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Ahn AB, Kulhari S, Karimi A, Sundararajan S, Sajatovic M. Readability of patient education material in stroke: a systematic literature review. Top Stroke Rehabil 2024; 31:345-360. [PMID: 37724783 DOI: 10.1080/10749357.2023.2259177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Stroke education materials are crucial for the recovery of stroke patients, but their effectiveness depends on their readability. The American Medical Association (AMA) recommends patient education materials be written at a sixth-grade level. Studies show existing paper and online materials exceed patients' reading levels and undermine their health literacy. Low health literacy among stroke patients is associated with worse health outcomes and decreased efficacy of stroke rehabilitation. OBJECTIVE We reviewed the readability of paper (i.e brochures, factsheets, posters) and online (i.e American Stroke Association, Google, Yahoo!) stroke patient education materials, reading level of stroke patients, accessibility of online health information, patients' perceptions on gaps in stroke information, and provided recommendations for improving readability. METHOD A PRISMA-guided systematic literature review was conducted using PUBMED, Google Scholar, and EbscoHost databases and "stroke", "readability of stroke patient education", and "stroke readability" search terms to discover English-language articles. A total of 12 articles were reviewed. RESULTS SMOG scores for paper and online material ranged from 11.0 - 12.0 grade level and 7.8 - 13.95 grade level respectively. Reading level of stroke patients ranged from 3rd grade to 9th grade level or above. Accessibility of online stroke information was high. Structured patient interviews illustrated gaps in patient education materials and difficulty with comprehension. CONCLUSION Paper and online patient education materials exceed the reading level of stroke patients and the AMA recommended 6th grade level. Due to limitations in readability, stroke patients are not being adequately educated about their condition.
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Affiliation(s)
- Aaron B Ahn
- Department of Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sajal Kulhari
- Department of Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Amir Karimi
- Department of Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Sophia Sundararajan
- Department of Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Martha Sajatovic
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
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Sarhan MBA, Fujiya R, Kiriya J, Htay ZW, Nakajima K, Fuse R, Wakabayashi N, Jimba M. Health literacy among adolescents and young adults in the Eastern Mediterranean region: a scoping review. BMJ Open 2023; 13:e072787. [PMID: 37290942 PMCID: PMC10255069 DOI: 10.1136/bmjopen-2023-072787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES For adolescents and young adults, most health literacy research has been conducted in Western countries, but few studies have been conducted in the Eastern Mediterranean region (EMR). This review aimed to explore the existing health literacy research in the EMR in addition to the levels of health literacy and its associated factors among adolescents and young adults. METHODS The search, conducted using the PubMed/MEDLINE, EBSCOhost/CINAHL plus, Web of Science and J-STAGE databases, was initially performed on 16 June 2022 and later updated on 1 October 2022. Studies that targeted 10-25 years old persons, conducted in any of the EMR countries and that used the health literacy concept and/or described its levels or predictors were included in the review. Content analysis was used for data extraction and analysis. Data related to the study methods, participants, outcome variables and health literacy were extracted. RESULTS The review included 82 studies, most of which were conducted in Iran and Turkey and adopted a cross-sectional design. Half of the studies showed that more than half of adolescents and young adults had low or moderate health literacy. Nine studies applied university-based or school-based health education interventions to improve health literacy, which was also predicted by demographic and socioeconomic factors and internet usage. Little attention was paid to assessing the health literacy of vulnerable people, such as refugees and those with a disability and exposed to violence. Finally, various health literacy topics were investigated, including nutrition, non-communicable diseases, media and depression. CONCLUSION Health literacy levels were low-to-moderate in adolescents and young adults in the EMR. To promote health literacy, it is recommended to use school-based health education and attempt to reach adolescents and young adults through social media platforms. More attention should be paid to refugees, people with disabilities and those exposed to violence.
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Affiliation(s)
- Mohammed B A Sarhan
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rika Fujiya
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
- Faculty of Nursing and Medical Care, Keio University, Fujisawa, Kanagawa, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Zin Wai Htay
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kayono Nakajima
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Rie Fuse
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
| | - Nao Wakabayashi
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Faiola A, Kamel Boulos MN, Bin Naeem S, ur-Rehman A. Integrating Social and Family Support as a Measure of Health Outcomes: Validity Implications from the Integrated Model of Health Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:729. [PMID: 36613058 PMCID: PMC9819503 DOI: 10.3390/ijerph20010729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Health literacy (HL) is one of the key determinants of health and healthcare outcomes. The objectives of this study are to measure and validate Sørensen et al.'s integrated model of health literacy (IMHL) in a developing country's youth population, as well as to assess the impact of family affluence and social and family support on healthcare domains. (2) Methods: A cross-sectional survey was carried out of undergraduate university students in 19 public and private sector universities in Pakistan during June-August 2022. A nine-factor measurement model was tested using confirmatory factor analysis (CFA), and structural equation modeling (SEM) based on the 56 valid items obtained from three different validated scales, such as the family affluence scale (FAS-II), the multidimensional scale of perceived social support (MSPSS), and the European Health Literacy Questionnaire (the HLS-EU-Q). (3) Results: The data were collected from 1590 participants with a mean age of 21.16 (±2.027) years. The model fit indices indicate that the model partially fitted the data: χ2 = 4.435, df = 1448, p = 0.000, RMSEA = 0.048, TLI = 0.906, CFI = 0.912, IFI = 0.912, GFI = 0.872, NFI = 0.889, RFI = 0.882, PGFI = 0.791. The structural equation model showed acceptable goodness of fit indices, indicating a significant direct influence of social and family support on healthcare and disease prevention. (4) Conclusions: Social and family support are the most influential factors, with regard to HL dimensions, in improving healthcare, disease prevention, and health promotion in low-income settings and among non-English-speaking communities.
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Affiliation(s)
- Anthony Faiola
- Department of Health and Clinical Sciences, College of Health Sciences, University of Kentucky, Lexington, KY 40506, USA
| | | | - Salman Bin Naeem
- Department of Health and Clinical Sciences, College of Health Sciences, University of Kentucky, Lexington, KY 40506, USA
- Department of Library & Information Science, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | - Aziz ur-Rehman
- Department of Library & Information Science, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
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Lima FMA, Jamas MT, Miot HA, Garcia de Avila MA. Heart Disease Knowledge Questionnaire: Psychometric Properties in Brazilian Adults. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2120121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
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Kumar R, Rehman S, Baloch GM, Vankwani M, Somrongthong R, Pongpanich S. Effectiveness of health education intervention on diabetes mellitus among the teachers working in public sector schools of Pakistan. BMC Endocr Disord 2022; 22:194. [PMID: 35907838 PMCID: PMC9338632 DOI: 10.1186/s12902-022-01110-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is considered as one of the major public health problems globally. Health education strategies can help in managing blood glucose level and complications among DM patients. Health education intervention is effective to manage and control the blood glucose levels among diabetic patients. This study explored the effectiveness of health education intervention on DM among school teachers in public sector schools of Pakistan. METHODS This was quasi-experimental study where baseline & end line assessments were conducted on teachers of public sector schools of Sindh province, Pakistan, from October to December 2019. Pretested structured questionnaire was used in this study. Participants (n = 136). were randomly selected from the list of government schools registered with district education department An intervention comprised of health education sessions with DM patients was undertaken after conducting baseline assessment followed by end line assessment. The institutional review board of Health Services Academy Pakistan ethically approved this study. RESULTS All the respondents completed post-test with mean ± SD age of participants being 39.2 ± 1.34 years. Female teachers comprised 65% out of which 70% were living in rural areas. Knowledge on DM pre-test score was 20.03 ± 3.31 that increased in post-test to 49.11 ± 2.21 (p < 0.05). Mean score of information on symptoms and causes of DM was 1.98 ± 0.21 for pre-test whereas for post-test it was 4.78 ± 0.12 (p < 0.05). The effect of intervention was significant on diabetes related complications (p < 0.05), symptoms (p < 0.05), overall score (p < 0.05) and preventive practices (p < 0.05). CONCLUSIONS The study provides evidence of the importance and effectiveness of health education intervention related to diabetes among school teachers, which has a positive impact on the knowledge and practices. We concluded that the health education session sensitized the teachers and they can bring cogent changes to enhance their knowledge about diabetes and its risks.
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Affiliation(s)
- Ramesh Kumar
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Sidra Rehman
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | | | | | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Kumar R, Farzeen M, Hafeez A, Achakzai BK, Vankwani M, Lal M, Iqbal R, Somrongthong R. Effectiveness of a health education intervention on the use of long-lasting insecticidal nets for the prevention of malaria in pregnant women of Pakistan: a quasi-experimental study. Malar J 2020; 19:232. [PMID: 32600347 PMCID: PMC7325083 DOI: 10.1186/s12936-020-03298-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open
Abstract
Background About one quarter of pregnant women in the population of Pakistan are using long-lasting insecticide-treated bed nets (LLINs) for prevention of malaria. Past research reported that adequate information and education would act as mediator to change behaviour among patients for prevention of malaria infection. The effective use of LLINs would contribute to reduction of disease burden caused by malaria. The aim of this study was to determine the effectiveness of health education on the adoption of LLINs among pregnant women living in Tharparkar, a remote district in Sindh Province, Pakistan. Methods A quasi-experimental study design with control and intervention groups was conducted with 200 pregnant women (100 in each group). Women in the intervention group were provided with health education sessions on malaria for 12 weeks, while those in the control group obtained routine information from lady health workers (LHWs). Pre- and post-intervention assessment was done of knowledge about malaria and use of LLIN, which was statistically analysed using descriptive statistics and difference in difference (DID) multivariable regression analysis to test effectiveness of the intervention. Results Baseline was conducted with 200 pregnant women. Demographic characteristics were similar in both groups with slight differences in age, education, income, type of latrine, and source of drinking water. There were no significant differences between mean knowledge and use of LLINs scores between groups at baseline. However, the estimated DID value after the intervention was 4.170 (p < 0.01) and represents an increase in scores of knowledge in the intervention group compared to control. Similarly DID value of 3.360 (p < 0.05) showed an increase in use of LLINs score after the intervention which was significant, showing that the intervention had a positive effect. Conclusions Results proved that health education could be an effective intervention for improving knowledge and usage of LLINs among pregnant women for the prevention of malaria. Such educational interventions have a positive potential to be implemented at larger scale by incorporating them into routine health sessions provided by health workers.
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Affiliation(s)
- Ramesh Kumar
- Health Services Academy, Ministry of National Health Services Regulation & Coordination, Government of Pakistan, Islamabad, Pakistan. .,College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
| | - Midhat Farzeen
- Health Services Academy, Ministry of National Health Services Regulation & Coordination, Government of Pakistan, Islamabad, Pakistan
| | - Assad Hafeez
- Health Services Academy, Ministry of National Health Services Regulation & Coordination, Government of Pakistan, Islamabad, Pakistan
| | - Baseer Khan Achakzai
- Directorate of Malaria, Ministry of National Health Services Regulation & Coordination, Government of Pakistan, Islamabad, Pakistan
| | - Muskan Vankwani
- Dow international Medical College Karachi, Karachi, Pakistan
| | - Manohar Lal
- Federal Government Polyclinic Postgraduate Institute, Islamabad, Pakistan
| | - Rabia Iqbal
- Federal Government Polyclinic Postgraduate Institute, Islamabad, Pakistan
| | - Ratana Somrongthong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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