fpubh.2020.00405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/09/2020] [Indexed: 11/24/2022] Open
Abstract
Aim: Our aim was to assess the independent association between blood glucose level and health literacy (HL) adjusting for many socio-demographic characteristics and body mass index (BMI) in an adult population in Albania, a transitional country in the South Eastern Europe. Methods: A cross-sectional study was carried out in Tirana in 2012–2014 including a population-based sample of 1,154 individuals aged ≥18 years (57% women; mean age: 45.5 ± 16.4 years; response rate: 88.6%). HL was assessed by use of HLS-EU-Q instrument. Blood glucose level was measured in a fasting state by use of rapid finger stick method. Information on socio-demographic characteristics was collected, and BMI was calculated based on measurement of height and weight in all participants. General Linear Model (GLM) and binary logistic regression were used to assess the independent association of blood glucose level and HL adjusting for all socio-demographic factors and BMI. Results: One-third of participants had pre-diabetes (100–125.9 mg/dl) and further 11% had diabetes (≥126 mg/dl) based on the measured blood glucose level. In fully-adjusted GLM, mean blood glucose level was significantly lower among individuals with excellent HL compared with their counterparts with inadequate HL (99.3 vs. 106.0, respectively). Furthermore, the odds for the presence of diabetes in the group of study participants whose HL was “inadequate” were 2.6 times higher (95% CI = 1.3–5.4) compared to those whose HL was “excellent.” Conclusion: We obtained evidence of a strong and significant inverse relationship between measured blood glucose level and HL, independent of many socio-demographic characteristics and measured BMI in a population-based study in a country of the Western Balkans.
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Affiliation(s)
- Qamil Dika
- Department of Sports Medicine, University of Sports, Tirana, Albania.,Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Marsida Duli
- Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Genc Burazeri
- Faculty of Medicine, University of Medicine, Tirana, Albania.,Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, Netherlands
| | - Dorina Toci
- Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Helmut Brand
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, Netherlands
| | - Ervin Toci
- Faculty of Medicine, University of Medicine, Tirana, Albania
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Alemany-Pagès M, Moura-Ramos M, Araújo S, Macedo MP, Ribeiro RT, do Ó D, Ramalho-Santos J, Azul AM. Insights from qualitative research on NAFLD awareness with a cohort of T2DM patients: time to go public with insulin resistance? BMC Public Health 2020; 20:1142. [PMID: 32690054 PMCID: PMC7372774 DOI: 10.1186/s12889-020-09249-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It is estimated that around 70% of Type 2 Diabetes Mellitus patients (T2DM) have Non-Alcoholic Fatty Liver Disease (NAFLD). Awareness and education are amongst the major shortcomings of the public health response to the increasing threat of NAFLD. Characterizing the specific NAFLD-related information needs of particular high-risk metabolic communities, for instance, T2DM patients, might aid in the development of evidence-based health promotion strategies, ultimately promoting NAFLD-awareness, treatment adherence and therapeutic success rates. METHODS Semi-structured interviews with T2DM patients were conducted to gain insight into their awareness of NAFLD, including its relationship with insulin resistance and T2DM. RESULTS Awareness of NAFLD as a disease entity, as well as its progression to end-stage liver disease or its relationship with other metabolic conditions, including insulin resistance and T2DM was low. Surveillance behaviours were also suboptimal and perceptions on the self-management knowledge and praxis regarding lifestyle intervention components of T2DM treatment seemed detached from those of NAFLD. CONCLUSIONS Our findings could inform the integration of NAFLD-related content in T2DM health promotion strategies. Rising awareness on NAFLD progression and its relationship with T2DM using culturally and community-relevant constructs might facilitate the development of primary and secondary prevention programmes to promote the adherence to lifestyle interventions by influencing NAFLD threat perceptions.
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Affiliation(s)
- Mireia Alemany-Pagès
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra, Rua Larga, 3000-504, Coimbra, Portugal.
- University of Coimbra, IIIUC-Institute for Interdisciplinary Research, 3030-789, Coimbra, Portugal.
| | - Mariana Moura-Ramos
- Centro Hospitalar e Universitário de Coimbra, Reproductive Medicine Unit, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Sara Araújo
- CES-Centre for Social Studies, University of Coimbra, 3000-104, Coimbra, Portugal
| | - Maria Paula Macedo
- APDP-Portuguese Diabetic Association, 1250-189, Lisbon, Portugal
- CEDOC-Centro de Estudos de Doenças Crónicas, NOVA Medical School/Faculdade de Ciências Médicas, 1150-082, Lisbon, Portugal
- Department of Medical Sciences, University of Aveiro, 3810-193, Aveiro, Portugal
| | | | - Dulce do Ó
- APDP-Portuguese Diabetic Association, 1250-189, Lisbon, Portugal
| | - João Ramalho-Santos
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra, Rua Larga, 3000-504, Coimbra, Portugal
- Department of Life Sciences, Calçada Martim de Freitas, University of Coimbra, 3000-456, Coimbra, Portugal
| | - Anabela Marisa Azul
- CNC-Center for Neuroscience and Cell Biology, CIBB, Rua Larga, University of Coimbra, Rua Larga, 3000-504, Coimbra, Portugal.
- University of Coimbra, IIIUC-Institute for Interdisciplinary Research, 3030-789, Coimbra, Portugal.
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Maleki Chollou K, Gaffari-fam S, Babazadeh T, Daemi A, Bahadori A, Heidari S. The Association of Health Literacy Level with Self-Care Behaviors and Glycemic Control in a Low Education Population with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Iran. Diabetes Metab Syndr Obes 2020; 13:1685-1693. [PMID: 32547130 PMCID: PMC7245439 DOI: 10.2147/dmso.s253607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/24/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Promoting Health Literacy (HL) can be a priority in strategic healthcare planning of the countries. Low HL is prevalent in some societies which make barriers to successful self-care of diseases. The aim of this study was to examine the association of HL with self-care behaviors and glycemic control in a low education population with type 2 diabetes mellitus. METHODS This cross-sectional study was conducted in Sarab city, Iran. The 192 participants were patients diagnosed as type 2 diabetes and with low level of education. Convenient sampling method was applied and the participants were chosen by their medical records in health-care centers. To collect data a valid and reliable tool was used based on HL dimensions and self-care behaviors. Using hierarchical logistic regression, the possible association of variables with self-care behaviors and glycemic control was assessed. RESULTS The mean age of study participants was 58.12 (±11.83) years. A 28.8% of the variation in the self-care behaviors is explained by the HL and the demographic variables (R= 0.288%; p-value<0.05). Furthermore, decision-making was the strongest predictor of self-care behaviors (β= 0.451). Approximately 80% of the variation in the HbA1c is explained by the HL, self-care behaviors, and the demographic variables (R= 0.804%; p-value<0.05). CONCLUSION This study revealed that the HL dimensions predicted approximately one-fourth of self-care behaviors and the self-care behaviors and HL dimensions about eight-tenths of HbA1c in this population. These findings call for the need for interventional programs on HL to improve the self-care behaviors and HbA1c control.
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Affiliation(s)
| | - Saber Gaffari-fam
- School of Nursing of Miandoab City, Urmia University of Medical Sciences, Urmia, Iran
| | - Towhid Babazadeh
- Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, Iran
- Correspondence: Towhid Babazadeh Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, IranTel +98 41 4322 4586Fax +98 41 4323 7412 Email
| | - Amin Daemi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Bahadori
- Food and Drug Safety Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Sohrab Heidari
- School of Nursing of Miandoab City, Urmia University of Medical Sciences, Urmia, Iran
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Hosseinzadeh H, Verma I, Gopaldasani V. Patient activation and Type 2 diabetes mellitus self-management: a systematic review and meta-analysis. Aust J Prim Health 2020; 26:431-442. [DOI: 10.1071/py19204] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 09/23/2020] [Indexed: 12/14/2022]
Abstract
Patient activation has been recognised as a reliable driver of self-management decision-making. This systematic review and meta-analysis examines existing evidence on whether embedding patient activation within Type 2 diabetes mellitus (T2DM) self-management programs can improve patient outcomes. This review has included 10 randomised controlled trials (RCTs) conducted between 2004 and 2019 retrieved from well-known databases such as MEDLINE, PubMed, CINAHL Plus, Scopus, ProQuest and ScienceDirect. The eligible RCTs were excluded if they scored low according to Cochrane Collaboration’s ‘risk of bias’ criteria. Random-effects meta-analyses showed that there were no significance changes in haemoglobin A1C (HbA1c), body mass index (BMI) and patient activation measure (PAM) between intervention and control groups after the intervention; however, the systematic review findings indicated that an improved patient activation level led to significant improvements in T2DM self-management and clinical outcomes including HbA1c level. Studies with a longer follow-up period conducted in community settings and delivered by peer coaches were more likely to lead to significant improvement in both patient activation levels and T2DM self-management and clinical outcomes. This review concludes that patient activation can be used as a reliable tool for improving T2DM self-management and clinical outcomes.
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