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Song M, Park S. Comparing two health literacy measurements used for assessing older adults’ medication adherence. J Clin Nurs 2020; 29:4313-4320. [DOI: 10.1111/jocn.15468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/15/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Min‐Sun Song
- College of Nursing Konyang University Daejeon Korea
| | - Soohyun Park
- Department of Nursing Eulji University Seongnam Korea
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Hoffman S, Rueda HA, Beasley L. Health-Related Quality of Life and Health Literacy among Mexican American and Black American Youth in a Southern Border State. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:114-124. [PMID: 32248757 DOI: 10.1080/19371918.2020.1747584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Among adults, health literacy and health-related quality of life are highly correlated constructs that are associated with tangible health outcomes. While the connection between these concepts and health outcomes among youth is still unclear, studying these factors among at-risk adolescent populations can provide researchers, policy-creators, and educators a quantifiable summary of the challenge they face in their efforts to reduce health disparities. The purpose of this study was to better understand the health of minority youth living in a Southern state near the US-Mexico border. Specifically, we sought to describe their health literacy and health-related quality of life, and identify how those concepts may be interrelated. Results indicated that our sample of primarily Mexican American and Black American youth living along the US-Mexico border may be struggling more than other known high-risk groups in terms of health literacy and health-related quality of life. Practical implications for families, schools, and border communities are discussed.
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Affiliation(s)
- Steven Hoffman
- School of Social Work, Brigham Young University, Provo, Utah, USA
| | - Heidi Adams Rueda
- Department of Social Work, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Lauren Beasley
- Knoxville Department of Kinesiology, Recreation and Sport Studies, University of Tennessee, Knoxville, Tennessee, USA
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[Patients' competences and health literacy assessment questionnaire]. J Healthc Qual Res 2019; 34:193-200. [PMID: 31713530 DOI: 10.1016/j.jhqr.2019.04.005] [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: 10/29/2018] [Revised: 04/11/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To design a questionnaire to identify patients with difficulties to obtain, understand and use health information. MATERIAL AND METHOD Qualitative study through semi-structured interviews and a consensus technique. A review of the literature on health literacy was carried out. Five semi-structured interviews were conducted with experts in the field. A 12-item instrument was designed. Content validity was determined using the Health Consensus technique. Participants were health professionals and patient representatives (5 semi-structured interviews and 60 Health Consensus). An instrument to measure the level of skills and literacy in patients' health was developed. The measures were 7categories on the health competencies and literacy construct: Ability to search for information, ability to understand the information, ability to communicate with health professionals, capacity for operational understanding, competence in decision making, ability to move and navigate through the health system, and competencies in self-care. RESULTS A 12-item questionnaire was designed. The median scores obtained in the Health Consensus ranged between 6.08 (1.43) and 7.22 (1.52), with an agreement level of between 73.87% to 84.19%. Finally, a 5-item instrument was obtained to assess the patients' health competencies. CONCLUSIONS The questionnaire is a useful tool to detect those at risk of having difficulties in obtaining, understanding and using health information. This would allow professionals to focus their attention on the type of information patients need and better adapt it to their needs.
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Eyüboğlu E, Schulz PJ. Do health literacy and patient empowerment affect self-care behaviour? A survey study among Turkish patients with diabetes. BMJ Open 2016; 6:e010186. [PMID: 26975936 PMCID: PMC4800124 DOI: 10.1136/bmjopen-2015-010186] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study aimed to assess the impact of health literacy and patient empowerment on diabetes self-care behaviour in patients in metropolitan Turkish diabetes centres. The conceptual background is provided by the psychological health empowerment model, which holds that health literacy without patient empowerment comes down to wasting health resources, while empowerment without health literacy can lead to dangerous or suboptimal health behaviour. DESIGN, SETTING AND PARTICIPANTS A cross-sectional study was conducted with 167 patients over the age of 18 from one of two diabetes clinics in a major Turkish City. Self-administered questionnaires were distributed to eligible outpatients who had an appointment in one of the clinics. Health literacy was measured by a newly translated Turkish version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Chew self-report scale. Patient empowerment was measured by a 12-item scale based on Spreitzer's conceptualisation of psychological empowerment in the workplace. Self-care behaviour was measured by the Self-care behaviours were measured by the Summary of Diabetes Self-Care Activities Measure (SDSCA). Level of diabetes knowledge was measured by Diabetes Knowledge Test. RESULTS Two subscales of empowerment, impact and self-determination, predicted self-reported frequency of self-care behaviours. Neither health literacy nor diabetes knowledge had an effect on self-care behaviours. CONCLUSIONS Health literacy might be more effective in clinical decisions while empowerment might exert a stronger influence on habitual health behaviours.
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Affiliation(s)
- Ezgi Eyüboğlu
- Public Relations and Publicity Department, Maltepe University, Marmara Eğitim Köyü, Istanbul, Turkey
| | - Peter J Schulz
- Institute of Communication and Health, Universita’ della Svizzera Italiana, Lugano, Switzerland
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Kurtovich E, Guendelman S, Neuhauser L, Edelman D, Georges M, Mason-Marti P. Development and First Phase Evaluation of a Maternity Leave Educational Tool for Pregnant, Working Women in California. PLoS One 2015; 10:e0129472. [PMID: 26107519 PMCID: PMC4479594 DOI: 10.1371/journal.pone.0129472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 05/09/2015] [Indexed: 11/18/2022] Open
Abstract
Background Despite the provision of maternity leave offered to mothers, many American women fail to take leave. Methods We developed an evidence-based maternity leave educational tool for working women in California using participatory design. We tested its short-term efficacy with a randomized controlled trial of pregnant English-speakers (n=155). Results Among intervention participants exposed to the tool, 65% reported that they learned something new; 38% were motivated to seek more information; and 49% said it helped them plan their maternity leave. Among participants who delivered at ≥ 37 weeks gestation and said the tool helped them plan their leave, 89% took more than one week of prenatal leave, a significantly higher proportion than among controls who did not receive the tool (64%, p=0.049). Other findings favored trial participants, but were not statistically significant in this small sample. More intervention participants took some prenatal leave (80%) vs. controls (74%, p=0.44). Among participants who had returned to work when surveyed (n=50), mean postnatal leave uptake was on average 1 week longer for intervention participants vs. controls (13.3 vs. 12.2 weeks, p=0.54). Conclusions The first-phase evaluation of this tool shows that it successfully informed women about maternity leave options, clarified complex regulations, encouraged women to seek further information and helped plan maternity leave. Compared to controls, trial participants who used the tool to plan their leave were far more likely to take prenatal leave close to term. Future evaluation of the tool when mediated by a health provider or employer is warranted.
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Affiliation(s)
- Elaine Kurtovich
- School of Public Health, University of California, Berkeley, California, United States of America
- * E-mail:
| | - Sylvia Guendelman
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Linda Neuhauser
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Dana Edelman
- March of Dimes, California Chapter, San Francisco, California, United States of America
| | - Maura Georges
- March of Dimes, California Chapter, San Francisco, California, United States of America
| | - Peyton Mason-Marti
- March of Dimes, California Chapter, San Francisco, California, United States of America
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Wolka A, Simpson K, Lockwood K, Neuhauser L. Focus on Health Literacy: Recommendations to Improve European Union Risk Management Plan Public Summaries. Ther Innov Regul Sci 2015; 49:369-376. [PMID: 30222406 DOI: 10.1177/2168479014561339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The complexity of drug risk information often exceeds patients' abilities to understand and effectively act on it. METHODS The authors evaluated a layperson-focused European Union Risk Management Plan Public Summary and revised it to improve its understandability and usability by applying health literacy principles. The Suitability Assessment of Materials was used to test the appropriateness of the document for readers with low-to-average literacy levels. Two rounds of usability tests were conducted with American adults who had low to average education levels to identify areas of confusion. Revisions were made within perceived regulatory constraints. RESULTS A number of health literacy principles can be applied to improve the understandability and usability of the document; however, the document contains many inherently complex concepts. CONCLUSIONS The authors recommend that stakeholders reassess the intended use of the document by members of the public and rethink its scope and structure, with close involvement of patients and caregivers.
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Affiliation(s)
- Anne Wolka
- 1 Eli Lilly and Company, Indianapolis, IN, USA
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Rudd RE. The evolving concept ofHealth literacy: New directions for health literacy studies. ACTA ACUST UNITED AC 2015. [DOI: 10.1179/1753806815z.000000000105] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
This study aimed to validate a Turkish version of the Short Test of Functional Health Literacy (S-TOFHLA) (Baker et al, Development of a brief test to measure functional health literacy. Patient Educ Counsel 1999; 38: :33-42) and a Turkish version of the Chew self-report scale (Chew et al., Brief questions to identify patients with inadequate health literacy. Family Med, 2004; 36: :588-94) for measuring functional health literacy. The original English version of the S-TOFHLA and the Chew items were translated by applying standardized translation methods and cultural adaptations, and both were administered to a sample of diabetes patients (N = 302) in two diabetes clinics in one of the major cities in Turkey. Self-administered paper-pencil questionnaires were distributed to eligible outpatients who had a clinic appointment. In addition to the S-TOFHLA measurement and the Chew screening questions, gender, age, educational attainment, income, marital status and diabetes knowledge were obtained. The Turkish version of S-TOFHLA showed high internal consistency. Both S-TOFHLA and the Chew screening scale correlated significantly with known predictors of health literacy: age, education and income. The Chew scale was also related weakly but significantly with general diabetes knowledge. It is expected that the Turkish versions of S-TOFHLA and the Chew scale will be used in Turkey as well as in other countries with large Turkish communities.
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Affiliation(s)
- Ezgi Eyüboğlu
- Public Relations and Publicity Department, Maltepe University, Marmara Eğitim Köyü, Maltepe, Istanbul 34857, Turkey
| | - Peter J Schulz
- Institute of Communication and Health, Università Della Svizzera Italiana, Lugano, Switzerland
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Woodward-Kron R, Connor M, Schulz PJ, Elliott K. Educating the patient for health care communication in the age of the world wide web: a qualitative study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:318-325. [PMID: 24362379 DOI: 10.1097/acm.0000000000000101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Communication skills teaching in medical education has yet to acknowledge the impact of the Internet on physician-patient communication. The authors present a conceptual model showing the variables influencing how and to what extent physicians and patients discuss Internet-sourced health information as part of the consultation with the purpose of educating the patient. METHOD A study exploring the role physicians play in patient education mediated through health information available on the Internet provided the foundation for the conceptual model. Twenty-one physicians participated in semistructured interviews between 2011 and 2013. Participants were from Australia and Switzerland, whose citizens demonstrate different degrees of Internet usage and who differ culturally and ethnically. The authors analyzed the interviews thematically and iteratively. The themes as well as their interrelationships informed the components of the conceptual model. RESULTS The intrinsic elements of the conceptual model are the physician, the patient, and Internet based health information. The extrinsic variables of setting, time, and communication activities as well as the quality, availability, and usability of the Internet-based health information influenced the degree to which physicians engaged with, and were engaged by, their patients about Internet-based health information. CONCLUSIONS The empirically informed model provides a means of understanding the environment, enablers, and constraints of discussing Internet-based health information, as well as the benefits for patients' understanding of their health. It also provides medical educators with a conceptual tool to engage and support physicians in their activities of communicating health information to patients.
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Affiliation(s)
- Robyn Woodward-Kron
- Dr. Woodward-Kron is associate professor, Healthcare Communication, Medical Education Unit, Melbourne Medical School, University of Melbourne, Melbourne, Australia. Dr. Connor is postdoctoral fellow, Institute of Communication and Health, University of Lugano, Lugano, Switzerland. Dr. Schulz is professor and director, Institute of Communication and Health, University of Lugano, Lugano, Switzerland. Dr. Elliott is senior lecturer, Medical Education Unit, Melbourne Medical School, University of Melbourne, Melbourne, Australia
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Smith D, Hudson S. Using the Person–Environment–Occupational Performance conceptual model as an analyzing framework for health literacy. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/1753807611y.0000000021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Halverson J, Martinez-Donate A, Trentham-Dietz A, Walsh MC, Strickland JS, Palta M, Smith PD, Cleary J. Health literacy and urbanicity among cancer patients. J Rural Health 2013; 29:392-402. [PMID: 24088213 DOI: 10.1111/jrh.12018] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Low health literacy is associated with inadequate health care utilization and poor health outcomes, particularly among elderly persons. There is a dearth of research exploring the relationship between health literacy and place of residence (urbanicity). This study examined the association between urbanicity and health literacy, as well as factors related to low health literacy, among cancer patients. METHODS A cross-sectional survey was conducted with a population-based sample of 1,841 cancer patients in Wisconsin. Data on sociodemographics, urbanicity, clinical characteristics, insurance status, and health literacy were obtained from the state's cancer registry and participants' answers to a mailed questionnaire. Partially and fully adjusted multivariate logistic regression models were fitted to examine: (1) the association between urbanicity and health literacy and (2) the role of socioeconomic status as a possible mediator of this relationship. FINDINGS Rural cancer patients had a 33% (95% CI: 1.06-1.67) higher odds of having lower levels of health literacy than their counterparts in more urban areas of Wisconsin. The association between urbanicity and health literacy attenuated after controlling for socioeconomic status. CONCLUSIONS Level of urbanicity was significantly related to health literacy. Socioeconomic status fully mediated the relationship between urbanicity and health literacy. These results call for policies and interventions to assess and address health literacy barriers among cancer patients in rural areas.
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Affiliation(s)
- Julie Halverson
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin; Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin
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Sykes S, Wills J, Rowlands G, Popple K. Understanding critical health literacy: a concept analysis. BMC Public Health 2013; 13:150. [PMID: 23419015 PMCID: PMC3583748 DOI: 10.1186/1471-2458-13-150] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 02/13/2013] [Indexed: 11/14/2022] Open
Abstract
Background Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. Method The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Results Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. Conclusions While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was first introduced in the literature, particularly those around empowerment, social and political action and the existence of the concept at both an individual and population level, have been lost in more recent representations. This has resulted in critical health literacy becoming restricted to a higher order cognitive individual skill rather than a driver for political and social change. The paper argues that in order to retain the uniqueness and usefulness of the concept in practice efforts should be made to avoid this dilution of meaning.
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Affiliation(s)
- Susie Sykes
- Faculty of health and Social care, London South Bank University, 101 Borough Road, SE1 OAA, London, UK.
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RUDD RIMAE. Mismatch Between Skills of Patients and Tools in Use: Might Literacy Affect Diagnoses and Research? J Rheumatol 2010; 37:885-6. [DOI: 10.3899/jrheum.100135] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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