1
|
Drummond H, Middleton TRF, Shepherd AI, Davenport S. Understanding the factors that influence stroke survivors to begin or resume exercise: a qualitative exploration. Top Stroke Rehabil 2024; 31:556-563. [PMID: 38288982 DOI: 10.1080/10749357.2024.2304970] [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: 08/29/2023] [Accepted: 12/30/2023] [Indexed: 07/25/2024]
Abstract
BACKGROUND Exercise after stroke has the potential to increase survivors' physical function and decrease disability. However, despite health professional reporting they recommend exercise to stroke survivors, the majority are physically inactive. Stroke survivors have previously expressed a lack of adequate knowledge and skills to engage in exercise. OBJECTIVES The aim of this study was to understand why active stroke survivors chose to (re)engage in exercise and how they went about doing so. A secondary aim was to understand if health professionals had a role in facilitating exercise engagement. METHODS Semi-structured interviews were conducted with stroke survivors who regularly engaged with exercise. Seven people aged between 60 and 71 years participated in the study. Time since stroke varied from 1 to 13 years. A reflexive thematic analysis approach was used to analyze interviews. RESULTS Exercise was spoken about in a positive light. For some, exercise had always been important, for others it became important after their stroke. The themes of Changing Support Over Time, Old and New Identity and Proactively Impacting the Future were developed. The participants felt that health professionals often facilitated engagement in exercise, although the type of support that was most valued differed at different points in the post-stroke journey. CONCLUSIONS Authoritative support from health professionals and family members helped participants to engage in exercise in the early stages after stroke. Collaboration and being part of a team was appreciated for ongoing exercise engagement. Exercise provided hope as participants developed their identity after stroke.
Collapse
Affiliation(s)
- Helena Drummond
- Physical Activity, Health and Rehabilitation Thematic Research Group, Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Thierry R F Middleton
- Physical Activity, Health and Rehabilitation Thematic Research Group, Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Anthony I Shepherd
- Physical Activity, Health and Rehabilitation Thematic Research Group, Clinical Health and Rehabilitation Team, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Sally Davenport
- Physiotherapy Group, Great Ormond Street Institute of Child Health, University College London, London, UK
| |
Collapse
|
2
|
Athanasopoulou K, Mentis M, Vathi-Sarava P, Nikolaou G, Panagiotopoulos E. Health literacy of older adults with musculoskeletal problems: A systematic review. Int J Orthop Trauma Nurs 2024; 55:101127. [PMID: 39217800 DOI: 10.1016/j.ijotn.2024.101127] [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: 05/27/2024] [Revised: 08/16/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria. RESULTS The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status. DISCUSSION It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.
Collapse
Affiliation(s)
- Katerina Athanasopoulou
- Educationalist, PhD Student, Department of Educational Sciences and Social Work, University of Patras, Greece.
| | - Manolis Mentis
- Assistant Professor, Department of Educational Sciences and Social Work, University of Patras, Greece.
| | | | - Georgios Nikolaou
- Professor, Department of Educational Sciences and Social Work, University of Patras, Greece.
| | | |
Collapse
|
3
|
Taylor ME, Ambrens M, Hawley-Hague H, Todd C, Close JCT, Lord SR, Clemson L, Lung T, Berlowitz D, Blennerhassett J, Dayhew J, Gluchowski A, Hodge W, Johnson P, Lasrado R, Merlene M, Miles L, O’Rourke S, Said CM, White L, Wilson N, Zask A, Delbaere K. Implementation of a digital exercise programme in health services to prevent falls in older people. Age Ageing 2024; 53:afae173. [PMID: 39113467 PMCID: PMC11306314 DOI: 10.1093/ageing/afae173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND StandingTall uses eHealth to deliver evidence-based balance and functional strength exercises. Clinical trials have demonstrated improved balance, reduced falls and fall-related injuries and high adherence. This study aimed to evaluate the implementation of StandingTall into health services in Australia and the UK. METHODS Two hundred and forty-six participants (Australia, n = 184; UK, n = 62) were recruited and encouraged to use StandingTall for 2 h/week for 6-months. A mixed-methods process evaluation assessed uptake and acceptability of StandingTall. Adherence, measured as % of prescribed dose completed, was the primary outcome. RESULTS The study, conducted October 2019 to September 2021 in Australia and November 2020 to April 2022 in the UK, was affected by COVID-19. Participants' mean age was 73 ± 7 years, and 196 (81%) were female. Of 129 implementation partners (e.g. private practice clinicians, community exercise providers, community service agencies) approached, 34% (n = 44) agreed to be implementation partners. Of 41 implementation partners who referred participants, 15 (37%) referred ≥5. Participant uptake was 42% (198/469) with mean adherence over 6 months being 41 ± 39% of the prescribed dose (i.e. 39 ± 41 min/week) of exercise. At 6 months, 120 (76%) participants indicated they liked using StandingTall, 89 (56%) reported their balance improved (moderately to a great deal better) and 125 (80%) rated StandingTall as good to excellent. For ongoing sustainability, health service managers highlighted the need for additional resources. CONCLUSIONS StandingTall faced challenges in uptake, adoption and sustainability due to COVID-19 and a lack of ongoing funding. Adherence levels were lower than the effectiveness trial, but were higher than other exercise studies. Acceptance was high, indicating promise for future implementation, provided sufficient resources and support are made available. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12619001329156.
Collapse
Affiliation(s)
- Morag E Taylor
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
- Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Meghan Ambrens
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
- Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Helen Hawley-Hague
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration—Greater Manchester, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Christopher Todd
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration—Greater Manchester, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Jacqueline C T Close
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
- Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Lindy Clemson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre of Excellence for Population Ageing Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Thomas Lung
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - David Berlowitz
- Austin Health, Heidelberg, Victoria, Australia
- Physiotherapy, University of Melbourne, Parkville, Australia
| | | | - Julia Dayhew
- Health Promotion, Northern NSW Local Health District, Lismore, New South Wales, Australia
| | - Ashley Gluchowski
- National Institute for Health and Care Research, Applied Research Collaboration—Greater Manchester, The University of Manchester, Manchester, UK
- School of Health & Society, University of Salford, Salford, UK
| | - Wendy Hodge
- ARTD Consultants, Sydney, New South Wales, Australia
| | - Pamela Johnson
- Mid North Coast Local Health District, New South Wales, Australia
| | - Reena Lasrado
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- National Institute for Health and Care Research, Applied Research Collaboration—Greater Manchester, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | | | - Lillian Miles
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
| | - Sandra O’Rourke
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
| | - Catherine M Said
- Physiotherapy, University of Melbourne, Parkville, Australia
- Physiotherapy, Western Health, St Albans, Victoria, Australia
- Australian Institute of Musculoskeletal Science, St Albans, Victoria, Australia
| | - Leanne White
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
- Health Promotion, Northern NSW Local Health District, Lismore, New South Wales, Australia
| | - Nicola Wilson
- Research & Innovation Service, Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Avigdor Zask
- Health Promotion, Northern NSW Local Health District, Lismore, New South Wales, Australia
- University Centre for Rural Health, School of Public Health, University of Sydney, Lismore New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Falls, Balance and Injury Research Centre, Sydney, New South Wales, Australia
- Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
4
|
Li S, Wang J, Ren L, Ye P, Niu W, Yu M, Hu Y, Jiang Y, Wu Y, Tian M, Zhao Y, Yao Y. Health literacy and falls among community-dwelling older people in China: is there a sex difference? Aging Clin Exp Res 2024; 36:148. [PMID: 39023697 PMCID: PMC11258050 DOI: 10.1007/s40520-024-02788-6] [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: 04/09/2024] [Accepted: 06/03/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Health literacy is one of the important determinants of healthy aging, yet few studies have focused on the association between health literacy and falls. AIMS This study aims to explore the relationship between health literacy and falls, with a focus on sex differences among older people in China. METHODS This cross-sectional study enrolled 2,144 older people aged ≥ 60 years from Shandong Province, China in 2021. We used general health literacy screening scale to assess health literacy, and collected the incidence of falls in the past year. Logistic regression models were employed to analyze the relationship between health literacy and falls. We investigated the sex differences by subgroup analyses. RESULTS The prevalence of adequate health literacy and falls was 21.7% (95% CI: 20.0-23.5%) and 25.4% (95% CI: 23.6-27.3%), respectively. In a fully-adjusted model, adequate health literacy was associated with a lower prevalence of falls in older adults (OR = 0.71, 95%CI: 0.52-0.96). Subgroup analysis revealed sex differences in this relationship (Pfor interaction <0.05). Specifically, the female group showed no significant relationship between health literacy and falls (OR = 0.92, 95% CI: 0.59-1.44); however, the male group demonstrated a robust and significant relationship (OR = 0.58, 95% CI: 0.37-0.90). CONCLUSIONS Older people with adequate health literacy have lower prevalence of falls, which appears to differ by sex. This relationship was significant among men but not among women. These findings emphasize the need for policymakers and healthcare providers to consider sex differences when designing and implementing programs aimed at improving health literacy and preventing falls in the older population. Improving health literacy among older women could be a strategic component in bridging sex inequality in falls.
Collapse
Affiliation(s)
- Shaojie Li
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingjing Wang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Longbing Ren
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Pengpeng Ye
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Wenyi Niu
- School of Public Health, Peking University, Beijing, China
| | - Mingzhi Yu
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Hu
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yuling Jiang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yifei Wu
- School of Public Health, Peking University, Beijing, China
| | - Maoyi Tian
- School of Public Health, Harbin Medical University, Harbin, 150081, China
- Department of General Practice, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yao Yao
- School of Public Health, Peking University, Beijing, China.
- China Center for Health Development Studies, Peking University, Beijing, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
| |
Collapse
|
5
|
Sukys S, Trinkuniene L, Tilindiene I. Physical Education Teachers' Health Literacy: First Evidence from Lithuania. Healthcare (Basel) 2024; 12:1346. [PMID: 38998880 PMCID: PMC11241491 DOI: 10.3390/healthcare12131346] [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: 05/16/2024] [Revised: 06/25/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Promotion of health literacy is an important goal in the context of promoting whole school health. Physical education teachers are of particular importance in achieving this goal. However, very limited empirical studies have addressed the health literacy of physical education teachers. This research aimed to test the structural validity and reliability of the HLS19-Q12, to measure health literacy among physical education teachers, and to evaluate associations of health literacy with health- and lifestyle-related indicators. METHODS We conducted a cross-sectional study of Lithuanian physical education teachers. The participants completed a self-administered online survey that collected information on socio-demographics and health literacy (HLS19-Q12 for general health literacy and the optional package HLS19-DIGI to measure digital health literacy) as well as health behavior. RESULTS A total of 332 participants completed the survey. The HLS19-Q12 demonstrated acceptable internal consistency (Cronbach's α of 0.73 and McDonald's ω of 0.75) and satisfactory structural validity (CFI = 0.924, TLI = 0.917, RMSEA = 0.081). Participants had an average score of 85.09 (SD = 17.23) when using the HLS19-Q12, with 19.3% and 48.8% displaying excellent and sufficient levels of health literacy, respectively. Regression analyses revealed that a higher level of health literacy was significantly associated with better health evaluation (β = 0.15, p < 0.01), but no significant association was found with other health behavior and lifestyle indicators. CONCLUSIONS Overall, the results suggest that teachers' general health literacy is relatively high. Our findings highlight the importance of conducting more in-depth studies to pursue the understanding of the whole school teachers' health literacy.
Collapse
Affiliation(s)
- Saulius Sukys
- Department of Physical and Social Education, Lithuanian Sports University, Sporto 6, LT-44221 Kaunas, Lithuania; (L.T.); (I.T.)
| | | | | |
Collapse
|
6
|
Yamaguchi T, Yabe H, Kono K, Moriyama Y, Yamada T. Differences in the purpose of exercise between hemodialysis patients who continued or dropped out of exercise programs: a multicenter cohort study. J Nephrol 2023; 36:2559-2569. [PMID: 37878181 DOI: 10.1007/s40620-023-01791-w] [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: 05/21/2023] [Accepted: 09/23/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Selecting suitable exercise goals is crucial for fostering adherence to, and maintenance of, exercise therapy. We aimed to evaluate the variance in exercise objectives between individuals who continued and those who dropped out of a 6-month intradialytic exercise program by analyzing an open-ended questionnaire administered to patients undergoing hemodialysis. METHODS The study consisted of outpatients (n = 541; mean age, 70 years) undergoing maintenance hemodialysis, who had been informed of an intradialytic exercise program and voluntarily agreed to participate. The primary outcome was the exercise purpose. The difference in exercise purpose was quantitatively analyzed between the exercise continuation and dropout groups. A co-occurrence network was created and concepts were constructed. The basic attributes were compared using chi-squared and independent t-tests. RESULTS Over 6 months, 154 patients (28.5%) dropped out of the intradialytic exercise program. Concepts related to the goals of the program were: (1) physical function and condition, (2) addressing limitations, (3) maintaining daily life activities, and (4) physical condition recognition. Co-occurrence network analysis showed that the exercise continuation group established their objectives based on the health benefits of exercise, and proactively set goals rooted in comprehending their current issues and problems. The dropout group tended to perceive treatment passively as an extension of daily clinical practice, rather than actively formulating exercise objectives. CONCLUSION The exercise objectives of those who continued the exercise program differed from those who dropped out. Patients in the exercise continuation group set more affirmative and specific exercise objectives, whereas those in the dropout group set more passive and abstract exercise objectives.
Collapse
Affiliation(s)
- Tomoya Yamaguchi
- Department of Rehabilitation, Hamamatsu University Hospital, Hamamatsu, Shizuoka, 431-3125, Japan.
| | - Hiroki Yabe
- Department of Physical Therapy, Seirei Christopher University. School of Rehabilitation, Hamamatsu, Shizuoka, 433-8558, Japan
| | - Kenichi Kono
- Department of Physical Therapy, School of Health Sciences at Narita, International University of Health and Welfare, Kozunomori, Narita, Chiba, 285-8686, Japan
| | - Yoshifumi Moriyama
- Department of Wellness Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, 454-0933, Japan
| | - Tetsuya Yamada
- Dialysis Division, Kaikoukai Healthcare Group, Nagoya, Aichi, 454-0933, Japan
| |
Collapse
|
7
|
Nagaki K, Mishima T, Ohura T, Kurihara K, Fujioka S, Tsuboi Y. Association between physical activity and health literacy in patients with Parkinson's disease: an online web survey. BMC Neurol 2023; 23:403. [PMID: 37957558 PMCID: PMC10642025 DOI: 10.1186/s12883-023-03437-7] [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: 05/13/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND For patients with Parkinson's disease (PwPD), promotion of habitual physical activity (PA) assists in the prevention of disease progression. Patients' health literacy (HL) is integral for meeting PA standards and turning it into a habit. This study evaluated the association between PA level and each HL domain in PwPD. METHODS Online web-based assessment instruments and self-administered questionnaires, including the PA Questionnaire (IPAQ) Short Form and the Functional, Communicative, and Critical Health Literacy (FCCHL) scale, were used to assess PA levels and health literacy domains of PwPD. RESULTS The mean age of PwPD (n = 114) was 65.9 (SD = 11.6) years; 59.6% female, and the mean duration of disease was 6.4 (SD = 5.1) years. Of participants, 47.4% met the recommended criteria for PA. When comparing each HL domain by PA level, participants with lower PA had significantly lower critical HL (p = 0.03). Logistic regression analysis revealed that PA level correlated with critical HL (OR = 2.46; 95% CI = 1.16-5.19; p = 0.02). CONCLUSIONS Adherence to recommended PA standards was associated with critical HL, but not other HL domains. Proactive attitudes to critically evaluate and utilize as well as understand health information may positively influence the promotion of PA.
Collapse
Affiliation(s)
- Koichi Nagaki
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-Ku, Fukuoka, 814-0180, Japan
| | - Takayasu Mishima
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-Ku, Fukuoka, 814-0180, Japan
| | - Tomoko Ohura
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi, 474-8511, Japan
| | - Kanako Kurihara
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-Ku, Fukuoka, 814-0180, Japan
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-Ku, Fukuoka, 814-0180, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Johnan-Ku, Fukuoka, 814-0180, Japan.
| |
Collapse
|
8
|
Júdice PB, Silva H, Teno SC, Monteiro P, Silva MN, Carraça EV, Santos I, Pereira S, Luz F, Viegas PC, Oliveira J, Santos IF, Palmeira AL. Providing office workers with height-adjustable workstation to reduce and interrupt workplace sitting time: protocol for the Stand Up for Healthy Aging (SUFHA) cluster randomized controlled trial. Trials 2023; 24:381. [PMID: 37280683 DOI: 10.1186/s13063-023-07407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Sedentary behavior (SB) has been linked to several negative health outcomes. Therefore, reducing SB or breaking up prolonged periods of SB improves functional fitness, food consumption, job satisfaction, and productivity. Reducing SB can be achieved by introducing a health-enhancing contextual modification promoted by a sit-stand desk in the workplace. The primary goal will be to test the effectiveness of this intervention in reducing and breaking up SB, while improving health outcomes in office-based workers during a 6-month intervention. METHODS A two-arm (1:1), superiority parallel-group cluster RCT will be conducted to evaluate the effectiveness of this intervention in a sample of office-based workers from a university in Portugal. The intervention will consist of a psychoeducation session, motivational prompts, and contextual modification promoted by a sit-stand desk in the workplace for 6 months. The control group will work as usual in their workplace, with no contextual change or prompts during the 6-month intervention. Three assessment points will be conducted in both groups, pre-intervention (baseline), post-intervention, and a 3-month follow-up. The primary outcomes include sedentary and physical activity-related variables, which will be objectively assessed with 24 h monitoring using the ActivPAL for 7 days. The secondary outcomes include (a) biometric indices as body composition, body mass index, waist circumference, and postural inequalities; and (b) psychosocial variables such as overall and work-related fatigue, overall discomfort, life/work satisfaction, quality of life, and eating behavior. Both the primary and secondary outcomes will be assessed at each assessment point. DISCUSSION This study will lean on the use of a sit-stand workstation for 6 months, prompted by an initial psychoeducational session and ongoing motivational prompts. We will aim to contribute to this topic by providing robust data on alternating sitting and standing postures in the workplace. TRIAL REGISTRATION The trial was prospectively registered, and the details are at: https://doi.org/10.17605/OSF.IO/JHGPW ; Registered 15 November 2022. OSF Preregistration.
Collapse
Affiliation(s)
| | - Hélio Silva
- CIDEFES, Universidade Lusófona, Lisbon, Portugal
| | | | - Patrícia Monteiro
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisbon, Portugal
| | - Marlene N Silva
- CIDEFES, Universidade Lusófona, Lisbon, Portugal
- Programa Nacional para a Promoção da Atividade Física- Direcção-Geral da Saúde, Lisbon, Portugal
| | | | - Inês Santos
- CIDEFES, Universidade Lusófona, Lisbon, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sara Pereira
- CIDEFES, Universidade Lusófona, Lisbon, Portugal
- CIFI2D, Faculty of Sport, University of Porto, Porto, Portugal
| | - Filipe Luz
- Hei-Lab - Universidade Lusófona, Campo Grande, Lisbon, Portugal
| | - Patrícia C Viegas
- Center for Other Worlds - Universidade Lusófona, Campo Grande, Lisbon, Portugal
| | - Jorge Oliveira
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisbon, Portugal
- Hei-Lab - Universidade Lusófona, Campo Grande, Lisbon, Portugal
| | - Isabel F Santos
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisbon, Portugal
- Hei-Lab - Universidade Lusófona, Campo Grande, Lisbon, Portugal
| | | |
Collapse
|
9
|
Uemura K, Tsukasa K, Watanabe A, Okamoto H, Yamada M. Association between community-level health literacy and frailty in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1253-1261. [PMID: 37087703 DOI: 10.1007/s40520-023-02405-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/31/2023] [Indexed: 04/24/2023]
Abstract
AIMS We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults. METHODS A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65 years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates. RESULTS The primary analysis included 6230 individuals (mean age = 74.3 years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates. CONCLUSIONS Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.
Collapse
Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-City, Osaka, 583-8555, Japan.
| | - Kamitani Tsukasa
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Atsuya Watanabe
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| |
Collapse
|
10
|
Buchmann M, Jordan S, Loer AKM, Finger JD, Domanska OM. Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany. BMC Public Health 2023; 23:331. [PMID: 36788515 PMCID: PMC9930360 DOI: 10.1186/s12889-023-15219-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Health literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy. METHODS Analyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status. RESULTS High compared to low health literacy was associated with a 1.65-times (95% CI = 1.39-1.96) greater probability of being in activity than planning. High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75-0.95). The associations persisted after adjusting for covariates. CONCLUSION High health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.
Collapse
Affiliation(s)
- Maike Buchmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Susanne Jordan
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Anne-Kathrin Mareike Loer
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| | - Jonas David Finger
- Senate Department for Higher Education and Research, Long-Term Care and Gender Equality, Department of Health, Oranienstraße 106, 10969 Berlin, Germany
| | - Olga Maria Domanska
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
| |
Collapse
|
11
|
Wong MYC, Ou KL, Chung PK, Chui KYK, Zhang CQ. The relationship between physical activity, physical health, and mental health among older Chinese adults: A scoping review. Front Public Health 2023; 10:914548. [PMID: 36684983 PMCID: PMC9853435 DOI: 10.3389/fpubh.2022.914548] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations.
Collapse
Affiliation(s)
- Ming Yu Claudia Wong
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Kai-ling Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Pak Kwong Chung
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Kei Yee Katie Chui
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Chun-qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
12
|
Attafuah PYA, Everink IHJ, Lohrmann C, Abuosi AA, Schols JMGA. Improving health and social care services for slum-dwelling older adults: Perspectives of health professionals. Front Public Health 2022; 10:988076. [PMID: 36299759 PMCID: PMC9589493 DOI: 10.3389/fpubh.2022.988076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/20/2022] [Indexed: 01/26/2023] Open
Abstract
Background Besides confronting the challenges of a growing older population, developing countries are dealing with limited resources and infrastructure, to ensure good health and social care services. One of these developing countries facing these challenges is Ghana. The healthcare system in Ghana currently does not have specialized geriatric services and is funded through the National Health Insurance Scheme (NHIS), private insurance companies and an out-of-pocket expenditure system. Social care services are important in improving Quality of Life (QoL) as it helps in building and strengthening relationships while also keeping slum-dwelling older adults active. There are various challenges with the health and social care of older adults in slums and practical ways to improve these have not been explored among the providers of this care. Aims This study, therefore, aimed to explore (1) the views of health professionals on older slum-dwelling adults' health and social care needs, access, and use, and (2) recommendations for improving access to health and social care services among slum-dwelling older adults. Method A qualitative exploratory descriptive approach was used among health professionals by conducting a focus group discussion (FGD) and interviews. A semi-structured interview guide was used to collect data from each participant. Results A total of 27 participants took part in the study. In the analysis of transcripts, 3 themes and 14 subthemes were conceptualized. Financial difficulties, queueing issues, distance to health facilities, health illiteracy and negative attitude of health professionals were identified as some barriers to the utilization of formal healthcare services. Social care services were described as non-existent, not structured, and having limited resources to cater for attendants. The health professionals also provided recommendations for improvement. Conclusion Health professionals in this study discussed barriers to access and use of health and social care services. Addressing these barriers is essential to improve the use of formal health and social care services and diminish health inequity among older adults.
Collapse
Affiliation(s)
- Priscilla Yeye Adumoah Attafuah
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
- Department of Health Services Research and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Irma H. J. Everink
- Department of Health Services Research and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Christa Lohrmann
- Department of Nursing, Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Aaron Asibi Abuosi
- Health Services Management Department, University of Ghana Business School, Accra, Ghana
| | - Jos M. G. A. Schols
- Department of Health Services Research and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Family Medicine and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
13
|
Yuan Y, Tao C, Yu P, Wang Y, Kitayama A, Takashi E, Yanagihara K, Liang J. Demand analysis of telenursing among empty-nest elderly individuals with chronic diseases based on the Kano model. Front Public Health 2022; 10:990295. [PMID: 36249233 PMCID: PMC9555810 DOI: 10.3389/fpubh.2022.990295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
Aim The increase in empty-nest elderly individuals with chronic diseases poses a major challenge to the provision of public health services in China. Telenursing can effectively relieve the pressure of public health services to a certain extent. This study aims to explore the telenursing needs of empty-nest elderly individuals with chronic diseases based on the Kano model to provide references for improving the quality of telenursing. Methods Participants were selected from five rural communities and five urban communities in Yangzhou and Nantong, Jiangsu Province, China. A total of 348 empty-nest elderly individuals with chronic diseases were included. The participants received a sociodemographic characteristics questionnaire, and their telenursing needs were surveyed and analyzed based on the Kano model. Results Of the 15 quality attributes evaluated by the participants, 3 telenursing services were categorized as "must-be quality", 5 were categorized as "one-dimensional quality", 5 were categorized as "attractive quality", and 2 were categorized as "indifferent quality". The proportion of individuals who desired telenursing services ranged from 47.41 to 83.62%, the better values (satisfaction) ranged from 35.29-83.98%, and the worse values (dissatisfaction) ranged from 10.91 to 63.27%. There were no significant differences in any items of telenursing needs for between participants in Yangzhou and Nantong (all P > 0.05), and there were also no significant differences in all items between rural and urban communities (all P > 0.05). Conclusion Based on the Kano model, it was found that empty-nest elderly individuals with chronic diseases had a positive attitude toward telenursing and that they had different levels of need for different telenursing services. These findings provided a theoretical basis for medical decision-makers to formulate medical policies and provided a scientific foundation for nursing managers to improve telenursing services to meet the needs of the empty-nest elderly individuals with chronic diseases.
Collapse
Affiliation(s)
- Yuan Yuan
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, China,Nagano College of Nursing, Komagane, Japan
| | - Chunhua Tao
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, China
| | - Ping Yu
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | | | | | - En Takashi
- Nagano College of Nursing, Komagane, Japan
| | | | - Jingyan Liang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China,Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China,*Correspondence: Jingyan Liang
| |
Collapse
|
14
|
de Boer JJ, Feleus A, Hesselink A, Siemonsma P, Verhoef J, Schmitt M. Using storytelling methodology to identify barriers and facilitators of sustained physical activity in patients with a chronic disease: a qualitative study. BMJ Open 2022; 12:e057236. [PMID: 35351725 PMCID: PMC8961147 DOI: 10.1136/bmjopen-2021-057236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/28/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To identify implicit and more profound barriers and facilitators and involving context elements to accomplish sustained physical activity (PA) in patients with a chronic disease. Understanding these barriers and facilitators may help develop future strategies to be used by healthcare professionals in primary care to support patients with a chronic disease to reach sustained PA. DESIGN AND METHODS The qualitative, narrative research method storytelling was applied. Perspectives of both patients with a chronic disease (n=12) and involved healthcare professionals (n=11) were collected. Stories were audiotaped and retrieved from the transcriptions. Analysis involved a cyclic process of constant comparison. Main themes were arranged in the theoretical framework of the Capability, Opportunity, Motivation and Behaviour (COM-B) model. PARTICIPANTS Patients were adults with a chronic disease or at high risk of developing a chronic disease who participated in a PA promoting programme. Eligible healthcare professionals were those involved in these PA promoting programmes in primary care, such as physiotherapists, nurse practitioners or sports consultants. RESULTS From 176 stories, 62 relevant and unique stories were selected for further analysis. Eleven main themes were identified and afterwards linked to the COM-B model. Trust in one's own capabilities and in the healthcare professional were relevant themes. Also, health literacy and coping with temporary interruption were important capabilities. Important motivators were customised PA, increasing awareness, meaningful activities, exercising in a group and success experiences. Aversion to sports was seen as a barrier. Interprofessional collaboration and prerequisites can be a facilitator or a barrier. CONCLUSIONS This study provides insight into deeper motivations, barriers and facilitators of sustained PA from both the patients' and healthcare professionals' perspective. Comparing these perspectives revealed different views and beliefs on some themes. Attention for temporary interruptions, aversion to sports and health literacy were identified to be important for sustained PA.
Collapse
Affiliation(s)
- Johanna Jacoba de Boer
- Department of Physiotherapy and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Anita Feleus
- Department of Physiotherapy and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Arlette Hesselink
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Petra Siemonsma
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - John Verhoef
- Department of Physical Therapy & Faculty of Health, University of Applied Sciences Leiden, Leiden, The Netherlands
| | - Maarten Schmitt
- Department of Physiotherapy and Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| |
Collapse
|
15
|
Lee HJ, Son YJ. Associated Factors and Health Outcomes of Health Literacy and Physical Frailty Among Older Adults: A Systematic Review. Res Gerontol Nurs 2021; 15:39-52. [PMID: 34807795 DOI: 10.3928/19404921-20211117-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The current review aimed to systematically describe and synthesize health outcomes and factors associated with health literacy and physical frailty among older adults. Seven electronic databases were searched for observational studies published in English, from database inception to March 31, 2021. The study protocol was registered with PROSPERO. Two reviewers independently performed study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Among the 479 studies identified, nine (6,337 participants) met eligibility criteria. Common factors associated with health literacy and physical frailty were lower educational level, multiple comorbidities, and cognitive dysfunction. Health literacy was mainly associated with self-reported outcomes, whereas physical frailty was related to clinical outcomes. Prospective studies are required to identify the impact of limited health literacy, combined with frailty, on long-term health outcomes in older adults. Health literacy interventions should consider the older adult population with multiple comorbidities. [Research in Gerontological Nursing, xx(x), xx-xx.].
Collapse
|
16
|
Lin CC, Kuo CT, Tsai MR. Association of functional, interactive, and critical health literacy with good self-rated health among Taiwanese community-dwelling older adults. Geriatr Nurs 2021; 43:91-96. [PMID: 34844130 DOI: 10.1016/j.gerinurse.2021.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 12/01/2022]
Abstract
The functional, interactive, and critical domains of health literacy are associated with health. However, studies examining the relationship between health literacy subdomains and health in the Chinese-speaking context are still limited. Thus, we aimed to examine the association of functional, interactive, and critical health literacy with self-rated health among older Taiwanese adults. A total of 1,072 participants aged 60 or older were included in the analysis. Health literacy was measured by the 11-item short-form Mandarin Health Literacy Scale and validated tools. Self-rated health was categorized into good (good/very good), fair, and poor (poor/very poor) status. Multinomial logistic regression revealed that only interactive health literacy was associated with reporting good health status (OR = 2.30; 95% CI = 1.65 to 3.21). Conversely, all health literacy subdomains were not associated with reporting poor health. This study suggested that interactive health literacy was the key determinant of good self-rated health status for community-dwelling older adults.
Collapse
Affiliation(s)
| | - Chun-Tung Kuo
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | |
Collapse
|