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Rouyard T, Endo M, Nakamura R, Moriyama M, Stanyon M, Kanke S, Nakamura K, Chen C, Hara Y, Ii M, Kassai R. Fukushima study for Engaging people with type 2 Diabetes in Behaviour Associated Change (FEEDBACK): study protocol for a cluster randomised controlled trial. Trials 2023; 24:317. [PMID: 37158959 PMCID: PMC10169507 DOI: 10.1186/s13063-023-07345-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND The growing burden of type 2 diabetes mellitus (T2DM) and the rising cost of healthcare worldwide make it imperative to identify interventions that can promote sustained self-management behaviour in T2DM populations while minimising costs for healthcare systems. The present FEEDBACK study (Fukushima study for Engaging people with type 2 Diabetes in Behaviour Associated Change) aims to evaluate the effects of a novel behaviour change intervention designed to be easily implemented and scaled across a wide range of primary care settings. METHODS A cluster randomised controlled trial (RCT) with a 6-month follow-up will be conducted to evaluate the effects of the FEEDBACK intervention. FEEDBACK is a personalised, multi-component intervention intended to be delivered by general practitioners during a routine diabetes consultation. It consists of five steps aimed at enhancing doctor-patient partnership to motivate self-management behaviour: (1) communication of cardiovascular risks using a 'heart age' tool, (2) goal setting, (3) action planning, (4) behavioural contracting, and (5) feedback on behaviour. We aim to recruit 264 adults with T2DM and suboptimal glycaemic control from 20 primary care practices in Japan (cluster units) that will be randomly assigned to either the intervention or control group. The primary outcome measure will be the change in HbA1c levels at 6-month follow-up. Secondary outcome measures include the change in cardiovascular risk score, the probability to achieve the recommended glycaemic target (HbA1c <7.0% [53mmol/mol]) at 6-month follow-up, and a range of behavioural and psychosocial variables. The planned primary analyses will be carried out at the individual level, according to the intention-to-treat principle. Between-group comparisons for the primary outcome will be analysed using mixed-effects models. This study protocol received ethical approval from the research ethics committee of Kashima Hospital, Fukushima, Japan (reference number: 2022002). DISCUSSION This article describes the design of a cluster RCT that will evaluate the effects of FEEDBACK, a personalised, multicomponent intervention aimed at enhancing doctor-patient partnership to engage adults with T2DM more effectively in self-management behaviour. TRIAL REGISTRATION The study protocol was prospectively registered in the UMIN Clinical Trials Registry (UMIN-CTR ID UMIN000049643 assigned on 29/11/2022). On submission of this manuscript, recruitment of participants is ongoing.
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Affiliation(s)
- Thomas Rouyard
- Research Center for Health Policy and Economics, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8601, Japan.
| | - Mei Endo
- Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1247, Japan
| | - Ryota Nakamura
- Research Center for Health Policy and Economics, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8601, Japan
- Graduate School of Economics, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8601, Japan
| | - Michiko Moriyama
- Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8553, Japan
| | - Maham Stanyon
- Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1247, Japan
| | - Satoshi Kanke
- Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1247, Japan
| | - Koki Nakamura
- Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1247, Japan
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Yasushi Hara
- Graduate School of Economics, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8601, Japan
- Graduate School of Business Administration, Kobe University, 2-1 Rokkōdaichō, Nada Ward, Kobe, Hyogo, 657-0013, Japan
| | - Masako Ii
- Graduate School of Economics, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8601, Japan
| | - Ryuki Kassai
- Department of Community and Family Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1247, Japan
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Hamidi N, Tan YR, Jawahir S, Tan EH. Determinants of community pharmacy utilisation among the adult population in Malaysia: findings from the National Health and Morbidity Survey 2019. BMC Health Serv Res 2021; 21:649. [PMID: 34217293 PMCID: PMC8254968 DOI: 10.1186/s12913-021-06656-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/17/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Community pharmacies provide alternatives for medication procurement and other basic and minor health-related services in addition to mainstream hospitals and primary healthcare services. This study aimed to determine the characteristics of community pharmacy users and associated factors for community pharmacy utilisation in Malaysia. METHODS Secondary data analysis was performed using data from the National Health and Morbidity Survey 2019, a nationwide cross-sectional household survey that used a two-stage stratified random sampling design. Adults aged 18 years and over were included in the analysis. Respondents who reported visiting the community pharmacy for health purposes two weeks prior to the study were considered as users. Complex sample descriptive statistics were used to describe the respondents' characteristics. Logistic regression analyses were employed to determine factors associated with community pharmacy utilisation. RESULTS Of the 11,155 respondents interviewed, 10.3 % reported community pharmacy utilisation for health purposes. Females (OR = 1.41, 95 % CI = 1.14, 1.73), those with tertiary education (OR = 2.03, 95 % CI = 1.26, 3.29), urban dwellers (OR = 1.42, 95 % CI = 1.13, 1.79), and those with self-reported health problems (OR = 7.62, 95 % CI = 6.05, 9.59) were more likely to utilise the community pharmacy. CONCLUSIONS Demographic and socioeconomic factors were important determinants of community pharmacy utilisation in Malaysia with sex, age, education level, locality, and self-reported health problems as the associated factors. These findings serve as evidence for policy interventions, crucial for improvements in accessibility to healthcare services.
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Affiliation(s)
- Normaizira Hamidi
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Yeung R'ong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Suhana Jawahir
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Ee Hong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, NIH Complex, No. 1, Jalan Setia Murni U13/52, Section U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
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Schmidt FM, Zottmann JM, Sailer M, Fischer MR, Berndt M. Statistical literacy and scientific reasoning & argumentation in physicians. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc77. [PMID: 34056066 PMCID: PMC8136351 DOI: 10.3205/zma001473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/05/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Objective: Statistical literacy (SL) of physicians, i.e. the ability to use and interpret statistical numbers in the context of science, is an essential prerequisite for risk estimation and communication. Together with scientific reasoning and argumentation (SRA) skills, SL provides the basis for evidence-based practice. Several studies suggest that in medical students both skills are underdeveloped. The aim of the present study was to investigate these skills in practicing physicians and how these skills were acquired. Methods: Data collection in N=71 physicians was conducted online and as paper pencil. SL was assessed with multiple-choice items. SRA skills evidence evaluation and drawing conclusions were measured with a decision scenario. Results: Study results indicated that physicians have medium levels of SL (M=17.58, SD=6.92, max 30 pts.) and SRA (evidence evaluation: M=7.75, SD=1.85, max 10 pts.; drawing conclusions: M=37.20, SD=5.35, max 60 pts.). Skills development via autodidactic learning activities (M=4.78, SD=1.13, range 1-6) was reported significantly more often than development during formal medical education (M=2.31, SD=1.46), t(71)=-9.915, p<.001, or in extracurricular activities (M=3.34, SD=1.87), t(71)=4.673, p<.001. The active involvement in research seemed decisive: The number of publications and time spent in research significantly correlated with SL, r(71)=.355, p=.002; respectively r(71)=.280, p=.018. SRA skills were predicted by the type of MD-thesis, β=-.380, p=.016, and working in research, β=3.355, p=.008. Conclusion: Active involvement in research activities seems to be a very important factor for the development of both SL and SRA skills. The implementation of systematic fostering of these skills during formal medical education seems warranted.
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Affiliation(s)
- Felicitas M. Schmidt
- University Hospital, LMU Munich, Institute of Medical Education, Munich, Germany
| | - Jan M. Zottmann
- University Hospital, LMU Munich, Institute of Medical Education, Munich, Germany
| | | | - Martin R. Fischer
- University Hospital, LMU Munich, Institute of Medical Education, Munich, Germany
| | - Markus Berndt
- University Hospital, LMU Munich, Institute of Medical Education, Munich, Germany
- Walden University, Richard W. Riley College of Education and Leadership, Minneapolis, USA
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Danya H, Yonekura Y, Nakayama K. Effects of graphic presentation on understanding medical risks and benefits among Japanese adults. COGENT MEDICINE 2021. [DOI: 10.1080/2331205x.2021.1907894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Hitomi Danya
- Department of Nursing Informatics, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
| | - Yuki Yonekura
- Department of Nursing Informatics, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
| | - Kazuhiro Nakayama
- Department of Nursing Informatics, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan
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Plaza-Zamora J, Legaz I, Osuna E, Pérez-Cárceles MD. Age and education as factors associated with medication literacy: a community pharmacy perspective. BMC Geriatr 2020; 20:501. [PMID: 33238894 PMCID: PMC7687724 DOI: 10.1186/s12877-020-01881-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Aging implies a higher prevalence of chronic pathologies and a corresponding increase in medication. The correct adherence and use of the medication are prerequisites for reducing risks of disease progression, comorbidity, and mortality. Medication literacy (ML) is the specific ability to safely access and understand the information available concerning medication, and to act accordingly. Currently, there are few specific instruments that ascertain the extent of ML in the general population. The aim of this work was to analyse ML in a large cohort of pharmacy customers. METHODS A total of 400 community pharmacy clients were analyzed to assess the level of ML (documental and numeracy) through the validated MedLitRxSE tool. RESULTS The results showed that out of a total of 400 community pharmacy clients only 136 (34%) had an adequate degree of ML, while the rest of the clients (n = 264; 66%) were adjudged not to have this ability. Statistically significant differences were found between the different age groups in terms of ML (P < 0.001; OR = 0.312; 95% CI: 0.195-0.499), the 51-65 and >65-year age groups having a lower frequency of adequate ML (23.5 and 7.1%, respectively) than the rest of the age groups. A statistically significant increase in adequate ML was observed as the academic level of the clients increased (P < 0.001; OR = 15.403; 95% CI: 8.109-29.257). Multivariate logistic regression confirmed the influence of both variables on ML. CONCLUSIONS An inadequate ML level was found in community pharmacy clients over the age of 51, and also in those with primary or non-formal studies. Our data add to our knowledge about ML, and should pharmacists and other health professionals to adopt new strategies to prevent, or at least reduce, errors in taking medicines, thus avoiding the undesirable effects of any misuse.
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Affiliation(s)
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Institute of Research into Aging. Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain.
| | - Eduardo Osuna
- Department of Legal and Forensic Medicine, Institute of Research into Aging. Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
| | - María D Pérez-Cárceles
- Department of Legal and Forensic Medicine, Institute of Research into Aging. Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, Murcia, Spain
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Bonaccorsi G, Lastrucci V, Vettori V, Lorini C. Functional health literacy in a population-based sample in Florence: a cross-sectional study using the Newest Vital Sign. BMJ Open 2019; 9:e026356. [PMID: 31221877 PMCID: PMC6589023 DOI: 10.1136/bmjopen-2018-026356] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/19/2019] [Accepted: 05/28/2019] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To assess the level of functional health literacy (HL) and its antecedents and consequences in an adult population-based sample, using the Italian version of Newest Vital Sign (NVS-IT). DESIGN Cross-sectional study. SETTING General population. PARTICIPANTS 984 people were randomly selected from the resident registers of 11 general practitioners; a total of 452 (46.2%) of the selected people completed the study. Inclusion criteria were the following: 18-69 years of age and Italian speaking. Exclusion criteria included cognitive impairment, severe psychiatric diseases and end-stage diseases. OUTCOME MEASURES HL levels as assessed by the NVS-IT and the following potential HL predictors and consequences were assessed using logistic regression models: sociodemographic characteristics, body mass index, presence of long-term illnesses, self-reported health status, health services use in the last 12 months. RESULTS High likelihood of limited HL, possibility of limited HL and adequate HL were found in 11.5%, 24.6% and 63.9% of the sample, respectively. The results of the multivariate logistic model for the antecedents showed that the risk of having high likelihood or possibility of limited HL levels increases with age (OR 1.07, 95% CI 1.05 to 1.09), lower educational level (OR 4.03; 95% CI 3.41 to 7.49) and with worse financial situation (OR 1.64; 95% CI 1.17 to 2.63). As far as health outcomes are concerned, HL resulted to be positively associated with self-reported health status (OR 2.25, 95% CI 1.75 to 2.75). CONCLUSIONS Findings show a good level of functional HL in the population. However, older, less educated and poorer population groups showed to have a higher likelihood of suffering from limited or inadequate HL. Efforts should be made to design and implement public health policies and interventions tailored to different HL levels. TRIAL REGISTRATION NUMBER CEAVC:10113.
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Affiliation(s)
| | - Vieri Lastrucci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Virginia Vettori
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Florence, Italy
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Talboy AN, Schneider SL. Improving Accuracy on Bayesian Inference Problems Using a Brief Tutorial. JOURNAL OF BEHAVIORAL DECISION MAKING 2016. [DOI: 10.1002/bdm.1949] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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De Oliveira GS, McCarthy RJ, Wolf MS, Holl J. The impact of health literacy in the care of surgical patients: a qualitative systematic review. BMC Surg 2015; 15:86. [PMID: 26182987 PMCID: PMC4504415 DOI: 10.1186/s12893-015-0073-6] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 07/09/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Inadequate health literacy affects more than 90 million Americans and it has been associated with adverse outcomes in the medicine field including increased hospitalization rates and greater mortality. Since surgical patients are often required to make complex decisions and adhere to complex instructions, health literacy may have a profound impact in the surgical practice. The main objective of the current study was to systematically evaluate the role of health literacy in surgical patients. METHODS A systematic search was performed to identify studies that evaluated the role of health literacy in the perioperative setting following the PRISMA guidelines. Only studies that examined health literacy using a validated instrument in the perioperative setting were included. RESULTS Ten studies including data on 1147 patients were included. The median (IQR) number of patients in the included studies was 101 (30 to 152). The majority of studies used the Short Test of Functional Literacy in adults (STOFHLA) to evaluate patients' health literacy. Five studies evaluated the patients preoperatively, four studies evaluated patients in the postoperative period and in one study the time of evaluation in relation to the surgical procedure was not defined. The lowest prevalence of inadequate health literacy was detected in kidney transplant patients, 6 out of 124 (5 %), while the highest prevalence of inadequate health literacy was detected in orthopedic patients having total joint replacement, 86 out of 126 (60 %). Inadequate health literacy in the preoperative period was associated with poor medical information comprehension and it may adversely affect adherence to preoperative medications and even modulate surgical disparities. Inadequate health literacy in the postoperative period was associated with poor comprehension of discharge instructions and worse kidney function in transplant recipients. CONCLUSIONS Health literacy seems to have a very significant impact in the care of surgical patients. More studies to establish the impact of poor health literacy on perioperative outcomes are needed.
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Affiliation(s)
- Gildasio S De Oliveira
- Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, 241 East Huron St, F5-704, Chicago, IL, USA.
| | - Robert J McCarthy
- Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, 241 East Huron St, F5-704, Chicago, IL, USA
| | - Michael S Wolf
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Jane Holl
- Center for Health Care studies, Northwestern University, Chicago, USA
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Suka M, Odajima T, Okamoto M, Sumitani M, Igarashi A, Ishikawa H, Kusama M, Yamamoto M, Nakayama T, Sugimori H. Relationship between health literacy, health information access, health behavior, and health status in Japanese people. PATIENT EDUCATION AND COUNSELING 2015; 98:660-8. [PMID: 25739344 DOI: 10.1016/j.pec.2015.02.013] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 01/26/2015] [Accepted: 02/15/2015] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people. METHODS A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status. RESULTS The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health. CONCLUSION HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan. PRACTICE IMPLICATIONS In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups.
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Affiliation(s)
- Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Takeshi Odajima
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Masako Okamoto
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Masahiko Sumitani
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Ataru Igarashi
- Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Makiko Kusama
- Laboratory of Pharmaceutical Regulatory Science, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Michiko Yamamoto
- Education Center for Clinical Pharmacy Practice, Showa Pharmaceutical University, Tokyo, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Hiroki Sugimori
- Department of Preventive Medicine, Graduate School of Sports and Health Sciences, Daito Bunka University, Saitama, Japan
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Maeda E, Sugimori H, Nakamura F, Kobayashi Y, Green J, Suka M, Okamoto M, Boivin J, Saito H. A cross sectional study on fertility knowledge in Japan, measured with the Japanese version of Cardiff Fertility Knowledge Scale (CFKS-J). Reprod Health 2015; 12:10. [PMID: 25638172 PMCID: PMC4417216 DOI: 10.1186/1742-4755-12-10] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 01/08/2015] [Indexed: 11/12/2022] Open
Abstract
Background A recent survey of 79 countries showed that fertility knowledge was lower in Japan than in any other developed country. Given the fertility decline in Japan and the importance of fertility knowledge, we conducted an online survey to examine fertility knowledge and the related factors for effective public education. Methods We studied people aged 18-59 years old, n = 4,328 (the “General” group), and also people who had been trying to conceive for at least six months, 18-50 years old, n = 618 (the “Triers” group). Fertility knowledge was assessed using the Japanese version of the 13-item Cardiff Fertility Knowledge Scale (CFKS-J). All participants provided socio-demographic and fertility information. Participants also completed a 14-item health literacy scale and an 11-item health numeracy scale. We asked participants who were aware of age-related decline in fertility when and where they first acquired that knowledge. Results The average percentages of CFKS-J items answered correctly were 53.1% in the Triers group and 44.4% in the General group (p < 0.001). Multivariate linear regression models showed in the Triers group greater fertility knowledge was associated with greater health literacy and prior medical consultation regarding their fertility. In the General group greater fertility knowledge was associated with being female, younger, university educated, currently trying to conceive, non-smoking, having higher household income, having higher health literacy and having higher health numeracy. Of those who were aware of the age-related decline in fertility, around 3% first learned the fact “at school”, and around 65% first learned it “through mass media” or “via the Internet”. More than 30% of the respondents first learned it “less than 5 years before” the survey. Conclusions Although fertility knowledge had improved since a previous study, possibly due to recent media coverage of age-related infertility, it was still low. Educational interventions, both in schools and in the community, may be needed to increase fertility knowledge in the general population because most people obtain fertility knowledge from mass media, which has been shown to often present distorted and inaccurate fertility information.
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Affiliation(s)
- Eri Maeda
- Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, 113-0033, Bunkyo-ku, Tokyo, Japan. .,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Hiroki Sugimori
- Department of Preventive Medicine, Graduate School of Sports and Health Sciences, Daito Bunka University, 560, Iwadono, 355-8501, Higashimatsuyama-shi, Saitama, Japan.
| | - Fumiaki Nakamura
- Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, 113-0033, Bunkyo-ku, Tokyo, Japan.
| | - Yasuki Kobayashi
- Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, 113-0033, Bunkyo-ku, Tokyo, Japan.
| | - Joseph Green
- Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, 113-0033, Bunkyo-ku, Tokyo, Japan.
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8, Nishishinba-shi, 105-8461, Minato-ku, Tokyo, Japan.
| | - Masako Okamoto
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 7-3-1, Hongo, 113-0033, Bunkyo-ku, Tokyo, Japan.
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Tower Building, Park Place, CF10 3AT, Cardiff, South Wales, UK.
| | - Hidekazu Saito
- Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1, Okura, 157-0074, Setagaya-ku Tokyo, Japan.
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Reading comprehension of health checkup reports and health literacy in Japanese people. Environ Health Prev Med 2014; 19:295-306. [PMID: 24810206 DOI: 10.1007/s12199-014-0392-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To determine the reading comprehension of health checkup reports in the context of health literacy (HL) in Japanese people. METHODS A web-based survey was conducted among 424 Japanese adults aged 35-59 years. Participants were asked to read specifically designed health checkup reports and then answer a series of questions to examine whether they accomplished the fundamental purposes of health checkup reports (recognition of the problems, recognition of the risk of illness, recognition of the need for preventive action, and motivation for preventive action). HL was simultaneously measured using the 14-item health literacy scale (HLS-14), the 11-item Lipkus scale (Lipkus-J), and the Newest Vital Sign (NVS-J). RESULTS About 70 % of the study subjects misread the normal/abnormal classification for at least one items. Those with lower HLS-14 scores were significantly less likely to recognize the problems, the risk of illness, and the need for preventive action for the examinee, and also less likely to express their willingness to take preventive action in compliance with the doctor's advice after having received the health checkup report. Compared with the HLS-14 scores, the Lipkus-J and NVS-J scores showed hardly any association with the reading comprehension of health checkup reports. CONCLUSION All examinees do not always have an adequate level of HL. HL may be the major determinant of reading comprehension of health checkup reports. For more effective health checkups, health promotion service providers should become aware of the existence of examinees with inadequate HL and address the problem of misreading health checkup results.
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Abstract
OBJECTIVES Most existing tools for measuring health literacy (HL) focus on reading comprehension and numeracy in English speakers. The aim of this study was to develop a generic HL measure for Japanese adults. METHODS A questionnaire survey was conducted among participants in multiphasic health examinations at a Japanese healthcare facility. HL was measured using the 14-item health literacy scale (HLS-14) that was adapted from the HL scale specific to diabetic patients developed by Ishikawa and colleagues. The 14 items consist of five items for functional HL, five items for communicative HL, and four items for critical HL. The reliability and validity of the HLS-14 were assessed among 1,507 eligible respondents aged 30-69 years. RESULTS Explanatory factor analysis produced a three-factor solution that was very similar to the original HL scale. Cronbach's alpha indicated satisfactory internal consistency of the functional, communicative, and critical HL scores (0.83, 0.85, and 0.76, respectively). There were no floor or ceiling effects in each HL score. Confirmatory factor analysis revealed an acceptable fit of the three-factor model (comparative fit index = 0.912, normed fit index = 0.905, root mean square error of approximation = 0.082). When the two groups with a total HL score above and below the median (50), respectively, were compared, those who could obtain medication information satisfactorily and those who wanted to participate in making medication decisions were more frequently observed in the group with the higher score. CONCLUSIONS The HLS-14 demonstrated adequate reliability and validity as a generic HL measure for Japanese adults. This scale can be utilized for measuring functional, communicative, and critical HL in the clinical and public health contexts.
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Suka M, Odajima T, Kasai M, Igarashi A, Ishikawa H, Kusama M, Nakayama T, Sumitani M, Sugimori H. The 14-item health literacy scale for Japanese adults (HLS-14). Environ Health Prev Med 2013; 18:407-15. [PMID: 23689952 DOI: 10.1007/s12199-013-0340-z] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 04/20/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES Most existing tools for measuring health literacy (HL) focus on reading comprehension and numeracy in English speakers. The aim of this study was to develop a generic HL measure for Japanese adults. METHODS A questionnaire survey was conducted among participants in multiphasic health examinations at a Japanese healthcare facility. HL was measured using the 14-item health literacy scale (HLS-14) that was adapted from the HL scale specific to diabetic patients developed by Ishikawa and colleagues. The 14 items consist of five items for functional HL, five items for communicative HL, and four items for critical HL. The reliability and validity of the HLS-14 were assessed among 1,507 eligible respondents aged 30-69 years. RESULTS Explanatory factor analysis produced a three-factor solution that was very similar to the original HL scale. Cronbach's alpha indicated satisfactory internal consistency of the functional, communicative, and critical HL scores (0.83, 0.85, and 0.76, respectively). There were no floor or ceiling effects in each HL score. Confirmatory factor analysis revealed an acceptable fit of the three-factor model (comparative fit index = 0.912, normed fit index = 0.905, root mean square error of approximation = 0.082). When the two groups with a total HL score above and below the median (50), respectively, were compared, those who could obtain medication information satisfactorily and those who wanted to participate in making medication decisions were more frequently observed in the group with the higher score. CONCLUSIONS The HLS-14 demonstrated adequate reliability and validity as a generic HL measure for Japanese adults. This scale can be utilized for measuring functional, communicative, and critical HL in the clinical and public health contexts.
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Affiliation(s)
- Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan,
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