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Louizou E, Panagiotou N, Dafli E, Smyrnakis E, Bamidis PD. Medical Doctors Approaches and Understanding of Health Literacy: A Systematic Literature Review. Cureus 2024; 16:e51448. [PMID: 38298293 PMCID: PMC10829061 DOI: 10.7759/cureus.51448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/02/2024] Open
Abstract
A physician's role is critical in fostering patient health literacy (HL) and influencing various aspects, including patient-physician communication and treatment effectiveness. The purpose of this systematic literature review is to analyze physicians' perspectives, comprehension, and management of HL. The focus of this review is on physicians' views, opinions, experiences, and strategies related to HL. We conducted comprehensive searches across seven databases, including PubMed, Scopus, ProQuest, Science Direct, Web of Science, The Cochrane Library, and Google Scholar. Original research articles published between January 1, 2009, and July 31, 2020, were considered for inclusion. This literature review incorporates qualitative studies and mixed-methods studies, with a focus on extracting qualitative data. Among the 22 articles included in our review, we employed the method of inductive thematic analysis for data analysis. A detailed description of the review methodology can be found in a previously published protocol available through PROSPERO (CRD42020212599). The themes that emerged from the thematic analysis include: (a) physicians' perception and management of HL; and (b) barriers. The results of the systematic review reveal that healthcare professionals exhibit varying perceptions of patients' HL levels and ascribe different meanings to it. However, none of them employ a specific measuring tool. While there appears to be no uniform approach to managing patients with low HL, some prioritize certain communication strategies, such as repetition, simplified language, and providing written instructions, among others. Most physicians cited multiple barriers that impede the development of patients' HL, including dysfunctions within the healthcare system, staff shortages, managing a large number of patients, limited time, work-related stress, cultural and socio-economic barriers, medical jargon, and language barriers. Considering the pivotal role of physicians in fostering patient HL, it is crucial to enhance medical education in addressing and managing HL, both within academic curricula and through continuing education seminars. Furthermore, there is a pressing need to improve healthcare professionals' working conditions, ensuring that each physician can allocate the necessary time to each patient based on their individual needs, without being hindered by stress-inducing work environments.
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Affiliation(s)
- Eleni Louizou
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Nikolaos Panagiotou
- School of Journalism & Mass Communications, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Eleni Dafli
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Emmanouil Smyrnakis
- Primary Health Care, General Practice and Health Services Research, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Panagiotis D Bamidis
- School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Louizou E, Panagiotou N, Smyrnakis Ε, Anastasiadis S, Diamantis KG, Papamalis F, Bamidis PD. Greek medical professionals approaches and understanding of health literacy: a qualitative study. BMC Health Serv Res 2023; 23:1209. [PMID: 37932722 PMCID: PMC10626757 DOI: 10.1186/s12913-023-10226-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Health literacy holds significant importance for medical professionals, as it is widely acknowledged as a key element in enhancing health promotion and overall well-being. The primary objective of this study is to explore Greek physicians' comprehension of health literacy, the significance they attribute to it, their strategies for addressing patients with low health literacy, and the potential barriers they face while striving to enhance a patient's health literacy. In this context, we examine the communication methods employed by physicians as an integral part of their approach to improving a patient's health literacy. METHODS A qualitative study was conducted between April 29, 2021, and February 17, 2022, utilizing in-depth, semi-structured interviews with 30 Greek medical professionals, of whom 15 were university professors. The research sample selection methodology employed in this study was purposive sampling. Data analysis was conducted using inductive thematic analysis. RESULTS The majority of physicians were not familiar with the concept of health literacy. The most significant barriers to the development of health literacy among physicians are a lack of time, issues within the healthcare system, and interference from third parties, although they acknowledge that a significant portion of the responsibility lies with them. Effective communication with patients is important for all physicians, as it plays a crucial role in the therapeutic process. When they realize that their patients are not understanding them, they employ communication methods such as using plain language, providing numerous examples, incorporating visuals like pictures and even using drawings. CONCLUSIONS The findings of this study underscore the importance of implementing targeted initiatives to promote health literacy within the Greek medical and academic community. Integrating health literacy training for physicians into the educational and training curriculum is essential. To accomplish this goal, it is imperative to first address the shortcomings within the healthcare system and improve the working conditions for physicians.
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Affiliation(s)
- Eleni Louizou
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece.
| | - Nikolaos Panagiotou
- Faculty of Economic and Political Sciences, School of Journalism & Mass Communications, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Εmmanouil Smyrnakis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Savvas Anastasiadis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Konstantinos G Diamantis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Foivos Papamalis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
| | - Panagiotis D Bamidis
- Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki (AUTH), Thessaloniki, P.O. Box 376, 54124, Greece
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Nguyen DT, Ho-Le TP, Pham L, Ho-Van VP, Hoang TD, Tran TS, Frost S, Nguyen TV. BONEcheck: A digital tool for personalized bone health assessment. Osteoporos Sarcopenia 2023; 9:79-87. [PMID: 37941533 PMCID: PMC10627863 DOI: 10.1016/j.afos.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/12/2023] [Accepted: 08/14/2023] [Indexed: 11/10/2023] Open
Abstract
Objectives Osteoporotic fracture is a significant public health burden associated with increased mortality risk and substantial healthcare costs. Accurate and early identification of high-risk individuals and mitigation of their risks is a core part of the treatment and prevention of fractures. Here we introduce a digital tool called 'BONEcheck' for personalized assessment of bone health. Methods The development of BONEcheck primarily utilized data from the prospective population-based Dubbo Osteoporosis Epidemiology Study and the Danish Nationwide Registry. BONEcheck has 3 modules: input data, risk estimates, and risk context. Input variables include age, gender, prior fracture, fall incidence, bone mineral density (BMD), comorbidities, and genetic variants associated with BMD. Results Based on the input variables, BONEcheck estimates the probability of any fragility fracture and hip fracture within 5 years, subsequent fracture risk, skeletal age, and time to reach osteoporosis. The probability of fracture is shown in both numeric and human icon array formats. The risk is also contextualized within the framework of treatment and management options on Australian guidelines, with consideration given to the potential fracture risk reduction and survival benefits. Skeletal age was estimated as the sum of chronological age and years of life lost due to a fracture or exposure to risk factors that elevate mortality risk. Conclusions BONEcheck is an innovative tool that empowers doctors and patients to engage in well-informed discussions and make decisions based on the patient's risk profile. Public access to BONEcheck is available via https://bonecheck.org and in Apple Store (iOS) and Google Play (Android).
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Affiliation(s)
- Dinh Tan Nguyen
- School of Biomedical Engineering, University of Technology, Sydney, Australia
- Saigon Precision Medicine Research Center, Ho Chi Minh, Viet Nam
| | - Thao P. Ho-Le
- School of Biomedical Engineering, University of Technology, Sydney, Australia
- Faculty of Engineering and Information Technology, Hatinh University, Hatinh, Viet Nam
| | - Liem Pham
- Saigon Precision Medicine Research Center, Ho Chi Minh, Viet Nam
| | - Vinh P. Ho-Van
- Faculty of Engineering and Information Technology, Hatinh University, Hatinh, Viet Nam
| | - Tien Dat Hoang
- Faculty of Engineering and Information Technology, Hatinh University, Hatinh, Viet Nam
| | - Thach S. Tran
- School of Biomedical Engineering, University of Technology, Sydney, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Steve Frost
- University of Wollongong, Wollongong, Australia
| | - Tuan V. Nguyen
- School of Biomedical Engineering, University of Technology, Sydney, Australia
- Tam Anh Research Institute, Ho Chi Minh, Viet Nam
- School of Population Health, UNSW Sydney, Australia
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Chiba T, Tanemura N. The Prevalence of Dietary Supplement Use for the Purpose of COVID-19 Prevention in Japan. Nutrients 2022; 14:3215. [PMID: 35956391 PMCID: PMC9370294 DOI: 10.3390/nu14153215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
COVID-19 is still the biggest issue worldwide. Many dietary supplements on the market claim to have anti-COVID-19 effects without scientific evidence. To elucidate the prevalence of dietary supplement usage for the prevention of COVID-19, we conducted an online cross-sectional questionnaire survey among Japanese adults in January 2022. The prevalence of dietary supplement use for the prevention of COVID-19 was 8.3%, and there was no gender difference. We also conducted additional research on these dietary supplement users (1000 males and 1000 females). The most popular ingredient used was vitamin C (61.0%), with vitamin D (34.9%) and probiotics (33.4%) following. Half of these participants reported using supplements for more than one year. The information sources that reportedly led them to start using dietary supplements for the prevention of COVID-19 were the Internet (44.0%), television and radio (29.9%), and family or friends (26.0%), and these information sources differed among generations. In conclusion, some of the population used vitamin/mineral supplements for the prevention of COVID-19 that might be beneficial for their health, but some used ingredients with no scientifically proven effects against the virus at this time. Therefore, information-based scientific evidence is important to prevent the inappropriate use of dietary supplements by consumers.
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Affiliation(s)
- Tsuyoshi Chiba
- Department of Food Function and Labeling, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8363, Japan
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Liu C, Wang D, Liu C, Jiang J, Wang X, Chen H, Ju X, Zhang X. What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med Community Health 2021; 8:fmch-2020-000351. [PMID: 32414834 PMCID: PMC7239702 DOI: 10.1136/fmch-2020-000351] [Citation(s) in RCA: 168] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The objective of this review was to clarify what health literacy represents. A systematic
review with qualitative syntheses was performed (CRD42017065149). Studies concerning
health literacy in all settings were included. Studies before 15 March 2017 were
identified from PubMed, Medline, Embase, Web of Science, Scopus, PsycARTICLES and the
Cochrane Library. The included literature either had defined the concept of health
literacy or made a detailed explanation of health literacy. A total of 34 original studies
met the inclusion criteria, including 13 involved in previous systematic reviews and 21
new studies. Health literacy was commonly conceptualised as a set of knowledge, a set of
skills or a hierarchy of functions (functional-interactive-critical). The construct of
health literacy covers three broad elements: (1) knowledge of health, healthcare and
health systems; (2) processing and using information in various formats in relation to
health and healthcare; and (3) ability to maintain health through self-management and
working in partnerships with health providers. Health literacy is defined as the ability
of an individual to obtain and translate knowledge and information in order to maintain
and improve health in a way that is appropriate to the individual and system contexts.
This definition highlights the diversity of needs from different individuals and the
importance of interactions between individual consumers, healthcare providers and
healthcare systems.
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Affiliation(s)
- Chenxi Liu
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Dan Wang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Chaojie Liu
- Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Junnan Jiang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Xuemei Wang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Haihong Chen
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Xin Ju
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology Tongji Medical College, Wuhan, China
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Betteridge N, Camilleri C, Stoyanoff L, Kopansky-Giles D, de Guzman J, Makri S, Mwaniki L. What do people need? Best Pract Res Clin Rheumatol 2020; 34:101567. [PMID: 32800698 PMCID: PMC7425545 DOI: 10.1016/j.berh.2020.101567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The key question addressed in this Chapter is "What do people need?", with "people" here meaning those who live with a rheumatic or musculoskeletal disease. The word "patient" is avoided at this point as not all of the problems or solutions identified are medical in nature. Many are personal, societal and/or environmental. The lead authors are all people who not only live with a rheumatic or musculoskeletal disease, but who are experienced "patient representatives". Therefore, their insights here stem from a combination of personal and collective experiences and views. Although from different continents, the authors identify a range of common barriers to social participation and optimum management of these conditions, such as late diagnosis, stigma and access to care. However, several solutions are common across these regions too, such as the need for supported self-management and greater public awareness of the impact of these diseases.
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Affiliation(s)
| | - Connie Camilleri
- St. Michael's Hospital, Unity Health Toronto, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada.
| | - Linda Stoyanoff
- MHI St. Michael's Hospital, Unity Health Toronto, 30 Bond St. Toronto, Ontario, M58 1W8, Canada.
| | - Deborah Kopansky-Giles
- Unity Health Toronto, St. Michael's Hospital, Department of Family and Community Medicine, 80 Bond Health Centre, Level 1, Room 12, Toronto, M5B 1X2, Ontario, Canada.
| | | | | | - Lillian Mwaniki
- 15 Mageta Road, Lavington P.O. Box 10232-00100, Nairobi, Kenya.
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Health Literacy in the Everyday Lives of Older Adults in Greece, Hungary, and the Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072411. [PMID: 32252281 PMCID: PMC7177367 DOI: 10.3390/ijerph17072411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 12/27/2022]
Abstract
Health literacy (HL) encompasses someone’s knowledge and abilities to access and use health information in order to make appropriate health decisions in life. HL is particularly valuable in later life when health challenges grow. An individual’s HL is typically considered a fixed and skills-based characteristic, without taking into account how these are situated in the context of everyday life. Also, lay perspectives on health literacy are relatively scarce. Therefore, the aim of this article is to explore the context-specific perspectives of older adults and health professionals on HL in later life in Greece, Hungary, and the Netherlands. We adopted a qualitative methodology and conducted 12 focus groups: seven with 50 older adults and five with 30 health professionals to gain insight into individual perspectives on HL as situated in the health care and everyday life contexts. An informed grounded theory approach was used in analyzing the data. The results are structured in three themes: (1) interactions with health professionals, (2) perceived quality of the health care system, and (3) managing health in the context of everyday life. An overarching finding is that, for older adults, HL reflects the demands placed on them when managing their health. In the experience of older adults, these demands are placed upon them by healthcare professionals, the healthcare system, as well as their everyday lives. Our findings underscore the importance of Critical Health Literacy (CHL) as that concept foregrounds that HL is context specific. Also, CHL has been argued to be a community characteristic, which is why we call for community-based approaches to improve HL.
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Jager M, de Zeeuw J, Tullius J, Papa R, Giammarchi C, Whittal A, de Winter AF. Patient Perspectives to Inform a Health Literacy Educational Program: A Systematic Review and Thematic Synthesis of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4300. [PMID: 31694299 PMCID: PMC6862529 DOI: 10.3390/ijerph16214300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 01/22/2023]
Abstract
Patient-centred care is tailored to the needs of patients and is necessary for better health outcomes, especially for individuals with limited health literacy (LHL). However, its implementation remains challenging. The key to effectively address patient-centred care is to include perspectives of patients with LHL within the curricula of (future) healthcare providers (HCP). This systematic review aimed to explore and synthesize evidence on the needs, experiences and preferences of patients with LHL and to inform an existing educational framework. We searched three databases: PsychInfo, Medline and Cinahl, and extracted 798 articles. One-hundred and three articles met the inclusion criteria. After data extraction and thematic synthesis, key themes were identified. Patients with LHL and chronic diseases encounter multiple problems in the care process, which are often related to a lack of person-centeredness. Patient perspectives were categorized into four key themes: (1) Support system; (2) Patient self-management; (3) Capacities of HCPs; (4) Barriers in healthcare systems. "Cultural sensitivity" and "eHealth" were identified as recurring themes. A set of learning outcomes for (future) HCPs was developed based on our findings. The perspectives of patients with LHL provided valuable input for a comprehensive and person-centred educational framework that can enhance the relevance and quality of education for (future) HCPs, and contribute to better person-centred care for patients with LHL.
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Affiliation(s)
- Margot Jager
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
| | - Janine de Zeeuw
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
- Department of Medical Sciences, Educational Institute, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Janne Tullius
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
| | - Roberta Papa
- Regional Health Agency Marche Region, 60125 Ancona, Italy; (R.P.); (C.G.)
- IRCCS INRCA, 60124 Ancona, Italy
| | - Cinzia Giammarchi
- Regional Health Agency Marche Region, 60125 Ancona, Italy; (R.P.); (C.G.)
- IRCCS INRCA, 60124 Ancona, Italy
| | - Amanda Whittal
- Department of Psychology & Methods, Jacobs University, 28759 Bremen, Germany;
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
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Brooks C, Ballinger C, Nutbeam D, Mander C, Adams J. Nursing and allied health professionals' views about using health literacy screening tools and a universal precautions approach to communication with older adults: a qualitative study. Disabil Rehabil 2019; 42:1819-1825. [PMID: 30669896 DOI: 10.1080/09638288.2018.1538392] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Health literacy describes individuals' abilities to access, understand and use health information. Lower health literacy is associated with poor health outcomes, is more common among older adults and impacts on the effectiveness of rehabilitation/self-management interventions. This research explored nursing and allied healthcare professionals' views about identifying and responding to older adults' health literacy needs.Methods: Qualitative focus groups were conducted with a purposive sample of 22 UK nursing and AHPs working with older adults. Focus groups were audio-recorded, transcribed verbatim and analyzed using framework approach.Results: Participants used a variety of practices to identify older patients' health literacy levels, but primarily relied on subtle cues. Participants lacked knowledge and confidence in identifying and addressing health literacy needs. Participants expressed concerns about patient reactions and described practical barriers to using recommended health literacy strategies.Conclusions: Participants recognized the importance of addressing patients' health literacy needs, but do not routinely use health literacy strategies, lack confidence and have reservations about recommended health literacy strategies. This impacts on healthcare professionals' abilities to support patients to self-manage and participate in rehabilitation. Health literacy education for health professionals should consider barriers to using health literacy strategies and be tailored to accommodate variation in teams and professions.Implications for rehabilitationRehabilitation professionals need to standardise their practice to health literacy, using strategies which can be easily integrated into routine practice.To meet older adults' health literacy needs, rehabilitation professionals should use clear and accessible tailored communication, build trust, assess understanding and involve patients' social networks.Rehabilitation professionals would benefit from further education regarding health literacy to build their knowledge/confidence and address their concerns about implementing health literacy strategies.Professional education regarding health literacy needs to accommodate variation between individuals and teams.
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Affiliation(s)
- Charlotte Brooks
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.,Therapy Services, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Don Nutbeam
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.,School of Public Health, University of Sydney, Sydney, Australia
| | - Clare Mander
- Quality and Professional Standards, Solent NHS Trust, Southampton, UK
| | - Jo Adams
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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Vogt D, Schaeffer D, Messer M, Berens EM, Hurrelmann K. Health literacy in old age: results of a German cross-sectional study. Health Promot Int 2017; 33:739-747. [DOI: 10.1093/heapro/dax012] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Dominique Vogt
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, Bielefeld, Germany
| | - Doris Schaeffer
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, Bielefeld, Germany
| | - Melanie Messer
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, Bielefeld, Germany
| | - Eva-Maria Berens
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Universitätsstraße 25, Bielefeld, Germany
| | - Klaus Hurrelmann
- Professor of Public Health and Education, Hertie School of Governance, Friedrichstraße 180, Berlin, Germany
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Howard Wilsher S, Brainard J, Loke Y, Salter C. Patient and public involvement in health literacy interventions: a mapping review. RESEARCH INVOLVEMENT AND ENGAGEMENT 2017; 3:31. [PMID: 29276627 PMCID: PMC5738234 DOI: 10.1186/s40900-017-0081-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/24/2017] [Indexed: 05/15/2023]
Abstract
PLAIN ENGLISH SUMMARY If people can read, understand and act on health information to better their health and reduce illness, they are thought to have "adequate" health literacy. Poor health literacy can mean people are less able to access health care and manage their health. Health literacy tends to worsen as adults get older, and is especially poor in adults age 65 and over. Ideally, health literacy interventions target people before age 65, to establish good skills and habits before people have many health problems associated with ageing. It is also good if researchers consult ordinary people, including patients and the public (PPI) when planning a programme to try to improve health literacy. This may help ensure individual needs are catered for.We therefore looked for studies that described any role of patient or public representatives in the research planning stages. We explored how the representatives contributed to each project. We found only 20 studies that included people other than the research team. Lack of reporting and consultation with patient and public representatives may contribute to less success when public health programmes are undertaken. BACKGROUND Health literacy is the ability to understand, access and use health care and is a critical mediating factor that affects the health of older adults. Patient and public involvement in health and social care research, policy and design of care delivery is one mechanism that can promote production of better health literacy. This mapping review looks for and describes practices, concepts and methods that have been reported involving patients and public in the development and design of health literacy interventions for older people. METHODS Studies for the present review were selected from an inventory of health behaviour studies published between 2003 and 2013. The inventory was created by systematic searches on bibliographic databases (Medline, CINAHL, Scopus, Google) for health literacy interventions involving older people (50+ years) and resulted in screening of 5561 articles, of which 1097 met study inclusion criteria. For the research described in this article 96 of the 1097 studies specifically focused on health literacy and were independently screened by two reviewers to assess involvement of stakeholders other than investigators and participants. RESULTS Twenty studies included patient and/or public involvement in at least one research domain: design, management or evaluation. Involvement included volunteers, older people, patients, and/or community representatives. CONCLUSIONS Patient and public involvement were rarely reported in studies on health literacy interventions for older people. Future intervention development needs high quality PPI, which is well reported to develop the evidence base and inform practice.
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Affiliation(s)
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - Yoon Loke
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - Charlotte Salter
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
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12
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Brooks C, Ballinger C, Nutbeam D, Adams J. The importance of building trust and tailoring interactions when meeting older adults’ health literacy needs. Disabil Rehabil 2016; 39:2428-2435. [DOI: 10.1080/09638288.2016.1231849] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Charlotte Brooks
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Claire Ballinger
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Don Nutbeam
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Jo Adams
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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13
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Brainard J, Wilsher SH, Salter C, Loke YK. Methodological review: quality of randomized controlled trials in health literacy. BMC Health Serv Res 2016; 16:246. [PMID: 27402048 PMCID: PMC4940982 DOI: 10.1186/s12913-016-1479-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 06/20/2016] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The growing move towards patient-centred care has led to substantial research into improving the health literacy skills of patients and members of the public. Hence, there is a pressing need to assess the methodology used in contemporary randomized controlled trials (RCTs) of interventions directed at health literacy, in particular the quality (risk of bias), and the types of outcomes reported. METHODS We conducted a systematic database search for RCTs involving interventions directed at health literacy in adults, published from 2009 to 2014. The Cochrane Risk of Bias tool was used to assess quality of RCT implementation. We also checked the sample size calculation for primary outcomes. Reported evidence of efficacy (statistical significance) was extracted for intervention outcomes in any of three domains of effect: knowledge, behaviour, health status. Demographics of intervention participants were also extracted, including socioeconomic status. RESULTS We found areas of methodological strength (good randomization and allocation concealment), but areas of weakness regarding blinding of participants, people delivering the intervention and outcomes assessors. Substantial attrition (losses by monitoring time point) was seen in a third of RCTs, potentially leading to insufficient power to obtain precise estimates of intervention effect on primary outcomes. Most RCTs showed that the health literacy interventions had some beneficial effect on knowledge outcomes, but this was typically for less than 3 months after intervention end. There were far fewer reports of significant improvements in substantive patient-oriented outcomes, such as beneficial effects on behavioural change or health (clinical) status. Most RCTs featured participants from vulnerable populations. CONCLUSIONS Our evaluation shows that health literacy trial design, conduct and reporting could be considerably improved, particularly by reducing attrition and obtaining longer follow-up. More meaningful RCTs would also result if health literacy trials were designed with public and patient involvement to focus on clinically important patient-oriented outcomes, rather than just knowledge, behaviour or skills in isolation.
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Affiliation(s)
- Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | | | - Charlotte Salter
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - Yoon Kong Loke
- Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
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Smith CA, Chang E, Brownhill S, Barr K. Complementary Medicine Health Literacy among a Population of Older Australians Living in Retirement Villages: A Mixed Methods Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:5672050. [PMID: 27429638 PMCID: PMC4939197 DOI: 10.1155/2016/5672050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/16/2016] [Accepted: 05/25/2016] [Indexed: 11/17/2022]
Abstract
Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of "trust" and "try and see" provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills.
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Affiliation(s)
- Caroline A. Smith
- National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Esther Chang
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Suzanne Brownhill
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Kylie Barr
- National Institute of Complementary Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
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McClure E, Ng J, Vitzthum K, Rudd R. A Mismatch Between Patient Education Materials About Sickle Cell Disease and the Literacy Level of Their Intended Audience. Prev Chronic Dis 2016; 13:E64. [PMID: 27172259 PMCID: PMC4867305 DOI: 10.5888/pcd13.150478] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Despite the first goal of the 2010 National Action Plan to Improve Health Literacy, the literacy demands of much health information exceeds the reading skills of most US adults. The objective of this study was to assess the health literacy level of publicly available patient education materials for people with sickle cell disease (SCD). METHODS We used 5 validated tools to evaluate 9 print and 4 online patient education materials: the simple measure of gobbledygook (SMOG) to assess reading grade level, the Peter Mosenthal and Irwin Kirsch readability formula (PMOSE/IKIRSCH) to assess structure and density, the Patient Education Materials Assessment Tool (PEMAT) to assess actionability (how well readers will know what to do after reading the material) and understandability, the Centers for Disease Control and Prevention's (CDC's) Clear Communication Index (Index) to obtain a comprehensive literacy demand score, and the Printed Cancer Education Materials for African Americans Cultural Sensitivity Assessment Tool. RESULTS Materials' scores reflected high reading levels ranging from 8th grade to 12th grade, appropriate (low) structural demand, and low actionability relative to understandability. CDC suggests that an appropriate Index score should fall in or above the 90th percentile. The scores yielded by materials evaluated in this assessment ranged from the 44th to the 76th percentiles. Eight of the 13 materials scored within the acceptable range for cultural sensitivity. CONCLUSION Reading levels of available patient education materials exceed the documented average literacy level of the US adult population. Health literacy demands should be a key consideration in the revision and development of patient education materials for people with SCD.
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Affiliation(s)
- Elizabeth McClure
- University of North Carolina at Chapel Hill - Epidemiology, 135 Dauer Dr, 2101 McGavran-Greenberg Hall, CB No 7435, Chapel Hill, NC 27599. . Ms. McClure is also affiliated with Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences
| | - Jared Ng
- Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Kelly Vitzthum
- Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Rima Rudd
- Harvard TH Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
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Brainard J, Loke Y, Salter C, Koós T, Csizmadia P, Makai A, Gács B, Szepes M. Healthy ageing in Europe: prioritizing interventions to improve health literacy. BMC Res Notes 2016; 9:270. [PMID: 27176006 PMCID: PMC4866482 DOI: 10.1186/s13104-016-2056-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 04/20/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Health literacy (HL) is low for 40-50 % of the population in developed nations, and is strongly linked to many undesirable health outcomes. Older adults are particularly at risk. The intervention research on health literacy in ageing populations project systematically created a large inventory of HL interventions targeting adults age 50+ , to support practical production of policy and practice guidelines for promoting health literacy in European populations. METHODS We comprehensively surveyed international scientific literature, grey literature and other sources (published 2003+) for implemented HL interventions that involved older adults. Studies were screened for eligibility criteria and further selected for aspects important in European public health policy, including priority diseases, risk factors and vulnerable target groups. Interventions were prioritised using a multiple criteria tool to select final interventions that also featured strong evidence of efficacy and a broad range of strategies. RESULTS From nearly 7000 written summaries, 1097 met inclusion criteria, of which 233 were chosen for scoring and ranking. Of these, seven had the highest multi-criteria scores. Eight more articles were selected based on rounded criteria including a high multi-criteria score as well as elements of innovation. Final selections were 18 articles describing 15 programmes, which feature strong evidence of efficacy among important diseases or risk factors and vulnerable groups, or that had success with elements of innovation were identified. Most programmes tried to increase skills in communication, self-management and understanding healthcare or lifestyle choices. CONCLUSIONS These programmes have multiple positive attributes which could be used as guidance for developing innovative intervention programmes to trial on European older adults. They provide evidence of efficacy in addressing high priority diseases and risk factors.
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Affiliation(s)
- Julii Brainard
- />Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - Yoon Loke
- />Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - Charlotte Salter
- />Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ UK
| | - Tamás Koós
- />Hungarian National Institute for Health Development, Budapest, 1437 Hungary
| | - Péter Csizmadia
- />Hungarian National Institute for Health Development, Budapest, 1437 Hungary
| | - Alexandra Makai
- />Hungarian National Institute for Health Development, Budapest, 1437 Hungary
- />Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pécs, 7621 Hungary
| | - Boróka Gács
- />Hungarian National Institute for Health Development, Budapest, 1437 Hungary
- />Department of Behavioural Sciences, University of Pécs Medical School, Pécs, 7624 Hungary
| | - Mária Szepes
- />Hungarian National Institute for Health Development, Budapest, 1437 Hungary
- />Institute of Behavioural Sciences, Semmelweis University Budapest, Budapest, 1089 Hungary
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