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Sheed L, Haua R, Honey MLL, Aspden TJ, Brackley KE, Chan AHY. Exploring medicines information needs of mental health service users at a New Zealand hospital. PSYCHOL HEALTH MED 2022; 27:1255-1267. [DOI: 10.1080/13548506.2020.1865547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Lucy Sheed
- Department of Pharmacy, Auckland District Health Board, Auckland, New Zealand
| | - Robert Haua
- Department of Pharmacy, Auckland District Health Board, Auckland, New Zealand
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | | | - Trudi J. Aspden
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Kim E. Brackley
- Department of Pharmacy, Auckland District Health Board, Auckland, New Zealand
| | - Amy H. Y. Chan
- Department of Pharmacy, Auckland District Health Board, Auckland, New Zealand
- School of Pharmacy, University of Auckland, Auckland, New Zealand
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Readability, accuracy and comprehensibility of patient information leaflets: The missing pieces to the puzzle of problem-solving related to safety, efficacy and quality of medication use. Res Social Adm Pharm 2021; 18:2557-2558. [PMID: 34711520 DOI: 10.1016/j.sapharm.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 11/22/2022]
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Tong V, Krass I, Robson S, Aslani P. Opt-in or opt-out health-care communication? A cross-sectional study. Health Expect 2021; 24:776-789. [PMID: 33761176 PMCID: PMC8235885 DOI: 10.1111/hex.13198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/19/2020] [Accepted: 01/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients need medication and medical condition-related information to better self-manage their health. Health-care professionals (HCPs) should be able to actively provide information outside of one-on-one consultations; however, patient consent may be required. OBJECTIVE To investigate the Australian public's preferences, and factors that may influence their preferences, towards an opt-in versus an opt-out approach to health communication. DESIGN A cross-sectional study using a structured questionnaire administered via Computer-Assisted Telephone Interviewing. SETTING AND PARTICIPANTS Participants across Australia who were adults, English-speaking and had a long-term medical condition. MAIN OUTCOME MEASURES Preferences for opt-in vs opt-out approach to receiving follow-up tailored information. RESULTS A total of 8683 calls were made to achieve the required sample size of 589 completed surveys. Many (346/589; 58.7%) indicated that they were interested in receiving tailored, ongoing follow-up information from their HCP. Nearly half (n = 281; 47.7%) preferred an opt-in service and 293/589 (49.7%) an opt-out service for receiving follow-up information. Reasons for preferring an opt-in service were being in control of the information received (n = 254); able to make a decision that is best for them (n = 245); opt-in service would save time for HCPs (n = 217); they may not want or need the information (n = 240). Many (n = 255) felt that an opt-out service should be part of the normal duty of care of their HCP and believed (n = 267) that this approach would ensure that everyone has access to information. CONCLUSIONS Respondents were interested in receiving tailored information outside of consultation times. However, preferences for an opt-in or opt-out approach were divided.
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Affiliation(s)
- Vivien Tong
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Pharmacy and Bank Building (A15), The University of Sydney, Camperdown, NSW, Australia
| | - Ines Krass
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Pharmacy and Bank Building (A15), The University of Sydney, Camperdown, NSW, Australia
| | | | - Parisa Aslani
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Pharmacy and Bank Building (A15), The University of Sydney, Camperdown, NSW, Australia
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Segun SJ, Victor BO. Utility of information in package inserts by pharmacists and pharmacy clients in a metropolitan city in Southwest Nigeria. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmaa006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Objective
Package inserts provide relevant information to patients and health care professionals on the safety and rational use of drugs. This study evaluated the utility of package inserts by pharmacy clients for information, and by pharmacists during consultation and counselling with patients.
Methods
This cross-sectional self-administered questionnaire-based study was conducted in Ibadan, Nigeria among 705 pharmacy clients and 344 community and hospital pharmacists. The questionnaire had a 12-item and a 14-item package insert utility scale for pharmacists and pharmacy clients, respectively. The level of utility and association between demographic variables and package insert utility scores were determined with Mann–Whitney U and Kruskal–Wallis tests at P < 0.05.
Key findings
The response rate was 88.2% for pharmacy clients and 67.2% for pharmacists. Most of the pharmacy clients, 459 (73.8%), check for package inserts in drug packs. The most assessed information in package inserts was dose 432 (69.5%). Some of the pharmacy clients, 276 (44.4%), considered information from health professionals more reliable than that in package inserts. The pharmacy clients’ level of education was associated with package insert utility score (P = 0.001). Most of the pharmacists, 137 (59.3%), read package inserts but only 36 (15.6%) consulted package inserts during counselling with patients. The pharmacists’ age and the number of years spent in practice were significantly associated with package insert utility scores (P < 0.05). The level of utility of the information in package inserts by the pharmacy clients and the pharmacists was moderate – 66.8 and 60.0%, respectively.
Conclusion
Both pharmacists and pharmacy clients use package insert content moderately. Pharmacy clients rely more on information provided by health professionals than the information in package inserts but pharmacists seldom consult package inserts during counselling process.
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Affiliation(s)
- Showande Johnson Segun
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Oyo State, Nigeria
| | - Babalola Olumuyiwa Victor
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Oyo State, Nigeria
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The Role of the Patient Information Leaflet in Patients'Medication Therapy: A Case Study within the Kumasi Metropolis of Ghana. ScientificWorldJournal 2020; 2020:2489137. [PMID: 33149725 PMCID: PMC7603630 DOI: 10.1155/2020/2489137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/08/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
One of the tools used in providing comprehensible medication information to patients on their medication use for improved adherence and subsequent optimal therapeutic effect is the Patient Information (PI) leaflet. In Ghana, the patient information leaflet is available through various sources including health-care professionals (HCPs) and electronic forms. The World Health Organization (WHO) estimates that more than 70% of patients, especially in the developing countries, who receive medications do not read the accompanying leaflet. This study assessed the role of the patient information leaflet in Patients' medication therapy in the Kumasi metropolis of Ghana. A random cross-sectional survey was conducted in various hospitals and pharmacies within selected districts in the Kumasi metropolis. The survey revealed that 96.9% of the sampled respondents (n = 300) were provided with PI leaflets on their medicines while only 3.1% of them indicated otherwise. Among the proportion of respondents who were provided with PI leaflets, 66.7% of them read the information on the drug leaflets whilst the remaining 33.3% did not. Ultimately, 62.4% of those who read the PI leaflets were influenced to discontinue their medication. In conclusion, reading of the drug information leaflet was higher than that found in previous studies in Ghana. Reading the leaflet did not increase adherence but aroused anxiety and decreased adherence in some patients. A large number of the patients who were given the PI leaflets indicated that it did not provide them with the needed information.
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Møller M, Herborg H, Andersen SE, Tjørnhøj-Thomsen T. Chronic medicine users' self-managing medication with information - A typology of patients with self-determined, security-seeking and dependent behaviors. Res Social Adm Pharm 2020; 17:750-762. [PMID: 32800714 DOI: 10.1016/j.sapharm.2020.06.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 06/08/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Information on medicines is key for safety and quality of care in long-term treatment courses with medicines. Little is known on how patients self-manage medication with information, and how interactions with health professionals influence such self-managing. OBJECTIVE The objective of this study was to investigate how patients manage long-term medication with information, and how interactions with health professionals influence this managing, with the aim of developing a typology of patients' practices for managing with information. A secondary objective was to generate theoretical reflections on patients' roles in establishing resilience in health care systems. METHODS Qualitative interviews with 15 chronic medicine users. A Safety-II-approach was used to obtain knowledge of what worked for medicine users, at the same time as acknowledging hindrances. Data were analyzed using thematic analysis and Halkiers' method for ideal-typologizing. RESULTS Four types of practices for managing medication with information were identified, distinguished by patients' ways of self-managing on their own and through relations with health professionals: Ideal-type I: Self-determined and highly self-managing; Ideal-type II: Security-seeking and self-managing; Ideal-type III: Dependent with limited self-managing; Ideal-type IV: Co-managing with close family. The findings suggest that patients with a high degree of self-managing medication with information have good chances for facilitating quality of medical treatment. For patients who are more dependent on oral information from health professionals, the character of dialogue facilitated or hindered their self-managing. All patients had the best options for managing medication when being recognized by health professionals through dialogues. CONCLUSION A typology of 4 types of managing practices was developed, characterized by patients' different abilities to self-manage medication with information and their relations to health professionals. Recognizing patients' different behaviors for managing medication with information is important for maximizing treatment quality of long-term medical treatment in a modern and resilient healthcare system.
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Affiliation(s)
- Marianne Møller
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen K, Denmark.
| | - Hanne Herborg
- Pharmakon, Danish College of Pharmacy Practice, Milnersvej 42, DK-3400 Hillerød, Denmark.
| | - Stig Ejdrup Andersen
- Clinical Pharmacology Unit, Zealand University Hospital, DK-4000 Roskilde, Denmark.
| | - Tine Tjørnhøj-Thomsen
- Department of Health and Social Context, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455 Copenhagen K, Denmark.
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Jose J. A healthcare professional's understanding of the medication information-seeking behaviour of patients: significance in the digital era. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:299-300. [PMID: 32643795 DOI: 10.1111/ijpp.12655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 01/11/2023]
Affiliation(s)
- Jimmy Jose
- School of Pharmacy, University of Nizwa, Nizwa, Sultanate of Oman
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Impact of dietary counseling on the perception of diet in patients with gestational diabetes mellitus. Diabetol Int 2020; 12:151-160. [PMID: 33786270 DOI: 10.1007/s13340-020-00454-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 12/13/2022]
Abstract
Aims/introduction Medical nutrition therapy is the cornerstone of gestational diabetes mellitus (GDM) treatment. Patients with GDM should receive dietary counseling regarding diet and exercise. Materials and methods To study patients' perception level of diet and their level of understanding after dietary counseling, we analyzed 225 reports of dietary counseling of patients with GDM prepared by dieticians. We also assessed the patients' level of understanding after dietary counseling by asking questions regarding the counseling content. The answers to the questions were aggregated, and substantially similar answers were grouped and categorized. Results The dieticians' suggestions were well understood by the patients. Moreover, the patients also identified their previous incorrect eating habits, such as excessive carbohydrate restriction or inappropriate fruit intake. Although distributed frequent meals were recommended by the dieticians, few patients actually practiced this for various reasons. Some patients were apparently influenced by dietary information from the mass media. Conclusion Dietary counseling was regarded as helpful and acceptable to most patients with GDM in our hospital, and many suggestions were recognized as informative for modification of previous dietary habits. By providing the results of the questionnaire survey to the dieticians, they can improve the quality of their counseling, which is expected to result in better individual care of the patients.
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Mete R, Curlewis J, Shield A, Murray K, Bacon R, Kellett J. Reframing healthy food choices: a content analysis of Australian healthy eating blogs. BMC Public Health 2019; 19:1711. [PMID: 31856783 PMCID: PMC6923928 DOI: 10.1186/s12889-019-8064-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blogs are widely being used by health professionals and consumers to communicate and access nutrition information. There are numerous benefits for dietitians to establish and contribute to healthy eating blogs. In particular, to disseminate evidence-based nutrition information to promote healthier dietary practices. The aim of this study was to explore characteristics of popular healthy eating blogs and inform the provision of healthy eating information in the Australian context. METHODS A content analysis approach was used to identify characteristics of popular Australian healthy eating blogs. A purposive and snowball sampling approach was used to identify healthy eating blogs from search engines including Google, Bing and Yahoo. Blogs were deemed eligible if: (1) the author self-identified as a health professional; (2) the blog was written by a single author; (3) the blog was written by an Australian author; (4) the blog had a minimum of one post per month, and (5) the blog focused on communicating healthy eating information to the general adult population. RESULTS Five popular blogs were followed over a three-month period (December 2017-March 2018), with 76 blog posts included for analysis. Characteristics of these popular blogs were examined and four main features were identified: (i) clearly conveying the purpose of each post; (ii) developing a strong understanding of the reader base and their preferences; (iii) employing a consistent writing style; use of vocabulary and layout; and (iv) communicating healthy eating information in a practical manner. These findings reveal important insight into the features that promote effective nutrition communication within this context. CONCLUSION Findings from this study highlight common characteristics of popular healthy eating blogs. Future research into the development of blog guidelines which incorporate the characteristics identified in this study can support dietitians in establishing or contributing to the successful provision of evidence-based nutritional information through blogs.
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Affiliation(s)
- Rebecca Mete
- Faculty of Health, The University of Canberra, University Dr, Bruce, ACT, 2617, Australia.
| | - Jayne Curlewis
- Faculty of Health, The University of Canberra, University Dr, Bruce, ACT, 2617, Australia
| | - Alison Shield
- Faculty of Health, The University of Canberra, University Dr, Bruce, ACT, 2617, Australia
| | - Kristen Murray
- Faculty of Health, The University of Canberra, University Dr, Bruce, ACT, 2617, Australia
| | - Rachel Bacon
- Faculty of Health, The University of Canberra, University Dr, Bruce, ACT, 2617, Australia
| | - Jane Kellett
- Faculty of Health, The University of Canberra, University Dr, Bruce, ACT, 2617, Australia
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Nunley ED. Prescription for Literacy: Patient Education Resources for Drugs, Complementary Medicine, and Vaccinations. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2019. [DOI: 10.1080/15398285.2019.1646586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Erin D. Nunley
- Preston Medical Library/Health Information Center, University of Tennessee Graduate School of Medicine/University of Tennessee Medical Center, Knoxville, Tennessee, USA
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Ahmadi P, Badri SS, Zargarzadeh AH. An investigation on patient attitudes toward package inserts and their accessibility in Iran. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:100. [PMID: 30595708 PMCID: PMC6282776 DOI: 10.4103/jrms.jrms_67_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/17/2018] [Accepted: 08/17/2018] [Indexed: 11/25/2022]
Abstract
Background: Package inserts (PIs) can be a source of information for patients, especially when clinicians do not provide adequate consultations to the patients. Therefore, for the first time, we investigated the state of PIs in Iran and evaluated patients’ attitude toward PI. Materials and Methods: In this descriptive study, conducted in a major teaching pharmacy in Isfahan, Iran, in 2016, 100 patients who presented a prescription were interviewed randomly and all medications in their medication bags were examined. The main outcome measures were whether or not the dispensed medications were accompanied by a PI and the behavior of patients in reading these PIs. Results: From the 237 medication items investigated, 129 (54.4%) were dispensed with a PI. Eighty-four percent of patients read the PIs and only 19% stated reading a non-Farsi PI. The level of education was the only significant factor related to reading the PI (P = 0.02). Reading the side effects was the main reason for reading the PI (64%). PIs were considered useful by 83% while 25% kept PIs as a source of drug information. Experience of fear to take the medication after reading the PI was reported by 47%. Conclusion: About half of medications were dispensed along with the PI. Although the majority of patients report reading the PIs and consider them useful, confidence in using the medicine may be diminished after reading the PI. Patients with higher education read the PIs the most.
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Affiliation(s)
- Parisa Ahmadi
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin S Badri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir H Zargarzadeh
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Browne SH, Barford K, Ramela T, Dowse R. The impact of illustrated side effect information on understanding and sustained retention of antiretroviral side effect knowledge. Res Social Adm Pharm 2018; 15:469-473. [PMID: 29803539 DOI: 10.1016/j.sapharm.2018.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Prompt management of side effects is critical to supporting adherence to antiretroviral (ARV) medication. OBJECTIVE This study examines the impact of presenting side effect information using simple text combined with pictograms on sustained knowledge of ARV side effects over three months. METHOD Previously designed side effect pictograms, combined with simple text, were incorporated into a side effects panel within an ARV information leaflet. In a randomised controlled study, 116 limited literacy HIV patients taking ARVs were randomly allocated to either control (standard care) or intervention groups (standard care plus illustrated information). Side effect knowledge was assessed at baseline, and intervention patients received the illustrated leaflet. Knowledge was re-tested at one and three months. Interpretation of side effect pictograms was evaluated at one month. RESULTS In intervention patients, mean side effect knowledge increased from 45.9% (baseline) to 95.7% (three months; p<0.0001), and pictogram interpretation was good. Knowledge did not change significantly in the control group. All found the pictograms clear and useful, and endorsed their routine use. CONCLUSIONS Providing patients with simple written information containing pictograms on ARV side effects significantly improved side effect knowledge, sustained over time, in limited literacy, rural South African HIV patients.
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Affiliation(s)
- Sara Hope Browne
- Center for AIDS Research (CFAR), School of Medicine, University of California at San Diego, United States; Specialists in Global Health, Encinitas, CA, United States
| | - Kirsty Barford
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Thato Ramela
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa
| | - Ros Dowse
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa.
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Chen X, Hay JL, Waters EA, Kiviniemi MT, Biddle C, Schofield E, Li Y, Kaphingst K, Orom H. Health Literacy and Use and Trust in Health Information. JOURNAL OF HEALTH COMMUNICATION 2018; 23:724-734. [PMID: 30160641 PMCID: PMC6295319 DOI: 10.1080/10810730.2018.1511658] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
There is a need to investigate which health information sources are used and trusted by people with limited health literacy to help identify strategies for addressing knowledge gaps that can contribute to preventable illness. We examined whether health literacy was associated with people's use of and trust in a range of potential health information sources. Six hundred participants from a GfK Internet survey panel completed an online survey. We assessed health literacy using the Newest Vital Sign, the sources participants used to get health information, and the extent to which participants trusted health information from these sources. We performed multivariable regressions, controlling for demographic characteristics. Lower health literacy was associated with lower odds of using medical websites for health information and with higher odds of using television, social media, and blogs or celebrity webpages. People with lower health literacy were less likely to trust health information from specialist doctors and dentists, but more likely to trust television, social media, blogs/celebrity webpages, friends, and pharmaceutical companies. People with limited health literacy had higher rates of using and trusting sources such as social media and blogs, which might contain lower quality health information compared to information from healthcare professionals. Thus, it might be necessary to enhance the public's ability to evaluate the quality of health information sources. The results of this study could be used to improve the reach of high-quality health information among people with limited health literacy and thereby increase the effectiveness of health communication programs and campaigns.
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Affiliation(s)
- Xuewei Chen
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Erika A. Waters
- Department of Surgery (Division of Public Health Sciences), Washington University Medical School, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63130 USA
| | - Marc T. Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Caitlin Biddle
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Elizabeth Schofield
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Yuelin Li
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Kimberly Kaphingst
- Department of Communication, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112 USA
| | - Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
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Christy SM, Gwede CK, Sutton SK, Chavarria E, Davis SN, Abdulla R, Ravindra C, Schultz I, Roetzheim R, Meade CD. Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs. JOURNAL OF HEALTH COMMUNICATION 2017; 22:923-931. [PMID: 29125435 PMCID: PMC6278594 DOI: 10.1080/10810730.2017.1377322] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The current study examined the sociodemographic and psychosocial variables that predicted being at risk for low health literacy among a population of racially and ethnically diverse patients accessing primary care services at community-based clinics. Participants (N = 416) were aged 50-75 years, currently not up-to-date with colorectal cancer (CRC) screening, at average CRC risk, and enrolled in a randomized controlled trial (RCT) aimed at promoting CRC screening. Participants completed a baseline interview that assessed health literacy as measured by Rapid Estimate of Adult Literacy in Medicine-Revised, sociodemographic factors, and psychosocial variables (e.g., health beliefs) prior to randomization and receipt of an intervention. Thirty-six percent of the participants were found to be at risk for low health literacy. Sociodemographic and psychosocial variables were assessed as predictors of being at risk for low health literacy using logistic regression. In the final model, predictors were male gender, being from a racial/ethnic minority group, being unable to work, having higher social influence scores, and having higher religious belief scores. These findings suggest several patient characteristics that may be associated with low health literacy, and highlight the importance of supporting all patients through simplified and clear communications and information to improve understanding of CRC screening information.
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Affiliation(s)
- Shannon M. Christy
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Clement K. Gwede
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Steven K. Sutton
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Enmanuel Chavarria
- University of Texas Health Science Center at Houston, School of Public Health, Department of Health Promotion and Behavioral Sciences, Brownsville, Texas, USA
| | - Stacy N. Davis
- Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Rania Abdulla
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Chitra Ravindra
- Florida Department of Health Pinellas County, St. Petersburg, Florida, USA
| | - Ida Schultz
- Premier Community HealthCare Group, Inc., Dade City, Florida, USA
| | - Richard Roetzheim
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Cathy D. Meade
- Division of Population Science, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
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Role of Information Anxiety and Information Load on Processing of Prescription Drug Information Leaflets. PHARMACY 2017; 5:pharmacy5040057. [PMID: 29035337 PMCID: PMC5748538 DOI: 10.3390/pharmacy5040057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/29/2017] [Accepted: 10/09/2017] [Indexed: 11/16/2022] Open
Abstract
In this study, we evaluate the role of information anxiety and information load on the intention to read information from prescription drug information leaflets (PILs). These PILs were developed based on the principals of information load and consumer information processing. This was an experimental prospective repeated measures study conducted in the United States where 360 (62% response rate) university students (>18 years old) participated. Participants were presented with a scenario followed by exposure to the three drug product information sources used to operationalize information load. The three sources were: (i) current practice; (ii) pre-existing one-page text only; and (iii) interventional one-page prototype PILs designed for the study. Information anxiety was measured as anxiety experienced by the individual when encountering information. The outcome variable of intention to read PILs was defined as the likelihood that the patient will read the information provided in the leaflets. A survey questionnaire was used to capture the data and the objectives were analyzed by performing a repeated measures MANOVA using SAS version 9.3. When compared to current practice and one-page text only leaflets, one-page PILs had significantly lower scores on information anxiety (p < 0.001) and information load (p < 0.001). The intention to read was highest and significantly different (p < 0.001) for PILs as compared to current practice or text only leaflets. Information anxiety and information load significantly impacted intention to read (p < 0.001). Newly developed PILs increased patient’s intention to read and can help in improving the counseling services provided by pharmacists.
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Munsour EE, Awaisu A, Hassali MAA, Darwish S, Abdoun E. Readability and Comprehensibility of Patient Information Leaflets for Antidiabetic Medications in Qatar. J Pharm Technol 2017; 33:128-136. [PMID: 34860991 PMCID: PMC5998532 DOI: 10.1177/8755122517706978] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Background:The readability and comprehensibility of the patient information leaflets (PILs) provided with antidiabetic medications are of questionable standards; this issue negatively affects adherence to drug therapy, especially in patients with limited literacy skills. Objective: To evaluate the readability and comprehensibility of PILs supplied with medications used for the treatment of type 2 diabetes mellitus in Qatar. Methods: All PILs of the antidiabetic medications in Qatar were evaluated using the Flesch Reading Ease (FRE) score for readability. The Flesch-Kincaid Grade Level, Gunning-Fog Index, and SMOG Grading were used to estimate the comprehensibility of PILs in terms of school grade levels. Results: A total of 45 PILs were evaluated: 32 (71.1%) PILs of brand-name products and 13 (28.9%) for generics. Nine (20%) of the PILs were in English only; 8 (17.8%) were in English, Arabic, and French; and 28 (62.2%) were in English and Arabic. The mean FRE score was 37.71 (±15.85), and the most readable PIL had FRE score of 62. The mean scores for the comprehensibility evaluations were 10.96 (±2.67), 15.02 (±2.52), and 11.41 (±1.6) for the Flesch-Kincaid Grade Level, Gunning-Fog Index, and SMOG Grading, respectively. The most commonly used antidiabetic medication was metformin with 1372.9 (±552.9) as PILs' mean number of words. Conclusion: Only 2.2% of PILs had acceptable readability scores. All PILs could be comprehended by at least an 11th grade student, which exceeds the recommended grade level for health-related materials. Approximately 20% of these PILs were in English only and were not readable by most patients.
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Affiliation(s)
| | | | | | - Sara Darwish
- Hamad General Hospital, Hamad Medical
Corporation, Doha, Qatar
| | - Einas Abdoun
- Hamad General Hospital, Hamad Medical
Corporation, Doha, Qatar
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Muller C, Bazin Kara D, Fourtage M, Ott J, Krummel T, Imhoff O, Garstka A, Richter S, Kolb I, Faller AL, Petit-Jean P, Kiener C, Alenabi F, Sissoko H, Léon É, Chantrel F, Dimitrov Y, Hannedouche T. [Compliance and leaflet's reading, which link and which media? Results from a French population with chronic kidney disease]. Nephrol Ther 2016; 12:443-447. [PMID: 27692384 DOI: 10.1016/j.nephro.2016.05.006] [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: 03/03/2016] [Revised: 05/03/2016] [Accepted: 05/04/2016] [Indexed: 10/20/2022]
Abstract
Leaflets inside drug boxes are complex and often poorly understood. Patients consulting in nephrology are mostly old and often suffer from multiple comorbidities. As so, they are often subject to various contra-indications and drug interactions. This paper aims to evaluate if patients actually read leaflets or other medical information on others medias such as Internet and whether this could, potentially, interfere with their observance. Results showed that leaflets were read by 65.1% of patients, leading to 12% of withdrawal or not taking drugs. Furthermore, compliance to medical guidance was deemed e-read by 65.1% of patients, leading to 12% of withdrawal or not taken drugs. Furthermore, this study showed no clear profile for non-compliant patients. Even the youngest patients (under 50 years old) have had a good compliance, with not more withdrawal or not taking pills. Nonetheless, youngest patients used more often to consult alternative medias and did not read much of the leaflets' information. Patients who were reading leaflets however, tended to search further information on other medias. This situation would create new challenges in health care, as it seems that data available on new medias are not systematically validated or adapted to the needs of the patients.
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Affiliation(s)
- Clotilde Muller
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France.
| | - Dorothée Bazin Kara
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Marion Fourtage
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Julien Ott
- Service de néphrologie, hôpital d'Haguenau, 63, avenue du Pr-Leriche, 67500 Haguenau, France
| | - Thierry Krummel
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Olivier Imhoff
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Antoine Garstka
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Sarah Richter
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Isabelle Kolb
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Anne-Laure Faller
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Philippe Petit-Jean
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Clotilde Kiener
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - Farideh Alenabi
- Service de néphrologie, clinique Sainte-Anne, 182, route de la Wantzenau, 67000 Strasbourg, France
| | - Henriette Sissoko
- Service de néphrologie, hôpital de Mulhouse, 20, avenue du Dr Laënnec, 68100 Mulhouse, France
| | - Émilie Léon
- Service de néphrologie, hôpital d'Haguenau, 63, avenue du Pr-Leriche, 67500 Haguenau, France
| | - François Chantrel
- Service de néphrologie, hôpital de Mulhouse, 20, avenue du Dr Laënnec, 68100 Mulhouse, France
| | - Yves Dimitrov
- Service de néphrologie, hôpital d'Haguenau, 63, avenue du Pr-Leriche, 67500 Haguenau, France
| | - Thierry Hannedouche
- Service de néphrologie, hôpital universitaire de Strasbourg, nouvel hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg, France
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Patel S, Dowse R. Understanding the medicines information-seeking behaviour and information needs of South African long-term patients with limited literacy skills. Health Expect 2015; 18:1494-507. [PMID: 24112215 PMCID: PMC5060885 DOI: 10.1111/hex.12131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although much health information-seeking behaviour (HISB) research has been reported in patients with good literacy skills, little is known about HISB in patients with limited literacy skills served by under-resourced health-care systems. OBJECTIVE To investigate medicine information-seeking behaviour and information needs in patients with limited literacy. METHODS Using a question guide, four focus group discussions (FGDs) were conducted to explore themes related to information needs, information-seeking practices and awareness of and ability to utilize information sources. Twenty-two isiXhosa-speaking long-term patients with limited formal education were recruited from a primary health-care clinic in South Africa. Discussions were audio-recorded and transcribed verbatim. NVivo(®) was used for initial coding of transcripts. Codes were analysed, and potential themes and subthemes in the entire data set were identified and refined. FINDINGS The results of this study reflect a passive, disempowered patient. Poor awareness of information sources, lack of health-related knowledge and stigma contributed to a lack of information-seeking practice, thus potentially adversely influencing patient-provider interactions. Patients neither asked questions nor were encouraged to ask questions. All expressed an unmet need for information and a desire for receiving the illustrated written medicines-related information displayed in the FGDs. The main sources of information were health-care professionals, followed by family and friends. CONCLUSION The significant level of patient disempowerment and passivity reported amongst patients underpinned their inability to actively seek information. Neither sources of information nor types of appropriate medicines information could be identified. Unmet information needs and a desire for information were reported.
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Affiliation(s)
- Sonal Patel
- Faculty of PharmacyRhodes UniversityGrahamstownSouth Africa
| | - Ros Dowse
- Faculty of PharmacyRhodes UniversityGrahamstownSouth Africa
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Fox RJ, Salter A, Alster JM, Dawson NV, Kattan MW, Miller D, Ramesh S, Tyry T, Wells BW, Cutter G. Risk tolerance to MS therapies: Survey results from the NARCOMS registry. Mult Scler Relat Disord 2015; 4:241-9. [PMID: 26008941 DOI: 10.1016/j.msard.2015.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/30/2014] [Accepted: 03/12/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is little information about risk acceptance of multiple sclerosis (MS) patients to various MS therapies. OBJECTIVE To determine MS patients׳ tolerance to risky therapies and identify associated characteristics. METHODS MS patients from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry׳s online cohort were invited to complete questionnaires on decision making and risk tolerance (RT) to two therapeutic scenarios: a theoretical cure for MS [CureMS], with permanent reversal of all MS symptoms but a risk of immediate painless death; and natalizumab [NAT], a real-life scenario with benefits and risks as defined by Phase III trial results. RESULTS The median RT for both scenarios was 1:10,000; 15-23% of respondents were not willing to take any risk for their MS therapy. Participants with greater disability or not taking any MS therapy showed a greater RT, while females and those caring for dependents had a lower RT. Females and older age were predictors of lower RT, while increasing disability and greater blunting attitude with respect to information seeking behavior were predictors of higher RT. CONCLUSION MS patients displayed a wide range of RT for MS therapies. Our study identified gender, age, disability and information seeking behavior to be associated with RT.
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Affiliation(s)
- Robert J Fox
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Amber Salter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joan M Alster
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Neal V Dawson
- Center for Health Care and Research Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA
| | - Michael W Kattan
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Deborah Miller
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sneha Ramesh
- Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tuula Tyry
- Barrows Neurological Institute, Phoenix, AZ, USA
| | - Brian W Wells
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
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Hamrosi KK, Raynor DK, Aslani P. Enhancing provision of written medicine information in Australia: pharmacist, general practitioner and consumer perceptions of the barriers and facilitators. BMC Health Serv Res 2014; 14:183. [PMID: 24754890 PMCID: PMC4000453 DOI: 10.1186/1472-6963-14-183] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 04/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Written medicine information can play an important role in educating consumers about their medicines. In Australia, standardised, comprehensive written information known as Consumer Medicine Information (CMI) is available for all prescription medicines. CMI is reportedly under-utilised by general practitioners (GPs) and community pharmacists in consultations, despite consumer desire for medicine information. This study aimed to determine consumers', GPs' and community pharmacists' preferences for CMI provision and identify barriers and facilitators to its use. METHOD Structured questionnaires were developed and administered to a national sample of Australian consumers (phone survey), community pharmacists and GPs (postal surveys) surrounding utilisation of CMI. Descriptive and comparative analyses were conducted. RESULTS Half of consumers surveyed wanted to receive CMI for their prescription medicine, with spoken information preferable to written medicine information for many consumers and healthcare professionals. GPs and pharmacists remained a preferred source of medicine information for consumers, although package inserts were appealing to many among all three cohorts. Overall pharmacists were the preferred provider of CMI primarily due to their medicine expertise, accessibility and perceived availability. GPs preferred CMI dissemination through both the GP and pharmacist. Some consumers preferred GPs as the provider of medicines information because of their knowledge of the patients' medicines and/or medical history, regularity of seeing the patient and good relationship with the patient. Common barriers to CMI provision cited included: time constraints, CMI length and perceptions that patients are not interested in receiving CMI. Facilitators to enhance provision included: strategies to increase consumer awareness, longer consultation times and counseling appointments, and improvements to pharmacy software technology and workflow. CONCLUSION Medicine information is important to consumers, whether as spoken, written or a combination of both. A tailored approach is needed to ascertain individual patient preference for delivery and scope of medicine information desired so that appropriate information is provided. The barriers of time and perceived attitudes of healthcare practitioners present challenges which may be overcome through changes to workplace practices, adoption of identified facilitators, and education about the positive benefits of CMI as a tool to engage and empower patients.
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Affiliation(s)
- Kim K Hamrosi
- Faculty of Pharmacy, The University of Sydney, Pharmacy & Bank Building A15, Sydney NSW 2006, Australia.
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Harrington KF, Valerio MA. A conceptual model of verbal exchange health literacy. PATIENT EDUCATION AND COUNSELING 2014; 94:403-10. [PMID: 24291145 PMCID: PMC3944213 DOI: 10.1016/j.pec.2013.10.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 10/10/2013] [Accepted: 10/26/2013] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To address a gap in understanding of verbal exchange (oral and aural) health literacy by describing the systematic development of a verbal exchange health literacy (VEHL) definition and model which hypothesizes the role of VEHL in health outcomes. METHODS Current health literacy and communication literature was systematically reviewed and combined with qualitative patient and provider data that were analyzed using a grounded theory approach. RESULTS Analyses of current literature and formative data indicated the importance of verbal exchange in the clinical setting and revealed various factors associated with the patient-provider relationship and their characteristics that influence decision making and health behaviors. VEHL is defined as the ability to speak and listen that facilitates exchanging, understanding, and interpreting of health information for health-decision making, disease management and navigation of the healthcare system. A model depiction of mediating and influenced factors is presented. CONCLUSION A definition and model of VEHL is a step toward addressing a gap in health literacy knowledge and provides a foundation for examining the influence of VEHL on health outcomes. PRACTICE IMPLICATIONS VEHL is an extension of current descriptions of health literacy and has implications for patient-provider communication and health decision making.
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Affiliation(s)
| | - Melissa A Valerio
- University of Texas Health Science Center at Houston, School of Public Health, San Antonio, USA
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Tsai HM, Cheng CY, Chang SC, Yang YM, Wang HH. Health Literacy and Health-Promoting Behaviors among Multiethnic Groups of Women in Taiwan. J Obstet Gynecol Neonatal Nurs 2014; 43:117-129. [DOI: 10.1111/1552-6909.12269] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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23
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Cuperus N, Smink AJ, Bierma-Zeinstra SMA, Dekker J, Schers HJ, de Boer F, van den Ende CH, Vliet Vlieland TPM. Patient reported barriers and facilitators to using a self-management booklet for hip and knee osteoarthritis in primary care: results of a qualitative interview study. BMC FAMILY PRACTICE 2013; 14:181. [PMID: 24289303 PMCID: PMC4219393 DOI: 10.1186/1471-2296-14-181] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/26/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND To enhance guideline-based non-surgical management of hip or knee osteoarthritis (OA), a multidisciplinary, stepped-care strategy has been implemented in primary care in a region of the Netherlands. To facilitate this implementation, the self-management booklet "Care for Osteoarthritis" was developed and introduced. The aim of the booklet was to educate patients about OA, to enhance the patient's active role in the treatment course, and to improve the communication with health care providers. To successfully introduce the booklet on a large scale we assessed barriers and facilitators for patients to using this booklet. METHODS Seventeen primary care patients with hip or knee OA who received the self-management booklet participated in this qualitative study using semi-structured interviews. Purposive sampling was used to ensure diversity of the patients' view about the booklet. The interviews were transcribed verbatim and analysed using a thematic analysis approach. RESULTS Three core themes with patient perceived barriers and facilitators to use the booklet emerged from the interviews: 1) the role of health care providers, 2) the patient's perceptions about OA and its manageability, and 3) the patient's perceptions about the usefulness of the booklet and patient's information needs. Regarding the first theme, a barrier was the lack of encouragement from health care providers to use the booklet in the treatment course of OA. Moreover, patients had doubts concerning the health care providers' endorsement of non-surgical treatment for OA. Barriers from the second theme were: thinking that OA is not treatable or that being pro-active during the treatment course is not important. In contrast, being convinced about the importance of an active participation in the treatment course was a facilitator. Third, patients' perceptions about the usefulness of the booklet and patients' information needs were both identified as barriers as well as facilitators for booklet use. CONCLUSIONS This study contributes to the understanding of patient perceived barriers and facilitators to use a self-management booklet in the treatment course of OA. The results offer practical starting points to tailor the implementation activities of the booklet nationwide and to introduce comparable educational tools in OA primary care or in other chronic diseases.
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Affiliation(s)
- Nienke Cuperus
- Department of Rheumatology, Sint Maartenskliniek, PO box 9011, Nijmegen 6500, GM, The Netherlands.
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Zhang Y. The effects of preference for information on consumers' online health information search behavior. J Med Internet Res 2013; 15:e234. [PMID: 24284061 PMCID: PMC3869058 DOI: 10.2196/jmir.2783] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 07/16/2013] [Accepted: 09/15/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Preference for information is a personality trait that affects people's tendency to seek information in health-related situations. Prior studies have focused primarily on investigating its impact on patient-provider communication and on the implications for designing information interventions that prepare patients for medical procedures. Few studies have examined its impact on general consumers' interactions with Web-based search engines for health information or the implications for designing more effective health information search systems. OBJECTIVE This study intends to fill this gap by investigating the impact of preference for information on the search behavior of general consumers seeking health information, their perceptions of search tasks (representing information needs), and user experience with search systems. METHODS Forty general consumers who had previously searched for health information online participated in the study in our usability lab. Preference for information was measured using Miller's Monitor-Blunter Style Scale (MBSS) and the Krantz Health Opinion Survey-Information Scale (KHOS-I). Each participant completed four simulated health information search tasks: two look-up (fact-finding) and two exploratory. Their behaviors while interacting with the search systems were automatically logged and ratings of their perceptions of tasks and user experience with the systems were collected using Likert-scale questionnaires. RESULTS The MBSS showed low reliability with the participants (Monitoring subscale: Cronbach alpha=.53; Blunting subscale: Cronbach alpha=.35). Thus, no further analyses were performed based on the scale. KHOS-I had sufficient reliability (Cronbach alpha=.77). Participants were classified into low- and high-preference groups based on their KHOS-I scores. The high-preference group submitted significantly shorter queries when completing the look-up tasks (P=.02). The high-preference group made a significantly higher percentage of parallel movements in query reformulation than did the low-preference group (P=.04), whereas the low-preference group made a significantly higher percentage of new concept movements than the high-preference group when completing the exploratory tasks (P=.01). The high-preference group found the exploratory tasks to be significantly more difficult (P=.05) and the systems to be less useful (P=.04) than did the low-preference group. CONCLUSIONS Preference for information has an impact on the search behavior of general consumers seeking health information. Those with a high preference were more likely to use more general queries when searching for specific factual information and to develop more complex mental representations of health concerns of an exploratory nature and try different combinations of concepts to explore these concerns. High-preference users were also more demanding on the system. Health information search systems should be tailored to fit individuals' information preferences.
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Affiliation(s)
- Yan Zhang
- University of Texas at Austin, Austin, TX, United States.
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Hamrosi KK, Raynor DK, Aslani P. Pharmacist, general practitioner and consumer use of written medicine information in Australia: are they on the same page? Res Social Adm Pharm 2013; 10:656-68. [PMID: 24239213 DOI: 10.1016/j.sapharm.2013.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/08/2013] [Accepted: 10/08/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Providing written medicine information to consumers enables them to make informed decisions about their medicines, playing an important role in educating and improving health literacy. In Australia, standardized written medicine information called Consumer Medicine Information (CMI) is available for medicines as package inserts, computer prints, or leaflets. Consumers want and read CMI, but may not always ask for it. General practitioners (GPs) and pharmacists are an important source of written medicine information, yet may not always provide CMI in their practice. OBJECTIVE To examine and compare the awareness, use and provision of CMI by consumers, pharmacists and general practitioners (GPs). METHODS Based on previous studies, structured questionnaires were developed and administered to a national sample of consumers (phone survey); community pharmacists and GPs (postal surveys) about utilization of CMI. Descriptive, comparative and logistic regression analyses were conducted. RESULTS The respondents comprised of 349 pharmacists, 181 GPs and 1000 consumers. Two-thirds of consumers, nearly all (99%) pharmacists and 90% of GPs were aware of CMI. About 88% of consumers reported receiving CMI as a package insert, however most pharmacists (99%) and GPs (56%) reported providing computer-generated CMI. GPs' and pharmacists' main reason for providing CMI was on patient request. Reasons for not providing were predominantly because consumers were already taking the medicine, concerns regarding difficulty understanding the information, or potential non-adherence. Of the 691 consumers reportedly reading CMI, 35% indicated concerns after reading. Factors associated with reading included gender, type of CMI received and frequency of provision. CONCLUSION Consumers want and read information about their medicines, especially when received from their GP or pharmacist. Healthcare professionals report usually discussing CMI when providing it to patients, although continued improvements in dissemination rates are desirable. Regular use of CMI remains a challenge, and ongoing strategies to promote CMI use are necessary to improve uptake of CMI in Australia.
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Affiliation(s)
- Kim K Hamrosi
- Faculty of Pharmacy, Pharmacy & Bank Building A15, University of Sydney, Sydney, NSW 2006, Australia.
| | | | - Parisa Aslani
- Faculty of Pharmacy, Pharmacy & Bank Building A15, University of Sydney, Sydney, NSW 2006, Australia
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Ng CJ, Lee PY, Lee YK, Chew BH, Engkasan JP, Irmi ZI, Hanafi NS, Tong SF. An overview of patient involvement in healthcare decision-making: a situational analysis of the Malaysian context. BMC Health Serv Res 2013; 13:408. [PMID: 24119237 PMCID: PMC3852442 DOI: 10.1186/1472-6963-13-408] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 10/09/2013] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Involving patients in decision-making is an important part of patient-centred care. Research has found a discrepancy between patients' desire to be involved and their actual involvement in healthcare decision-making. In Asia, there is a dearth of research in decision-making. Using Malaysia as an exemplar, this study aims to review the current research evidence, practices, policies, and laws with respect to patient engagement in shared decision-making (SDM) in Asia. METHODS In this study, we conducted a comprehensive literature review to collect information on healthcare decision-making in Malaysia. We also consulted medical education researchers, key opinion leaders, governmental organisations, and patient support groups to assess the extent to which patient involvement was incorporated into the medical curriculum, healthcare policies, and legislation. RESULTS There are very few studies on patient involvement in decision-making in Malaysia. Existing studies showed that doctors were aware of informed consent, but few practised SDM. There was limited teaching of SDM in undergraduate and postgraduate curricula and a lack of accurate and accessible health information for patients. In addition, peer support groups and 'expert patient' programmes were also lacking. Professional medical bodies endorsed patient involvement in decision-making, but there was no definitive implementation plan. CONCLUSION In summary, there appears to be little training or research on SDM in Malaysia. More research needs to be done in this area, including baseline information on the preferred and actual decision-making roles. The authors have provided a set of recommendations on how SDM can be effectively implemented in Malaysia.
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Affiliation(s)
- Chirk-Jenn Ng
- University Malaya Primary Care Research Group, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ping-Yein Lee
- Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Malaysia
| | - Yew-Kong Lee
- University Malaya Primary Care Research Group, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Malaysia
| | - Julia P Engkasan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zarina-Ismail Irmi
- Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nik-Sherina Hanafi
- University Malaya Primary Care Research Group, Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Seng-Fah Tong
- Department of Family Medicine, Medical Faculty, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Sheng X, Simpson PM. Seniors, Health Information, and the Internet: Motivation, Ability, and Internet Knowledge. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:740-6. [DOI: 10.1089/cyber.2012.0642] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Xiaojing Sheng
- College of Business Administration, The University of Texas–Pan American, Edinburg, Texas
| | - Penny M. Simpson
- College of Business Administration, The University of Texas–Pan American, Edinburg, Texas
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Carter SR, Moles R, White L, Chen TF. Medication information seeking behavior of patients who use multiple medicines: how does it affect adherence? PATIENT EDUCATION AND COUNSELING 2013; 92:74-80. [PMID: 23433733 DOI: 10.1016/j.pec.2013.01.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 01/09/2013] [Accepted: 01/24/2013] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This article explores medication information seeking behavior (MISB). We aimed to develop a scale for measuring MISB and use it to explore the relationships between MISB, adherence and factors, which drive information seeking. METHODS Patients (N=910) using multiple medicines completed questionnaires. Exploratory and confirmatory factor analyses were performed. Correlations and multivariate analyses were used to investigate the relationships between variables. RESULTS Respondents sought medication information mainly from health professionals and written medicines information. The medication information seeking behavior scale (MISB) had acceptable reliability and validity. Information seeking was most intense among respondents who had recent changes in their medicine regimen and worries about their medicines. Those who sought medication information from autonomous sources were more likely to be non-adherent than those who never did (OR=2.00 [1.48, 2.70]). Seeking information from health professionals had no influence on adherence. CONCLUSION Health practitioners should carefully attend to patients' questions about medicines information. When patients mention that they are worried about their medicines and have sought medication information from television, magazines, brochures or family and friends, this could be a sign that they tend towards non-adherent behavior. PRACTICE IMPLICATIONS The MISB scale could be used to learn more about patients' use of medication information.
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Affiliation(s)
- Stephen R Carter
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia.
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Longacre ML. Cancer caregivers information needs and resource preferences. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:297-305. [PMID: 23553000 PMCID: PMC3665756 DOI: 10.1007/s13187-013-0472-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This study sought to characterize the need for information about personal psychosocial care, providing direct care, and managing care among cancer caregivers and to explore preferred resources for caregiving information. Data come from cross-sectional telephone interviews of 1,247 family caregivers, which included 104 cancer caregivers. A majority of cancer caregivers expressed one or more information need for each of the three content categories. Four out of ten caregivers expressed needing information about managing physical and emotional stress. A significantly higher percentage of male caregivers reported needing more information pertinent to providing direct care than females. Heightened objective burden was significantly associated with caregivers preferring to receive information from health professionals than informal sources (e.g., Internet), while the opposite was found among caregivers with lower objective burden. These findings suggest that specific types of information and resources may be most relevant to specific subgroups of cancer caregivers.
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Affiliation(s)
- Margaret L Longacre
- Fox Chase Cancer Center, 333 Cottman Avenue, Robert C. Young Pavilion, 4th Floor, Philadelphia, PA, 19111, USA.
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Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. Respir Med 2013; 107:1481-90. [PMID: 23643487 DOI: 10.1016/j.rmed.2013.04.005] [Citation(s) in RCA: 333] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/30/2013] [Accepted: 04/07/2013] [Indexed: 11/24/2022]
Abstract
Suboptimal adherence to pharmacological treatment of asthma and chronic obstructive pulmonary disease (COPD) has adverse effects on disease control and treatment costs. The reasons behind non-adherence revolve around patient knowledge/education, inhaler device convenience and satisfaction, age, adverse effects and medication costs. Age is of particular concern given the increasing prevalence of asthma in the young and increased rates of non-adherence in adolescents compared with children and adults. The correlation between adherence to inhaled pharmacological therapies for asthma and COPD and clinical efficacy is positive, with improved symptom control and lung function shown in most studies of adults, adolescents and children. Satisfaction with inhaler devices is also positively correlated with improved adherence and clinical outcomes, and reduced costs. Reductions in healthcare utilisation are consistently observed with good adherence; however, costs associated with general healthcare and lost productivity tend to be offset only in more adherent patients with severe disease, versus those with milder forms of asthma or COPD. Non-adherence is associated with higher healthcare utilisation and costs, and reductions in health-related quality of life, and remains problematic on an individual, societal and economic level. Further development of measures to improve adherence is needed to fully address these issues.
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Duncan LR, Latimer AE, Pomery E, Rivers SE, Salovey P. Testing messages to encourage discussion of clinical trials among cancer survivors and their physicians: examining monitoring style and message detail. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:119-126. [PMID: 23143846 PMCID: PMC3594111 DOI: 10.1007/s13187-012-0431-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Encouraging cancer survivors to discuss clinical trials with their physicians may increase enrollment in clinical trials. Health messages offer one method for encouraging such discussions. We hypothesized that matching messages to an individual's preference for detailed or non-detailed information (i.e., monitoring style) would result in more discussions. Participants (N = 538) were cancer survivors, who phoned the National Cancer Institute's Cancer Information Service (CIS). Participants were classified as higher or lower monitors and then randomized to receive detailed or non-detailed messages in the mail 1 and 4 weeks following their baseline CIS call. At 12 weeks, there was a significant interaction between monitoring style and message detail. Follow-up analyses were nonsignificant but suggested a theoretically consistent pattern in which non-detailed messages were more effective among lower monitors. These findings imply that providing extremely detailed information may be excessive, even to individuals engaged in information seeking behavior.
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Affiliation(s)
- Lindsay R. Duncan
- Health, Emotion, and Behavior Laboratory, Department of Psychology, Yale University, P.O. Box 208205, New Haven, CT, USA 06520-8205
| | - Amy E. Latimer
- School of Kinesiology and Health Studies, Queens University, 28 Division St., Kingston, ON, Canada K7L 3N6
| | - Elizabeth Pomery
- Health, Emotion, and Behavior Laboratory, Department of Psychology, Yale University, P.O. Box 208205, New Haven, CT, USA 06520-8205
| | - Susan E. Rivers
- Health, Emotion, and Behavior Laboratory, Department of Psychology, Yale University, P.O. Box 208205, New Haven, CT, USA 06520-8205
| | - Peter Salovey
- Health, Emotion, and Behavior Laboratory, Department of Psychology, Yale University, P.O. Box 208205, New Haven, CT, USA 06520-8205
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Dickinson R, Hamrosi K, Knapp P, Aslani P, Sowter J, Krass I, Raynor DK. Suits you? A qualitative study exploring preferences regarding the tailoring of consumer medicines information. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2012; 21:207-15. [PMID: 23419082 DOI: 10.1111/j.2042-7174.2012.00252.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 09/18/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To explore participants' opinions and preferences on tailored written medicines information. METHODS Forty-five participants were recruited to eight focus groups, run concurrently in Australia (23 participants in four groups) and the UK (22 participants in four groups). Participants were provided with exemplar leaflets for a cardiovascular medicine based on the angiotensin-converting enzyme (ACE) inhibitor ramipril, which was tailored for a man aged 55 with hypertension. Reference to other indications of the medicine, children's doses, pregnancy and breast-feeding information were removed. A topic guide directed the discussion and explored preferences and opinions on tailored leaflets. Focus group discussions were recorded, transcribed verbatim and content analysed using adapted cross-case study analysis. KEY FINDINGS Participants welcomed the concept of tailored information, desiring shorter and more relevant information. Information tailored to their condition or disease was most sought-after, followed by tailoring by age or gender. However, some participants voiced concerns about the potential for the wrong information being given to patients who would be unable to recognise that it was incorrect. Other concerns included how tailoring might impact upon the quality of information available and the feasibility of delivery, especially regarding the legal implications (Australia) and the cost (UK). A key finding was the participants' desire for a truly individualised approach to tailoring medicines information, as opposed to the generalised tailored information provided in the study. Participants said they would value having spoken communication with a healthcare professional at the same time as they received tailored leaflets. CONCLUSIONS Most participants welcomed tailored leaflets but overall valued a more personalised approach than the generalised tailored information we provided. Despite concerns about quality and delivery, many felt tailoring written medicines information could improve the relevance of the information to the individual and potentially encourage them to value it.
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Ellis J, Mullan J, Worsley A, Pai N. The role of health literacy and social networks in arthritis patients' health information-seeking behavior: a qualitative study. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2012; 2012:397039. [PMID: 22997575 PMCID: PMC3444832 DOI: 10.1155/2012/397039] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 06/21/2012] [Accepted: 08/01/2012] [Indexed: 05/23/2023]
Abstract
Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants' understanding about their arthritis and arthritis medication and to determine how the participants' health literacy informed selection of where they found information about their arthritis and pain medication. Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network. Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients' health literacy.
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Affiliation(s)
- Janette Ellis
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Nagesh Pai
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
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Al-Ramahi R, Zaid AN, Kettana N, Sweileh W, Al-Jabi D. Attitudes of consumers and healthcare professionals towards the patient package inserts - a study in Palestine. Pharm Pract (Granada) 2012; 10:57-63. [PMID: 24155818 PMCID: PMC3798163 DOI: 10.4321/s1886-36552012000100010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 02/22/2012] [Indexed: 11/18/2022] Open
Abstract
Reading the patient package inserts (PPIs) is a key source of information
about medications for patients. They should be clear and understandable to
the general population. Objective The aims of this study were to obtain base-line data on the extent of reading
PPIs by consumers and possible factors that might affect this; to explore
the attitude of the Palestinian public and healthcare professionals towards
the patient package inserts (PPIs); and to review a random sample of PPIs
for the availability of different information. Methods The first part of the study was a cross-sectional self-administered
questionnaire. The questionnaire for consumers included 15 items. The
questionnaire for healthcare professionals included 10 items and it was very
similar to that of consumers with some modifications. In the second part, a
random sample of PPIs was reviewed. In our community pharmacies, where
medications are arranged according to their producing company, a researcher
was asked to choose randomly 10-15 medications for every company to check
for the availability of pharmacological, pharmaceutical and clinical
information. Results A total of 304 healthcare professionals out of 320 (95.0%) and 223 consumers
out of 240 (92.9%) accepted to answer the survey. Forty five percent
consumers reported that they always read the PPIs, and 29.3% said that they
read the PPIs most of the times. Increased rate of reading the leaflet was
found among females (P = 0.047). The preferred language for the PPIs was
Arabic for most of the consumers (89.6%) while it was English for most of
the healthcare professionals (80.8%). 35.9% of the consumers and 43.6% of
the healthcare professionals found the font size suitable. 42.3% of the
consumers and 25.5% of the healthcare professionals said that they found the
information in the PPIs useful and enough. The PPIs of 135 randomly sampled
medications were reviewed. Many important sections were not found in the
PPIs' sample. Conclusions A high percentage of consumers read the PPIs, but still this needs to be
improved. People would appreciate a more detailed and clear PPI. Pharmacists
should advocate reading the PPIs but they need to provide consumers with
detailed counseling to compensate for the missing information in some of the
PPIs. Authorities and manufacturers should implement appropriate measures to
regulate the quality and quantity of information in the PPIs.
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Affiliation(s)
- Rowa' Al-Ramahi
- Department of Pharmacy, AnNajah National University . Nablus ( Palestine )
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Dowse R, Ramela T, Browne SH. An illustrated leaflet containing antiretroviral information targeted for low-literate readers: development and evaluation. PATIENT EDUCATION AND COUNSELING 2011; 85:508-515. [PMID: 21306856 DOI: 10.1016/j.pec.2011.01.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 01/11/2011] [Accepted: 01/14/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To apply a dual visual/textual modal approach in developing and evaluating a medicine information leaflet with pictograms suitable for low-literate HIV/AIDS patients. To identify and recommend best practices in this type of information design. METHODS A simple leaflet incorporating pictograms was designed for an antiretroviral regimen. Cognitive testing for understanding was conducted in 39 low-literate, South African, antiretroviral-naïve adults. Participants were required to locate and explain the information, and were questioned on their opinion of leaflet layout and contents. RESULTS Average understanding of the leaflet was 60%. Basic medication information was the best understood. An overall lack of knowledge of HIV/AIDS and its core concepts was found. Only half the participants considered this simple leaflet "easy" to read. All endorsed the inclusion of pictograms. CONCLUSION This testing method used in ARV-naïve individuals was invaluable in identifying areas needing modification before its use in patients. Text associated with pictograms was more noticeable and better understood, but only if they were closely juxtaposed. PRACTICE IMPLICATIONS Leaflet design should consider culture and literacy skills, be informed by learning theory and design principles, include visuals to enhance appeal and improve understanding, and involve end-users. Verbal counseling should accompany written information.
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Affiliation(s)
- Ros Dowse
- Faculty of Pharmacy, Rhodes University, Grahamstown, South Africa.
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Freedman AM, Miner KR, Echt KV, Parker R, Cooper HLF. Amplifying diffusion of health information in low-literate populations through adult education health literacy classes. JOURNAL OF HEALTH COMMUNICATION 2011; 16 Suppl 3:119-133. [PMID: 21951247 DOI: 10.1080/10810730.2011.604706] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Over the next decade, as literacy rates are predicted to decline, the health care sector faces increasing challenges to effective communication with low-literate groups. Considering the rising costs of health care and the forthcoming changes in the American health care system, it is imperative to find nontraditional avenues through which to impart health knowledge and functional skills. This article draws on classroom observations and qualitative interviews with 21 students and 3 teachers in an adult education health literacy class to explore the efficacy of using adult education courses to teach functional health literacy skills to low-literate populations. Data were analyzed using a combination of thematic and content analyses. Results describe the motivation of students to share information within the classroom and with friends and family outside the classroom. This article also provides several recommendations to help ensure accuracy of diffused information both within and outside of the classroom. Ultimately, this study suggests that the adult education system is in a prime position to impart functional health literacy skills to low-literate populations in the classroom. Significantly, this study demonstrates that adult education students themselves may be a powerful vehicle for health communication beyond the walls of the classroom.
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Affiliation(s)
- Ariela M Freedman
- Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
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Murphy A, Gardner D, Kutcher S, Davidson S, Manion I. Collaborating with youth to inform and develop tools for psychotropic decision making. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2010; 19:256-63. [PMID: 21037916 PMCID: PMC2962538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. METHODS A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. RESULTS Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. CONCLUSION An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders.
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Affiliation(s)
- Andrea Murphy
- School of Nursing, Dalhousie University, Halifax, Nova Scotia
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University, Halifax, Nova Scotia
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - David Gardner
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
| | - Stan Kutcher
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University, Halifax, Nova Scotia
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia
- IWK Health Centre, Halifax, Nova Scotia
- WHO Collaborating Centre, Dalhousie University, Halifax, Nova Scotia
| | - Simon Davidson
- The Provincial Centre of Excellence for Child and Youth Mental Health at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
- Department of Psychiatry, University of Ottawa, Ottawa
| | - Ian Manion
- The Provincial Centre of Excellence for Child and Youth Mental Health at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario
- School of Psychology, University of Ottawa, Ottawa
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Ankrah DN, Ofei CN. The effect of advice to read the medicine/patient information leaflet among patients in Ghana: a cross-sectional study. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2010. [DOI: 10.1111/j.1759-8893.2010.00009.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Miller MJ, Allison JJ, Schmitt MR, Ray MN, Funkhouser EM, Cobaugh DJ, Saag KG, LaCivita C. Using single-item health literacy screening questions to identify patients who read written nonsteroidal anti-inflammatory medicine information provided at pharmacies. JOURNAL OF HEALTH COMMUNICATION 2010; 15:413-427. [PMID: 20574879 DOI: 10.1080/10810731003753091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Our goal was to assess the relationships between single-item health literacy screening questions and reading prescription nonsteroidal anti-inflammatory drug (NSAID) written medicine information (WMI) provided at pharmacies. The health literacy of 382 patients from primary care physician practices in Alabama was estimated using validated health literacy screening questions related to understanding written medical information (SQ1); confidence in completing medical forms alone (SQ2); and need for assistance in reading hospital materials (SQ3). Reading WMI was measured by a "Yes" response to the question, "Often the drug store gives you written information such as pamphlets or handouts along with your prescription. Have you read about the risks of NSAIDs in this written material provided by the drug store?" Relationships were assessed using generalized linear latent and mixed models. Two-thirds (67.6%) of patients read WMI. Higher estimated health literacy was associated with increased odds of reading WMI. Adjusted odds ratios (95% CI) were 2.08 (1.08-4.03); 2.09 (1.12-3.91); and 1.98 (1.04-3.77) using SQ1-SQ3. Current WMI may be unable to meet the needs of those with inadequate health literacy. Health literacy screening questions can be used to triage patients at risk for not reading WMI so they can be assisted with supplemental educational strategies.
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Affiliation(s)
- Michael J Miller
- College of Pharmacy, Department of Pharmacy: Clinical and Administrative Sciences, University of Oklahoma, Tulsa, Oklahoma, USA
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Shieh C, Mays R, McDaniel A, Yu J. Health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. Health Care Women Int 2009; 30:971-88. [PMID: 19809901 DOI: 10.1080/07399330903052152] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We investigated health literacy and its association with the use of information sources and with barriers to information seeking in clinic-based pregnant women. The Short Test of Functional Health Literacy in Adults (STOFHLA) was used to measure health literacy in 143 English-speaking low-income pregnant women. About 15% of the participants demonstrated low health literacy. Participants with low health literacy were less likely to use the Internet and more likely to have self-efficacy barriers than participants with high health literacy. Interventions to promote information-seeking skills and Internet access are indicated for women with low health literacy.
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Affiliation(s)
- Carol Shieh
- Department of Environments for Health, Indiana University School of Nursing, Indianapolis, Indiana 46077, USA.
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Williams-Piehota P, Latimer AE, Katulak NA, Cox A, Silvera SAN, Mowad L, Salovey P. Tailoring messages to individual differences in monitoring-blunting styles to increase fruit and vegetable intake. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2009; 41:398-405. [PMID: 19879495 PMCID: PMC2807207 DOI: 10.1016/j.jneb.2008.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Revised: 06/04/2008] [Accepted: 06/05/2008] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information. DESIGN/SETTING Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later. PARTICIPANTS 531 callers to a cancer information hotline who did not meet the 5 A Day guideline. INTERVENTION A brief telephone-delivered message and 3 mailings of booklets and promotional items encouraging fruit and vegetable intake, tailored for either monitors or blunters. MAIN OUTCOME MEASURE Fruit and vegetable intake 2 and 4 months post-baseline. ANALYSIS Hierarchical regression modeling. RESULTS Messages matched to MBCS were more effective than mismatched messages, particularly for the monitor message, in increasing intake at 2 months but not at 4 months. CONCLUSIONS AND IMPLICATIONS These minimal interventions influenced fruit and vegetable intake. MBCS may be a promising target for developing tailored messages aimed at increasing intake, although additional research is needed to verify the robustness of these findings.
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Kidd L, Hubbard G, O'Carroll R, Kearney N. Perceived control and involvement in self care in patients with colorectal cancer. J Clin Nurs 2009; 18:2292-300. [PMID: 19583662 DOI: 10.1111/j.1365-2702.2009.02802.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This paper reports the qualitative findings from a mixed methods study which explored patients' understandings of perceived control in relation to their self care during chemotherapy for colorectal cancer. BACKGROUND A greater degree of patient involvement in self care is increasingly being encouraged; however, little is known about how factors such as perceived control influence patients' active involvement in self care. DESIGN Qualitative, longitudinal study. METHODS Semi structured interviews were conducted with 11 patients before and after six months of chemotherapy treatment for colorectal cancer in a Scottish cancer centre between March 2005-June 2006. The interviews, conducted as part of a larger study, explored patients' understandings of their perceived control over managing treatment-related side effects and how this influenced their attitudes toward, and role preferences in, self care. RESULTS Patients fell into one of two groups: 'high' or 'low' perceived controllers. High-perceived controllers were more likely to view their active involvement in self care positively, as being necessary in managing treatment-related effects and were less likely to rely on nurses to take overall responsibility for the management of treatment-related side effects. Low-perceived controllers were less likely to believe in the importance or necessity of their active involvement in self care and more likely to perceive nurses as being the ones responsible for the management of treatment-related side effects. CONCLUSIONS Perceived control during treatment for cancer influences patients' perceptions toward, and role preferences in, self care. RELEVANCE TO CLINICAL PRACTICE Clinical interventions designed to enhance involvement in self care would benefit from focussing on enhancing patients' perceived control and understanding their role preferences in self care. Patients with different understandings of perceived control may require different help and support to encourage their involvement in self care.
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Affiliation(s)
- Lisa Kidd
- Department of Nursing & Midwifery, Cancer Care Research Centre, University of Stirling, Stirling, UK.
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Sauro A, Greco A, Greco PL, Scalzitti F, Sirignano AR, Sortino D, Letizia M. The COPD Italian Lung Information Needs Questionnaire (LINQ): Development, preliminary validation, and findings. Eur J Gen Pract 2009; 14:65-7. [DOI: 10.1080/13814780802342630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Restrepo RD, Alvarez MT, Wittnebel LD, Sorenson H, Wettstein R, Vines DL, Sikkema-Ortiz J, Gardner DD, Wilkins RL. Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis 2009; 3:371-84. [PMID: 18990964 PMCID: PMC2629978 DOI: 10.2147/copd.s3036] [Citation(s) in RCA: 273] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Although medical treatment of COPD has advanced, nonadherence to medication regimens poses a significant barrier to optimal management. Underuse, overuse, and improper use continue to be the most common causes of poor adherence to therapy. An average of 40%–60% of patients with COPD adheres to the prescribed regimen and only 1 out of 10 patients with a metered dose inhaler performs all essential steps correctly. Adherence to therapy is multifactorial and involves both the patient and the primary care provider. The effect of patient instruction on inhaler adherence and rescue medication utilization in patients with COPD does not seem to parallel the good results reported in patients with asthma. While use of a combined inhaler may facilitate adherence to medications and improve efficacy, pharmacoeconomic factors may influence patient’s selection of both the device and the regimen. Patient’s health beliefs, experiences, and behaviors play a significant role in adherence to pharmacological therapy. This manuscript reviews important aspects associated with medication adherence in patients with COPD and identifies some predictors of poor adherence.
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Affiliation(s)
- Ruben D Restrepo
- Department of Respiratory Care, The University of Texas Health Science Center at San Antonio,Texas 78229, USA.
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von Wagner C, Steptoe A, Wolf MS, Wardle J. Health Literacy and Health Actions: A Review and a Framework From Health Psychology. HEALTH EDUCATION & BEHAVIOR 2008; 36:860-77. [DOI: 10.1177/1090198108322819] [Citation(s) in RCA: 270] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The association between performance on health literacy measures and health outcomes is well established. The next step is to understand the processes through which health literacy affects health. This review introduces a framework drawing on ideas from health psychology and proposing that associations between health literacy and health outcomes could be mediated by a range of health actions involving access and use of health care, patient—provider interactions, and the management of health and illness. The framework outlines routes through which health literacy might affect either health actions themselves or the motivational and volitional determinants that have been identified in social cognition models. The implications of the framework for future research and intervention strategies are discussed.
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Affiliation(s)
- Christian von Wagner
- University College London, Department of Epidemiology and Public Health, Health Behaviour Research Centre,
| | - Andrew Steptoe
- University College London, Department of Epidemiology and Public Health, Psychobiology Unit
| | - Michael S. Wolf
- Health Literacy and Learning Program, Institute for Healthcare Studies, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
| | - Jane Wardle
- University College London, Department of Epidemiology and Public Health, Health Behaviour Research Centre
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Siminoff LA, Hausmann LRM, Ibrahim S. Barriers to obtaining diagnostic testing for coronary artery disease among veterans. Am J Public Health 2008; 98:2207-13. [PMID: 18381987 DOI: 10.2105/ajph.2007.123224] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to identify factors associated with appointment nonattendance for diagnostic testing of coronary artery disease among veterans. For patients with possible heart disease, appointment nonattendance may seriously compromise short- and long-term outcomes. Understanding factors associated with nonattendance may help improve care while reducing inefficiency in service delivery. METHODS We surveyed patients who attended (n = 240) or did not attend (n = 139) a scheduled cardiac appointment at a midwestern Veterans Administration medical center. Multivariable regression models were used to assess factors associated with nonattendance. RESULTS Younger age, lower income, unemployment, and longer wait times for appointments were predictive of nonattendance. Nonattenders reported fewer cardiac symptoms and were more likely to attribute their symptoms to something other than heart disease. Nonattendance was also associated with a coping style characterized by avoidance of aversive information. Logistical issues, fear of diagnostic procedures, disbelief that one had heart disease, and medical mistrust were some of the reasons given for missed appointments. CONCLUSIONS Appointment nonattendance among veterans scheduled for cardiology evaluation was associated with several important cognitive factors. These factors should be considered when one is designing clinical systems to reduce patient nonattendance.
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Affiliation(s)
- Laura A Siminoff
- Department of Social and Behavioral Health, Virginia Commonwealth University, Richmond, VA 23298, USA.
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Women's perceived control of their birth outcomes in the Central Pennsylvania Women's Health Study: implications for the use of preconception care. Womens Health Issues 2007; 18:17-25. [PMID: 17951072 DOI: 10.1016/j.whi.2007.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 08/07/2007] [Accepted: 08/07/2007] [Indexed: 11/21/2022]
Abstract
PURPOSE This study examines nonpregnant women's beliefs about whether or not they can influence their future birth outcomes with respect to the baby's health and factors associated with internal locus of control for birth outcomes. Perceived internal control of birth outcomes could be a predisposing factor for use of preconception care, which is recommended for all women of childbearing age by the Centers for Disease Control and Prevention. The overall hypothesis is that internal control of birth outcomes is a function of prior pregnancy experiences, current health status and stress levels, access to health care, and sociodemographics. METHODS Data are from the Central Pennsylvania Women's Health Study random digit dial telephone survey of 2,002 women ages 18-45; the analytic sample is 614 nonpregnant women with current reproductive capacity who reported that they are considering a future pregnancy. Internal control of birth outcomes is measured using 1) a 4-item Internal Control of Birth Outcomes Scale, 2) a single-item measure of Preconceptional Control, and 3) a score reflecting high internal control on both of these measures. FINDINGS In multiple logistic regression analyses, internal control of birth outcomes is positively associated with older age (35-45 vs. 18-34 years), higher education (some college or more), marital status (currently married or living with a partner), and higher self-rated physical health status on the SF-12v2 (but not mental health status or psychosocial stress). Previous adverse pregnancy outcomes and current access to health care have no association with internal control for birth outcomes. CONCLUSION Variables associated with internal control of birth outcomes among women contemplating a future pregnancy are primarily sociodemographic and physical health related. Educational and social marketing efforts to increase women's use of preconception care may be particularly important for women who are likely to have lower internal control, including younger, less educated, unmarried, and less healthy women.
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