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Peprah P, Lloyd J, Ajang DA, Harris MF. A qualitative study of negative sociocultural experiences of accessing primary health care services among Africans from refugee backgrounds in Australia: implications for organisational health literacy. BMC PRIMARY CARE 2024; 25:327. [PMID: 39232655 PMCID: PMC11375895 DOI: 10.1186/s12875-024-02567-2] [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: 02/06/2024] [Accepted: 08/08/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Primary health care is the first point of contact for patients from refugee backgrounds in the Australian health system. Sociocultural factors, including beliefs and value systems, are salient determinants of health literacy and access to primary health care services. Although African refugees in Australia have diverse sociocultural backgrounds, little is known about the influence of sociocultural factors on their experiences of accessing primary health care services. Guided by the theoretical framework of access to health care, this study examined from the perspective of African refugees how culturally and religiously conditioned, constructed and bound health beliefs, knowledge and practices influence their experiences of access to, acceptance and use of primary health care services and information in Australia. METHODS This exploratory, qualitative study involved 19 African refugees from nine countries living in New South Wales, Australia. Semi-structured interviews were conducted and recorded using Zoom software. The interviews were transcribed verbatim and analysed using a bottom-up thematic analytical approach for theme generation. RESULTS Four main themes were identified. The themes included: participants' experiences of services as inaccessible and monocultural and providing information in a culturally unsafe and insensitive manner; the impact of the clinical care environment; meeting expectations and needs; and overcoming access challenges and reclaiming power and autonomy through familiar means. The findings generally support four dimensions in the access to health care framework, including approachability, acceptability, availability and accommodation and appropriateness. CONCLUSION African refugees experience significant social and cultural challenges in accessing primary health care services. These challenges could be due to a lack of literacy on the part of health services and their providers in servicing the needs of African refugees. This is an important finding that needs to be addressed by the Australian health care system and services. Enhancing organisational health literacy through evidence-informed strategies in primary health systems and services can help reduce disparities in health access and outcomes that may be exacerbated by cultural, linguistic and religious differences.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia.
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
| | | | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
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Gustafsdottir SS, Mårtensson L, Sigurdardottir AK, Arnadottir SA. When great responsibility comes with limited options: experiences and needs of older community-dwelling adults regarding accessing, understanding, appraising and using health-related information. BMC Geriatr 2024; 24:640. [PMID: 39085871 PMCID: PMC11292880 DOI: 10.1186/s12877-024-05236-2] [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: 01/03/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND In previous research, older adults have been associated with reduced levels of health literacy (HL) influenced by a range of contextual factors. To optimise HL, it is essential to better understand the interactions between the ageing process and both personal and environmental factors as perceived by older adults. This study aimed to explore the experiences and needs of older community-dwelling adults when accessing, understanding, appraising and using health-related information. METHODS An explorative, qualitative design was used within the social constructivism framework. Semi-structured individual interviews were conducted with 20 adults aged 70-96 living at home in three areas in Northern Iceland. The transcribed interviews were constructed into categories and subcategories using qualitative content analysis. FINDINGS Four categories emerged. "Expectations for responsibility" describes the experience that individuals are responsible for taking care of their health, including accessing, understanding, appraising and using information and services, showing initiative and keeping needed communications active. "A gap between expectancy and ability/context" includes experiences while taking responsibility for expectations not aligning with skills/situations, creating information gaps. "Finding one's own ways" comprises various adapted ways to access, understand, and use information and services. "Bridging the gap" describes experiences of needing shared responsibility and more manageable options to enable reasoned health-related decisions and navigation in the healthcare system. CONCLUSIONS The participants valued and took full responsibility for accessing, understanding, appraising and using information and services as part of a social norm; however, they experience information gaps. They request shared responsibility by being provided with fundamental health-related information as a vital step in making reasoned health-related decisions and navigating the healthcare system. They also request more inclusive and accessible service opportunities to bridge the gaps and facilitate HL. It is necessary to critically address, at a systematic level, the conflict between expected individual responsibility and the existence of options to act upon this responsibility. In matters of health, health services and HL, the need to analyse and confront structural disadvantages experienced by older adults is highlighted.
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Affiliation(s)
- Sonja Stelly Gustafsdottir
- Faculty of Occupational Therapy, School of Health, Business and Natural Sciences, University of Akureyri, Nordurslod 2, Akureyri, 600, Iceland.
- Department of Physical Therapy, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
| | - Lena Mårtensson
- Health and Rehabilitation at the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Arun K Sigurdardottir
- Faculty of Nursing, School of Health, Business and Natural Sciences, University of Akureyri, Akureyri, Iceland
- Akureyri Hospital, Akureyri, Iceland
| | - Solveig A Arnadottir
- Department of Physical Therapy, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Gorczynski P, Aron CM, Moore M, Reardon CL. The Epidemiology of Mental Health Symptoms and Disorders Among Elite Athletes and the Evolution of Mental Health Literacy. Clin Sports Med 2024; 43:1-11. [PMID: 37949504 DOI: 10.1016/j.csm.2023.06.001] [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: 11/12/2023]
Abstract
Within elite sport, epidemiological evidence is needed concerning the incidence and prevalence of mental health symptoms and disorders in relation to athlete demographic factors such as (dis)ability, race, ethnicity, sexual orientations, and different genders. Mental health promotion campaigns are often based on mental health literacy strategies. Such strategies aim to increase knowledge of mental health symptoms and disorders, address aspects of self- and public stigma, and promote help-seeking behaviors. Sporting organizations need to take responsibility to ensure that policies, practices, and services reflect organizational values concerning mental health. Organizational mental health literacy ensures that information is culturally competent and responsive, easy to find, straightforward, and offers simple, legitimate opportunities to access support.
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Affiliation(s)
- Paul Gorczynski
- Psychology and Counselling, School of Human Sciences, University of Greenwich, Old Royal Naval College, Spinnaker Building, Cambridge Road, Park Row, Greenwich SE10 9LS, UK; Ascend Consultation in Healthcare, 737 North Michigan Avenue #1925, Chicago, IL 60611, USA.
| | - Cindy Miller Aron
- Ascend Consultation in Healthcare, 737 North Michigan Avenue #1925, Chicago, IL 60611, USA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Boulevard, Madison, WI 53719, USA
| | - Matt Moore
- Department of Social Work, Ball State University, Health Professions Building, Room 501, Muncie, IN 47306, USA; Department of Family Science and Social Work, Miami University, McGuffey Hall, Room 101C, Oxford, OH 45056, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, 6001 Research Park Boulevard, Madison, WI 53719, USA
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Paucar-Caceres A, Vílchez-Román C, Quispe-Prieto S. Health Literacy Concepts, Themes, and Research Trends Globally and in Latin America and the Caribbean: A Bibliometric Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7084. [PMID: 37998315 PMCID: PMC10671712 DOI: 10.3390/ijerph20227084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Health literacy (HL) debates have increased significantly in the last two decades. HL concepts/themes and models have achieved substantial development in the US and Europe. Although there have been some efforts to develop HL in Latin America and the Caribbean (LAC), these seem to be few and scattered. This paper reviews and discusses developments of HL concepts and themes globally and in LAC over the last two decades. (2) Purpose: This study aimed to identify the prevalent health literacy concepts/themes deployed globally and in LAC as reported in academic journals from 2005 to 2022. We looked into which fields of knowledge have been informing HL research over the last decades. (3) Methods: We conducted a structured search on the Web of Science (WoS), Scopus, PubMed, and SciELO databases to extract the textual data for bibliometric analysis. We analyzed the textual data with VOSviewer and Biblioshiny to better understand health literacy themes and strands currently being researched in the LAC region. We conducted the searches in two periods: the first in May 2023 and the second in October 2023. (4) Results: The bibliometric study highlighted five WoS categories informing most HL global studies: (i) public environmental occupational health; (ii) environmental sciences; (iii) health policy services; (iv) health care science services; and (v) communication. The two predominant categories in LAC are public environmental occupation health and health policy services. Journals hosting HL publications come from these WoS categories. Themes in HL publications can be organized into four thematic clusters: (i) analytical (research designs, analytic techniques, and criteria for examining HL data); (ii) psychometric (measurement properties of data collection tools); (iii) pragmatic (practical issues related to implementing HL programs); and (iv) well-being (effectiveness of HL programs on mental health and illness treatment). (5) Conclusions: There is expanding interest in health literacy among scholars. The number of publications has increased substantially, particularly over the last five years. These are dominated by the Global North. The metrics show that LAC and Africa are trailing in publications. There is an emerging focus on adult literacy, functional/low health literacy, and their effect on improving capabilities, comprehension, and communication regarding health-related topics.
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Affiliation(s)
- Alberto Paucar-Caceres
- Department for Operations, Technology, Events and Hospitality Management, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Carlos Vílchez-Román
- Research Department, Centrum Católica Graduate Business School (CCGBS), Pontificia Universidad Católica del Perú (PUCP), Lima 15023, Peru;
| | - Silvia Quispe-Prieto
- School of Nursing, Faculty of Health Sciences, National University Jorge Basadre Grohmann, Tacna 23000, Peru;
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Smith G, Lui SF, Kalantar-Zadeh K, Bonner A. The Shift from Individual to Organizational Health Literacy: Implications for Kidney Healthcare Leaders and Clinicians. Nephron Clin Pract 2023; 148:349-356. [PMID: 38109858 DOI: 10.1159/000534073] [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: 04/01/2023] [Accepted: 08/23/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND As a social determinant of health, health literacy has a vital role in the management of chronic disease management, including chronic kidney disease (CKD). SUMMARY To be able to manage their condition, patients with CKD need to be able to assess, comprehend, appraise, and utilize complex health-related information. Those patients are much more likely to understand and use health information appropriately, if it addresses their personal needs related to language, culture, educational background, and socioeconomic status. One aspect of health literacy, organizational health literacy (OHL), relates to the degree with which health organizations justifiably empower patients to locate, understand, and utilize health information and facilities to inform their decision-making and health behaviours. With increasing evidence-based about OHL as a way to improve healthcare, it is a new concept for kidney clinicians. KEY MESSAGES As producers of health-related information, the multidisciplinary kidney healthcare team have a responsibility to meet the needs of those in their care, as such, priority should be given to implementation of OHL initiatives. Through enhancing the clarity of information, OHL initiatives may provide a game plan for person-centred care for those with CKD.
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Affiliation(s)
- Graeme Smith
- School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, Hong Kong, China
| | - Siu-Fai Lui
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong, China
| | | | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia,
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Ribeiro OMPL, Coimbra VMO, Pereira SCDA, Faria ADCA, Teles PJFC, da Rocha CG. Impact of COVID-19 on the Environments of Professional Nursing Practice and Nurses' Job Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16908. [PMID: 36554789 PMCID: PMC9779541 DOI: 10.3390/ijerph192416908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: The repercussions of work environments were widely studied before the pandemic. However, there are still many difficulties to be discovered considering the impact generated by it. Thus, this study aimed to analyse the impact of COVID-19 on nursing practice environments and nurses' job satisfaction. (2) Methods: A correlational study was conducted in a hospital in northern Portugal, with the participation of 416 registered nurses. Data were collected in June 2021 through questionnaires. The study was approved by the Institutional Ethics Committee. (3) Results: COVID-19 had a favourable impact on the structure component of the practice environments; the process component decreased compared to the pre-pandemic period; the outcome component remained moderately favourable to the quality of care. Nurses were not very satisfied or not at all satisfied with their valuation and remuneration; moderately satisfied with the leadership and staffing; and satisfied with the organisation and resources, co-workers and valuation by patients and families. In more favourable environments, nurses' job satisfactions were higher. (4) Conclusions: Identifying the dimensions with the best and worst scores allowed the institution's managers to concentrate efforts on where improvements were needed, thus preparing professional contexts for the recovery of care activities.
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Affiliation(s)
| | | | | | | | - Paulo João Figueiredo Cabral Teles
- School of Economics, University of Porto, 4200-465 Porto, Portugal
- Laboratory of Artificial Intelligence and Decision Support—INESC Porto LA, 4200-465 Porto, Portugal
| | - Carla Gomes da Rocha
- Institute of Health, School of Health Sciences, HES-SO Valais-Wallis, 1950 Sion, Switzerland
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Macauda MM, Arent MA, Sakhuja M, Yelton B, Noblet S, Fedrick D, Zona D, New C, Isenhower WD, Wandersman A, Friedman DB. Elements for successful implementation of a clinic-based health literacy intervention. Front Public Health 2022; 10:977765. [PMID: 36388330 PMCID: PMC9650509 DOI: 10.3389/fpubh.2022.977765] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/07/2022] [Indexed: 01/25/2023] Open
Abstract
Improving health literacy is a national public health priority. Given the context of the COVID-19 pandemic, it is even more critical for health and medical information to be clear and understandable for patients and their families. Clinic-based programs to improve health literacy need to be pragmatic, feasible, and helpful for the implementing clinic and patients. This paper describes the development, implementation, and evaluation of a pragmatic, clinic-based health literacy intervention in a safety-net clinic that serves uninsured and indigent patients. Study methods are guided by a previous pilot study and components recommended for pragmatic interventions. An electronic readiness assessment was distributed to out-patient clinics affiliated with a statewide hospital association. The AskMe3 tool was used for the intervention as it is evidence informed and relatively easy to implement. Implementation included ongoing dialogue between the clinic and the academic research team. Within the implementing clinic, data collected from patients via verbally administered questionnaires was analyzed using descriptive statistics and chi-squares. Interview data collected from the clinic director was analyzed qualitatively for themes. The implementing clinic had some of the lowest average scores of the 34 clinics who participated in the initial readiness assessment. Despite this, they were able to successfully implement the health literacy intervention during a global pandemic. Eighty-eight participants completed patient questionnaires at this clinic. Most patients (96%) agreed the AskMe3 questions helped them talk with the doctor or nurse at their current appointment. Most (99%) also perceived the AskMe3 tool to be very helpful when used in a clinical setting. The clinic director offered that the staff initially thought the intervention would be difficult to implement. However, implementation by clinic volunteers with encouragement and prioritization of health literacy by the clinic director contributed to success. When considering interventions for clinical settings, a pragmatic approach can help with selection and implementation of a program that fits with the realities on the ground. Further, frequent technical assistance can help resolve implementation barriers. Interventions utilizing tools such as AskMe3, because of their simplicity, allow creative solutions to capacity issues for clinics who see a need for health literacy improvements.
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Affiliation(s)
- Mark M. Macauda
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States,Center for Applied Research and Evaluation, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States,*Correspondence: Mark M. Macauda
| | - Michelle A. Arent
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Mayank Sakhuja
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Brooks Yelton
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Samuel Noblet
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States,Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | | | - Diana Zona
- South Carolina Hospital Association, Columbia, SC, United States
| | - Cyndi New
- South Carolina Hospital Association, Columbia, SC, United States
| | | | | | - Daniela B. Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Lindert L, Kühn L, Kuper P, Choi KE(A. Organizational Health Literacy in the Context of Employee Health: An Expert-Panel-Guided Scoping Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4381. [PMID: 35410062 PMCID: PMC8998773 DOI: 10.3390/ijerph19074381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 11/17/2022]
Abstract
Health literacy (HL) is an interplay of individual and organizational health literacy (OHL). While individual HL has been intensively studied, the importance of OHL has become a greater focus of research attention. The National Action Plan Health Literacy in Germany emphasizes the promotion of HL in all areas of everyday life, including occupation and the workplace. The proposed scoping review aims at identifying and evaluating definitions, empirical studies and instruments on OHL targeting employee recipients. The search will be conducted in two consecutive steps and guided by expert-panel discussions in accordance to the method of Consensus Development Panels. The search will be conducted in Web of Science, PubMed and Google Scholar according to the methodological framework of Arksey and O'Malley and supplemented by the snowball principle and a hand search. All records will be included that were published until the final search date. To define eligibility criteria, the PCC framework of the Joanna Briggs Institute is used. The scoping review will critically discuss whether a new definition of OHL in the context of employee health is of purpose for future research and practice. Nonetheless, it will provide orientation in the context of employee health, also facing the consequences of SARS-CoV-2.
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Affiliation(s)
- Lara Lindert
- Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany; (L.K.); (P.K.); (K.-E.C.)
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Kaundinya T, Agrawal R. Unpacking a Telemedical Takeover: Recommendations for Improving the Sustainability and Usage of Telemedicine Post-COVID-19. Qual Manag Health Care 2022; 31:68-73. [PMID: 34173773 PMCID: PMC8963434 DOI: 10.1097/qmh.0000000000000329] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Telemedicine technology and regulation have been steadily growing over the last 2 decades. Prior to the coronavirus disease-2019 (COVID-19) pandemic, the availability of telemedicine in health systems and coverage of telemedicine were variable. Sudden and improved access to telemedicine was propelled by the COVID-19 pandemic, during which governments, insurers, and health systems ramped up telemedical utilization with short-term exceptions and waivers. As in-person care opportunities open back up, the presence of telemedicine is not receding and thus its widespread adoption needs to be facilitated outside pandemic-specific conditions. Long-term funding for telemedicine acquisition, centralized electronic health records, extended waivers related to telemedicine coverage and use, a Medicaid expansion that involves parity in telemedicine and in-person care, a nationalized licensure system, and an assessment of what types of care settings can and cannot utilize telemedicine are necessary recommendations to improve the sustainability of telemedicine after the pandemic.
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Affiliation(s)
- Trisha Kaundinya
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rishi Agrawal
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Sadural E, Riley KE, Zha P, Pacquiao D, Faust A. Experiences with a postpartum mHealth intervention during the COVID-19 pandemic: Qualitative study (Preprint). JMIR Form Res 2022; 6:e37777. [PMID: 35699998 PMCID: PMC9237765 DOI: 10.2196/37777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/15/2022] [Accepted: 05/22/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ernani Sadural
- Department of Obstetrics and Gynecology, Cooperman Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, United States
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, United States
| | - Kristen E Riley
- Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Peijia Zha
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, United States
| | - Dula Pacquiao
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, United States
| | - Amanda Faust
- The Shaw Wellness Institute, Colgate University, Hamilton, NY, United States
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Harris MA, Colvin KF, Lindner NE, Manganello JA, Mohamed L, Shaw AV. Development and Initial Validation of the Refugee Health Literacy Assessment Tool (RHLAT). AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1978908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Patil U, Kostareva U, Hadley M, Manganello JA, Okan O, Dadaczynski K, Massey PM, Agner J, Sentell T. Health Literacy, Digital Health Literacy, and COVID-19 Pandemic Attitudes and Behaviors in U.S. College Students: Implications for Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3301. [PMID: 33806763 PMCID: PMC8004744 DOI: 10.3390/ijerph18063301] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 01/24/2023]
Abstract
The COVID-19 pandemic has been accompanied by rapidly emerging evidence, changing guidance, and misinformation, which present new challenges for health literacy (HL) and digital health literacy (DHL) skills. This study explored whether COVID-19-related information access, attitudes, and behaviors were associated with health literacy and digital health literacy among college students in the United States. Self-reported measures of health literacy, along with items on pandemic-related attitudes, behaviors, information sources, and social networks, were collected online using a managed research panel. In July 2020, 256 responses were collected, which mirrored the racial/ethnic and gender diversity of U.S. colleges. Only 49% reported adequate HL, and 57% found DHL tasks easy overall. DHL did not vary by HL level. In multivariable models, both HL and DHL were independently associated with overall compliance with basic preventive practices. Higher DHL, but not HL, was significantly associated with greater willingness to get a COVID-19 vaccine and the belief that acquiring the disease would negatively impact their life. On average, respondents discussed health with 4-5 people, which did not vary by HL or DHL measures. The usage of online information sources varied by HL and DHL. The study findings can inform future student-focused interventions, including identifying the distinct roles of HL and DHL in pandemic information access, attitudes, and behaviors.
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Affiliation(s)
- Uday Patil
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, 1960 East West Road, Honolulu, HI 96822, USA;
| | - Uliana Kostareva
- School of Nursing and Dental Hygiene, University of Hawai‘i at Mānoa, 2528 McCarthy Mall, Honolulu, HI 96822, USA;
| | - Molly Hadley
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA; (M.H.); (J.A.M.)
| | - Jennifer A. Manganello
- School of Public Health, University at Albany, One University Place, Rensselaer, NY 12144, USA; (M.H.); (J.A.M.)
| | - Orkan Okan
- Interdisciplinary Centre for Health Literacy, Bielefeld University, Universitätsstraße 25, 33615 Bielefeld, Germany;
| | - Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Leipziger Straße 123, 36037 Fulda, Germany;
- Center for Applied Health Science, Leuphana University of Lueneburg, Wilschenbrucher Weg 84a, 21335 Lüneburg, Germany
| | - Philip M. Massey
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA 19104, USA;
| | - Joy Agner
- Department of Psychology, University of Hawai‘i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96822, USA;
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, 1960 East West Road, Honolulu, HI 96822, USA;
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