1
|
Tang MJ, Roosblad J, Codrington J, Peters M, Toekoen A, van Rheenen PF, Juliana A. Evaluation of the Newborn Screening Pilot for Sickle Cell Disease in Suriname Using the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework. Int J Neonatal Screen 2024; 10:46. [PMID: 39051402 PMCID: PMC11270170 DOI: 10.3390/ijns10030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/26/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024] Open
Abstract
The early detection of sickle cell disease (SCD) is vital to reduce mortality among affected children. Suriname currently lacks a newborn screening programme (NSP) for SCD. We performed a pilot programme to evaluate the scalability of such an initiative. Dried blood spots were collected from five birth centres and subjected to electrophoresis analysis. The programme scalability was evaluated using the non-adoption, abandonment, scale-up, spread, and sustainability framework. Challenges across six domains (illness, technology, value proposition, adopter system, organisation, and societal system), were categorised hierarchically as simple 😊, complicated 😐, or complex 😢. It has been proven that implementing programmes with mainly complicated challenges is difficult and those in mainly complex areas may be unachievable. SCD was detected in 33 of 5185 (0.64%) successfully screened newborns. Most of the domains were classified as simple or complicated. Disease detection and technology suitability for screening in Suriname were confirmed, with favourable parental acceptance. Only minor routine adjustment was required from the medical staff for programme implementation. Complex challenges included a reliance on external suppliers for technical maintenance, ensuring timely access to specialised paediatric care for affected newborns, and securing sustainable financial funding. Scaling up is challenging but feasible, particularly with a targeted focus on identified complex challenges.
Collapse
Affiliation(s)
- Ming-Jan Tang
- Department of Paediatrics, Streekziekenhuis Koningin Beatrix, 7101 BN Winterswijk, The Netherlands
| | - Jimmy Roosblad
- Laboratory Academisch Ziekenhuis, Paramaribo, Suriname (J.C.)
| | - John Codrington
- Laboratory Academisch Ziekenhuis, Paramaribo, Suriname (J.C.)
| | - Marjolein Peters
- Department of Paediatric Haematology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Aartie Toekoen
- Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname (A.J.)
| | - Patrick F. van Rheenen
- University of Groningen, University Medical Centre Groningen, Beatrix Children’s Hospital, Department of Paediatric Gastroenterology, Hepatology and Nutrition, 9713 GZ Groningen, The Netherlands;
| | - Amadu Juliana
- Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname (A.J.)
| |
Collapse
|
2
|
de Jesus PR, Bianchini BV, Ziegelmann PK, Dal Pizzol TDS. The low health literacy in Latin America and the Caribbean: a systematic review and meta-analysis. BMC Public Health 2024; 24:1478. [PMID: 38824501 PMCID: PMC11144327 DOI: 10.1186/s12889-024-18972-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Health literacy (HL) impacts people's health and well-being. In Latin America and the Caribbean (LAC), there are no general estimates of the prevalence of low HL. This study aimed to estimate the prevalence of low HL among citizens of LAC and identify the tools used to measure it. METHODS We included observational studies quantifying the prevalence of low HL in people living in LAC. We searched PubMed, CINAHL, EMBASE, ERIC, LILACS, PsycINFO, Redalyc, SciELO, Web of Science, PQDT, and the reference lists of the included studies in June 2023. Two reviewers independently conducted the selection, extraction, and risk of bias assessment using the JBI Critical Appraisal Tools. Meta-analysis of proportions using random effects models was used to summarize the prevalence of low HL estimated. This prevalence was measured in each study using different classification methods: word recognition items, reading and numeracy comprehension items, and self-reported comprehension items. RESULTS Eighty four studies involving 23,914 participants from 15 countries were included. We identified 23 tools to assess HL, and most of the studies were carried out in health services. The pooled prevalence of low HL were 44.02% (95%CI: 36.12-52.24) for reading and numeracy comprehension items, 50.62% (95%CI: 41.82-59.39) for word recognition items, and 41.73% (95%CI: 31.76-52.43) for self-reported comprehension items. CONCLUSION Despite the variability in the prevalence of low HL and a diversity of tools, the average of low HL is of concern. Almost half of the participants in the included studies have low HL. Most of the studies targeted users of healthcare services. Further research investigating the prevalence of low HL in the general population and actions focused on health education, communication, and information are necessary. TRIAL REGISTRATION PROSPERO (CRD42021250286).
Collapse
Affiliation(s)
- Patricia Romualdo de Jesus
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Bianca Vendruscolo Bianchini
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Patrícia Klarmann Ziegelmann
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Tatiane da Silva Dal Pizzol
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
3
|
Toapanta N, Salas-Gama K, Pantoja PE, Soler MJ. The role of low health literacy in shared treatment decision-making in patients with kidney failure. Clin Kidney J 2023; 16:i4-i11. [PMID: 37711638 PMCID: PMC10497376 DOI: 10.1093/ckj/sfad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Indexed: 09/16/2023] Open
Abstract
The classic paternalist medicine in nephrology has been modified to a shared decision-making model that clearly offers a benefit in patients with kidney disease. One of the cornerstones of shared treatment decision in patients with kidney failure is the understanding of kidney disease. As kidney disease is silent until advanced stages and is also an entity with a complex pathophysiology with little knowledge in the general population, its presence and understanding are difficult for most people. Health literacy (HL) plays a crucial role in the care of patients with kidney disease and the shared treatment decision. Limited HL has been associated with inefficient use of health services, non-compliance of medications, worse quality of life and increased mortality. In this review, we will address the importance of low HL in nephrology in terms of diagnosis, measurement, its effect on shared decision-making and how to increase it in people with kidney disease.
Collapse
Affiliation(s)
- Néstor Toapanta
- Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Karla Salas-Gama
- Quality, Process and Innovation Direction, Vall d'Hebron University Hospital, Barcelona, Spain
- Health Services Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital University, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- PhD candidate at the Methodology of Biomedical Research and Public Health program, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Percy Efrain Pantoja
- Quality, Process and Innovation Direction, Vall d'Hebron University Hospital, Barcelona, Spain
- Health Services Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital University, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - María José Soler
- Department of Nephrology, Vall d'Hebron University Hospital, Barcelona, Spain
| |
Collapse
|
4
|
Teles M, Kaya S. Health literacy of cardiology patients: determinants and effects on patient outcomes. SOCIAL WORK IN HEALTH CARE 2021; 60:656-673. [PMID: 34877925 DOI: 10.1080/00981389.2021.2014615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/30/2021] [Indexed: 06/13/2023]
Abstract
Health literacy is important for the management of chronic cardiovascular diseases. Comprehensive studies related to health literacy of cardiac patients are limited. The aims of this study were to determine the determinants of health literacy and its effects on patient outcomes in cardiology patients. The European Health Literacy Survey Questionnaire (HLS-EU-Q- 47 items) was applied to 530 patients who presented to cardiology polyclinics of a university hospital in Ankara. Correlation coefficients, univariate and multi-linear regression analyses were used in the study. Determinants of health literacy were sex, education level, place of residence and perception of social status (p < .05). Although adjustments were made based on relevant control variables in multivariate analyses, health literacy was found to affect 14 of 26 patient outcomes within the scope of the study (p < .05). Higher education level and perception of social status, residing in the city center and being female were among the determinants of high health literacy. Higher health literacy was associated with more positive patient outcomes. Health literacy affected health behaviors and risks, drug use habits, health status, use of preventive health services and patient satisfaction.
Collapse
Affiliation(s)
- Mesut Teles
- Niğde Zübeyde Hanım School of Health, Department of Health Management, Niğde Ömer Halisdemir University, Turkey
| | - Sıdıka Kaya
- Faculty of Economics and Administrative Sciences, Department of Health Care Management, Hacettepe University, Ankara, Turkey
| |
Collapse
|
5
|
Arrighi E, Ruiz de Castilla EM, Peres F, Mejía R, Sørensen K, Gunther C, Lopez R, Myers L, Quijada JG, Vichnin M, Pleasant A. Scoping health literacy in Latin America. Glob Health Promot 2021; 29:78-87. [PMID: 34169760 PMCID: PMC9203673 DOI: 10.1177/17579759211016802] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies evaluating the influence of health literacy on patient behavior and outcomes suggest a positive relationship between health literacy and health knowledge, health behaviors, and health status. In Latin American countries, studies assessing health literacy are few, regional, and demonstrate considerable variation, with reported rates of adequate health literacy ranging from 5.0% to 73.3%. In this paper, we examine and explore the state of health literacy and efforts to promote it in Latin America. Key challenges to those efforts include socioeconomic inequality, social/geographic isolation, and cultural-, language-, and policy-related barriers, many of which disproportionately affect indigenous populations and others living in rural areas. Greater use of infographics, videos, and mobile apps may enhance health literacy and patient empowerment, especially when language barriers exist. This paper provides strategies and tools for tailored programming, examples of successful health literacy interventions, and policy recommendations to improve health literacy in Latin America, intending to spur additional discussion and action. Centrally organized collaboration across multiple sectors of society, with community involvement, will enhance health literacy and improve health and well-being across Latin America.
Collapse
Affiliation(s)
- E Arrighi
- Escuela de Pacientes, Buenos Aires, Argentina
| | | | - F Peres
- Sergio Arouca National School of Public Health, Rio de Janeiro, Brazil
| | - R Mejía
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - K Sørensen
- Global Health Literacy Academy, Risskov, Denmark
| | | | - R Lopez
- Merck & Co., Inc., Kenilworth, USA
| | - L Myers
- Merck & Co., Inc., Kenilworth, USA
| | | | | | | |
Collapse
|
6
|
Dahlman D, Ekefäll M, Garpenhag L. Health Literacy among Swedish Patients in Opioid Substitution Treatment: A Mixed-Methods Study. Drug Alcohol Depend 2020; 214:108186. [PMID: 32721789 DOI: 10.1016/j.drugalcdep.2020.108186] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Poor health and unmet healthcare needs is common among people with substance use disorder (SUD) including patients in opioid substitution treatment (OST). Low health literacy (HL) is associated with poverty, low education and physical limitations, but is unexplored in an OST context. METHODS Mixed-methods were used. Participants were consecutively recruited by clinic staff or researcher, from five OST clinics in Malmö, Sweden, during September - November 2019. HL level was measured through HLS-EU-Q16 (n?=?286). Self-reported socioeconomic correlates of HL were analyzed through logistic regression. Patients' experiences of HL-related problems were assessed through six focus group interviews (n?=?23) moderated by an OST employee. RESULTS While 46% had sufficient HL (13-16 points of maximum 16), 32% did not receive a HL score due to too many missing answers. No correlates of sufficient HL level were found. Missing HL level was associated with low educational attainment (Ajusted odds ratio [AOR] 1.94; 95% Confidence interval [CI] 1.13-3.32) and negatively associated with employment (AOR 0.28; 95% CI 0.11-0.71). Qualitative data revealed a diversity in participants' self-assessed capabilities, and problems associated with access, comprehension, trust and dependency on addiction-specific services. CONCLUSIONS This study highlights that HL level is low, and identifies a number of concrete problems related to HL in the studied population. The results implicate a need for tailored interventions regarding health information among OST patients.
Collapse
Affiliation(s)
- Disa Dahlman
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden.
| | - Malin Ekefäll
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden
| | - Lars Garpenhag
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Region Skåne, Malmö, Sweden
| |
Collapse
|
7
|
Diemer FS, Snijder MB, Agyemang C, Haan YC, Karamat FA, van Montfrans GA, Oehlers GP, Peters RJG, Brewster LM, Stronks K. Hypertension prevalence, awareness, treatment, and control in Surinamese living in Suriname and The Netherlands: the HELISUR and HELIUS studies. Intern Emerg Med 2020; 15:1041-1049. [PMID: 31950398 DOI: 10.1007/s11739-019-02269-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/21/2019] [Indexed: 01/14/2023]
Abstract
We studied hypertension prevalence, awareness, treatment, and control among persons living in a middle-income country compared with those of similar ethnicity living in a high-income country. Data from the cross-sectional HELISUR and HELIUS studies were used among 1000 Surinamese and 6971 Surinamese migrants living in The Netherlands (18-70 years), respectively. Groups were formed based on country and self-defined ethnicity, and stratified by sex. Age-adjusted odds ratios (OR) with 95% confidence intervals (CI) were calculated for hypertension prevalence, awareness, treatment, and control. Subsequently, we focused on hypertension prevalence and adjusted for risk factors for hypertension: BMI and waist circumference (model 2), educational level, physical activity, and smoking (model 3). After adjustment for age, no significant differences in hypertension prevalence, awareness, treatment, and control between countries were seen in men. However, women in Suriname were more often hypertensive with lower levels of awareness and control than those in The Netherlands (African: OR 1.54 [95% CI 1.19, 2.00]; South-Asian: 1.90 [1.35, 2.67]; awareness: 0.62 [0.43, 0.88] in African women; control: 0.48 [0.28, 0.84] in South-Asian women). Higher hypertension prevalence was explained by differences in BMI and waist circumference in African women (adjusted OR 1.26 [0.96, 1.65]) and by education, physical activity, and smoking in South-Asian women (adjusted OR 1.29 [0.87, 1.89]). Particularly, women in Suriname bear a relatively high hypertension burden with lower levels of awareness and control. As the higher hypertension prevalence was mainly explained by lifestyle-related risk factors, health promotion interventions may reduce the hypertension burden in Suriname.
Collapse
Affiliation(s)
- Frederieke Sophie Diemer
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
- Department of Cardiology, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Marieke Brigitte Snijder
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Yentl Christina Haan
- Department of Vascular Medicine, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | - Fares Aziz Karamat
- Department of Vascular Medicine, Amsterdam UMC, Univ of Amsterdam, Amsterdam, The Netherlands
| | | | - Glenn Paul Oehlers
- Department of Cardiology, Academic Hospital Paramaribo, Paramaribo, Suriname
| | | | - Lizzy Maritza Brewster
- The Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands
- Creatine Kinase Foundation, Amsterdam, The Netherlands
- Department of Public Health, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Karien Stronks
- Department of Public Health, Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| |
Collapse
|
8
|
Chan RWY, Kisa A. A Scoping Review of Health Literacy Measurement Tools in the Context of Cardiovascular Health. HEALTH EDUCATION & BEHAVIOR 2019; 46:677-688. [PMID: 30829066 DOI: 10.1177/1090198119831754] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Despite the strong link between health literacy and cardiovascular health outcomes, health literacy measurements remain flawed and fragmented. There exists a gap in the knowledge when formulating a valid measurement to capture the broad concept of health literacy. The existence of various tools for health literacy measurement also hampers the availability of health literacy data. Additionally, little research is available on a valid measurement tool for cardiovascular health literacy. Objective. This study aims to provide an overview of the health literacy measurement tools used in the context of cardiovascular health. Method. A scoping review was conducted. Two electronic databases, Medline and Embase, were searched to identify studies that described a tool for the measurement of health literacy in the context of cardiovascular health. Results. After reviewing the available studies, 53 studies met the inclusion criteria. A total of 26 health literacy measurement tools were identified in the studies. Among the 26 tools, 16 used an objective measurement approach, 9 adopted a subjective approach, and 1 employed a mixed approach. Additionally, 28 studies used tools to measure print literacy, 15 studies measured print literacy and numeracy, and 5 studies measured print literacy, oral literacy, and numeracy. Conclusions. STOFHLA, TOFHLA, and REALM were the mostly commonly used tools in the selected studies. The majority of tools were based heavily on reading skills and word recognition. Researchers should focus on the development of more comprehensive and reliable health literacy measurement tool(s) specific to cardiovascular health to assist health care providers to more efficiently and accurately identify people with cardiovascular problems who have inadequate health literacy.
Collapse
Affiliation(s)
| | - Adnan Kisa
- University of Oslo, Oslo, Norway
- Kristiania University College, Oslo, Norway
| |
Collapse
|
9
|
Degan TJ, Kelly PJ, Robinson LD, Deane FP. Health literacy in substance use disorder treatment: A latent profile analysis. J Subst Abuse Treat 2019; 96:46-52. [DOI: 10.1016/j.jsat.2018.10.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 02/07/2023]
|
10
|
Arafat SMY, Majumder MAA, Kabir R, Papadopoulos K, Uddin MS. Health Literacy in School. OPTIMIZING HEALTH LITERACY FOR IMPROVED CLINICAL PRACTICES 2018. [DOI: 10.4018/978-1-5225-4074-8.ch010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Health literacy is a core element of patient-centered healthcare. Poor health literacy is a silent epidemic across the globe as it affects every aspect of health. Schools bear an important role in increasing health literacy. Improving health literacy in adolescence is supposed to improve the later life as adolescents are used to carry their modified behavior lifelong. Various school-based interventions covering physical and mental health have been studied and found to be effective. International bodies recommend incorporation of health-related tasks into school lessons and considered that teaching the young people will be a good investment for future. Multisectoral collaborations and locally proved effective strategies are the practical challenges. This chapter aims to focus on health literacy, global scenario of health literacy, measurement tools, role of school, interventions, limitations, and challenges of health literacy.
Collapse
|