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Liu K, Ng C, Zhang J, Li Z, Zeng X, Xie S. Health literacy and its associated factors among the population in two schistosomiasis-endemic villages in Jiangxi Province, China. Medicine (Baltimore) 2024; 103:e39107. [PMID: 39093802 PMCID: PMC11296410 DOI: 10.1097/md.0000000000039107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 07/01/2024] [Indexed: 08/04/2024] Open
Abstract
This cross-sectional study aimed to assess the levels of health literacy and the associated factors among the general population living in 2 schistosomiasis-endemic villages in Jiangxi Province, China. Multistage stratified random sampling was used to select participants, and a face-to-face survey was conducted from July to August 2021 to collect participants' socio-demographic characteristics and levels of overall health literacy (HL) and its 3 subscales: health literacy of basic knowledge and concepts (HL-BKC), health literacy of behavior and lifestyle (HL-BAL), and health literacy of health-related skills (HL-HRS). The Chi-square test and logistic regression models were used to assess the association between socio-demographic characteristics and low HL levels. The prevalence rates of low overall HL, HL-BKC, HL-BAL, and HL-HRS were 84.3%, 61.8%, 82.6%, and 86%, respectively. In addition, no significant differences (P > .05) were noted between the 2 villages regarding overall HL scores and the 3 subscales of health literacy scores. Older age (P < .001), occupation (P < .001), lower educational level (P < .001), and lower annual household income (P < .05) were associated with an increased risk of low HL. Multivariate logistic regression revealed that occupation as a student (OR = 32.289, 95% CI:1.965-530.462, P < .05) and fishermen (OR = 27.902, 95%CI:1.91-407.642, P < .05), lower education level (OR = 0.384, 95%CI:0.149-0.99, P < .05), older age (OR = 5.228, 95%CI:1.458-18.75, P < .001), and lower annual household income (OR = 0.452, 95%CI:0.24-0.851, P < .05) were independently associated with low HL. The prevalence of low HL is high among the population in the schistosomiasis-endemic villages of Jiangxi Province, China. Age, education level, occupation, and annual household income were all independent factors associated with HL levels. Health educational interventions to improve HL should be simultaneously conducted in health promotion work to reduce risky habits.
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Affiliation(s)
- Kexing Liu
- Jiangxi Provincial Institute of Parasitic Diseases, Jiangxi Province Key Laboratory of Schistosomiasis Prevention and Control, Nanchang, China
| | - ChiuWan Ng
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive, Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jing Zhang
- Jiangxi Provincial Institute of Parasitic Diseases, Jiangxi Province Key Laboratory of Schistosomiasis Prevention and Control, Nanchang, China
| | - Zhaojun Li
- Jiangxi Provincial Institute of Parasitic Diseases, Jiangxi Province Key Laboratory of Schistosomiasis Prevention and Control, Nanchang, China
| | - Xiaojun Zeng
- Jiangxi Provincial Institute of Parasitic Diseases, Jiangxi Province Key Laboratory of Schistosomiasis Prevention and Control, Nanchang, China
| | - Shuying Xie
- Jiangxi Provincial Institute of Parasitic Diseases, Jiangxi Province Key Laboratory of Schistosomiasis Prevention and Control, Nanchang, China
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Trutner ZD, Furlough K, Martinez A, Vetter I, Uhler LM, Haynes A, Jayakumar P. Is Health Literacy Associated With Surgical Outcomes? A Systematic Review. J Surg Res 2023; 291:720-733. [PMID: 37572516 DOI: 10.1016/j.jss.2023.06.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 08/14/2023]
Abstract
INTRODUCTION Low levels of health literacy have been shown to increase healthcare utilization and negatively affect health outcomes within medical specialties. However, the relationship of health literacy with clinical, patient-centered, and process-oriented surgical outcomes is not as well understood. MATERIALS AND METHODS We sought to systematically review the current evidence base regarding the relationship between health literacy and a range of outcomes in patients experiencing surgical care. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched six databases and then identified and extracted data from 25 cross-sectional or cohort studies deemed eligible for a systematic review. RESULTS Among included studies, strong evidence exists to support an association between low health literacy and worse patient-centered outcomes, as well as an association between low health literacy and poorer process-oriented surgical outcomes. However, the relationship between health literacy and clinical outcomes remains unclear. CONCLUSIONS Substantial opportunities remain to improve our understanding of the impact of health literacy on surgical outcomes. Future work should expand the range of institutional and specialized surgical settings studied, implement a standardized set of validated health literacy assessment tools, include more diverse patient populations, and investigate a comprehensive range of patient-reported outcomes.
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Affiliation(s)
- Zoe D Trutner
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas.
| | - Kenneth Furlough
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Anuska Martinez
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Imelda Vetter
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Lauren M Uhler
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Alex Haynes
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Prakash Jayakumar
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
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Shan Y, Ji M, Dong Z, Xing Z, Wang D, Cao X. The Chinese Version of the Patient Education Materials Assessment Tool for Printable Materials: Translation, Adaptation, and Validation Study. J Med Internet Res 2023; 25:e39808. [PMID: 37200085 DOI: 10.2196/39808] [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: 05/24/2022] [Revised: 03/02/2023] [Accepted: 03/30/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Providing people with understandable and actionable health information can considerably promote healthy behaviors and outcomes. To this end, some valid and reliable scales assessing the patient-friendliness of health education materials, like the PEMAT-P (Patient Education Materials Assessment Tool for printable materials), have been well developed in English-speaking countries. However, the English version of the PEMAT-P has not been translated and adapted into simplified Chinese and validated in mainland China. OBJECTIVE This study sought to translate the PEMAT-P tool into a simplified Chinese (Mandarin) version (C-PEMAT-P, a Chinese version of the Patient Education Materials Assessment Tool for printable materials) and verify its validity and reliability for assessing the comprehensibility and actionability of health education resources written in simplified Chinese. As a result, the validated C-PEMAT-P could be used to guide health researchers and educators to design more comprehensible and actionable materials for more tailored and targeted health education and interventions. METHODS We translated the PEMAT-P into simplified Chinese in the following three steps: (1) forward-translating the PEMAT-P into simplified Chinese, (2) back-translating the simplified Chinese version into English, and (3) testing translation equivalence linguistically and culturally by examining the original English version of the PEMAT-P and the back-translated English version of the tool. Any discrepancies between the original English tool and the back-translated English tool were resolved through a panel discussion among the research team of all authors to produce a revised forward-translated Chinese version (C-PEMAT-P). We then evaluated the clarity of construction and wording as well as the content relevance of the C-PEMAT-P using a 4-point ordinal scale to determine its content validity. After that, 2 native Chinese speakers (health educators) used the C-PEMAT-P to rate 15 health education handouts concerning air pollution and health to validate their reliability. We calculated the Cohen coefficient and Cronbach α to determine the interrater agreement and internal consistency of the C-PEMAT-P, respectively. RESULTS We finalized the translated Chinese tool after discussing the differences between the 2 English versions (original and back-translated) of the PEMAT-P, producing the final Chinese version of the PEMAT-P (C-PEMAT-P). The content validity index of the C-PEMAT-P version was 0.969, the Cohen coefficient for the interrater scoring agreement was 0.928, and the Cronbach α for internal consistency was .897. These values indicated the high validity and reliability of the C-PEMAT-P. CONCLUSIONS The C-PEMAT-P has been proven valid and reliable. It is the first Chinese scale for assessing the comprehensibility and actionability of Chinese health education materials. It can be used as an assessment tool to evaluate health education materials currently available and a guide to help health researchers and educators design more comprehensible and actionable materials for more tailored and targeted health education and interventions.
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Affiliation(s)
- Yi Shan
- School of Foreign Studies, Nantong University, Nantong, China
| | - Meng Ji
- School of Languages and Cultures, The University of Sydney, Sydney, Australia
| | - Zhaogang Dong
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Ji'nan, China
| | - Zhaoquan Xing
- Department of Urology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Ding Wang
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Ji'nan, China
| | - Xiangting Cao
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Ji'nan, China
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Zakeri MA, Tavan A, Nadimi AE, Bazmandegan G, Zakeri M, Sedri N. Relationship Between Health Literacy, Quality of Life, and Treatment Adherence in Patients with Acute Coronary Syndrome. Health Lit Res Pract 2023; 7:e71-e79. [PMID: 37053051 PMCID: PMC10104679 DOI: 10.3928/24748307-20230320-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes. OBJECTIVE This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome. METHODS This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis. RESULTS Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = -0.167, p < .01), and quality of life (r = -0.153, p < .01), and a positive association between treatment adherence and quality of life (r = 0.169, p < .01). CONCLUSION The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [HLRP: Health Literacy Research and Practice. 2023;7(2):e71-e79.].
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Affiliation(s)
| | | | | | | | | | - Nadia Sedri
- Address correspondence to Nadia Sedri, MSc, Nursing Research Center, Kerman University of Medical Sciences, Hapht Bagh St. 7616913555, Kerman, Iran;
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Elbashir M, ElHajj MS, Rainkie D, Kheir N, Hamou F, Abdulrhim S, Mahfouz A, Alyafei S, Awaisu A. Evaluation of Health Literacy Levels and Associated Factors Among Patients with Acute Coronary Syndrome and Heart Failure in Qatar. Patient Prefer Adherence 2023; 17:89-105. [PMID: 36642998 PMCID: PMC9835006 DOI: 10.2147/ppa.s385246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/17/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To determine the prevalence of inadequate health literacy and its associated risk factors among patients with acute coronary syndrome (ACS) and/or heart failure (HF) in Qatar. PATIENTS AND METHODS This cross-sectional observational study was conducted among patients with ACS and/or HF attending the national Heart Hospital in Qatar. Health literacy was assessed using the abbreviated version of the Test of Functional Health Literacy in Adults (S-TOFHLA) and the Three-item Brief Health Literacy Screen (3-item BHLS). RESULTS Three hundred patients with ACS and/or HF, majority male (88%) and non-Qatari (94%), participated in the study. The median (IQR) age of the participants was 55 (11) years. The prevalence of inadequate to marginal health literacy ranged between 36% and 54%. There were statistically significant differences in health literacy level between patients based on their marital status (p=0.010), education (p≤0.001), ability to speak any of Arabic, English, Hindi, Urdu, Malayalam, or other languages (p-values ≤0.001 to 0.035), country of origin (p≤0.001), occupation (p≤0.001), and receiving information from a pharmacist (p=0.008), a physiotherapist (p≤0.001), or a nurse (p=0.004). CONCLUSION Inadequate health literacy is common among patients with ACS and/or HF. This study suggests a need for developing strategies to assist healthcare professionals in improving health literacy skills among patients with ACS and HF. A combination of interventions may be needed to improve patients' understanding of their disease and medications, and ultimately overall health outcomes.
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Affiliation(s)
- Marwa Elbashir
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Pharmacy Department, Airport Health Center, Primary Health Care Corporation, Doha, Qatar
| | - Maguy Saffouh ElHajj
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Daniel Rainkie
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Nadir Kheir
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Fatima Hamou
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sara Abdulrhim
- Pharmacy Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Ahmed Mahfouz
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Sumaya Alyafei
- Pharmacy Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Correspondence: Ahmed Awaisu, Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar, Tel +974 4403 5596, Fax +974 4403 5551, Email
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Furukawa E, Okuhara T, Okada H, Shirabe R, Yokota R, Iye R, Kiuchi T. Translation, Cross-Cultural Adaptation, and Validation of the Japanese Version of the Patient Education Materials Assessment Tool (PEMAT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15763. [PMID: 36497836 PMCID: PMC9739219 DOI: 10.3390/ijerph192315763] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/14/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The Patient Education Materials Assessment Tool (PEMAT) systematically evaluates the understandability and actionability of patient education materials. This study aimed to develop a Japanese version of PEMAT and verify its reliability and validity. METHODS After assessing content validation, experts scored healthcare-related leaflets and videos according to PEMAT to verify inter-rater reliability. In validation testing with laypeople, the high-scoring material group (n = 800) was presented with materials that received high ratings on PEMAT, and the low-scoring material group (n = 799) with materials that received low ratings. Both groups responded to the understandability and actionability of the materials and perceived self-efficacy for the recommended actions. RESULTS The Japanese version of PEMAT showed strong inter-rater reliability (PEMAT-P: % agreement = 87.3, Gwet's AC1 = 0.83. PEMAT-A/V: % agreement = 85.7, Gwet's AC1 = 0.80). The high-scoring material group had significantly higher scores for understandability and actionability than the low-scoring material group (PEMAT-P: understandability 6.53 vs. 5.96, p < 0.001; actionability 6.04 vs. 5.49, p < 0.001; PEMAT-A/V: understandability 7.65 vs. 6.76, p < 0.001; actionability 7.40 vs. 6.36, p < 0.001). Perceived self-efficacy increased more in the high-scoring material group than in the low-scoring material group. CONCLUSIONS Our study showed that materials rated highly on Japanese version of PEMAT were also easy for laypeople to understand and action.
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Affiliation(s)
- Emi Furukawa
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan
| | - Ritsuko Shirabe
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Rie Yokota
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Reina Iye
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan
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Hung CT, Chen YH, Hung TL, Chiang CP, Chen CY, Wang WM. Clinician-created educational video for shared decision-making in the outpatient management of acne. PLoS One 2022; 17:e0271100. [PMID: 35802643 PMCID: PMC9269380 DOI: 10.1371/journal.pone.0271100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
Shared decision-making (SDM) provides patient-centered care. However, the limited consultation time was the main factor hindering the application. Patient education is crucial in the process of SDM. The use of visual aids as health education materials is an effective way to improve patients’ health literacy and medication adherence. This study aimed to determine the effectiveness of the clinician-created educational video of acne, accessed by patients during the waiting time, including knowledge level and satisfaction. This study was conducted in dermatology outpatient clinics and collected patient responses through electronic devices. During the waiting time, patients with acne would read educational pamphlets and complete the test first. Then, a clinician-created 8-minute educational video, as a patient decision aid (PDA), was accessed by patients using their own mobile smart devices, followed by a test and questionnaire about the satisfaction of the pamphlet and video. We enrolled 50 patients with acne, including 33 males and 17 females. The mean age is 25.55 ± 6.27 years old, ranging from 15 to 47 years old. About the patients’ knowledge, the test score improved significantly after watching the video (P < .001). The same findings were observed in the subgroup analysis of gender and different age groups. A higher proportion of patients preferred the educational video over the pamphlet in both genders and different age groups. All patients agreed with the video helped them to understand the educational information and impressed them more than reading pamphlets. The application of clinician-created educational videos in patient education seems to be an efficient solution to implement SDM in the daily clinical work. Besides, we could remind patients to watch the video anytime when they were not sure about the treatment choices, side effects, or the precautions of medications.
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Affiliation(s)
- Chih-Tsung Hung
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of General Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Yi-Hsien Chen
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of General Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Tzu-Ling Hung
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Ping Chiang
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Yu Chen
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Ming Wang
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Vice Chairman, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Gill AS, Biggs PC, Hagwood G, Beliveau AM, Shahlaie K, Strong EB, Steele TO. Health Literacy and Web-Based Audiovisual Multimedia in Pituitary and Endoscopic Skull Base Surgery. Skull Base Surg 2022; 83:e401-e409. [DOI: 10.1055/s-0041-1729979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
Abstract
Introduction The internet presents a rich milieu of multimedia options relating to pituitary and endoscopic skull base surgery (ESBS). Misinformation can create discordance between patient and provider expectations. The purpose of this study is to analyze the understandability and actionability of available ESBS and pituitary surgery audiovisual information on YouTube and Google.
Methods The top 50 videos generated by searching “pituitary surgery/transsphenoidal surgery” and “endoscopic skull base surgery” in both YouTube and Google were sorted by relevance. Two independent reviewers evaluated each for understandability and actionability based on the Patient Education Materials Assessment Tool for audiovisual material (PEMAT-A/V). Source, authorship, audience, and education/advertisement variables were collected. Chi-square test followed by univariate and multivariate regression analyses assessed the association between these variables and quality.
Results A total of 85 videos (52 YouTube and 33 Google) met inclusion criteria for analysis. There was no significant difference in the presence of the aforementioned variables between YouTube and Google (p < 0.05). Also, 72% of videos targeted patients and 28% targeted surgeons. Academic institutions uploaded 58% of videos. Surgeon-targeted videos were more educational (p = 0.01) and patient-targeted videos involved more advertisement (p = 0.01). Understandability and actionability scores were below the 70% threshold for both YouTube (65 ± 15, 38 ± 33, p = 0.65) and Google (66 ± 12, 38 ± 26, p = 0.94). Patient-targeted videos (p = 0.002) were more understandable, while surgeon- (p < 0.001) and education-focused videos (p < 0.001) were more actionable.
Conclusion Understandability and actionability of YouTube and Google audiovisual patient information on ESBS and pituitary surgery is poor. Consideration should be given to the formation of a standardized patient information resource.
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Affiliation(s)
- Amarbir S. Gill
- Department of Otolaryngology—Head and Neck Surgery, University of California Davis, Sacramento, California, United States
| | - Philip C. Biggs
- Department of Otolaryngology—Head and Neck Surgery, University of California Davis, Sacramento, California, United States
| | - Garrett Hagwood
- Department of Otolaryngology—Head and Neck Surgery, University of California Davis, Sacramento, California, United States
| | - Angela M. Beliveau
- Department of Otolaryngology—Head and Neck Surgery, University of California Davis, Sacramento, California, United States
| | - Kiarash Shahlaie
- Department of Neurological Surgery, University of California Davis, Sacramento, California, United States
| | - E. B. Strong
- Department of Otolaryngology—Head and Neck Surgery, University of California Davis, Sacramento, California, United States
| | - Toby O. Steele
- Department of Otolaryngology—Head and Neck Surgery, University of California Davis, Sacramento, California, United States
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Dowdle TS, Nguyen JM, Steadman JN, Layher H, Sturgeon ALE, Akin R. Online Readability Analysis: Mohs Micrographic Surgery Postsurgical Wound Care. Adv Skin Wound Care 2022; 35:213-218. [PMID: 35026774 DOI: 10.1097/01.asw.0000816960.79821.e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although various treatment modalities exist for skin cancer care, Mohs micrographic surgery (MMS) is one of the most effective and cosmetically sensitive surgical techniques. The readability of online informational materials specifically related to MMS postsurgical wound care is extremely relevant for patients given the high rates of skin cancer in the US and the number of patients utilizing the internet for information. METHODS Investigators conducted Google searches to evaluate the current state of readability on MMS postsurgical wound care using the specific keywords "healing after Mohs surgery" and "wound care Mohs surgery." The readabilities of individual websites were analyzed using the WebFX online software. Health-specific click-through rate was used to select the number of samples assessed. RESULTS Based on the 33 unique websites evaluated, the aggregate readability of online MMS postsurgical wound care materials was 11.3, corresponding to an 11th-grade reading level by US standards. CONCLUSIONS Although this level of readability is an improvement in online MMS postsurgical wound care information relative to prior literature, there is still considerable work to be done by the dermatologic community in improving the readability of online patient materials regarding MMS.
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Affiliation(s)
- Travis S Dowdle
- Travis S. Dowdle, BS, is Medical Student, Texas Tech University Health Sciences Center, School of Medicine, Lubbock, Texas, United States. Jeannie M. Nguyen, MD, is Dermatology Resident, Texas Tech University Health Sciences Center. Jesse N. Steadman, BS, is Medical Student, University of Utah, School of Medicine, Salt Lake City. At the Texas Tech University Health Sciences Center, Heather Layher, DO, is Mohs Fellow; Ashley L. E. Sturgeon, MD, is Mohs Fellow and Professor; and Russell Akin, MD, is Mohs Fellow and Professor
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Fang KM, Lau GC, Park JY, Tchen P. Exploring Factors That Influence Student Engagement in Community-Engaged Learning Activities Within a Pharmacy Context. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8637. [PMID: 34400398 PMCID: PMC10159408 DOI: 10.5688/ajpe8637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/02/2021] [Indexed: 05/06/2023]
Abstract
Objective. To investigate and identify factors that enhance and restrict Doctor of Pharmacy student engagement in mandatory and voluntary community-engaged learning activities.Methods. A phenomenological study exploring the motivations and barriers faced by pharmacy students in a mandatory community-engaged learning course and voluntary community-engaged learning activities (eg, community outreach) was conducted using semi-structured interviews. Fifteen students were randomly selected to participate in the interviews. Student responses were analyzed using qualitative thematic analysis.Results. Primary factors motivating student engagement in mandatory community-engaged learning included having structured learning activities for students and incorporating reflective learning. Motivating factors for students participating in voluntary community-engaged learning included personal interest in the topic, convenient location and time of activity, opportunity for career development, and the chance to advocate for the pharmacy profession. Overlapping motivations for both mandatory and voluntary community-engaged learning included developing a better understanding of and broader perspective on the diverse populations in the community and having a positive impact. Common barriers identified included having limited information about student responsibilities, being given a limited student role, and feeling unconfident or unprepared.Conclusion. Students perceived benefits from both mandatory and voluntary participation in community-engaged learning activities. However, opportunities exist for identifying and managing barriers to enhancing student engagement in community-engaged learning within a pharmacy program. Additionally, learning tools such as critical reflection can be used to further enhance student engagement with community-engaged learning activities.
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Affiliation(s)
- Kayla M Fang
- The University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada
| | - Gilly C Lau
- The University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada
| | - Jamie Y Park
- The University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada
| | - Paulo Tchen
- The University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada
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Nizet P, Touchefeu Y, Pecout S, Cauchin E, Beaudouin E, Mayol S, Fronteau C, Huon JF. Exploring the factors influencing adherence to oral anticancer drugs in patients with digestive cancer: a qualitative study. Support Care Cancer 2022; 30:2591-2604. [PMID: 34812952 PMCID: PMC8794904 DOI: 10.1007/s00520-021-06663-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to explore the beliefs, perceptions and representations of patients in order to identify the determinants of oral anticancer drugs adherence and to take action in current practice to improve patient support in digestive oncology. METHODS We constructed a semi-directed interview guide which aimed to explore the patient's relationship with medication, their health history, their experiences at the time of the announcement of treatment, their confidence, their fears, their motivations to adhere to their treatment and the constraints linked to their treatment. The data were analysed and discussed using a thematic approach. RESULTS Seventeen patients agreed to participate in the study. The median age was 60 years. Ten patients had colorectal cancer, 3 patients had hepatocellular carcinoma, 3 patients had gastrointestinal stromal tumour and 1 patient had neuroendocrine pancreatic tumour. We identified five categories of factors influencing adherence: demographic and socioeconomic, disease-related, treatment-related, care system-related, and patient representation and pathways' factors. A majority of patients emphasised the importance of family support in the adherence process and the convenience of per os treatment compared to other intravenous treatments. However, several negative determinants emerged such as the toxicity of the treatment, fears of forgetting to take the medication, difficulties with the galenic formulation and negative beliefs of the family. CONCLUSION This study demonstrates the need to address the different dimensions of the patient in order to understand his or her behaviour with regard to adherence and to identify the levers for improvement.
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Affiliation(s)
- Pierre Nizet
- Clinical Pharmacy Unit, Nantes University Hospital, 1 Rue Gaston Veil, 44000, Nantes, France.
| | - Yann Touchefeu
- Digestive Oncology, Institut Des Maladies De L'Appareil Digestif, Nantes University Hospital, Nantes, France
| | - Solange Pecout
- Digestive Oncology, Institut Des Maladies De L'Appareil Digestif, Nantes University Hospital, Nantes, France
| | - Estelle Cauchin
- Digestive Oncology, Institut Des Maladies De L'Appareil Digestif, Nantes University Hospital, Nantes, France
| | - Eva Beaudouin
- INSERM, UMR 1246-SPHERE, MethodS in Patients-Centered Outcomes and HEalth ResEarch, Nantes and Tours, France
| | - Séverine Mayol
- Research Department, Nantes University Hospital, Nantes, France
| | - Clémentine Fronteau
- Clinical Pharmacy Unit, Nantes University Hospital, 1 Rue Gaston Veil, 44000, Nantes, France
| | - Jean-François Huon
- Clinical Pharmacy Unit, Nantes University Hospital, 1 Rue Gaston Veil, 44000, Nantes, France
- INSERM, UMR 1246-SPHERE, MethodS in Patients-Centered Outcomes and HEalth ResEarch, Nantes and Tours, France
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Griffeth E, Sharif I, Caldwell A, Townsend Cooper M, Tyrrell H, Dunlap M. Health Literacy Perceptions and Knowledge in Pediatric Continuity Practices. Health Lit Res Pract 2022; 6:e51-e60. [PMID: 35263233 PMCID: PMC8919674 DOI: 10.3928/24748307-20220208-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Low health literacy affects one-third of adults in the United States and can have a negative effect on health behavior and outcomes. Objective: The goal of this study was to examine attitudes and knowledge of health literacy among pediatric residents and faculty in pediatric resident continuity clinics across the country. Methods: An online mixed-methods survey was distributed to pediatric faculty and residents through the Academic Pediatric Association's Continuity Research Network. The 20-question survey included questions about the participants' health literacy knowledge and health literacy practices in continuity clinics, such as use of universal health literacy precautions. Categorical answer choices were dichotomized into positive and negative groupings and resident and faculty responses were compared using the Chi-squared test (significance p < .05). Qualitative data were analyzed using emergent coding and grounded theory to determine themes. Key Results: Responses were received from 402 individuals at 24 pediatric residency programs. Most participants agreed or strongly agreed that they could correctly identify participants with low health literacy (76% residents vs. 53% faculty). Only 19% of residents and 26% of faculty were familiar with universal health literacy precautions. Many residents and faculty had received no training in health literacy (37% residents vs. 38% faculty). Barriers and challenges around health literacy included time, language, limited training or resources, low literacy, disease mismanagement, and fixed misconceptions. Conclusion: Despite ample evidence in the literature to the contrary, most respondents believed they could correctly identify individuals with low health literacy. Additionally, most participants had not heard of universal health literacy precautions and were unaware of their usage in their practice setting. This is not consistent with current expert recommendations. These findings are troubling as they are from academic residency programs, indicating an educational deficit. These findings point toward a next step in health literacy education for pediatric residents. [HLRP: Health Literacy Research and Practice. 2022;6(1):e51–e60.] Plain Language Summary: Pediatric residents and faculty in continuity clinics were surveyed about their opinions, health literacy knowledge, ability, and practices in continuity clinics. Despite evidence to the contrary, most respondents believed they could correctly identify individuals with low health literacy and had not heard of universal health literacy precautions. These findings highlight the need for more health literacy education for pediatric residents.
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Affiliation(s)
| | | | | | | | | | - Marny Dunlap
- Address correspondence to Marny Dunlap, MD, University of Oklahoma Health Sciences Center, 1200 Children's Avenue, Suite 12400, Oklahoma City, OK 73104;
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Asharani PV, Lau JH, Roystonn K, Devi F, Peizhi W, Shafie S, Chang S, Jeyagurunathan A, Yiang CB, Abdin E, Vaingankar JA, Sum CF, Lee ES, Dam RV, Chong SA, Subramaniam M. Health Literacy and Diabetes Knowledge: A Nationwide Survey in a Multi-Ethnic Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9316. [PMID: 34501905 PMCID: PMC8431510 DOI: 10.3390/ijerph18179316] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Health literacy is a key determinant of the public health and health climate of the nation. This study examined the functional health literacy of the nation, factors associated with health literacy, and its relationship with diabetes recognition. This cross-sectional survey recruited participants (N = 2895) who were 18 years and above from a population registry through disproportionate stratified sampling. The Brief Health Literacy Screen and other questionnaires were administered through face-to-face interviews, in one of the four national languages (English, Chinese, Malay or Tamil). The majority (80.5%) had adequate functional health literacy and were able to recognise symptoms of diabetes correctly (83.5% overall; 83.7% and 82.2% in those with adequate and inadequate health literacy, respectively). Those with inadequate health literacy had a higher incidence of chronic conditions (p < 0.001) compared to those with adequate health literacy in bivariate analysis. The majority of the sample had sufficient levels of physical activity (83.3%), and more than half reported an unhealthy lifestyle (57.4%). Older age, Chinese ethnicity, those who were employed, with lower education (secondary or below), and were married had significantly higher odds of inadequate health literacy. Health literacy was not associated with lifestyle, physical activity, chronic conditions and diabetes recognition. Health literacy interventions should focus on the disadvantaged social groups for improving their health literacy.
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Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Wang Peizhi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chua Boon Yiang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Janhavi Ajit Vaingankar
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore 730676, Singapore;
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics 3 Fusionopolis Link, Singapore 138543, Singapore;
| | - Rob Van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (K.R.); (F.D.); (W.P.); (S.S.); (S.C.); (A.J.); (C.B.Y.); (E.A.); (J.A.V.); (S.A.C.); (M.S.)
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore;
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Mbanda N, Dada S, Bastable K, Ingalill GB, Ralf W S. A scoping review of the use of visual aids in health education materials for persons with low-literacy levels. PATIENT EDUCATION AND COUNSELING 2021; 104:998-1017. [PMID: 33339657 DOI: 10.1016/j.pec.2020.11.034] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/14/2020] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To conduct a scoping review on the literature on visual aids in health education for persons with low-literacy. METHODS A scoping review methodology was employed. Pre-defined selection criteria identified 47 studies for inclusion. Data were extracted in relation to: (a) definitions of low-literacy and health literacy, (b) population studied, (c) research country, (d) consent procedures, (e) visual aids used, (f) development of visual aids, and (g) targeted outcomes. RESULTS Visual aids developed with persons with low-literacy demonstrated statistically significant improvements in health literacy outcomes, with benefits in medication adherence and comprehension also reported. Pictograms and videos were the most effective visual aids. Only one study adapted consent procedures for low-literacy participants. DISCUSSION Visual aids in health education materials may benefit persons with low-literacy levels, but large gaps in the research base are evident. Experimental research in low- and middle-income countries, with a particular focus on consent for participants with low-literacy is needed. PRACTICE IMPLICATIONS Visual aid design needs to include stakeholders. Consent procedures and decision-making need to be specifically adapted for participants with low-literacy.
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Affiliation(s)
- Njabulo Mbanda
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa.
| | - Kirsty Bastable
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | | | - Schlosser Ralf W
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa; Department of Communication Sciences and Disorders, Northeastern University, USA
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15
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Bird ML, Elmer S, Osborne RH, Flittner A, O'Brien J. Training physiotherapists to be responsive to their clients' health literacy needs. Physiother Theory Pract 2020; 38:1398-1406. [PMID: 33225778 DOI: 10.1080/09593985.2020.1850956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To evaluate health literacy learning modules designed specifically for physiotherapists in private practice.Methods: Mixed-method design was used, evaluating pre-post physiotherapist health literacy knowledge and competencies using questionnaires and semi-structured interviews. One rural and one metropolitan private physiotherapy practice were recruited.Participants: Clients, physiotherapists, and other clinic staff. The OPHELIA (Optimizing Health Literacy and Access) process was applied to identify the health literacy needs of clients; co-design interventions; and implement and evaluate the interventions. The health literacy learning modules were co-designed with the physiotherapists and included one 3-h face-to-face workshop, followed by two 1-h videoconference workshops. Health literacy knowledge (rated 1-5 for 10 items, max score 50) and skills (rated 1-5 for 5 items, max score 25) were assessed before and after the workshops. Data were analyzed by paired t-test. Interviews were recorded, transcribed, and thematically analyzed.Results: Health literacy knowledge of 19 health professionals improved after the workshop by 63% (pre 26.0 (7.5), post 41.0 (2.7), p < .001). Health literacy skills improved by 65% (pre 4.2 (3.3), post 21.8 (2.3), p < .001). We identified three themes from interview data: 1) 'the multi-faceted nature of health literacy requires multiple strategies'; 2) 'changing practice to promote understanding'; and 3) 'reflection on roles of multidisciplinary private practice.'Practice Implications: Improvements in health literacy knowledge and skills are possible through post-graduate professional development.Conclusion: Workshops changed physiotherapists' understanding of their role in promoting health literacy.
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Affiliation(s)
- Marie-Louise Bird
- College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Shandell Elmer
- Faculty of Health, Arts and Design, Swinburne University, Melbourne, Australia
| | - Richard H Osborne
- Faculty of Health, Arts and Design, Swinburne University, Melbourne, Australia
| | - Anna Flittner
- College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Jane O'Brien
- College of Health and Medicine, University of Tasmania, Launceston, Australia
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Salama A, Panoch J, Bandali E, Carroll A, Wiehe S, Downs S, Cain MP, Frankel R, Chan KH. Consulting "Dr. YouTube": an objective evaluation of hypospadias videos on a popular video-sharing website. J Pediatr Urol 2020; 16:70.e1-70.e9. [PMID: 31928900 PMCID: PMC7186156 DOI: 10.1016/j.jpurol.2019.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Parents who make decisions about hypospadias repair for their child may seek information from online platforms such as YouTube. OBJECTIVE The purpose of this study is to evaluate the health literacy demand of hypospadias videos on YouTube using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). STUDY DESIGN We performed a YouTube search using the term "hypospadias," limiting results to the first 100 videos. We excluded videos that were <1 min or >20 min and videos that were not in English or did not include subtitles. Two evaluators independently examined videos and determined PEMAT-A/V scores for understandability and actionability (i.e., ability to identify actions the viewer can take). Videos with scores >70% are understandable or actionable. The inter-rater reliability (kappa) and intraclass correlation coefficient (ICC) of PEMAT scores were calculated. Bivariate and multivariable linear regression models assessed the association of video characteristics with respective scores. RESULTS Of the 100 videos that were identified on YouTube, 47 (47%) were excluded leaving 53 for analysis: 14 were >20 min, 14 were <1 min, 9 had no audio or subtitles, 7 were not in English, 1 was a duplicate, 1 was unrelated to hypospadias, and 1 was deleted at the time of data analysis. Three (5.6%) were understandable (mean score 54.5%, standard deviation (SD) 14.9) and eight (15.1%) were actionable (mean score 21.8%, SD 16.6) (Extended Summary Figure). Kappa values ranged from 0.4 to 1. The ICC's were 0.55 and 0.33 for understandability and actionability, respectively. In the bivariate analysis, mean understandability scores were significantly higher for English language videos (p = 0.04), videos with animation (p = 0.002), and those produced by industry (p = 0.02). In the multivariable analysis, mean understandability scores were significantly higher for "expert testimonial" or "other" video types after adjusting for graphics type and overall tone (p = 0.04). Mean understandability scores were also significantly higher for videos with animation after adjusting for video type and overall tone (p = 0.01). Mean actionability scores were significantly higher for videos with a negative tone (p = 0.01). DISCUSSION The vast majority of hypospadias-related YouTube content is not appropriate for users with low health literacy although certain types of videos, such those with animation and expert testimonials, scored higher on understandability than other types. CONCLUSION Due to the lack of sufficient online informational content regarding hypospadias, we plan to engage parents of sons with hypospadias in the development of high-quality patient educational materials about hypospadias.
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Affiliation(s)
- Amr Salama
- Department of Urology, Indiana University School of Medicine, USA
| | - Janet Panoch
- Department of Urology, Indiana University School of Medicine, USA
| | - Elhaam Bandali
- Department of Urology, Indiana University School of Medicine, USA
| | - Aaron Carroll
- Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, USA
| | - Sarah Wiehe
- Department of Pediatrics, Children's Health Services Research Center, USA
| | - Stephen Downs
- Department of Pediatrics, Children's Health Services Research Center, USA
| | - Mark P Cain
- Department of Urology, Indiana University School of Medicine, USA
| | - Richard Frankel
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Cleveland Clinic Learner Institute, Cleveland, OH, USA
| | - Katherine H Chan
- Department of Urology, Indiana University School of Medicine, USA; Department of Pediatrics, Center for Pediatric and Adolescent Comparative Effectiveness Research, USA.
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Higashi RT, Juengst SB. Patient-Centered Measure Development and Spanish Validation Exemplar. Health Lit Res Pract 2019; 3:e243-e249. [PMID: 31768495 PMCID: PMC6831507 DOI: 10.3928/24748307-20190925-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/20/2019] [Indexed: 11/20/2022] Open
Abstract
Traumatic brain injury (TBI) often results in cognitive impairments that require investigators to consider language accessibility of survey instruments, clinical evaluations, and other research tools. We describe an iterative language validation process for the Behavioral Assessment Screening Tool (BAST) and BAST Spanish version (BAST-ESP), consisting of two phases: (1) achieving an accessible literacy level for English-speaking people with TBI and (2) translating, validating, and cognitively testing the BAST-ESP for Spanish-speaking people with TBI. Investigators recruited scientific experts and members of the target populations to adapt and test the surveys. Modifications to original survey instruments included simplified semantic structures, enhanced conceptual clarity, rephrased idiomatic expressions, and rewording to bridge cultural differences in linguistic connotation. Findings from participants in focus groups and cognitive interviews confirmed accuracy and ease of comprehension and informed further adjustments and content relevant to the specific target populations. We demonstrate the importance of a systematic adaptation and validation process to develop a lower-literacy instrument appropriate for people with cognitive deficits and to enhance the BAST-ESP beyond translation alone. This article, along with a previously published article about BAST content validity process, provides a road map for other investigators to conduct systematic adaptation of scientific instruments for low-literacy and non-English-speaking populations. [HLRP: Health Literacy Research and Practice. 2019;3(4):e243-e249.].
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Affiliation(s)
| | - Shannon B. Juengst
- Address correspondence to Shannon B. Juengst, PhD, CRC, Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9055;
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Xie J, Hu Y, Lu C, Fu Q, Carbone JT, Wang L, Deng L. What Are the Risk Factors of Negative Patient Experience? A Cross-Sectional Study in Chinese Public Hospitals. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2019; 56:46958019847865. [PMID: 31081434 PMCID: PMC6537228 DOI: 10.1177/0046958019847865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/03/2019] [Accepted: 04/10/2019] [Indexed: 12/30/2022]
Abstract
Hospitals are struggling to involve patients and learn from their experience. The risk factor of patient experience is increasingly recognized as a critical component in improving patient experience. Our study explored risk factors of negative patient experience in order to improve the health-service quality of public hospitals. We conducted a cross-sectional study in Hubei province, China. A total of 583 respondents were surveyed by the Outpatient Experience Questionnaire with good validity and reliability in July 2015. T-tests were conducted to compare the experience scores among different outpatient groups. Multiple linear regression was performed to determine the significant factors that influenced the outpatient experience. Outpatients between 18 and 44 years old had the lowest experience scores (65.89 ± 0.79), whereas outpatients completely paying out-of-pocket had the lowest experience scores (64.68 ± 0.81) among all participants. Outpatients with poor self-rated health status had the lowest experience scores (66.14 ± 1.61) among different self-rated health status groups. While age, type of payment, and self-rated health status were significantly risk factors that influenced outpatient experience in the multiple linear regression. Thus, health-care providers should pay more attention to outpatients who are young (age <45), completely out-of-pocket and poor health status, and provide precision health care to improve outpatient experience.
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Affiliation(s)
- Jinzhu Xie
- School of Medicine and Health
Management, Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, P.R. China
| | - Yinhuan Hu
- School of Medicine and Health
Management, Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, P.R. China
| | - Chuntao Lu
- School of Medicine and Health
Management, Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, P.R. China
| | - Qiang Fu
- Department of Epidemiology and
Biostatistics, College for Public Health and Social Justice, Saint Louis University,
MO, USA
| | - Jason T. Carbone
- School of Social Work, College for
Public Health and Social Justice, Saint Louis University, MO, USA
| | - Liuming Wang
- Tongji Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Lu Deng
- School of Medicine and Health
Management, Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, P.R. China
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Cabellos-García AC, Martínez-Sabater A, Castro-Sánchez E, Kangasniemi M, Juárez-Vela R, Gea-Caballero V. Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review. BMC Public Health 2018; 18:1157. [PMID: 30286744 PMCID: PMC6172776 DOI: 10.1186/s12889-018-6070-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 09/25/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Oral anticoagulants (OAC) are widely used in patients with cardiovascular diseases. However, for optimal OAC self-care patients must have skills, among which health literacy (HL) is highlighted. We aimed to describe the relation between HL and self-care in cardiovascular patients on OAC treatment. METHODS Electronic searches were carried out in the PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, SciELO, IME-Biomedicina, CUIDEN Plus and LILACS databases, limited to Spanish and English language and between January 2000-December 2016. Papers reported on adults older than 18 years, taking OAC by themselves for at least three months. PRISMA guidelines were used for paper selection. RESULTS We identified 142 articles and finally included 10; almost all of them about warfarin. Our results suggest that in patients taking OAC treatments there is a positive relationship between HL and the level of knowledge. In addition, a small percentage of participants on the selected papers recognized the side effects and complications associated with OAC treatment. Lower HL level was associated with greater knowledge deficits and less adherence to treatment. CONCLUSION There is a paucity of research evaluating the effect of HL on diverse aspects of OAC treatments. There is a need to expand the evidence base regarding appropriate HL screening tools, determinants of adequate knowledge and optimal behaviours related to OAC self-management.
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Affiliation(s)
| | | | - Enrique Castro-Sánchez
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Du Cane Road, W12 0NN, London, UK
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Raul Juárez-Vela
- Universidad San Jorge de Zaragoza, Villanueva de Gállego, Zaragoza, Spain
| | - Vicente Gea-Caballero
- Escuela de Enfermería La Fe, centro adscrito Universidad de Valencia, Valencia, Spain
- Instituto de Investigación La Fe. Grupo de investigación GREIACC, Valencia, Spain
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Roh YH, Noh JH, Gong HS, Baek GH. Comparative adherence to weekly oral and quarterly intravenous bisphosphonates among patients with limited heath literacy who sustained distal radius fractures. J Bone Miner Metab 2018; 36:589-595. [PMID: 28983705 DOI: 10.1007/s00774-017-0867-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/27/2017] [Indexed: 10/18/2022]
Abstract
Individuals with limited health literacy (HL) are less likely to obtain preventive care. We designed a study to compare adherence to weekly oral and quarterly intravenous bisphosphonates among patients with low HL. The study enrolled a total of 432 female patients who presented with a distal radius fracture caused by low-energy trauma. Participant HL was measured using the Newest Vital Sign tool, and patients were randomized to weekly oral or quarterly intravenous bisphosphonate groups. Subjects in the intravenous bisphosphonate group received intravenous injections of 3 mg ibandronate every 3 months, and those in the oral bisphosphonate group self-administered 70 mg alendronate orally once each week for 12 months. The adherence to weekly oral or quarterly intravenous bisphosphonates was analyzed by HL level. The rate of adherence to quarterly intravenous bisphosphonates was significantly higher than that for weekly oral bisphosphonates in patients with inadequate HL (73 vs. 46%, p = 0.001), whereas no significant differences were observed between HL groups in adherence to intravenous bisphosphonate. Conversely, the rate of adherence to orally administered bisphosphonates was significantly lower in patients with inadequate HL than in those with appropriate HL (46 vs. 65%, p = 0.005). After controlling for confounding variables, inadequate HL, the presence of comorbidities, and weekly oral bisphosphonates were associated with a higher likelihood of nonadherence to osteoporosis treatment. Thus patients with limited health literacy can achieve rates of adherence to quarterly intravenous bisphosphonates, as opposed to weekly oral bisphosphonates, similar to rates among patients with appropriate literacy.
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Affiliation(s)
- Young Hak Roh
- Department of Orthopaedic Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jung Ho Noh
- Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon, Gangwon-do, 200-722, Korea.
| | - Hyun Sik Gong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
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Du S, Zhou Y, Fu C, Wang Y, Du X, Xie R. Health literacy and health outcomes in hypertension: An integrative review. Int J Nurs Sci 2018; 5:301-309. [PMID: 31406840 PMCID: PMC6626246 DOI: 10.1016/j.ijnss.2018.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/14/2018] [Accepted: 06/08/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to summarize the evidence of health literacy and health outcomes in hypertensive patients. METHODS Articles published in English were searched from six databases: MEDLINE, CINAHL, Embase, ERIC, psycINFO, and SCOPUS. The articles published up to September 2017 were included. RESULTS Nineteen publications were included in the review. There was quality and consistent evidence that hypertensive patients with lower literacy had poorer knowledge. There was inconsistent evidence to show the relationship between health literacy and clinical outcomes, of systolic and diastolic blood pressure, and blood pressure control; behavioral outcomes, of self-care, self-efficacy, adherence; patient-physician interactions outcomes, of patient-physician communication, patient trust, involvement in decision making and other outcomes. CONCLUSION The person with low health literacy is likely to have poor knowledge of hypertension. However, there is insufficient evidence to suggest that health literacy is associated with outcomes of hypertension independently.
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Affiliation(s)
| | | | | | - Yan Wang
- School of Nursing, Hebei University, Hebei, China
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Abstract
PURPOSE/AIM The aim of this study was to investigate whether health literacy, self-efficacy, and medication adherence can explain or predict the variance in health outcomes (measured as perceived physical or mental health status [HS]) in persons with chronic heart failure (HF). DESIGN A nonexperimental cross-sectional survey study used data gathered from 175 patients with chronic HF from urban cardiology practices in the northeast United States. METHODS The Paasche-Orlow and Wolf Causal Pathways conceptual model and Bandura's self-efficacy theory were used to select and test variables in the study. A demographic questionnaire, the Short Test of Functional Health Literacy, the Self-Efficacy for Appropriate Medication Use Scale, the Morisky Medication Adherence Scale, and the Short Form-12 version 2 assessing perceived physical and mental HS were completed. Multiple hierarchical regression analyses were used to analyze relationships among the variables. RESULTS Significant associations between health literacy and self-efficacy and between health literacy and perceived mental HS were found (P < .05). High self-efficacy was the strongest predictor of physical HS (P < .01). The strongest predictor of mental HS was medication adherence (P < .01). CONCLUSIONS Support of self-efficacy and medication adherence may improve HS. Including health literacy strategies in clinical practice may support improvements in HS in people with chronic HF.
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Affiliation(s)
- June M Como
- Author Affiliation: Assistant Professor of Nursing, Graduate and Clinical Doctorate in Nursing Practice Programs Coordinator, and Fellow of the New York Academy of Medicine, College of Staten Island, City University of New York
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Roh YH, Koh YD, Noh JH, Gong HS, Baek GH. Effect of health literacy on adherence to osteoporosis treatment among patients with distal radius fracture. Arch Osteoporos 2017; 12:42. [PMID: 28421547 DOI: 10.1007/s11657-017-0337-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/10/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Patients with inadequate health literacy, those with medical comorbidities, or those with a previous history of adverse drug events have a higher likelihood of non-adherence to osteoporosis treatment after sustaining a distal radius fracture. INTRODUCTION Patients with a distal radial fracture (DRF) have a higher risk of subsequent fractures, which provides an important opportunity to begin treatment for osteoporosis. This study assessed the effect that health literacy of patients suffering from a DRF has on the subsequent adherence to osteoporosis treatment. METHODS A total of 116 patients (female, over 50 years of age) presenting a DRF caused by low-energy trauma were enrolled. Their health literacy was measured using the Newest Vital Sign (NVS). Alendronate (70 mg, orally, once weekly) was prescribed to all patients for 1 year, and adherence was defined as taking at least 80% of the tablets for 12 months and returning for the visit on month 12. Multivariable analyses were conducted to determine whether the patients' clinical, demographic, and health literacy factors influenced their adherence to osteoporosis treatment. RESULTS About half (52%) of the participants who sustained a DRF exhibited an inadequate health literacy, and the rate of non-adherence to osteoporosis treatment was 38%. The rate of non-adherence for patients with inadequate literacy was significantly higher than for those with appropriate literacy (47 vs. 29%, p = 0.04). The results of the regression analysis indicate that limited health literacy, the presence of comorbidities, and prior history of adverse drug events are associated with a higher likelihood of non-adherence to osteoporosis treatment after sustaining a DRF. CONCLUSIONS Patients with inadequate health literacy, adverse drug events, or medical comorbidities had higher rates of non-adherence with alendronate treatment after sustaining a DRF. Further research is needed to show whether improvements in patient comprehension via informational intervention in patients with a DRF will improve adherence to osteoporosis treatment.
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Affiliation(s)
- Young Hak Roh
- Department of Orthopaedic Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Young Do Koh
- Department of Orthopaedic Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Jung Ho Noh
- Department of Orthopaedic Surgery, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon-si, Gangwon-do, 200-722, South Korea.
| | - Hyun Sik Gong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea
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Rajah R, Ahmad Hassali MA, Jou LC, Murugiah MK. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies. Perspect Public Health 2017; 138:122-132. [PMID: 28980881 DOI: 10.1177/1757913917733775] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. METHODS CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. RESULTS A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. CONCLUSION Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.
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Affiliation(s)
- Retha Rajah
- Pharmacy Department, Hospital Seberang Jaya, Penang, Malaysia.,Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Mohamed Azmi Ahmad Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Lim Ching Jou
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Battersby M, Egger G, Litt J. Self-Management in Lifestyle Medicine. LIFESTYLE MEDICINE 2017. [DOI: 10.1016/b978-0-12-810401-9.00006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Downes JM, O'Neal KS, Miller MJ, Johnson JL, Gildon BL, Weisz MA. Identifying opportunities to improve medication management in transitions of care. Am J Health Syst Pharm 2016; 72:S58-69. [PMID: 26272894 DOI: 10.2146/ajhp150059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The types and causes of medication discrepancies during the transition from inpatient to ambulatory care were investigated. METHODS A descriptive study was conducted at an academic outpatient group practice affiliated with a private nonacademic hospital to (1) describe discrepancies between inpatient discharge summaries and patient-reported medication lists, (2) identify patient and system factors related to breakdowns in medication documentation, and (3) determine reasons for medication discrepancies. During a four-month period, 17 patients at high risk for medication misadventures while transitioning from hospital care to outpatient follow-up were contacted by telephone soon after discharge and asked to provide information on all medications they were taking. Patient-reported medication lists were compared with the corresponding discharge summaries, and medication discrepancies were categorized by patient- and system-level factors using a validated instrument. RESULTS Of the total of 96 discrepancies identified, more than two thirds (n = 67, 68%) involved the omission of a prescribed medication from either the patient-reported list or the discharge summary. Cardiovascular medications, including antihypertensives, antilipemics, diuretics, and antiarrhythmics, accounted for almost one quarter of all medication discrepancies. About 15% (n = 14) and 16% (n = 15) of identified discrepancies related to medication dose and frequency, respectively. CONCLUSION Among 17 patients transitioning from inpatient to outpatient care, nearly 100 discrepancies between patient-reported medication lists and discharge summaries were identified. Most discrepancies were attributed to nonintentional nonadherence and resumption of home medications without instructions to do so. All 17 patients had at least 1 medication discrepancy categorized as involving a system-level factor.
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Affiliation(s)
- Jessica M Downes
- Jessica M. Downes, Pharm.D., BCACP, is Clinical Assistant Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, and Clinical Pharmacist, One-World Community Health Center, Omaha; at the time of writing, she was Postgraduate Year 2 Pharmacy Resident, University of Oklahoma (OU) College of Pharmacy-Tulsa. Katherine S. O'Neal, Pharm.D., M.B.A., BCACP, CDE, BC-ADM, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael J. Miller, B.S.Pharm., Dr.P.H., FAPha, is Associate Professor; and Jeremy L. Johnson, Pharm.D., BCACP, CDE, BC-ADM, is Assistant Professor, Department of Pharmacy Practice, Southwestern Oklahoma State University College of Pharmacy, Weatherford. Brooke L. Gildon, Pharm.D., BCPS, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael A. Weisz, M.D., MACP, is Professor, Department of Internal Medicine, OU School of Community Medicine-Tulsa.
| | - Katherine S O'Neal
- Jessica M. Downes, Pharm.D., BCACP, is Clinical Assistant Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, and Clinical Pharmacist, One-World Community Health Center, Omaha; at the time of writing, she was Postgraduate Year 2 Pharmacy Resident, University of Oklahoma (OU) College of Pharmacy-Tulsa. Katherine S. O'Neal, Pharm.D., M.B.A., BCACP, CDE, BC-ADM, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael J. Miller, B.S.Pharm., Dr.P.H., FAPha, is Associate Professor; and Jeremy L. Johnson, Pharm.D., BCACP, CDE, BC-ADM, is Assistant Professor, Department of Pharmacy Practice, Southwestern Oklahoma State University College of Pharmacy, Weatherford. Brooke L. Gildon, Pharm.D., BCPS, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael A. Weisz, M.D., MACP, is Professor, Department of Internal Medicine, OU School of Community Medicine-Tulsa
| | - Michael J Miller
- Jessica M. Downes, Pharm.D., BCACP, is Clinical Assistant Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, and Clinical Pharmacist, One-World Community Health Center, Omaha; at the time of writing, she was Postgraduate Year 2 Pharmacy Resident, University of Oklahoma (OU) College of Pharmacy-Tulsa. Katherine S. O'Neal, Pharm.D., M.B.A., BCACP, CDE, BC-ADM, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael J. Miller, B.S.Pharm., Dr.P.H., FAPha, is Associate Professor; and Jeremy L. Johnson, Pharm.D., BCACP, CDE, BC-ADM, is Assistant Professor, Department of Pharmacy Practice, Southwestern Oklahoma State University College of Pharmacy, Weatherford. Brooke L. Gildon, Pharm.D., BCPS, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael A. Weisz, M.D., MACP, is Professor, Department of Internal Medicine, OU School of Community Medicine-Tulsa
| | - Jeremy L Johnson
- Jessica M. Downes, Pharm.D., BCACP, is Clinical Assistant Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, and Clinical Pharmacist, One-World Community Health Center, Omaha; at the time of writing, she was Postgraduate Year 2 Pharmacy Resident, University of Oklahoma (OU) College of Pharmacy-Tulsa. Katherine S. O'Neal, Pharm.D., M.B.A., BCACP, CDE, BC-ADM, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael J. Miller, B.S.Pharm., Dr.P.H., FAPha, is Associate Professor; and Jeremy L. Johnson, Pharm.D., BCACP, CDE, BC-ADM, is Assistant Professor, Department of Pharmacy Practice, Southwestern Oklahoma State University College of Pharmacy, Weatherford. Brooke L. Gildon, Pharm.D., BCPS, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael A. Weisz, M.D., MACP, is Professor, Department of Internal Medicine, OU School of Community Medicine-Tulsa
| | - Brooke L Gildon
- Jessica M. Downes, Pharm.D., BCACP, is Clinical Assistant Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, and Clinical Pharmacist, One-World Community Health Center, Omaha; at the time of writing, she was Postgraduate Year 2 Pharmacy Resident, University of Oklahoma (OU) College of Pharmacy-Tulsa. Katherine S. O'Neal, Pharm.D., M.B.A., BCACP, CDE, BC-ADM, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael J. Miller, B.S.Pharm., Dr.P.H., FAPha, is Associate Professor; and Jeremy L. Johnson, Pharm.D., BCACP, CDE, BC-ADM, is Assistant Professor, Department of Pharmacy Practice, Southwestern Oklahoma State University College of Pharmacy, Weatherford. Brooke L. Gildon, Pharm.D., BCPS, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael A. Weisz, M.D., MACP, is Professor, Department of Internal Medicine, OU School of Community Medicine-Tulsa
| | - Michael A Weisz
- Jessica M. Downes, Pharm.D., BCACP, is Clinical Assistant Professor, Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, and Clinical Pharmacist, One-World Community Health Center, Omaha; at the time of writing, she was Postgraduate Year 2 Pharmacy Resident, University of Oklahoma (OU) College of Pharmacy-Tulsa. Katherine S. O'Neal, Pharm.D., M.B.A., BCACP, CDE, BC-ADM, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael J. Miller, B.S.Pharm., Dr.P.H., FAPha, is Associate Professor; and Jeremy L. Johnson, Pharm.D., BCACP, CDE, BC-ADM, is Assistant Professor, Department of Pharmacy Practice, Southwestern Oklahoma State University College of Pharmacy, Weatherford. Brooke L. Gildon, Pharm.D., BCPS, AE-C, is Assistant Professor, Department of Pharmacy: Clinical and Administrative Sciences, OU College of Pharmacy-Tulsa and Department of Pediatrics, OU School of Community Medicine-Tulsa. Michael A. Weisz, M.D., MACP, is Professor, Department of Internal Medicine, OU School of Community Medicine-Tulsa
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Teixeira JDF, Goulart MR, Busnello FM, Pellanda LC. Hypertensives' Knowledge About High-Sodium Foods and Their Behavior. Arq Bras Cardiol 2016; 106:404-10. [PMID: 27096524 PMCID: PMC4914005 DOI: 10.5935/abc.20160049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/11/2016] [Indexed: 11/20/2022] Open
Abstract
Background In Brazil, the prevalence of systemic arterial hypertension (SAH) is
approximately 30% of the total population. In 2010, SAH was the cause of
death of about 9.4 million people worldwide. A healthy dietary pattern is
important to maintain proper blood pressure levels and, consequently,
disease control. Objectives To describe the knowledge and practices of hypertensive patients cared for at
a public hypertension outpatient clinic, and its relationship with
high-sodium food. Methods We applied a questionnaire to patients with questions related to
sociodemographics, dietary pattern, frequency of ingestion of certain foods,
and knowledge about their own disease. Results We studied 221 patients, 56.1% of whom were women, and 53.8% had only
elementary education. Their mean age was 57.7 ±13.5 years, and 75.6%
of them reported having high blood pressure, and 11.3%, diabetes mellitus.
Regarding dietary pattern, 62% used ready-to-use seasonings, but 94.1%
reported not adding extra salt to their ready meals. Regarding patients'
knowledge about high-sodium foods and SAH, only 8 patients had 100% of right
answers, 37 patients had 73.8%, and 42 patients, 57% of right answers. Conclusion Knowledge about SAH prevention and high-sodium foods was insufficient. Based
on this study's findings, more effective educational strategies targeted at
this population can be developed.
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Affiliation(s)
| | - Maíra Ribas Goulart
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Chesser AK, Keene Woods N, Smothers K, Rogers N. Health Literacy and Older Adults: A Systematic Review. Gerontol Geriatr Med 2016; 2:2333721416630492. [PMID: 28138488 PMCID: PMC5119904 DOI: 10.1177/2333721416630492] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 12/17/2015] [Accepted: 12/30/2015] [Indexed: 11/28/2022] Open
Abstract
Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults.
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Ibrahim AM, Vargas CR, Koolen PG, Chuang DJ, Lin SJ, Lee BT. Readability of online patient resources for melanoma. Melanoma Res 2016; 26:58-65. [DOI: 10.1097/cmr.0000000000000210] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Fleisher JE, Shah K, Fitts W, Dahodwala NA. Associations and implications of low health literacy in Parkinson's Disease. Mov Disord Clin Pract 2015; 3:250-256. [PMID: 27331078 DOI: 10.1002/mdc3.12272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Low health literacy (HL) indicates a limited ability to understand and use basic information to make appropriate healthcare decisions. While low HL is associated with higher morbidity, mortality, and healthcare costs in multiple chronic conditions, little is known about HL and its associations in Parkinson's disease (PD). METHODS Cross-sectional study of non-demented adults with PD participating in the National Parkinson Foundation Parkinson's Outcomes Project at the University of Pennsylvania. Subjects were administered two brief HL assessments-the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF), a word-recognition test, and the Newest Vital Sign (NVS), a test of literacy, numeracy and understanding of health information-as well as demographic and clinical questionnaires. Adverse outcomes included falls in the 3 months preceding the study visit, and hospital admissions, emergency room visits, infections, or injuries in the preceding year. Caregiver burden was measured using the Multidimensional Caregiver Strain Index. RESULTS 168 subjects completed both HL screens (mean 65.8 years, 65.5% male, 65.2% Hoehn & Yahr Stage 2). Using the REALM-SF, 97.6% of subjects had adequate HL. Using the NVS, however, 29.8% had low HL, which was associated with older age, lower education, male gender, greater disease severity, and poorer cognition. Low HL was associated with hospital admission and increased caregiver burden. CONCLUSIONS Low HL is common and associated with greater caregiver burden and a higher likelihood of hospitalization in patients with PD. Since HL is associated with both disease severity and adverse outcomes, it may be an important, modifiable contributor to morbidity.
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Affiliation(s)
- Jori E Fleisher
- Department of Neurology, New York University Langone School of Medicine, New York, New York, USA
| | - Krunal Shah
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Whitney Fitts
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Nabila A Dahodwala
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Toronto CE, Weatherford B. Health Literacy Education in Health Professions Schools: An Integrative Review. J Nurs Educ 2015; 54:669-76. [DOI: 10.3928/01484834-20151110-02] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 07/08/2015] [Indexed: 11/20/2022]
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Geboers B, Brainard JS, Loke YK, Jansen CJM, Salter C, Reijneveld SA, de Winter AF, deWinter AF. The association of health literacy with adherence in older adults, and its role in interventions: a systematic meta-review. BMC Public Health 2015; 15:903. [PMID: 26377316 PMCID: PMC4573285 DOI: 10.1186/s12889-015-2251-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/08/2015] [Indexed: 12/14/2022] Open
Abstract
Background Low health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this age group with low health literacy was also explored. Methods Eight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in older adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion. Results Reviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population. Conclusions Evidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2251-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bas Geboers
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, PO Box 196, , 9700 AD, Groningen, The Netherlands.
| | - Julii S Brainard
- Norwich Medical School, Faculty of Medicine & Health Sciences, University of East Anglia, Norwich, UK.
| | - Yoon K Loke
- Norwich Medical School, Faculty of Medicine & Health Sciences, University of East Anglia, Norwich, UK.
| | - Carel J M Jansen
- Department of Communication and Information Studies, Faculty of Arts, University of Groningen, Groningen, The Netherlands.
| | - Charlotte Salter
- Norwich Medical School, Faculty of Medicine & Health Sciences, University of East Anglia, Norwich, UK.
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, PO Box 196, , 9700 AD, Groningen, The Netherlands.
| | - Andrea F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, FA10, PO Box 196, , 9700 AD, Groningen, The Netherlands.
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Reprint of: Health literacy in Canada and the ophthalmology patient. Can J Ophthalmol 2015; 50 Suppl 1:S40-6. [PMID: 26049890 DOI: 10.1016/j.jcjo.2015.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 09/05/2011] [Accepted: 10/04/2011] [Indexed: 01/04/2023]
Abstract
Health literacy represents the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health.(1) According to the 2003 International Adult Literacy and Life Skills Survey (IALSS), over 12 million (60%) adult Canadians lack the capacity to obtain, understand, and act on health information and services, as well as make appropriate health decisions on their own.(2,3) Of these 12 million Canadians, the elderly are the most health illiterate age group in Canada. What this suggests for Canadian physicians is that to improve the CanMEDS roles of communicator and health advocate,(4) physicians need to recognize health literacy as a modifiable contributor of poor health outcomes and work to remove literacy-related barriers.(5) This is particularly important for ophthalmologists who manage chronic illnesses in elderly patients.(2,6,7) The objective of this review is 2-fold. The first objective is to describe health literacy in Canada and provide a summary on the current state of health literacy research, both generally in medicine and specifically to Ophthalmology. The second objective is to propose a 3-step approach of evidence based techniques for managing low health literate patients in clinic.
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Palumbo R. Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review. Int J Health Policy Manag 2015; 4:417-30. [PMID: 26188806 PMCID: PMC4493582 DOI: 10.15171/ijhpm.2015.95] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 05/09/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Scholars describe poor health literacy as a "silent epidemic," which is challenging the functioning of healthcare systems all over the world. Health literacy is mainly meant as an individual trait which concerns the ability to obtain, process, and understand basic health information in order to effectively navigate the health system. Low health literate patients perceive poor self-efficacy dealing with their health conditions, are not willing to be involved in the provision of care, show larger risks of hospitalization and mortality, and are not aware about the determinants of well-being. Hence, limited health literacy has been associated with inadequate management of long-term conditions; nonetheless, several authors argue that health literacy has been an overlooked factor dealing with HIV. METHODS This study is aimed at discussing the effects of poor health literacy on people living with HIV, drawing from the findings of a narrative literature review which involved 41 papers retrieved from the databases "Scopus-Elsevier" and "PubMed." RESULTS The scientific literature is not consistent dealing with the relationship between health literacy and HIV treatment. For example, health literate patients seem to better understand their health conditions; on the other hand, people living with poor health literacy are likely to report higher compliance with providers' prescriptions, blindly trusting healthcare professionals. CONCLUSION Poor health literacy is a social barrier to access healthcare services and to appropriate health treatment among patients living with HIV. Tailored interventions should be aimed at enhancing the health skills of patients affected by HIV infection to improve their ability to navigate the health system.
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Affiliation(s)
- Rocco Palumbo
- Department of Management and Information Technology, University of Salerno, Salerno, Italy
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Abstract
BACKGROUND Health literacy (HL) may be a mediator for known socioeconomic and racial disparities in living kidney donation. METHODS We evaluated the associations of patient and demographic characteristics with HL in living kidney donors (LD), living donor kidney transplant recipients (LDR), and deceased donor recipients (DDR) in a single-center retrospective review of patients undergoing kidney donation or transplantation from September 2010 to July 2012. HL and demographic data were collected. HL was assessed via the Short Literacy Survey (SLS) comprising three self-reported screening questions scored using the five-point Likert scale (low, moderate, high). Chi-square and logistic regression were used to test factors associated with lower HL. RESULTS The sample included 360 adults (105 LD, 103 LDR, and 152 DDR; 46±14 years; 70% white; 56% male; 14±3 years of education). HL scores were skewed (49% high, 41% moderate, and 10% low). The distribution of HL categories differed significantly among groups (P=0.019). After controlling for age, race, sex, education, and a race-education interaction term, DDR was more likely to have moderate or low HL than LDR (OR, 1.911; 95% CI, 1.096-3.332; P=0.022). CONCLUSION Overall, living donors had high HL. The distribution of low, moderate, and high HL differed significantly between LD, DDR, and LDR. DDR had a higher likelihood of having low HL than LDR. Screening kidney transplant candidates and donors for lower HL may identify barriers to living donation. Future interventions addressing HL may be important to increase living donation and reduce disparities.
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Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. PATIENT EDUCATION AND COUNSELING 2014; 96:395-403. [PMID: 24973195 PMCID: PMC5085258 DOI: 10.1016/j.pec.2014.05.027] [Citation(s) in RCA: 504] [Impact Index Per Article: 50.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/28/2014] [Accepted: 05/30/2014] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To develop a reliable and valid instrument to assess the understandability and actionability of print and audiovisual materials. METHODS We compiled items from existing instruments/guides that the expert panel assessed for face/content validity. We completed four rounds of reliability testing, and produced evidence of construct validity with consumers and readability assessments. RESULTS The experts deemed the PEMAT items face/content valid. Four rounds of reliability testing and refinement were conducted using raters untrained on the PEMAT. Agreement improved across rounds. The final PEMAT showed moderate agreement per Kappa (Average K=0.57) and strong agreement per Gwet's AC1 (Average=0.74). Internal consistency was strong (α=0.71; Average Item-Total Correlation=0.62). For construct validation with consumers (n=47), we found significant differences between actionable and poorly-actionable materials in comprehension scores (76% vs. 63%, p<0.05) and ratings (8.9 vs. 7.7, p<0.05). For understandability, there was a significant difference for only one of two topics on consumer numeric scores. For actionability, there were significant positive correlations between PEMAT scores and consumer-testing results, but no relationship for understandability. There were, however, strong, negative correlations between grade-level and both consumer-testing results and PEMAT scores. CONCLUSIONS The PEMAT demonstrated strong internal consistency, reliability, and evidence of construct validity. PRACTICE IMPLICATIONS The PEMAT can help professionals judge the quality of materials (available at: http://www.ahrq.gov/pemat).
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Affiliation(s)
| | - Michael S Wolf
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Cindy Brach
- Agency for Healthcare Research and Quality (AHRQ), Rockville, USA
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How can health literacy influence outcomes in heart failure patients? Mechanisms and interventions. Curr Heart Fail Rep 2014; 10:232-43. [PMID: 23873404 DOI: 10.1007/s11897-013-0147-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the home, access care in the community, promote provider-patient interactions, structure self-care, and navigate health care programs both locally and nationally. Further, health literacy is a key determinant of health and a critical dimension for assessing individuals' needs, and, importantly, their capacity for self-care. Poorer health knowledge/status, more medication errors, costs, and higher rates of morbidity, readmissions, emergency room visits, and mortality among patients with health illiteracy have been demonstrated. Individuals at high risk for low health literacy include the elderly, disabled, Blacks, those with a poverty-level income, some or less high school education, either no insurance or Medicare or Medicaid, and those for whom English is a second language. As a consequence, health literacy is a complex, multifaceted, and evolving construct including aspects of social, psychological, cultural and economic circumstances. The purpose of this paper is to describe the mechanisms and consequences of health illiteracy. Specifically, the prevalence, associated demographics, and models of health literacy are described. The mechanism of health illiteracy's influence on outcomes in heart failure is proposed. Tools for health literacy assessment are described and compared. Finally, the health outcomes and general interventions to enhance the health outcomes in heart failure are discussed.
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Wheeler KJ, Roberts ME, Neiheisel MB. Medication adherence part two: predictors of nonadherence and adherence. J Am Assoc Nurse Pract 2014; 26:225-232. [PMID: 24574102 DOI: 10.1002/2327-6924.12105] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE This is the second of a three-part series on medication adherence in which the authors describe the continuum of adherence to nonadherence of medication usage. DATA SOURCES Research articles through MEDLINE and PubMed. CONCLUSIONS Understanding the magnitude and scope of the problem of medication nonadherence is the first step in reaching better adherence rates (described in Part One of this series). The second step is to recognize the complexities of the reasons for medication adherence/nonadherence (described here). Reasons for nonadherence include beliefs related to the benefits of medication for physical and mental disorders, complexities of systems of health care and treatment plans, and lifestyle and demographic characteristics of patients. The final step is to evaluate each patient for medication adherence, tailoring the plan of care according to patient and system specific barriers (described in Part Three of this series). IMPLICATIONS FOR PRACTICE Nurse practitioners must recognize a critical element of thorough care is to assess medication adherence at each patient visit, countering patient and system barriers as indicated. Nurse practitioners also need to adjust assessment and prescribing practices according to the evidence for best practices to improve medication adherence.
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Affiliation(s)
- Kathy J Wheeler
- University of Kentucky College of Nursing, Lexington, Kentucky, Seton Hall University, South Orange, New Jersey, University of Louisiana at Lafayette, Lafayette, Louisiana
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Claydon-Platt K, Manias E, Dunning T. The barriers and facilitators people with diabetes from a nonEnglish speaking background experience when managing their medications: a qualitative study. J Clin Nurs 2013; 23:2234-46. [DOI: 10.1111/jocn.12501] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Kate Claydon-Platt
- Melbourne School of Health Sciences; The University of Melbourne; Carlton Vic. Australia
| | - Elizabeth Manias
- Melbourne School of Health Sciences; The University of Melbourne; Carlton Vic. Australia
| | - Trisha Dunning
- Centre for Nursing and Allied Health Research; Faculty of Health; Deakin University and Barwon Health Waterfront Campus; Geelong Vic. Australia
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Ostini R, Kairuz T. Investigating the association between health literacy and non-adherence. Int J Clin Pharm 2013; 36:36-44. [DOI: 10.1007/s11096-013-9895-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/22/2013] [Indexed: 10/26/2022]
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Shoemaker SJ, Staub-DeLong L, Wasserman M, Spranca M. Factors affecting adoption and implementation of AHRQ health literacy tools in pharmacies. Res Social Adm Pharm 2013; 9:553-63. [DOI: 10.1016/j.sapharm.2013.05.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Revised: 02/04/2013] [Accepted: 05/07/2013] [Indexed: 10/26/2022]
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Al Sayah F, Majumdar SR, Williams B, Robertson S, Johnson JA. Health literacy and health outcomes in diabetes: a systematic review. J Gen Intern Med 2013; 28:444-52. [PMID: 23065575 PMCID: PMC3579965 DOI: 10.1007/s11606-012-2241-z] [Citation(s) in RCA: 237] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 07/02/2012] [Accepted: 09/20/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Low health literacy is considered a potential barrier to improving health outcomes in people with diabetes and other chronic conditions, although the evidence has not been previously systematically reviewed. OBJECTIVE To identify, appraise, and synthesize research evidence on the relationships between health literacy (functional, interactive, and critical) or numeracy and health outcomes (i.e., knowledge, behavioral and clinical) in people with diabetes. METHODS English-language articles that addressed the relationship between health literacy or numeracy and at least one health outcome in people with diabetes were identified by two reviewers through searching six scientific databases, and hand-searching journals and reference lists. FINDINGS Seven hundred twenty-three citations were identified and screened, 196 were considered, and 34 publications reporting data from 24 studies met the inclusion criteria and were included in this review. Consistent and sufficient evidence showed a positive association between health literacy and diabetes knowledge (eight studies). There was a lack of consistent evidence on the relationship between health literacy or numeracy and clinical outcomes, e.g., A1C (13 studies), self-reported complications (two studies), and achievement of clinical goals (one study); behavioral outcomes, e.g., self-monitoring of blood glucose (one study), self-efficacy (five studies); or patient-provider interactions (i.e., patient-physician communication, information exchange, decision-making, and trust), and other outcomes. The majority of the studies were from US primary care setting (87.5 %), and there were no randomized or other trials to improve health literacy. CONCLUSIONS Low health literacy is consistently associated with poorer diabetes knowledge. However, there is little sufficient or consistent evidence suggesting that it is independently associated with processes or outcomes of diabetes-related care. Based on these findings, it may be premature to routinely screen for low health literacy as a means for improving diabetes-related health-related outcomes.
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Affiliation(s)
- Fatima Al Sayah
- />School of Public Health, University of Alberta, Edmonton, AB T6G 2E1 Canada
- />Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD), University of Alberta, Edmonton, AB Canada
- />Faculty of Nursing, University of Alberta, Edmonton, AB Canada
| | - Sumit R. Majumdar
- />Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD), University of Alberta, Edmonton, AB Canada
- />Faculty of Medicine, University of Alberta, Edmonton, AB Canada
| | - Beverly Williams
- />Faculty of Nursing, University of Alberta, Edmonton, AB Canada
| | - Sandy Robertson
- />Faculty of Nursing, University of Alberta, Edmonton, AB Canada
| | - Jeffrey A. Johnson
- />School of Public Health, University of Alberta, Edmonton, AB T6G 2E1 Canada
- />Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD), University of Alberta, Edmonton, AB Canada
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Effectiveness of education programs about oral antibiotic suspensions in pediatric outpatient services. Pediatr Neonatol 2013; 54:34-42. [PMID: 23445741 DOI: 10.1016/j.pedneo.2012.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 03/26/2012] [Accepted: 03/27/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The effectiveness of education programs for pediatric patients receiving oral antibiotic suspension was unclear. METHODS When pediatric patients were prescribed antibiotics in powder form for suspension at the outpatient clinic of a university hospital, the responsible 150 caregivers were consecutively allocated into three education programs: Group 1 subjects read the package insert; Group 2 read a photograph-designed educational sheet; and Group 3 received a face-to-face medication education from a pharmacist with the photograph-designed educational sheet. The effectiveness of the three education programs for pediatric patients' caregivers was evaluated using a questionnaire comprised of 12 questions. RESULTS The proportions of the caregivers in Groups 1, 2 and 3 who answered the questionnaire perfectly with 100% accuracy were 2%, 14% and 74%, respectively (p < 0.001). The means ± standard deviations of the overall time spent by the caregivers in Groups 1, 2 and 3 were 353 ± 135, 334.2 ± 115.1, and 281.4 ± 114 seconds, respectively (p = 0.013). Clearly, the pharmacist's face-to-face mediation education program provided effective and time-saving medication instructions for pediatric oral antibiotics. The specific questions regarding easy-to-make errors related to the reconstitution step (p < 0.001), water volume for reconstitution (p < 0.001), storage temperature (p = 0.004) and shelf life (p = 0.002) of stock powder, whether the drug should be taken before or after a meal (p < 0.001), and the method and volume for syrup measurement (p < 0.001). CONCLUSION This study demonstrated that when compared to reading a package insert or education sheet, a pharmacist's verbal education with photographic education materials was significantly more effective and time-saving in providing caregivers with the correct knowledge of oral antibiotic suspensions in pediatrics.
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MacKay C, Davis AM, Mahomed NN, Badley EM. A single group follow-up study of non-surgical patients seen by physiotherapists working in expanded roles in orthopaedic departments: recall of recommendations, change in exercise and self-efficacy. BMC Res Notes 2012. [PMID: 23206311 PMCID: PMC3538671 DOI: 10.1186/1756-0500-5-669] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Specially trained physiotherapists (advanced practice physiotherapists (APP)) are working in orthopaedic clinics to improve access to orthopaedic services and support chronic disease management. Little attention has been paid to the impact APPs may have on non-surgical patients. In non-surgical patients with hip or knee arthritis consulting an APP in an orthopaedic clinic, the objectives were to: 1) describe patients' recall of APP recommendations, use of self-management strategies, and barriers to management six weeks following consultation; and, 2) compare exercise behaviour and self-efficacy at baseline and six weeks. FINDINGS This was a single group pre-and post-intervention study of patients who saw an APP when consulting the orthopaedic departments of two hospitals. At baseline and six weeks participants completed the adapted Stanford Exercise Behaviour Scale (response options: none, < 60 minutes/week, 1-3 hours/week or > 3 hours/week), and the Chronic Disease Self-efficacy Scale (range 1-10; higher scores indicate higher self-efficacy). At follow-up participants completed questions on recall of APP recommendations, use of self-management strategies and barriers to management. Seventy three non-surgical patients with hip or knee arthritis participated, a response rate of 89% at follow-up. Seventy one percent of patients reported that the APP recommended exercise, of whom 83% reported exercising to manage their arthritis since the visit. Almost 50% reported an increase in time spent stretching; over 40% reported an increase in time spent walking or doing strengthening exercises at follow-up. Common barriers to arthritis management were time, cost and other health problems. Mean chronic disease self-efficacy scores significantly improved from 6.3 to 7.2 (p < 0.001). The mean difference was 0.95 (95% CI 0.43, 1.62); the effect size was 0.51. CONCLUSIONS This pilot study of an APP intervention for non-surgical patients referred for orthopaedic consultation showed promising results, particularly for enhancing use of conservative management strategies such as exercise.
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Affiliation(s)
- Crystal MacKay
- Division of Health Care and Outcomes Research and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, Toronto, ON, Canada.
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Claridad de las recomendaciones al paciente en el informe de alta hospitalaria. ACTA ACUST UNITED AC 2012; 27:283-7. [DOI: 10.1016/j.cali.2012.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 02/06/2012] [Accepted: 02/13/2012] [Indexed: 11/19/2022]
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Socha YM, Oelschlegel S, Vaughn CJ, Earl M. Improving an outreach service by analyzing the relationship of health information disparities to socioeconomic indicators using geographic information systems. J Med Libr Assoc 2012; 100:222-5. [PMID: 22879813 DOI: 10.3163/1536-5050.100.3.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Yvonne M Socha
- School of Information Sciences, University of Tennessee, Knoxville, TN 37996, USA.
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Noureldin M, Plake KS, Morrow DG, Tu W, Wu J, Murray MD. Effect of health literacy on drug adherence in patients with heart failure. Pharmacotherapy 2012; 32:819-26. [PMID: 22744746 DOI: 10.1002/j.1875-9114.2012.01109.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
STUDY OBJECTIVE To assess the effect of health literacy on drug adherence in the context of a pharmacist-based intervention for patients with heart failure. DESIGN Post hoc analysis of a randomized controlled trial. SETTING Inner-city ambulatory care practice affiliated with an academic medical center. PATIENTS The original trial enrolled 314 patients with heart failure who were aged 50 years or older and were taking at least one cardiovascular drug for heart failure; 122 patients received the pharmacist intervention (patient education, therapeutic monitoring, and communication with primary care providers), and 192 patients received usual care (regular follow-up with primary care providers). We analyzed the results of 281 patients who had available health literacy and adherence data. MEASUREMENTS AND MAIN RESULTS Drug adherence was assessed over 9 months using electronic prescription container monitors on cardiovascular drugs. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults (scores range from 0-36, with an adequate literacy score defined as ≥ 23). Taking adherence, defined as the percentage of prescribed drug doses taken by the patient compared with the number of doses prescribed by the physician, was assessed for each group. Patients were a mean ± SD of 63 ± 9 years old, 51% had less than 12 years of education, 29% had inadequate health literacy, and they received a mean ± SD of 11 ± 4 drugs. In the usual care group, taking adherence was greater among patients with adequate (69.4%) than those with inadequate (54.2%) health literacy (p=0.001). In the intervention group, the difference in taking adherence among patients with adequate (77.3%) and inadequate (65.3%) health literacy was not statistically significant (p=0.06). Among patients with inadequate health literacy, the intervention increased adherence (65%, 95% confidence interval [CI] 54-77%) by an order of magnitude similar to that of the baseline adherence of patients with adequate health literacy (69%, 95% CI 65-74%). Multivariable analysis supported the association between health literacy and adherence. CONCLUSION In patients with heart failure, those with adequate health literacy have better adherence to cardiovascular drugs than those with inadequate health literacy. The pharmacist intervention improved adherence in patients with adequate and inadequate health literacy. Health literacy may be an important consideration in drug adherence interventions.
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Affiliation(s)
- Marwa Noureldin
- Department of Pharmacy Practice, Center on Aging and the Life Course, College of Pharmacy, Purdue University, West Lafayette, Indiana, USA
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Taggart J, Williams A, Dennis S, Newall A, Shortus T, Zwar N, Denney-Wilson E, Harris MF. A systematic review of interventions in primary care to improve health literacy for chronic disease behavioral risk factors. BMC FAMILY PRACTICE 2012; 13:49. [PMID: 22656188 PMCID: PMC3444864 DOI: 10.1186/1471-2296-13-49] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 04/02/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND To evaluate the effectiveness of interventions used in primary care to improve health literacy for change in smoking, nutrition, alcohol, physical activity and weight (SNAPW). METHODS A systematic review of intervention studies that included outcomes for health literacy and SNAPW behavioral risk behaviors implemented in primary care settings.We searched the Cochrane Library, Johanna Briggs Institute, Medline, Embase, CINAHL, Psychinfo, Web of Science, Scopus, APAIS, Australasian Medical Index, Google Scholar, Community of Science and four targeted journals (Patient Education and Counseling, Health Education and Behaviour, American Journal of Preventive Medicine and Preventive Medicine).Study inclusion criteria: Adults over 18 years; undertaken in a primary care setting within an Organisation for Economic Co-operation and Development (OECD) country; interventions with at least one measure of health literacy and promoting positive change in smoking, nutrition, alcohol, physical activity and/or weight; measure at least one outcome associated with health literacy and report a SNAPW outcome; and experimental and quasi-experimental studies, cohort, observational and controlled and non-controlled before and after studies.Papers were assessed and screened by two researchers (JT, AW) and uncertain or excluded studies were reviewed by a third researcher (MH). Data were extracted from the included studies by two researchers (JT, AW). Effectiveness studies were quality assessed. A typology of interventions was thematically derived from the studies by grouping the SNAPW interventions into six broad categories: individual motivational interviewing and counseling; group education; multiple interventions (combination of interventions); written materials; telephone coaching or counseling; and computer or web based interventions. Interventions were classified by intensity of contact with the subjects (High ≥ 8 points of contact/hours; Moderate >3 and <8; Low ≤ 3 points of contact hours) and setting (primary health, community or other).Studies were analyzed by intervention category and whether significant positive changes in SNAPW and health literacy outcomes were reported. RESULTS 52 studies were included. Many different intervention types and settings were associated with change in health literacy (73% of all studies) and change in SNAPW (75% of studies). More low intensity interventions reported significant positive outcomes for SNAPW (43% of studies) compared with high intensity interventions (33% of studies). More interventions in primary health care than the community were effective in supporting smoking cessation whereas the reverse was true for diet and physical activity interventions. CONCLUSION Group and individual interventions of varying intensity in primary health care and community settings are useful in supporting sustained change in health literacy for change in behavioral risk factors. Certain aspects of risk behavior may be better handled in clinical settings while others more effectively in the community. Our findings have implications for the design of programs.
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Affiliation(s)
- Jane Taggart
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Anna Williams
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Sarah Dennis
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Anthony Newall
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Tim Shortus
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Nicholas Zwar
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052, Australia
| | - Elizabeth Denney-Wilson
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia
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Roberts SR, Crigler J, Lafferty WE, Bonham AJ, Hunter JL, Smith AJ, Banderas JW, Early GL, King RK. Addressing Social Determinants to Improve HealthCare Quality and Reduce Cost. J Healthc Qual 2012; 34:12-20. [DOI: 10.1111/j.1945-1474.2011.00179.x] [Citation(s) in RCA: 3] [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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