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Folayan MO, Coelho EMRDB, Ayouni I, Nguweneza A, Al-Batayneh OB, Daryanavard H, Duangthip D, Sun IG, Arheiam A, Virtanen JI, Gaffar B, El Tantawi M, Schroth RJ, Feldens CA. Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review. BMC Oral Health 2024; 24:517. [PMID: 38698356 PMCID: PMC11064360 DOI: 10.1186/s12903-024-04291-w] [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: 03/22/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC. METHODS The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework. RESULTS In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4-12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services. CONCLUSION The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Elisa Maria Rosa de Barros Coelho
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
- Department of Pediatric Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Imen Ayouni
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arthemon Nguweneza
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ola Barakat Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Preventive Dentistry Department, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamideh Daryanavard
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dubai Health Authority, Dubai, United Arab Emirates
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Arheiam Arheiam
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community and Preventive Dentistry, University of Benghazi, Benghazi, Libya
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Maha El Tantawi
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Canada
| | - Carlos Alberto Feldens
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
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Consales A, Toscano L, Ceriotti C, Tiraferri V, Castaldi S, Giannì ML. From womb to world: mapping gut microbiota-related health literacy among Italian mothers, a cross-sectional study. BMC Public Health 2024; 24:1012. [PMID: 38605379 PMCID: PMC11010343 DOI: 10.1186/s12889-024-18497-8] [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: 12/12/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The gut microbiota is a key determinant of long-term health. Promoting maternal health literacy may enhance children well-being. Aim of the present study was to assess gut microbiota-related health literacy of Italian women and identify potential gaps in awareness. METHODS A cross-sectional survey study was conducted using an online questionnaire (17 questions) on determinants and long-term impact of infant gut microbiota. The survey targeted Italian pregnant women and mothers of children under 2 years old, and was distributed through various social media channels between September 28th and November 15th, 2022. A total score was calculated as the sum of positive answers. Data on demographics, pregnancy status, and pre-existing knowledge of the infant gut microbiota were also collected. Descriptive and inferential statistics were applied. RESULTS The questionnaire was completed by 1076 women. Median total score was 9 [7-11]. The 81.7% of respondents declared prior knowledge of the gut microbiota. The internet was among the most commonly cited primary sources of information. Independent predictors of total score were having a university degree (B = 0.656, p = 0.002) and prior knowledge (B = 2.246, p < 0.001). Conversely, older age was associated with lower total scores (B = -0.092, p < 0.001). The least known determinants of infant gut microbiota were gestational BMI, prematurity, mode of delivery and NICU stay. Pregnant women failed to recognize the role of breastfeeding in the development of infant gut microbiota more frequently than non-pregnant women. The 97.5% of participants reported increased interest in the gut microbiota, with heightened interest associated with prior knowledge. CONCLUSIONS Our study revealed a moderate level of knowledge about infant gut microbiota among respondents, emphasizing the positive impact of prior knowledge on understanding and interest. Targeted educational interventions are needed to address awareness gaps, especially concerning the influence of breastfeeding on infant gut microbiota. Healthcare providers have the potential to enhance women's knowledge and awareness of this topic.
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Affiliation(s)
- Alessandra Consales
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Letizia Toscano
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Chiara Ceriotti
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Valentina Tiraferri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Quality Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Lorella Giannì
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ofori Boateng M, Asuman D, Kugbey N, Amoah PA, Agyei-Baffour P, Enemark U. Health literacy and household financial loss on malaria treatment for children under five in Ghana: a patients' perspective. Int Health 2024:ihae022. [PMID: 38563469 DOI: 10.1093/inthealth/ihae022] [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: 08/25/2023] [Revised: 01/17/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Inadequate health literacy increases medical costs and leads to poor health outcomes. However, there is a paucity of empirical evidence of such associations in sub-Saharan Africa. This study investigates how the household cost of malaria in children under five in Ghana varies based on different levels of health literacy. METHODS A cross-sectional survey involving 1270 caregivers of children under five was conducted. The survey included health literacy questionnaire and several pieces of sociodemographic and behavioural variables. RESULTS We created seven caregiver health literacy profiles by scoring nine dimensions. The mean total cost for managing malaria among respondents was US$20.29 per episode. The total household cost for caregivers with high health literacy (Profile 1) (US$24.77) was higher than all other profiles, with the lowest cost (US$17.93) among the low health literacy profile (Profile 6). Compared with Profile 4, caregivers with high health literacy (Profile 1) spent more on managing malaria in children, while those with the lowest health literacy (Profile 7) spent less. CONCLUSION The current study presents a snapshot of malaria treatment costs, and argues that low health literacy may lead to increased costs due to possible reinfections from delayed healthcare use. There is a need for longitudinal studies to understand causal relationship between health literacy and household expenses on malaria treatment to inform policy development and interventions. LAY SUMMARY This study explores the impact of caregiver health literacy levels on the cost of managing malaria incidents in children under five in Ghana. High health-literate caregivers incurred the highest total household cost at US$24.77, with US$17.93 incurred by lower health-literate caregivers per malaria episode.
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Affiliation(s)
- Millicent Ofori Boateng
- Faculty of Health, Department of Public Health, Aarhus University, Bartholins Alle 2, Building 1260, DK 8000 Aarhus C, Aarhus, Denmark
- School of Public Health, Department of Community Health, Ensign Global College, P.O. Box AK 136, Akosombo, Eastern Region, Ghana
| | - Derek Asuman
- Health Economics Unit, Lund University, Medicon Village 301:5, Scheelevagen 2, 223 81, Box 117, 221 00 Lund, Sweden
| | - Nuworza Kugbey
- School of Public Health, Department of Community Health, Ensign Global College, P.O. Box AK 136, Akosombo, Eastern Region, Ghana
- Department of General Studies, School of Natural and Environmental Sciences, University of Environment and Sustainable Development, PMB, Somanya, Ghana
| | - Padmore Adusei Amoah
- Department of Psychology, Institute of Policy Studies, School of Graduate Studies, Lingnan University, 8 Castle Peak Road, Lingnan, Tuen Mun, Hong Kong
| | - Peter Agyei-Baffour
- Department of Occupational Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Private Mail Bage, University Post Office, Kumasi, Ghana
| | - Ulrika Enemark
- Faculty of Health, Department of Public Health, Aarhus University, Bartholins Alle 2, Building 1260, DK 8000 Aarhus C, Aarhus, Denmark
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Hölgyesi Á, Luczay A, Tóth-Heyn P, Muzslay E, Világos E, Szabó AJ, Baji P, Kovács L, Gulácsi L, Zrubka Z, Péntek M. The Impact of Parental Electronic Health Literacy on Disease Management and Outcomes in Pediatric Type 1 Diabetes Mellitus: Cross-Sectional Clinical Study. JMIR Pediatr Parent 2024; 7:e54807. [PMID: 38506893 PMCID: PMC10993131 DOI: 10.2196/54807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Despite the growing uptake of smart technologies in pediatric type 1 diabetes mellitus (T1DM) care, little is known about caregiving parents' skills to deal with electronic health information sources. OBJECTIVE We aimed to assess the electronic health literacy of parents caring for children with T1DM and investigate its associations with disease management and children's outcomes. METHODS A cross-sectional survey was performed involving 150 parent-child (8-14 years old with T1DM) dyads in a university pediatric diabetology center. Parents' electronic health literacy (eHealth Literacy Scale [eHEALS]), general health literacy (Chew questionnaire and Newest Vital Sign [NVS]), and attitudes toward T1DM care (Parental Self-Efficacy Scale for Diabetes Management [PSESDM] and Hypoglycemia Fear Survey [HFS]) were investigated. Children's treatment, HbA1c level, and quality of life (Pediatric Quality of Life Inventory Diabetes Module [PedsQL Diab] and EQ-5D-Y-3L) were assessed. Multiple linear regression analysis was performed to investigate the determining factors of 6-month average HbA1c. RESULTS Of the 150 children, 38 (25.3%) used a pen, 55 (36.7%) used a pen plus a sensor, 6 (4.0%) used an insulin pump, and 51 (34.0%) used an insulin pump plus a sensor. Parents' average eHEALS score (mean 31.2, SD 4.9) differed significantly by educational level (P=.04) and the children's treatment (P=.005), being the highest in the pump + sensor subgroup. The eHEALS score showed significant Pearson correlations with the Chew score (r=-0.45; P<.001), NVS score (r=0.25; P=.002), and PSESDM score (r=0.35; P<.001) but not with the children's HbA1c (r=-0.143; P=.08), PedsQL Diab (r=-0.0002; P>.99), and EQ-5D-Y-3L outcomes (r=-0.13; P=.12). Regression analysis revealed significant associations of the child's HbA1c level with sex (β=0.58; P=.008), treatment modality (pen + sensor: β=-0.66; P=.03; pump + sensor: β=-0.93; P=.007), and parents' self-efficacy (PSESDM; β=-0.08; P=.001). CONCLUSIONS Significantly higher parental electronic health literacy was found in T1DM children using a glucose sensor. The electronic health literacy level was associated with parents' diabetes management attitude but not with the child's glycemic control. Studies further investigating the role of parental electronic health literacy in T1DM children managed at different levels of care and the local context are encouraged.
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Affiliation(s)
- Áron Hölgyesi
- Doctoral School, Semmelweis University, Budapest, Hungary
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Andrea Luczay
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | | | - Eszter Muzslay
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Eszter Világos
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Attila J Szabó
- Pediatric Center, Semmelweis University, Budapest, Hungary
| | - Petra Baji
- Musculoskeletal Research Unit, University of Bristol, Bristol, United Kingdom
| | - Levente Kovács
- Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
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Tahan L, Habchy P, Moussi C, Khadra T, Jawich M, Njeim A, Kattan O, Abou Habib L, El Bitar W, El Asmar B, Chahine MN. A National School Health Campaign in Lebanon on Children Aged between 3 and 12 Years Old: Concordance Level between Parents' Reports and Medical Visit Findings about Physical and Mental Health. CHILDREN (BASEL, SWITZERLAND) 2024; 11:214. [PMID: 38397326 PMCID: PMC10887313 DOI: 10.3390/children11020214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
A school's commitment to promoting health extends beyond students' efforts to encompass parental involvement and must recognize the critical role of parents in enhancing overall student well-being. This study, conducted in 27 schools across Lebanon, assessed parents' awareness of their children's physical and mental health. A school health campaign involved direct medical interventions on 7184 students, followed by phone interviews with 3880 parents to compare their responses with the medical findings. Discordances ranged from extreme mismatches (≥50%) to mild mismatches (<15%), with notable disparities in incomplete vaccination (67.8%), BMI (59%), and mental health indicators (expressions of sadness (69.1%), loneliness (61.0%), and anxiety (53.4%)). Factors such as school type, child's age, governorate, family income, parents' occupation, education level, and marital status significantly influenced discordance rates. Notably, mental health aspects exhibited higher disparities, emphasizing the need for improved communication between parents, physicians, and children. Bridging these gaps could empower parents with better knowledge, fostering environments conducive to lifelong healthy behaviors in children. The study underscores the urgency for enhanced communication strategies to bridge discrepancies and ensure a more comprehensive understanding of children's physical and mental well-being.
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Affiliation(s)
- Léa Tahan
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Peter Habchy
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Charbel Moussi
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Tia Khadra
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Melissa Jawich
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Alain Njeim
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Ogarite Kattan
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
| | - Leila Abou Habib
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
| | - Wassim El Bitar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Department of Pediatrics, Bellevue Medical Center University Hospital, Mansourieh P.O. Box 295, Lebanon
| | - Béchara El Asmar
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Faculty of Medicine, Saint Joseph University, Beirut P.O. Box 17-5208, Lebanon
- Department of Cardiology, Hotel-Dieu de France Hospital, Achrafieh, Beirut P.O. Box 11-5190, Lebanon
| | - Mirna N. Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon; (L.T.); (P.H.); (C.M.); (T.K.); (M.J.); (A.N.); (O.K.)
- Lebanese Association of the Knights of Malta (Order of Malta Lebanon), Vanlian Bldg, 6th Fl. City Rama Str. Dekwaneh, Beirut P.O. Box 11-4286, Lebanon; (L.A.H.); (W.E.B.); (B.E.A.)
- Basic Sciences Department, Faculty of Medical Sciences, Lebanese University, Hadath P.O. Box 3, Lebanon
- Foundation-Medical Research Institutes (F-MRI®), Achrafieh, Beirut P.O. Box 64, Lebanon
- Foundation-Medical Research Institutes (F-MRI®), 1211 Geneva, Switzerland
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Ladd DL, Everette SS. Development of a Health Literacy Workshop. J Nurses Prof Dev 2023; 39:267-271. [PMID: 37683204 DOI: 10.1097/nnd.0000000000000870] [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: 11/25/2022]
Abstract
A consumer health librarian and nurse educators collaborated to conduct health literacy workshops to teach healthcare providers skills to reduce the health literacy burden of their patients. The workshop content included health literacy overview, patient literacy levels, teach-back, evaluation of patient educational materials, and finding consumer health information. Forty-eight healthcare providers registered, and 39 in total attended one of five workshops and represented eight healthcare disciplines. Feedback from the workshops was positive.
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Hollo A, Nimmer M, Cheaton B, Melzer-Lange M, Levas M. Youth victim perspective: optimizing presentation of patient-reported outcomes in a violence intervention program. Inj Epidemiol 2023; 10:37. [PMID: 37491300 PMCID: PMC10369679 DOI: 10.1186/s40621-023-00451-8] [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: 12/03/2022] [Accepted: 07/07/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION The health, well-being and psychological development of children in urban areas is threatened by exposure to interpersonal violence. Violence intervention programs, such as Project Ujima, provide children with comprehensive treatment following exposure to violence. Services focus on the interruption of the violence cycle, mental health, and developing resiliency. The collection of patient-reported outcomes (PROs) from youth victims of violence informs community-based, programmatic, and individual participant interventions. Although the collection of PROs throughout treatment has been demonstrated to be feasible, youth and crime victim specialist preferences for data presentation is unknown. We sought to determine patient and crime victim specialist preferences regarding which PROs are of interest and how best to visually display them for optimal engagement. RESULTS Fifteen youth and nine crime victim specialists consented to participate. Both preferred visuals with the highest level of color-shading and descriptions. The domains with the highest level of interest among both youth and case workers were social, anger, emotional, school, physical, peer relations, and psychosocial well-being. Youth and crime victim specialists expressed low interest in positive affect, meaning/purpose, physical stress experience, and depression domains. Youth wanted to see their scores compared to others in the program, while crime victim specialists did not think such comparisons would be beneficial. In contrast to youth, crime victim specialists believed youth should see their physical functioning and PTSD scores. CONCLUSION Youth participants and their crime victim specialists in a violence intervention program desired to see their PROs in a graphical form and agreed on their preference for many of the domains except for PTSD and physical functioning. Both groups preferred visuals with the highest level of shading and descriptions. Further investigation is needed to determine how to implement PRO visuals with the desired domains into regular violence intervention programming. METHODS Participants in Project Ujima's 8-week summer camp, ages 7-18 years, who were either a victim of violent injury, a direct relative of a violent injury victim, or a homicide survivor were recruited for this qualitative study. Crime victim specialists, who work directly with these youth throughout the year, were also recruited to participate. We conducted structured interviews to determine which parameters and visual formats were of highest interest and best understood by youth participants and crime victim specialists.
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Affiliation(s)
| | - Mark Nimmer
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI USA
| | | | | | - Michael Levas
- Section of Emergency Medicine, Medical College of Wisconin, Milwaukee, WI USA
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Lin M, Chu M, Li X, Ma H, Fang Z, Mao L, Wang P, Chen T, Chiang YC. Factors influencing adolescent experimental and current smoking behaviors based on social cognitive theory: A cross-sectional study in Xiamen. Front Public Health 2023; 11:1093264. [PMID: 37033036 PMCID: PMC10073720 DOI: 10.3389/fpubh.2023.1093264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction China has the largest youth population in the world. To better implement the Smoke-free School Initiative, this study aims to examine the protective and risk factors for different smoking behaviors (never smoked, experimental smoking, and current smoking) among school adolescents based on social cognitive theory. Methods This research was a secondary analysis of a cross-sectional survey of middle schools in Huli District of Xiamen, China. The final sample consisted of 1937 participants with an average age of 15.41 (SD = 1.64). Descriptive statistics were used to summarize the sociodemographic characteristics of the sample. Multivariate multinomial logistic regression analysis was performed using four models. Results Of the respondents, 1685 (86.99%) were never smokers, 210 (10.84%) were experimental smokers, and 42 (2.17%) were current smokers. Social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies were associated with adolescents' smoking behaviors. The number of smoking family members, classmates smoking, the perception that smoking is cool and attractive, and attitudes toward control tobacco policies were the predictors of current smoking behavior (p < 0.05). In contrast, friends smoking and individual and social relationship motivation were associated with only experimental smoking (p < 0.05). Discussion The relationship of social norms, positive outcome expectations, anti-smoking self-efficacy, and attitudes toward control tobacco policies varied across smoking behaviors. Family, school, society and the government need to cooperate in prevention and intervention programs for adolescent smoking. The relationships between these factors and adolescents' different smoking behaviors needs to be further verified.
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Affiliation(s)
- Manzhi Lin
- Xiamen Huli District Center for Disease Control and Prevention, Xiamen, China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Honghao Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Zhiwei Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Li Mao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Pengjun Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Straughan PT, Xu C. How does parents' social support impact children's health practice? Examining a mediating role of health knowledge. Glob Health Res Policy 2023; 8:8. [PMID: 36945067 PMCID: PMC10028785 DOI: 10.1186/s41256-023-00291-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 03/05/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Family environmental factors play a vital role in shaping children's health practices (e.g., obesity prevention). It is still unclear how parents' social support affects children's obesity-related health practices. The present study argues that whether parents' social support positively associates with children's obesity-related health practice depends on if it could promote parents' obesity-related health knowledge. Thus, we hypothesize that health knowledge mediates the relationship between parents' social support and children's health practice regarding weight management. METHODS To test the hypothesis, we conducted a questionnaire survey and collected a nationally representative sample of 1488 household responses in Singapore. The survey included questions about parents' social support, health knowledge, children's health practices, and socio-demographic variables. All participants have at least one child 14 years old or younger. In the sample, 66.1% of the respondents are female, and 93.7% are below 50 years old. Structural equation modeling (SEM) via Stata was used to examine the associations between parents' social support, health knowledge, and children's health practice. RESULTS The results of our analysis support our hypothesis. Specifically, (1) parents' social support shows a positive relationship with health knowledge (Coef. = 0.17, p < 0.001 for BMI knowledge and Coef. = 0.18, p < 0.001 for nutrition knowledge); (2) parents' social support (total effect of social support = 0.081, p = 0.071) and health knowledge positively associate with children's obesity-related health practice (coefficient of BMI knowledge = 0.10, p < 0.01; coefficient of nutrition knowledge = 0.31, p < 0.001); and (3) the effects of parents' social support on children's health practice is fully mediated by parents' health knowledge (mediating effect = 100%, p = 0.007). CONCLUSION The present study provides fresh evidence from a multicultural context to understand the relationships between parents' social support, health knowledge, and children's obesity-related health practice. Our findings support the argument that social support from parents' social networks does not necessarily promote health outcomes. The only social support that carries proper health knowledge can facilitate good health practice.
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Affiliation(s)
- Paulin Tay Straughan
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Chengwei Xu
- Public Management and Policy Analysis (PMPP), Graduate School of International Relations (GSIR), International University of Japan (IUJ), Minamiuonuma, Japan.
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10
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Oncel D, Bal S, Mazon NKC, Smith Z, Marjane S, Gable E. Use of Informational Brochures on Knowledge of Cataracts in Rural Ecuador. Cureus 2023; 15:e35555. [PMID: 37007411 PMCID: PMC10060030 DOI: 10.7759/cureus.35555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
Background Cataracts are the leading global cause of preventable blindness. Despite the high prevalence of cataracts in rural Ecuadorian communities, no community-wide educational efforts on the impact of cataract-related blindness have been attempted. This study used an educational brochure to assess individual knowledge of cataract blindness before and after the distribution of the brochure. Methods We conducted electronic surveys with 100 patients over the age of 18 who visited the Fundacion Internacional Buen Samaritano Paul Martel (FIBUSPAM) clinic serving the Chimborazo region of Ecuador. Participation in the study included an introduction and written consent followed by a pre-survey. Every patient was given a brochure. After reviewing the brochure, patients were then asked to complete the same survey again. Each survey question received one mark. Knowledge was considered "good" if the subject correctly answered four out of seven questions and "poor" if they scored ≤3. Results Of the 100 patients, 21 had poor knowledge surrounding cataracts. Cataract awareness was lowest in the group without formal education (50%). In addition, 17 participants demonstrated poor knowledge before the informational brochure was distributed, and all improved to "good" knowledge after. Following brochure distribution, there was an improved knowledge of cataract anatomy (correct answer: 32.9% to 94.6%), treatment of cataracts (80% to 95.9%), cataract symptoms (36.7% to 95.9%), age at risk (88.8% to 97.3%), and relationship to blindness (93.5% to 98.6%). In contrast, overall knowledge of the risk factors for cataracts (46.8% to 37%) and prevention of the onset of the cataract (81.3% to 77%) slightly decreased after the brochure was given. Overall, the increase in the number of correct answers after the brochure was not significant (p = 0.25). Conclusions To our knowledge, this is a rare study to assess the effect of informational brochures on cataract knowledge in rural Ecuador. This study was limited by selection bias and did not look at the long-term recall of knowledge. The results of this study suggest that brochures can improve health awareness; however, brochures alone may not be enough. Additional assessments on the use of oral and visual aids are needed. Health education efforts should go beyond simple brochures and focus on innovative strategies to improve health education and communication efforts.
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11
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Zaidman EA, Scott KM, Hahn D, Bennett P, Caldwell PH. Impact of parental health literacy on the health outcomes of children with chronic disease globally: A systematic review. J Paediatr Child Health 2023; 59:12-31. [PMID: 36536542 DOI: 10.1111/jpc.16297] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/24/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
AIM Health literacy is the ability to understand and interpret health information and navigate the health-care system. Low health literacy is associated with poorer health knowledge and disease management, increased chronic illness, underutilisation of preventative health services and increased hospitalisations. The aim of the study is to review the available literature on the relationship between parental health literacy and health outcomes for children with chronic disease in high-income countries (HIC) and low- and middle-income countries (LMIC). METHODS We systematically searched Medline, EMBASE and Web of Science, and assessed study quality using the Newcastle Ottawa Scale. We reviewed all relevant studies, and identified themes using thematic analysis. RESULTS Of 1167 studies assessed, 49 were included in the review. All studies were of adequate quality. Twenty-two were from LMIC and 27 from HIC. Six themes were identified: Parental health literacy, parental education, socio-economic conditions, identity and culture, family factors, and health behaviours. In both HIC and LMIC, lower parental health literacy was associated with poorer child health outcomes. Disease-specific knowledge was found in a number of papers to directly impact parent health behaviour and child health outcomes, and may mitigate the effects of low parental health literacy. CONCLUSION There is a clear link between parental health literacy, health behaviour and health outcomes for children with chronic disease. Disease-specific knowledge as a target for health-care interventions holds promise for application in low-resourced settings with parents (particularly mothers) who have lower health literacy, where disease-specific education may improve child health outcomes, although more research is required to determine how we can best facilitate these programmes.
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Affiliation(s)
- Elaine A Zaidman
- Department of Paediatric Intensive Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Karen M Scott
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Deirdre Hahn
- Department of Nephrology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Patricia Bennett
- Medical Library, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Patrina Hy Caldwell
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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12
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Liu Y, Shepherd-Banigan M, Evans KE, Stilwell L, Terrell L, Hurst JH, Gifford EJ. Do children evaluated for maltreatment have higher subsequent emergency department and inpatient care utilization compared to a general pediatric sample? CHILD ABUSE & NEGLECT 2022; 134:105938. [PMID: 36330904 PMCID: PMC11025450 DOI: 10.1016/j.chiabu.2022.105938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/16/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Child maltreatment leads to substantial adverse health outcomes, but little is known about acute health care utilization patterns after children are evaluated for a concern of maltreatment at a child abuse and neglect medical evaluation clinic. OBJECTIVE To quantify the association of having a child maltreatment evaluation with subsequent acute health care utilization among children from birth to age three. PARTICIPANTS AND SETTING Children who received a maltreatment evaluation (N = 367) at a child abuse and neglect subspecialty clinic in an academic health system in the United States and the general pediatric population (N = 21,231). METHODS We conducted a retrospective cohort study that compared acute health care utilization over 18 months between the two samples using data from electronic health records. Outcomes were time to first emergency department (ED) visit or inpatient hospitalization, maltreatment-related ED use or inpatient hospitalization, and ED use or inpatient hospitalization for ambulatory care sensitive conditions (ACSCs). Multilevel survival analyses were performed. RESULTS Children who received a maltreatment evaluation had an increased hazard for a subsequent ED visit or inpatient hospitalization (hazard ratio [HR]: 1.3, 95 % confidence interval [CI]: 1.1, 1.5) and a maltreatment-related visit (HR: 4.4, 95 % CI: 2.3, 8.2) relative to the general pediatric population. A maltreatment evaluation was not associated with a higher hazard of health care use for ACSCs (HR: 1.0, 95 % CI: 0.7, 1.3). CONCLUSION This work can inform targeted anticipatory guidance to aid high-risk families in preventing future harm or minimizing complications from previous maltreatment.
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Affiliation(s)
- Yuerong Liu
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America.
| | - Megan Shepherd-Banigan
- Margolis Center for Health Policy, Duke University, Durham, NC, United States of America; Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America
| | - Kelly E Evans
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America
| | - Laura Stilwell
- Sanford School of Public Policy, Duke University, Durham, NC, United States of America; School of Medicine, Duke University, Durham, NC, United States of America
| | - Lindsay Terrell
- Department of Pediatrics, School of Medicine, Duke University, Durham, NC, United States of America; Department of Pediatrics, Duke Children's Primary Care, Duke University Medical Center, Durham, NC, United States of America
| | - Jillian H Hurst
- Department of Pediatrics, Division of Infectious Diseases, Duke University, Durham, NC, United States of America; Children's Health and Discovery Initiative, Duke University, Durham, NC, United States of America
| | - Elizabeth J Gifford
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America; Margolis Center for Health Policy, Duke University, Durham, NC, United States of America; Department of Pediatrics, School of Medicine, Duke University, Durham, NC, United States of America; Children's Health and Discovery Initiative, Duke University, Durham, NC, United States of America
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13
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Areemit R, Saengnipanthkul S, Sutra S, Lumbiganon P, Pornprasitsakul P, Paopongsawan P, Sripanidkulchai K. Effectiveness of a mobile app, KhunLook versus the maternal and child health handbook on Thai parent’s health literacy, accuracy of health assessments and convenience of use: A randomized controlled trial (Preprint). J Med Internet Res 2022; 25:e43196. [PMID: 37159258 DOI: 10.2196/43196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/17/2023] [Accepted: 03/28/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Children of parents who have higher health literacy (HL) benefit more from preventive child health care. Digital interventions have been used to improve parents' HL with high satisfaction. KhunLook is a Thai mobile app conceived using strategies to improve HL. It was developed to assist parents in assessing and keeping track of their child's health in complement to the standard Maternal and Child Health Handbook (MCHH). OBJECTIVE This trial focuses on the effectiveness of using the KhunLook app with the MCHH and standard care (intervention) compared with the conventional MCHH and standard care (control) on parents' HL. Data on accuracy of parents' assessment of their child's health and growth as well as convenience of use of the tool (app or MCHH) in the well-child clinic were collected at 2 visits (immediate=visit 1, and intermediate=visit 2). METHODS Parents of children under 3 years of age who (1) had a smartphone or tablet and the MCHH and (2) could participate in 2 visits, 2-6 months apart at Srinagarind Hospital, Khon Kaen, Thailand, were enrolled in this 2-arm parallel randomized controlled trial between April 2020 and May 2021. Parents were randomized 1:1 to 2 groups. At visit 1, data on demographics and baseline HL (Thailand Health Literacy Scales) were collected. Parents in the app group used the KhunLook app and the control group used their child's handbook to assess their child's growth, development, nutrition and feeding, immunization status and rated the convenience of the tool they used. At visit 2, they repeated the assessments and completed the HL questionnaire. RESULTS A total of 358 parents completed the study (358/408, 87.7%). After the intervention, the number of parents with high total HL significantly increased from 94/182 (51.6%) to 109/182 (59.9%; 15/182; Δ 8.2%; P=.04), specifically in the health management (30/182; Δ 16.4%; P<.001) and child health management (18/182; Δ 9.9%; P=.01) domains in the app group, but not in the control group. Parents in the app group could correctly assess their child's head circumference (172/182, 94.5% vs 124/176, 70.5%; P<.001) and development (173/182, 95.1% vs 139/176, 79.0%; P<.001) better than those in the control group at both visits. A higher proportion of parents in the app group rated their tool as very easy or easy to use (174-181/182, 95.6%-99.5% vs 141-166/176, 80.1%-94.3%; P<.001) on every item since the first visit. CONCLUSIONS Our results suggest the potential of a smartphone app (KhunLook) to improve parents' HL as well as to promote superior accuracy of parents' assessment of their child's head circumference and development, with a similar effect on weight, height, nutrition and feeding, and immunization as in traditional interventions. Using the KhunLook app is useful and more convenient for parents in promoting a healthy child preventive care during early childhood. TRIAL REGISTRATION Thai Clinical Trials Registry TCTR20200312003; https://www.thaiclinicaltrials.org/show/TCTR20200312003.
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Affiliation(s)
- Rosawan Areemit
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Sumitr Sutra
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pagakrong Lumbiganon
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Kunwadee Sripanidkulchai
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
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14
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Meldgaard M, Jensen AL, Johansen AD, Maimburg RD, Maindal HT. Health literacy and related behaviour among pregnant women with obesity: a qualitative interpretive description study. BMC Pregnancy Childbirth 2022; 22:712. [PMID: 36123636 PMCID: PMC9483451 DOI: 10.1186/s12884-022-05023-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
Background Obesity in pregnant women is increasing worldwide, affecting the health of both mother and baby. Obesity may be associated with inadequate health literacy, a central competence when navigating antenatal health information and services. This study explores women’s health literacy by examining their knowledge, motivation and skills to access, understand and evaluate health information and the related behaviour among a sample of pregnant women with a prepregnant body mass index (BMI) > 25 kg/m2. Methods An inductive, qualitative study using an interpretive description methodology. Data was collected through ten semi-structured interviews with pregnant women with a prepregnancy BMI > 25 kg/m2 attending antenatal care at the midwifery clinic at Aarhus University Hospital in the Central Denmark Region. Results Pregnant women with obesity understand general health information provided by health professionals, but translating this knowledge into specific healthy behaviours presents a challenge. Although difficulties navigating booking systems and available digital services contribute to this problem, apps can help facilitate navigation. However, successful navigation may depend on adequate e-health literacy. Conflicting information from health professionals, social media and families also present a challenge for pregnant women, requiring a broad skillset for critical evaluation and resolution. Conclusions Adequate health literacy is necessary for pregnant women receiving antenatal care to (i) translate general health information into personalised healthy behaviour, (ii) access and navigate complex and digitalised systems, and (iii) critically evaluate conflicting information. Person-centred differentiation in the organisation of antenatal care may benefit vulnerable pregnant women with inadequate health literacy. Trial registration The study was registered cf. General Data Protection Regulation, Aarhus University Journal number 2016–051-000001, serial number 1934. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05023-0.
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Affiliation(s)
- Maiken Meldgaard
- Department of Public Health, Aarhus University, Aarhus, Denmark.
| | | | | | - Rikke Damkjær Maimburg
- Department of Clinical Medicine & Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.,School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
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15
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Chawłowska E, Karasiewicz M, Lipiak A, Cofta M, Fechner B, Lewicka-Rabska A, Pruciak A, Gerreth K. Exploring the Relationships between Children's Oral Health and Parents' Oral Health Knowledge, Literacy, Behaviours and Adherence to Recommendations: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811288. [PMID: 36141563 PMCID: PMC9517628 DOI: 10.3390/ijerph191811288] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/01/2023]
Abstract
Although preventable, early childhood caries (ECC) is a burdening condition in all WHO regions, with Poland being one of the most affected countries in Europe. Effective home-based prevention of ECC is available and recommended by several expert bodies. Therefore, we wanted to determine how well parents were following selected oral health recommendations in preschool children. Additionally, we wanted to determine which socioeconomic factors influenced such practices the most, and how parents' oral health literacy and behaviours affected the oral hygiene and oral health status of their children. A cross-sectional survey involving 2338 parents and caregivers of children from 167 kindergartens was performed. Children's oral hygiene and oral health status were found to be associated with parents' education and economic status. They were also strongly influenced by parental health literacy and behaviours. With respect to recommendations for preschoolers, the lowest adherence was found in the use of fluoride toothpaste and its age-appropriate amount, supervision of toothbrushing, and refraining from eating after last toothbrushing. The improvement in these areas could be achieved thanks to the involvement of health professionals such as gynaecologists, midwives, and primary care personnel in efforts aimed at increasing parents' oral health knowledge and literacy.
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Affiliation(s)
- Ewelina Chawłowska
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Monika Karasiewicz
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Agnieszka Lipiak
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Mateusz Cofta
- Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Brittany Fechner
- Laboratory of International Health, Department of Preventive Medicine, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Agnieszka Lewicka-Rabska
- Department of Hypertension, Angiology and Internal Diseases, Poznan University of Medical Sciences, 61-848 Poznan, Poland
| | - Agata Pruciak
- Institute of Plant Protection-National Research Institute, Research Centre of Quarantine, Invasive and Genetically Modified Organisms, 60-318 Poznan, Poland
| | - Karolina Gerreth
- Department of Risk Group Dentistry, Chair of Paediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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16
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Titheradge D, Godfrey J, Eke H, Price A, Ford T, Janssens A. Why young people stop taking their attention deficit hyperactivity disorder medication: A thematic analysis of interviews with young people. Child Care Health Dev 2022; 48:724-735. [PMID: 35102579 PMCID: PMC9545018 DOI: 10.1111/cch.12978] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 01/20/2022] [Accepted: 01/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can persist into adulthood. Young people often stop taking ADHD medication during adolescence despite evidence that continuation would be beneficial. Increasingly, young people are restarting medication in early adulthood suggesting that cessation was premature. In this paper we explore the reasons given by young people for discontinuing ADHD medication. METHODS Qualitative data from the Children and Adolescents with ADHD in Transition between Children's and Adult Services (CATCh-uS) project was analysed to look for reasons for stopping medication. Semi-structured interviews with three groups of young people were analysed using thematic and framework analysis; this included young people prior to transition (n = 21); young people that had successfully transitioned to adult services (n = 22); and young people who left children's services prior to transition but re-entered adult services later (n = 21). RESULTS Reasons given by young people for stopping ADHD medication included the following: the perceived balance between benefits and adverse effects of medication; perceptions of ADHD as a childhood or educational disorder; life circumstance of the young person and challenges young people faced in accessing services. CONCLUSIONS A multidimensional approach is needed to address discontinuation of ADHD medication in order to improve the long-term prospects and quality of life for these young people. Possible approaches include access to non-pharmacological treatments and improved psychoeducation. As many reasons given by young people are not unique to ADHD, these findings are also of relevance to medication adherence in other chronic childhood conditions.
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Affiliation(s)
- Daniel Titheradge
- College of Medicine and HealthUniversity of ExeterExeterUK,Population Health Sciences, School of Physiology, Pharmacology and NeuroscienceUniversity of BristolBristolUK
| | - Jo Godfrey
- College of Medicine and HealthUniversity of ExeterExeterUK,Livewell SouthwestPlymouthUK
| | - Helen Eke
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Anna Price
- College of Medicine and HealthUniversity of ExeterExeterUK
| | - Tamsin Ford
- College of Medicine and HealthUniversity of ExeterExeterUK,Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Astrid Janssens
- College of Medicine and HealthUniversity of ExeterExeterUK,Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
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Doustmohammadian A, Omidvar N, Keshavarz-Mohammadi N, Eini-Zinab H, Amini M, Abdollahi M. The association and mediation role of Food and Nutrition Literacy (FNLIT) with eating behaviors, academic achievement and overweight in 10-12 years old students: a structural equation modeling. Nutr J 2022; 21:45. [PMID: 35778743 PMCID: PMC9248125 DOI: 10.1186/s12937-022-00796-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Food and nutrition literacy is a key factor in shaping healthy dietary behaviors and may result in decreasing decrease the prevalence of overweight. Empirical research on food and nutrition literacy and its outcomes is limited, especially among children and adolescents. Thus, this study investigates the link between Food and Nutrition Literacy (FNLIT) with eating behaviors, academic performance, and overweight in 10–12 years old students in Tehran, Iran. Methods This study was performed through two phases: 1) Proposing a conceptual model of the relationship between FNLIT and its determinants and outcomes, based on the existing evidence and previous models, and 2) Testing the proposed FNLIT model through a cross-sectional study on 803 primary school students (419 boys and 384 girls, from 34 public and 10 private primary schools), aged 10–12 years using structural equation modeling. Demographic, socio-economic, and household food security characteristics were collected by interviewing the students and their mothers/caregivers using a questionnaire. FNLIT was measured by a self-administered, locally designed, and validated questionnaire. Results The fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ2/df = 2.03, p < 0.001, goodness of fit index (GFI) = 0.90, adjusted goodness of fit index (AGFI) = 0.88, comparative fit index (CFI) = 0.91, incremental fit index (IFI) = 0.91, root mean square error of approximation (RMSEA) = 0.04, standardized root mean residual (SRMR) = 0.06). SES was directly and positively related to FNLIT and its subscale in students. FNLIT score had a positive direct (non-mediated) relationship with healthy eating behavior and academic performance. This pattern was strongly reversed in unhealthy eating behavior. There was a full mediation relationship between FNLIT and overweight/obesity via healthy eating behaviors. SES predicted academic performance partially through the mediating effect of Food Label Literacy (FLL). The results indicated that despite the direct relationship between SES and academic performance, an indirect but negative relationship existed with food insecurity. The finding also revealed the fully mediating role of Food Choice Literacy (FCL) in the relationship between demographic factors and healthy eating behaviors. Our study also found that Interactive Food and Nutrition Literacy (IFNL) protected unhealthy eating behaviors, and FCL predicted healthy eating behaviors in children. Conclusion Our study draws attention to FNLIT, especially the skills domain, including IFNL, FCL, and FLL, as the most important determinant of healthy eating behavior, academic performance, and weight status in school-age children reduces social inequalities in children’s development. To ensure an adequate level of FNLIT, educators should assess and plan to enhance food literacy skills in children and adolescents. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00796-8.
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Affiliation(s)
- Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | | | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, and National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Amini
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lindemann U, Gröben B, Braksiek M. Adaptation und Validierung von Skalen zur Erfassung der bewegungsbezogenen Gesundheitskompetenz von Kindern und Jugendlichen im Alter von 10–16 Jahren. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00835-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
ZusammenfassungDie bewegungsbezogene Gesundheitskompetenz stellt eine relevante Gesundheitsdeterminante dar. Ziel der Studie war die kindgerechte Adaptation und Validierung von Skalen zur Erfassung von Facetten einer bewegungsbezogenen Gesundheitskompetenz von Kindern und Jugendlichen im Alter von 10 bis 16 Jahren. Die Skalen wurden an einer Stichprobe von 772 Kindern und Jugendlichen (MAlter = 12,75; 43,1 % weiblich) validiert. Alle drei Skalen (bewegungsspezifische Befindensregulation, Selbstkontrolle für die Verhaltensumsetzung, gesundheitsbezogene Verantwortungsübernahme) erwiesen sich als faktoriell, diskriminant, konvergent und kriteriumsvalide sowie reliabel. Zudem konnte ihre Messinvarianz bezogen auf die Variablen Geschlecht, Sportvereinszugehörigkeit und Alter gezeigt werden. Ein latentes Mediationsmodell konnte im Rahmen der Prüfung auf Kriteriumsvalidität zeigen, dass der positive Effekt der gesundheitsbezogenen Verantwortungsübernahme auf die berichtete körperliche Aktivität der Kinder und Jugendlichen vollständig über die Selbstkontrolle für die Verhaltensumsetzung mediiert wird. Die validierten Skalen können nun u. a. für Interventionsstudien zur Förderung und querschnittlichen Messung der bewegungsbezogenen Gesundheitskompetenz von Kindern und Jugendlichen verwendet werden.
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Rademakers J, Hahnraths MTH, van Schayck OCP, Heijmans M. Children's Health Literacy in Relation to Their BMI z-Score, Food Intake, and Physical Activity: A Cross-Sectional Study among 8-11-Year-Old Children in The Netherlands. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060925. [PMID: 35740862 PMCID: PMC9221614 DOI: 10.3390/children9060925] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
Overweight and obesity in children are an increasing public health problem. Health literacy (HL) is a determinant of obesity and body mass index (BMI) rates in adults, but few studies have addressed the impact of children’s own HL on their weight and lifestyle. In this study, we aim to assess the impact of Dutch children’s HL on (1) their BMI z-score, (2) dietary behaviour, and (3) the amount of physical activity (PA) they engage in. A sample of 139 children (age 8–11 years) filled out a digital questionnaire, including an HL measurement instrument and questions regarding their food intake and PA. Furthermore, the height and weight of the children were measured, and background information was collected using a parental questionnaire. Multiple regression revealed a significant positive relation between children’s HL and their PA. No significant association between children’s HL and their BMI z-score or dietary behaviour was found. HL of children in primary school thus has an impact on some aspects of children’s lifestyle, although more research in a larger, more diverse sample is needed to further investigate this.
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Affiliation(s)
- Jany Rademakers
- Netherlands Institute for Health Services Research (Nivel), P.O. Box 1568, 3500 BN Utrecht, The Netherlands;
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.T.H.H.); (O.C.P.v.S.)
- Correspondence:
| | - Marla T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.T.H.H.); (O.C.P.v.S.)
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.T.H.H.); (O.C.P.v.S.)
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (Nivel), P.O. Box 1568, 3500 BN Utrecht, The Netherlands;
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Huizar MI, Alman R, Arena R, Laddu DR. The path forward: Highlighting social justice pearls in public health campaigns and initiatives to deliver equitable healthy living medicine. Prog Cardiovasc Dis 2022; 71:51-57. [PMID: 35490868 DOI: 10.1016/j.pcad.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 11/15/2022]
Abstract
The prevalence of unhealthy living behaviors is largely driven by environments that support them and has become a key concern at global, national, and individual (patient) levels. Healthy Living Medicine offers a compelling path forward to move people towards healthy living behaviors and better health outcomes when complemented by socially just and equitable public campaigns and initiatives. Some of the concepts that are critical for these campaigns and initiatives that will be discussed in this manuscript include the social determinants of health, the communication loop, health literacy, and implicit bias and discrimination. Considering what is practical and achievable, examples of actionable, socially-just strategies will be described to inform and encourage health professionals and other stakeholders to prioritize healthy living and reverse the poor health trajectory among our most vulnerable populations.
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Affiliation(s)
- Martha I Huizar
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Rocio Alman
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Deepika R Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, IL, United States of America; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
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Lammers SM, Woods RJ, Brotherson SE, Deal JE, Platt CA. Explaining Adherence to American Academy of Pediatrics Screen Time Recommendations With Caregiver Awareness and Parental Motivation Factors: Mixed Methods Study. JMIR Pediatr Parent 2022; 5:e29102. [PMID: 35380541 PMCID: PMC9019621 DOI: 10.2196/29102] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/01/2021] [Accepted: 12/11/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND With the increasing integration of technology into society, it is advisable that researchers explore the effects of repeated digital media exposure on our most vulnerable population-infants. Excessive screen time during infancy has been linked to delays in language, literacy, and self-regulation. OBJECTIVE This study explores the awareness of and adherence to the American Academy of Pediatrics' (AAP) recommendations related to avoiding screen time for infants younger than 2 years and the motivational factors associated with screen time exposure. METHODS A mixed methods survey design was used to gather responses from 178 mothers of infants younger than 2 years. The measures included infant screen time use and duration, maternal awareness of screen time use recommendations, and motivations related to screen time exposure. A variety of statistical procedures were used to explore associations between caregiver awareness of and adherence to AAP guidelines for screen time exposure, motivations related to screen time for infants, and the duration of infant screen time exposure. RESULTS The results indicated that 62.2% (111/178) of mothers were aware of the AAP screen time recommendations, but only 46.1% (82/178) could cite them accurately, and most mothers learned of them via the internet or from a medical professional. Mothers who were aware of the guidelines allowed significantly less screen time for infants than those who were unaware (P=.03). In addition, parents who adhered to the AAP guidelines reported significantly less infant screen time per day than those who did not adhere (P<.001). Among mothers who reported not adhering to the guidelines, the greatest motivation for allowing screen time was perceived educational benefits. Less educated mothers rated an infant's relaxation as a motivational factor in allowing screen time significantly higher than more highly educated mothers (P=.048). The regression analysis indicated that none of the parental motivation factors predicted daily infant screen time. CONCLUSIONS These results indicate 2 key approaches to improving adherence to screen time recommendations. First, the awareness of the AAP recommendations needs to be increased, which tends to improve adherence. Second, the myth that screen time can be educational for infants needs to be dispelled.
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Affiliation(s)
- Shea M Lammers
- Research Institute, Children's Minnesota, Minneapolis, MN, United States
| | | | - Sean E Brotherson
- Department of Human Development and Family Science, North Dakota State University, Fargo, ND, United States
| | - James E Deal
- Department of Human Development and Family Science, North Dakota State University, Fargo, ND, United States
| | - Carrie Anne Platt
- Department of Communication, North Dakota State University, Fargo, ND, United States
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Promoting the health and wellbeing of children: A feasibility study of a digital tool among professionals. PLoS One 2022; 17:e0265355. [PMID: 35316279 PMCID: PMC8939777 DOI: 10.1371/journal.pone.0265355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/01/2022] [Indexed: 11/19/2022] Open
Abstract
The foundations of children’s health and wellbeing are laid in early childhood. A gamified app (EmpowerKids tool) was designed to support professionals to have discussions with 6- to 12-year-olds from low-income families about their health and wellbeing. The aim of this feasibility study was to evaluate the usability and acceptability of the tool from the perspective of professionals in social, health and education settings. The study was conducted using a one-group post-test-only design. The usability data were collected using System Usability Scale and the acceptability data were collected using an open-ended questionnaire distributed to professionals (n = 24) in Estonia, Finland and Latvia. The data were collected during two phases. The tool was modified further on the basis of the results. The total usability scores were 82/100 (first testing) and 84/100 (second testing), indicating excellent usability. The answers related to acceptability were divided into four categories: suitability for the context; satisfaction and quality; attractiveness; modification needs. The professionals perceived that the tool helped them to build an overall picture of a child’s health and wellbeing, and to gain information about the child’s individual needs. The requirements for modification detected during the first testing were mostly related to difficulties with textual expressions and graphics. No major modification requirements were expressed during the second testing. The tool is considered feasible and may be used by professionals from different settings to support children’s health and wellbeing. Further studies are needed to evaluate the effectiveness of the tool from the perspective of child outcomes.
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Gill FJ, Cooper AL, Laird P, Leslie GD. Aboriginal perspectives on recognising clinical deterioration in their child and communicating concerns to clinicians. J Pediatr Nurs 2022; 63:e10-e17. [PMID: 34801328 DOI: 10.1016/j.pedn.2021.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/13/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the perspectives of family members of Aboriginal children about a) their involvement in recognising clinical deterioration in a hospital setting and b) the effectiveness of a poster designed to promote family involvement. BACKGROUND To assist in the early recognition and response to clinical deterioration for hospitalised children, many escalation of care processes now include family involvement. Little is currently known about the perspectives of Australian Aboriginal families in recognising deterioration in their child and raising the alarm, or if current escalation of care systems meet the needs of Aboriginal families. DESIGN Qualitative pragmatist approach using semi-structured interviews. METHODS Seven interviews were conducted with five mothers and two grandmothers of Aboriginal children who were inpatients at a children's hospital. Thematic analysis was undertaken. FINDINGS Two themes were identified: Theme one was: Family role in recognising and responding to clinical deterioration, with two subthemes of knowing when to worry and communicating concerns. Participants reported that some families needed more knowledge to recognise clinical deterioration. Communication barriers between families and clinicians were identified. Theme two was: Effective visual communication with three subthemes of linguistic clarity, visual appeal and content. CONCLUSIONS Additional strategies are needed to promote effective communication between clinicians and families of Aboriginal children in hospital. Posters were considered effective, particularly if including a cultural connection, images and simplified language. PRACTICE IMPLICATIONS These insights provide important information for health professionals and health service managers to be aware that additional communication strategies are required to support Aboriginal family involvement in recognising clinical deterioration and escalation of care.
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Affiliation(s)
- Fenella J Gill
- Nursing Research, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, WA, Australia; School of Nursing, Curtin University, Perth 6102, WA, Australia; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
| | - Alannah L Cooper
- School of Nursing, Curtin University, Perth 6102, WA, Australia.
| | - Pamela Laird
- Physiotherapy Department, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, WA, Australia; Breath Team, Wal-Yan Respiratory Research Centre, Telethon Kids Institute, 15 Hospital Avenue, Nedlands 6009, WA, Australia; School of Medicine, University of Western Australia, 35 Stirling Highway, Crawley 6009, WA, Australia.
| | - Gavin D Leslie
- School of Nursing, Curtin University, Perth 6102, WA, Australia.
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Callander EJ, Bull C, Lain S, Wakefield CE, Lingam R, Marshall GM, Wake M, Nassar N. Inequality in early childhood chronic health conditions requiring hospitalisation: A data linkage study of health service utilisation and costs. Paediatr Perinat Epidemiol 2022; 36:156-166. [PMID: 34806212 DOI: 10.1111/ppe.12818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/27/2021] [Accepted: 09/02/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The cost of socioeconomic inequality in health service use among Australian children with chronic health conditions is poorly understood. OBJECTIVES To quantify the cost of socioeconomic inequality in health service use among Australian children with chronic health conditions. METHODS Cohort study using a whole-of-population linked administrative data for all births in Queensland, Australia, between July 2015 and July 2018. Socioeconomic status was defined by an areas-based measure, grouping children into quintiles from most disadvantaged (Q1) to least disadvantaged (Q5) based on their postcode at birth. Study outcomes included health service utilisation (inpatient, emergency department, outpatient, general practitioner, specialist, pathology and diagnostic imaging services) and healthcare costs. RESULTS Of the 238,600 children included in the analysis, 10.4% had at least one chronic health condition. Children with chronic health conditions in Q1 had higher rates of inpatient (6.6, 95% confidence interval [CI] 6.4, 6.7), emergency department (7.2, 95% CI 7.0, 7.5) and outpatient (20.3, 95% CI 19.4, 21.3) service use compared to children with chronic health conditions in Q5. They also had lower rates of general practitioner (37.5, 95% CI 36.7, 38.4), specialist (8.9, 95% CI 8.5, 9.3), pathology (10.7, 95% CI 10.2, 11.3), and diagnostic imaging (4.3, 95% CI 4.2,4.5) service use. Children with any chronic health condition in Q1 incurred lower median out-of-pocket fees than children in Q5 ($0 vs $741, respectively), lower median Medicare funding ($2710, vs $3408, respectively), and higher median public hospital funding ($31, 052 vs $23, 017, respectively). CONCLUSIONS Children of most disadvantage are more likely to access public hospital provided services, which are accessible free of charge to patients. These children are less likely to access general practitioner, specialist, pathology and diagnostic imaging services; all of which are critical to the ongoing management of chronic health conditions, but often attract an out-of-pocket fee.
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Affiliation(s)
- Emily J Callander
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Claudia Bull
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Samantha Lain
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
| | - Raghu Lingam
- Population Child Health Research Group, School of Women and Children's Health, UNSW Sydney, Sydney, Australia
| | - Glenn M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Children's Cancer Institute, Lowy Centre, UNSW Sydney, Sydney, Australia
- School of Women and Children's Health, UNSW Sydney, Sydney, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, Australia
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, Australia
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Vander Wyst KB, Olson ML, Bailey SS, Valencia AM, Peña A, Miller J, Shub M, Seabrooke L, Pimentel J, Olsen K, Rosenberg RB, Shaibi GQ. Communicating incidental and reportable findings from research MRIs: considering factors beyond the findings in an underrepresented pediatric population. BMC Med Res Methodol 2021; 21:275. [PMID: 34865631 PMCID: PMC8647358 DOI: 10.1186/s12874-021-01459-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/27/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The application of advanced imaging in pediatric research trials introduces the challenge of how to effectively handle and communicate incidental and reportable findings. This challenge is amplified in underserved populations that experience disparities in access to healthcare as recommendations for follow-up care may be difficult to coordinate. Therefore, the purpose of the present report is to describe the process for identifying and communicating findings from a research MRI to low-income Latino children and families. METHODS Latino adolescents (n = 86) aged 12-16 years old with obesity and prediabetes underwent a research MRI (3 Tesla Philips Ingenia®) as part of a randomized controlled diabetes prevention trial. The research MRIs were performed at baseline and 6 months to assess changes in whole-abdominal fat distribution and organ fat in response to the intervention. An institutional pathway was developed for identifying and reporting findings to participants and families. The pathway was developed through a collaborative process with hospital administration, research compliance, radiology, and the research team. All research images were reviewed by a board-certified pediatric radiologist who conveyed findings to the study pediatrician for determination of clinical actionability and reportability to children and families. Pediatric sub-specialists were consulted as necessary and a primary care practitioner (PCP) from a free community health clinic agreed to receive referrals for uninsured participants. RESULTS A total of 139 images (86 pre- and 53 post-intervention) were reviewed with 31 findings identified and 23 deemed clinically actionable and reportable. The only reportable finding was severely elevated liver fat (> 10%, n = 14) with the most common and concerning incidental findings being horseshoe kidney (n = 1) and lung lesion (n = 1). The remainder (n = 7) were less serious. Of youth with a reportable or incidental finding, 18 had a PCP but only 7 scheduled a follow-up appointment. Seven participants without a PCP were referred to a safety-net clinic for follow-up. CONCLUSIONS With the increased utilization of high-resolution imaging in pediatric research, additional standardization is needed on what, when, and how to return incidental and reportable findings to participants, particularly among historically underrepresented populations that may be underserved in the community. TRIAL REGISTRATION Preventing Diabetes in Latino Youth, NCT02615353.
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Affiliation(s)
- Kiley B Vander Wyst
- College of Graduate Studies, Midwestern University, Glendale, AZ, USA
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St, Phoenix, AZ, 85004, USA
| | - Micah L Olson
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St, Phoenix, AZ, 85004, USA
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Smita S Bailey
- Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Ana Martinez Valencia
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St, Phoenix, AZ, 85004, USA
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St, Phoenix, AZ, 85004, USA
| | - Jeffrey Miller
- Department of Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Mitchell Shub
- Division of Gastroenterology, Phoenix Children's Hospital, Phoenix, AZ, USA
- Department of Child Health, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Lee Seabrooke
- Office of Research, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Janiel Pimentel
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Kiri Olsen
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA
- Office of Research, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Robert B Rosenberg
- Office of Research, Phoenix Children's Hospital, Phoenix, AZ, USA
- Division of Pediatric Critical Care Medicine, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St, Phoenix, AZ, 85004, USA.
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, AZ, USA.
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, AZ, USA.
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Beasley L, Hoffman S, Andelin R. Physical health literacy of student-athletes. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e116-e125. [PMID: 33278318 DOI: 10.1111/hsc.13251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/04/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
Student-athletes are a vulnerable population who face many unique stressors and often engage in risky physical behaviours. Understanding that high levels of health literacy (HL) can lead to improved health knowledge and decreased negative health outcomes, the purpose of this study was to assess the HL of both student-athletes and their non-athlete peers attending NCAA Division I, II and III institutions. Specifically, guided by Nutbeam's (2000) framework of HL, we assessed functional, communicative and critical HL in 205 student-athletes and 205 non-athlete students using the All Aspects of Health Literacy Scale. Compared to non-athletes, student-athletes had lower functional HL (b = 0.20; p < .001; d = 0.21), lower communicative HL (b = 0.12; p < .01; d = 0.13) and higher critical HL (b = 0.11; p < .05; d = 0.11). These findings suggest that additional interventions may be needed to increase the self-sufficiency of student-athletes to care for personal physical health. As social work in sport is an emerging subspecialty of the profession, social workers may consider increased involvement in advocating for this group by working with individuals, coaches and teams to decrease stigma in requesting health services, attending to the complexity of interacting systems and stressors in student-athletes' lives in therapeutic interventions, and connecting them to empowering health education resources.
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Stassen G, Grieben C, Hottenrott N, Rudolf K, Froböse I, Schaller A. Associations between health-related skills and young adults' work ability within a structural health literacy model. Health Promot Int 2021; 36:1072-1083. [PMID: 33319224 PMCID: PMC8405247 DOI: 10.1093/heapro/daaa099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Young adults have a high societal relevance but are still an under-represented target group in health promotion. Health literacy is widely acknowledged as one of the strongest predictors and key determinant of health, so its influence on work ability is of great interest. The purpose of the study was to examine the associations between health-related skills and work ability within the structural model of health literacy of Lenartz, Soellner and colleagues, which explains health behaviour and health through the indirect and direct influence of six 'advanced skills' ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The cross-sectional study was based on baseline data of a health literacy promotion intervention (495 vocational school students, 59.0% female, age span 18-25 years). Structural equation modelling with partial least squares was used to examine the associations between the six constructs of the model and the Work Ability Index (WAI). Mean WAI score was 39.7 ± 4.5 (51.1% categorized 'moderate'/'poor'). Five out of six constructs of the model showed a statistically significant indirect or direct effect, respectively, on work ability. The model explained 24.8% of the WAI score variance. Our findings show associations between the health literacy model and the work ability among young employees. In view of demographic change, it is crucial to develop and analyse target group-specific health literacy interventions. The model offers new facets in the modelling of health literacy.
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Affiliation(s)
- Gerrit Stassen
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Christopher Grieben
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Nina Hottenrott
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Kevin Rudolf
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Ingo Froböse
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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Nash R, Patterson K, Flittner A, Elmer S, Osborne R. School-Based Health Literacy Programs for Children (2-16 Years): An International Review. THE JOURNAL OF SCHOOL HEALTH 2021; 91:632-649. [PMID: 34096058 DOI: 10.1111/josh.13054] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health literacy impacts children's health and educational attainment. Therefore, determining the most appropriate pedagogical design is critical. The long-term health benefits of health literacy for each child's life course further justify this imperative. School-based health literacy programs are of interest internationally. METHODS We brainstormed the search terms and established inclusion/exclusion criteria for this systematic review. We searched 2 databases (CINAHL, ERIC) following PRISMA guidelines. Three authors screened and sorted the findings. RESULTS We identified 21 relevant studies from 629 retrieved. Few (6/21) studies were situated in the primary school setting. CONCLUSIONS This review found a variety of project designs, evaluation methods, and conceptual models. Descriptive analysis of the final 21 papers highlighted the importance of multicomponent design (whole-of-school and curriculum), cross-curricula integration, professional development for teachers, age of children, role of parents, and role of community. The results of this analysis may inform primary school program design in the future. Schools provide a logical setting for health literacy development. Despite the evidence that adolescence is too late, few studies have been situated in primary schools. Teachers lack confidence to teach health and need ongoing professional development. Parent, child, and community voices are essential for sustained engagement and program success.
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Affiliation(s)
- Rosie Nash
- Lecturer in Public Health and Health Systems, , College of Health & Medicine, University of Tasmania, Medical Science 2 17 Liverpool Street, Private Bag 34, Hobart, TAS, 7001, Australia
| | - Kira Patterson
- Lecturer in Health Pedagogy, , School of Education, College of Arts, Law and Education, University of Tasmania; Healthspan Advisory Board Member, University of Illinois, Chicago, Locked Bag 1307, Launceston, TAS, 7250, Australia
| | - Anna Flittner
- Associate Lecturer and HealthLit4Kids Research Assistant, , College of Health & Medicine, University of Tasmania, Hobart, TAS, 7001, Australia
| | - Shandell Elmer
- Senior Research Fellow, , School of Health Sciences, Faculty Arts, Health & Design, Swinburne University of Technology, PO Box 218, Hawthorne, VIC, 3122, Australia
- Adjunct Senior Lecturer, School of Education, University of Tasmania, Hobart, TAS, Australia
| | - Richard Osborne
- Global Health Equity, Distinguished Professor of Health Sciences, NHMRC Principal Research Fellow (2019-2023), Prof (Hon), , University of Copenhagen, Denmark; Bualuang ASEAN Chair Professorship, Thammasat University, Thailand; Faculty of Health, Arts and Design, Swinburne University, Hawthorn, Australia
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Yuhas M, Zoellner J, Hou X, Alexander R, Hill J, You W, Estabrooks P. Understanding Teach-Back and Teach-To-Goal Strategies Embedded in Support Calls for a Health Literacy-Sensitive Childhood Obesity Treatment Trial. Health Lit Res Pract 2021; 5:e208-e217. [PMID: 34379548 PMCID: PMC8356482 DOI: 10.3928/24748307-20210713-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/27/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Low caregiver health literacy (HL) is related to increased obesity risk for their children. Teach-Back and Teach-to-Goal (TB/TTG) are strategies that may improve comprehension of key concepts for people who have low HL but have yet to be examined in the context of childhood obesity treatment. OBJECTIVE This study evaluated TB/TTG strategies integrated within support calls delivered to caregivers as part of a 3-month childhood obesity intervention. METHODS Ninety-four caregivers (60% Black, 42% high school education or less, 53% with income ≤$29,999, and 34% low HL) with overweight/obese children age 8 to 12 years enrolled in a childhood obesity intervention. Caregiver HL was assessed at baseline using the Newest Vital Sign and caregivers were dichotomized to low and adequate HL groups for analyses. Caregivers received 6 bi-weekly support calls that alternated with in-person, family sessions. Call completion rates, comprehension of key content (correct responses on TB/TTG questions), and satisfaction with support calls were evaluated. Qualitative information on call satisfaction was gathered at the 3-month time point. KEY RESULTS Average completion rate across all calls was 62% with a mean call time of 26 minutes (no significant difference between HL groups). Caregivers had an average score of 0.90 out of 1 when evaluating overall call comprehension by scoring TB/TTG performance. Content comprehension in calls 1, 3, and 4 was significantly higher among caregivers with adequate HL relative to low HL (p < .1). Caregivers from both HL groups felt satisfied with calls [9.1 (2.0)/10-point scale] and agreed that calls helped them learn class material better [8.1 (2.7)]. Qualitatively, caregivers provided 81 (75%) positive responses (e.g., good content) and 27 (25%) negative responses (e.g., too lengthy) regarding the support calls. CONCLUSIONS Support calls using TB/TTG strategies were feasible, well received, and should be considered for incorporation into childhood obesity interventions. [HLRP: Health Literacy Research and Practice. 2021;5(3):e208-e217.] Plain Language Summary: This study evaluated support calls that used Teach-Back and Teach-to-Goal health literacy strategies as part of a childhood obesity treatment trial. Support calls were well accepted and facilitated comprehension of the key learning objectives in caregivers, regardless of health literacy level. These strategies should be considered for incorporation into childhood obesity treatment interventions to increase uptake of main concepts.
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Affiliation(s)
- Maryam Yuhas
- Address correspondence to Maryam Yuhas, PhD, RD, Department of Nutrition and Food Studies, Syracuse University, Falk College, 558 White Hall, Syracuse, NY 13244;
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Faus A, Schlaier J. Health Literacy of Youth with Co-Occurring Behavioral and Physical Health Care Needs: A Preliminary Report. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2021. [DOI: 10.1080/15398285.2021.1901053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Amy Faus
- Bergen’s Promise, Inc., Hackensack, New Jersey, USA
| | - Jan Schlaier
- Bergen’s Promise, Inc., Hackensack, New Jersey, USA
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Aristizabal P, Ma AK, Kumar NV, Perdomo BP, Thornburg CD, Martinez ME, Nodora J. Assessment of Factors Associated With Parental Perceptions of Voluntary Decisions About Child Participation in Leukemia Clinical Trials. JAMA Netw Open 2021; 4:e219038. [PMID: 33944924 PMCID: PMC8097494 DOI: 10.1001/jamanetworkopen.2021.9038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
IMPORTANCE Obtaining voluntary informed consent prior to enrollment in clinical trials is a fundamental ethical requirement. OBJECTIVE To assess whether health literacy, contextual factors, or sociodemographic characteristics are associated with perception of voluntariness among parents who had consented for their child's participation in a leukemia therapeutic clinical trial. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study prospectively enrolled 97 parents of children diagnosed as having leukemia at Rady Children's Hospital San Diego, a large tertiary academic center in California, from 2014 to 2017. Health literacy, contextual factors (acculturation, decisional regret, and satisfaction with informed consent), sociodemographic characteristics, and perception of voluntariness after consenting for a therapeutic clinical trial were measured. Univariable and multivariable regression were used to determine significant associations. The analyses for the present study were conducted from May 2019 to May 2020. EXPOSURES Informed consent for a therapeutic leukemia clinical trial. MAIN OUTCOMES AND MEASURES The primary outcome of interest was perception of voluntariness and its associations with health literacy and other contextual factors (acculturation, decisional regret, and satisfaction with informed consent) and sociodemographic characteristics, including age, race/ethnicity, parental language, educational level, insurance type, marital status, and socioeconomic status. RESULTS Of 97 parents included, the majority were women (65 [67%]), married (71 [73%]), and of self-reported Hispanic ethnicity (50 [52%]). Lower perception of voluntariness was significantly associated with lower health literacy (r = 0.30; 95% CI, 0.11-0.47; P = .004), Spanish language (x̅ = -4.50, P = .05), lower acculturation if of Hispanic ethnicity (r = 0.30; 95% CI, 0.02-0.54; P = .05), greater decisional regret (r = -0.54; 95% CI, -0.67 to -0.38; P < .001), and lower satisfaction with informed consent (r = 0.39; 95% CI, 0.21-0.54; P < .001) in univariable analysis. Lower health literacy remained significantly associated with lower perception of voluntariness in multivariable analysis after adjustment for contextual factors and sociodemographic characteristics (β = 4.06; 95% CI, 1.60-6.53; P = .001). Lower health literacy was significantly associated with Hispanic ethnicity (mean, 4.16; 95% CI, 3.75-4.57; P < .001), Spanish language spoken at home (mean, 3.17; 95% CI, 1.94-4.40; P < .001), high school or less educational level (mean, 3.41; 95% CI, 2.83-3.99; P < .001), public insurance (mean, 4.00; 95% CI, 3.55-4.45; P < .001), and unmarried status (mean, 3.71; 95% CI, 2.91-4.51; P = .03). CONCLUSIONS AND RELEVANCE Among parents of children with newly diagnosed leukemia who had consented for their child's participation in a therapeutic clinical trial, lower perception of voluntariness was significantly associated with lower health literacy. These results suggest that parents with low health literacy may perceive external influences in their decision for their child's participation in clinical trials. This finding highlights the potential role of recruitment interventions tailored to the participant's health literacy level to improve voluntary informed consent in underserved populations.
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Affiliation(s)
- Paula Aristizabal
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California San Diego, La Jolla
- Peckham Center for Cancer and Blood Disorders, Rady Children’s Hospital San Diego, San Diego
- Population Sciences, Disparities and Community Engagement, University of California San Diego Moores Cancer Center, La Jolla
| | - Arissa K. Ma
- School of Medicine, University of California San Diego, La Jolla
- Now with MemorialCare Health System, Fountain Valley, California
| | - Nikhil V. Kumar
- School of Medicine, University of California San Diego, La Jolla
| | - Bianca P. Perdomo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California San Diego, La Jolla
- Peckham Center for Cancer and Blood Disorders, Rady Children’s Hospital San Diego, San Diego
- Population Sciences, Disparities and Community Engagement, University of California San Diego Moores Cancer Center, La Jolla
| | - Courtney D. Thornburg
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of California San Diego, La Jolla
- Peckham Center for Cancer and Blood Disorders, Rady Children’s Hospital San Diego, San Diego
| | - Maria Elena Martinez
- Population Sciences, Disparities and Community Engagement, University of California San Diego Moores Cancer Center, La Jolla
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla
| | - Jesse Nodora
- Population Sciences, Disparities and Community Engagement, University of California San Diego Moores Cancer Center, La Jolla
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla
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Bridging the gap between respiratory research and health literacy: an
interactive web-based platform. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:163-166. [DOI: 10.1136/bmjstel-2020-000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 11/03/2022]
Abstract
Many patients with respiratory disease lack an understanding of basic
respiratory physiology and the changes occurring in their lungs due to disease.
Describing how the lungs work using realistic 3D visualisation of lung structure
and function will improve communication of complicated concepts, resulting in
improved health literacy. We developed a web-based platform, using anatomically
realistic 3D lung models, to create an interactive visualisation tool to improve
health literacy for patients with respiratory disease. A small amount of
non-identifying personal information including gender, age, weight, height and
smoking history can be used to customise the visualisation to an individual user.
3D computer modelling was used to create a web-based application that helps people
understand how their lungs work in health and disease. The web-based application
includes pages describing and visualising how the lungs work and the changes that
occur during asthma and damage that smoking may be doing to their lungs. The
application is freely available and located at https://sites.bioeng.auckland.ac.nz/silo6/lung_new/. This
application bridges the gap between computational modelling and patient education,
giving a visually compelling view into the patient’s body that cannot be provided
with any existing tools, hence providing a novel platform for enhancing
patient–clinician interaction.
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Anderson M, Duran Sahin D, Tsilingaridis G. Dental trauma in toddlers 1-3 years of age living in multicultural areas of Stockholm, Sweden: A retrospective cohort study. Dent Traumatol 2021; 37:639-646. [PMID: 33838081 DOI: 10.1111/edt.12677] [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] [Received: 11/13/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND/AIM Traumatic dental injuries are common and affect many children. The aim of this retrospective study was to investigate the prevalence and characteristics of dental trauma as well as the costs and resource use in a cohort of children aged 1-3 years in low socioeconomic areas (low income and educational level) of Stockholm. MATERIALS AND METHODS Data were extracted from a larger intervention trial and analyzed for the prevalence and other characteristics of dental trauma as well as patient characteristics of children (n = 1346) from six dental clinics in low-income, multicultural areas. Variables describing the trauma, socioeconomic status, direct and indirect costs, and time spent at the emergency visit for the dental trauma were retrieved from the dental records. The study also recorded which healthcare profession handled the first and follow-up visits. RESULTS The prevalence of dental trauma in the study cohort was 8.2%, and higher among boys (n = 71) than girls (n = 39). Boys exhibited a significantly higher risk for dental trauma (OR, 1.76; 95% CI = 1.17-2.65). Maxillary incisors were the teeth most often traumatized, and lateral luxation was the most common diagnosis. The mean time spent per child during the first year following the dental trauma was 36 min, and the mean costs per child were EUR 878. The total average per-child cost (direct and indirect costs) for dental trauma was EUR 2107. Dental visits due to traumatic injuries were significantly less common among children with an immigrant background and in families with an income ≤EUR 2000 per month. CONCLUSIONS Toddlers in families who have a low socioeconomic status, a foreign background, and live in multicultural areas of Stockholm visit dental clinics for traumatic dental injuries less often than non-immigrant children living in families with a high socioeconomic status.
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Affiliation(s)
- Maria Anderson
- Department of Pediatric Dentistry, Eastman Institute, Public Dental Service, Stockholm, Sweden.,Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - Demet Duran Sahin
- Department of Pediatric Dentistry, Eastman Institute, Public Dental Service, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
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Bröder J, Okan O, Bauer U, Schlupp S, Pinheiro P. Advancing perspectives on health literacy in childhood and youth. Health Promot Int 2021; 35:575-585. [PMID: 31143943 DOI: 10.1093/heapro/daz041] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Children and young people's importance as core target population for health literacy has been highlighted throughout the literature due to the relevance of the early life phases for maintaining, restoring and promoting health during the life course. Transferring health literacy concepts to the target population, however, requires proper testing of their applicability and their fit to the developmental phases as well as the target populations' realities and needs. This article aims to discuss children's and young people's health literacy by elaborating and exploring childhood and youth as life phases with unique characteristics from multidisciplinary perspectives. Drawing on theories and findings from developmental studies, sociology and socialization research, health literacy in childhood and youth is discussed along five 'D' dimensions: (i) disease patterns and health perspectives, (ii) demographic patterns, (iii) developmental change, (iv) dependency and (v) democracy. The unique particularities of children and young people relevant for health literacy include their disease and health-risk profiles, their vulnerability to demographic factors, their social role and status, and their right to participation. Inter- and intra-generational relationships and an unequal distribution of power can either promote or hinder children and young people's health literacy development and their opportunities for participating in health-related decision making. Specifying what is called the 'contextual' and 'relational' dimension of health literacy for the target group requires considering their personal attributes and agency as contextually embedded and interrelated. Taking these considerations into account can help to move towards a more tailored and holistic approach to health literacy of children and young people.
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Affiliation(s)
- Janine Bröder
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, Bielefeld, Germany
| | - Orkan Okan
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, Bielefeld, Germany
| | - Ullrich Bauer
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, Bielefeld, Germany
| | - Sandra Schlupp
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, Bielefeld, Germany
| | - Paulo Pinheiro
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, Bielefeld, Germany
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Bhatt N, Boggio L, Simpson ML. Using an educational intervention to assess and improve disease-specific knowledge and health literacy and numeracy in adolescents and young adults with haemophilia A and B. Haemophilia 2021; 27:229-236. [PMID: 33590938 DOI: 10.1111/hae.14228] [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: 03/04/2020] [Revised: 11/08/2020] [Accepted: 11/24/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Health literacy (HL) and health numeracy (HN) are underestimated barriers to treatment adherence in patients with haemophilia. AIM To test the ability of an educational intervention to improve knowledge, HL, HN, adherence and joint health in adolescent and young adult (AYA) males with haemophilia. METHODS We performed a longitudinal pilot study of 41 participants aged 12-21 years with haemophilia A or B during two clinic visits 6-12 months apart. The first visit included a comprehensive pre-intervention assessment: demographics, knowledge survey, Montreal Cognitive Assessment testing, 5-question tool to assess baseline HN, assessment of HL with the Rapid Estimate of Adolescent Literacy in Medicine tool, history of adherence and Haemophilia Joint Health Score (HJHS). An educational intervention using a visual aid explained basic pharmacokinetic (PK) concepts and personal teaching regarding haemophilia treatment regimens was used during this visit. The second visit included a post-intervention assessment: a reassessment of knowledge, HL, HN, HJHS, adherence to prescribed therapy and number of joint bleeds since the pre-intervention visit. RESULTS Forty-one males with haemophilia A or B were enrolled in the study. Of these, 33 completed the post-intervention assessment. Knowledge (p = .002) and HN (p = .05) were significantly improved post-intervention, although the HL, number of joint bleeds, adherence to prescribed therapy and HJHS were not. CONCLUSIONS Participants with low HL and/or HN may benefit from alternate methods of education such as audiovisual material. Education using audiovisual materials improved knowledge and HN in this study; however, this did not affect adherence to prescribed therapy.
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Affiliation(s)
- Nidhi Bhatt
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA.,Rush Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, USA.,Department of Hematology-Oncology, University of Illinois at Chicago Hospital, Chicago, IL, USA
| | - Lisa Boggio
- Rush Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, USA
| | - Mindy L Simpson
- Rush Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, USA
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Radicke A, Barkmann C, Adema B, Daubmann A, Wegscheider K, Wiegand-Grefe S. Children of Parents with a Mental Illness: Predictors of Health-Related Quality of Life and Determinants of Child-Parent Agreement. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020379. [PMID: 33418993 PMCID: PMC7825308 DOI: 10.3390/ijerph18020379] [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: 12/04/2020] [Revised: 12/31/2020] [Accepted: 01/02/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Health-related quality of life (HRQoL) is frequently reduced in children of parents with a mental illness (COPMI). Child self- and parent proxy-ratings vary with raters’ characteristics and facets of HRQoL. This study aimed at analyzing risk and protective factors associated with HRQoL in COPMI, and at examining the magnitude, direction, and predictors of child–parent agreement. (2) Methods: Analyses were based on baseline data of the German CHIMPS (children of parents with a mental illness) project with n = 134 parents diagnosed with mental illness and n = 198 children and adolescents aged 8 to 18 years. (3) Results: Both children and parents reported significantly lower HRQoL than the reference population, particularly for the child’s physical and psychological well-being. Parents’ proxy-report indicated a lower HRQoL than the children’s self-report. Child and parental psychopathology, social support, and the child’s age significantly predicted HRQoL. Interrater agreement was satisfactory and better for observable aspects like physical well-being and school environment. The child’s gender-identity and mental health significantly predicted child–parent agreement. (4) Conclusions: Parental psychopathology significantly reduces children’s HRQoL. Interventions should promote resilience in children by targeting risk and protective factors. Child–parent agreement emphasizes the need to obtain both self- and proxy-reports, whenever possible.
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Affiliation(s)
- Alina Radicke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (C.B.); (B.A.); (S.W.-G.)
- Correspondence:
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (C.B.); (B.A.); (S.W.-G.)
| | - Bonnie Adema
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (C.B.); (B.A.); (S.W.-G.)
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (A.D.); (K.W.)
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (A.D.); (K.W.)
| | - Silke Wiegand-Grefe
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; (C.B.); (B.A.); (S.W.-G.)
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Chinese Students' Health Literacy Level and Its Associated Factors: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010204. [PMID: 33383968 PMCID: PMC7796290 DOI: 10.3390/ijerph18010204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/24/2022]
Abstract
Health Literacy (HL) is an important determinant of health. Many scholars have conducted a large number of studies on the level of Chinese students’ HL and its associated factors. However, previous studies on HL level and the factors that influence it have been contradictory. Therefore, this systematic review and meta-analysis was conducted to estimate the level of Chinese students’ HL and its three dimensions (knowledge, behavior and skills) and to identify factors associated with HL in Chinese students. Two investigators independently searched literature, selected research and extracted data through comprehensively searching of four international electronic databases and three Chinese electronic database to identify all relevant observational studies on affecting factors for HL in Chinese students published in English and Chinese from database January, 2010 to September, 2020. In total, 61 articles were extracted in the study. The results showed that the level rates of HL and its three dimensions were 26%, 35%, 26%, 51%, respectively. For Chinese students, the significant factors were urban residents, senior class students, well performance at school, the Han nationality, focus on health knowledge, less exposure to video games, highly educated parents, income of one-child families, receiving health education, having medical background. This study provides some inspirations for improving the level of Chinese students’ HL and their health. First, the findings may help Chinese policy makers understand the overall HL of Chinese students and their levels across three dimensions (knowledge, behavior and skills). Second, protective factors for Chinese students’ HL were found in this research, which will help to improve the level of Chinese students’ HL, stimulate students’ awareness of prevention, and lay the foundation for a healthy China.
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Knisel E, Rupprich H, Wunram A, Bremer M, Desaive C. Promotion of Elementary School Students' Health Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249560. [PMID: 33371224 PMCID: PMC7766722 DOI: 10.3390/ijerph17249560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 11/16/2022]
Abstract
Health literacy is an important outcome of the discussion of school-related health education and health promotion in the 21st century. Although the improvement of health literacy at an early age is increasingly recognized and few interventions show the development of children´s health literacy, still there is little research in this area. The purpose of the study was to examine the enhancement of health literacy among children in a physical activity-based program at elementary school. In total, 137 students aged 6–12 years participated in the program, which included health knowledge transfer in child-appropriate games and exercises. Participants´ health literacy was assessed using the HLS-Child-Q15-DE at the beginning and the end of the program. The instrument measures the access, understanding, appraisal and application of health-related information on a four-point Likert-type scale. As expected, the Wilcoxon signed-rank test revealed significant increases in self-reported health literacy over time. The results show that the degree of change in health literacy was not associated with gender or age. The results suggest that the physical activity-based program has the potential to improve elementary school children´s health literacy, even though in a single group pilot study.
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Affiliation(s)
- Elke Knisel
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
- Correspondence: ; Tel.: +49-(0)391-6756981
| | - Helge Rupprich
- Faculty of Social Sciences, Media, and Sports, Institute of Sport Science, Johannes Gutenberg University Mainz, 55128 Mainz, Germany;
| | - Annika Wunram
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
| | - Markus Bremer
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
| | - Christiane Desaive
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-Universität Magdeburg, 39106 Magdeburg, Germany; (A.W.); (M.B.); (C.D.)
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Vinke PC, Tigelaar C, Küpers LK, Corpeleijn E. The Role of Children's Dietary Pattern and Physical Activity in the Association Between Breastfeeding and BMI at Age 5: The GECKO Drenthe Cohort. Matern Child Health J 2020; 25:338-348. [PMID: 33258042 PMCID: PMC7870607 DOI: 10.1007/s10995-020-03063-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 12/26/2022]
Abstract
Objectives Breastfeeding is protective against childhood obesity, but the role of childhood lifestyle in this association is unclear. We investigated whether physical activity and dietary pattern at age 5 differed between breastfed and non-breastfed children, and how they relate to Body Mass Index (BMI) Z-scores. Methods 1477 children of the Dutch GECKO Drenthe birth cohort were included. At one month, children were categorized as breastfed (receiving breast milk exclusively or in combination with formula milk) or non-breastfed (receiving formula milk exclusively). At age 5, height and weight were objectively measured, physical activity was measured by ActiGraph GT3x and dietary patterns were assessed with a parent-reported food pattern questionnaire, assessing the consumption frequency of selected food items at seven occasions over the day. Results Non-breastfed children had higher BMI Z-scores (0.36 ± 0.90 vs. 0.20 ± 0.80 SD, p = 0.002), more frequently consumed sugar-sweetened beverages (25.0 ± 10.5 vs. 22.5 ± 9.71 times per week, p < 0.001), and consumed relatively less whole-wheat or brown bread (p = 0.007). Differences in sugar-sweetened beverage consumption were most pronounced during main meals. Total fruit consumption, sedentary time and moderate-to-vigorous physical activity levels did not differ between the groups. Multivariable adjusted linear regression analyses showed that the differences in BMI-z score between non-breastfed and breastfed children were not explained by the differences in sugar-sweetened beverages or type of bread consumed. Conclusions Infant breastfeeding itself is indicative of healthy dietary behaviors in early life, and is also more likely to be followed by a favorable dietary pattern at toddler age. However, the differences in dietary habits between breastfed and non-breastfed children did not explain the difference in BMI Z-score at the age of 5. Electronic supplementary material The online version of this article (10.1007/s10995-020-03063-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Petra Corianne Vinke
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands.
| | - Carolien Tigelaar
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands
| | - Leanne Karen Küpers
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands.,Division of Human Nutrition and Health, Wageningen University & Research, PO Box 8129, Wageningen, 6700 EV, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, Groningen, 9700 RB, The Netherlands
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Limaye VS, Grabow ML, Stull VJ, Patz JA. Developing A Definition Of Climate And Health Literacy. Health Aff (Millwood) 2020; 39:2182-2188. [PMID: 33284692 PMCID: PMC8428792 DOI: 10.1377/hlthaff.2020.01116] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A new generation of activists is calling for bold responses to the climate crisis. Although young people are motivated to act on climate issues, existing educational frameworks do not adequately prepare them by addressing the scope and complexity of the human health risks associated with climate change. We adapted the US government's climate literacy principles to propose a definition and corresponding set of elements for a concept we term climate and health literacy. We conducted a scoping review to assess how the peer-reviewed literature addresses these elements. Our analysis reveals a focus on training health professionals; more international than US domestic content; and limited information about data and models, fossil fuels, and equity. We propose developing a framework that builds on the elements to support a broader educational agenda that prepares students and future leaders to recognize the complex health ramifications of a changing climate.
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Affiliation(s)
- Vijay S Limaye
- Vijay S. Limaye is a climate and health scientist at the Natural Resources Defense Council, in New York, New York
| | - Maggie L Grabow
- Maggie L. Grabow is a primary care research fellow in the Department of Family Medicine and Community Health at the University of Wisconsin-Madison School of Medicine and Public Health, in Madison, Wisconsin
| | - Valerie J Stull
- Valerie J. Stull is a postdoctoral research associate in the Global Health Institute at the University of Wisconsin-Madison
| | - Jonathan A Patz
- Jonathan A. Patz is a professor in the Nelson Institute for Environmental Studies and the Department of Population Health Sciences and director of the Global Health Institute at the University of Wisconsin-Madison
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Health Literacy in Female – Association with Socioeconomic Factors and Effects on Reproductive Health. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2018-0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The aim of the study is to assess the health literacy of women who are using health services within the Gynecology Obstetric Clinic “Narodni Front” in Belgrade. Testing of health literacy was conducted as a cross-sectional study in the period October-November 2012. As instruments of research the following questionnaires are used: Short Test of Functional Health Literacy in Adults and General information questionnaire of respondents who referred to the demographic, social and economic characteristics of respondents, self-assessment of health, use of health services, health knowledge and behavior in the area of reproductive health. Inadequate health literacy level is registered in every ten respondents. The education level of the respondents proved to be a significant predictor of health literacy. Demographic and socio-economic characteristics of the patients (age, occupation, marital status) as well as self-evaluation of the health status were not significantly related to the health literacy. Health literacy respondents did not significantly dependent on risk behaviors related to reproductive health. The level of health literacy is consistent with the knowledge of subjects in the field of protection of reproductive health. Health literacy as the ability to function within the health care system is equally certain by individual characteristics and skills, characteristics of the health and education systems as well as a wide range of social and cultural factors. Health literacy is more systematic than individual problem, so it requires a broader social action.
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Aghazadeh SA, Aldoory L, Mills T. Integrating Health Literacy Into Core Curriculum: A Teacher-Driven Pilot Initiative for Second Graders. THE JOURNAL OF SCHOOL HEALTH 2020; 90:585-593. [PMID: 32510639 DOI: 10.1111/josh.12907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/02/2019] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Limited research has addressed the effects of health literacy interventions in elementary schools. However, school-aged children's health literacy is critical because children make decisions about their health every day. The purpose of the pilot project was to explore the feasibility of integrated health literacy lesson plans for second graders. METHODS A pretest-posttest evaluation was conducted with second grade students following implementation of health literacy lessons that were integrated into core curriculum (language arts, science, and social studies). RESULTS Health educators, a hospital/health care system, and a school district developed a partnership. A research team of teachers, administrators, health literacy experts and health care organizations designed and implemented health literacy lesson plans. A developmentally appropriate measure of health literacy was adapted from the Newest Vital Sign. Data showed that students' health literacy scores significantly increased after implementation of 4 lesson plans. CONCLUSIONS This was an exploratory, pilot project that provided a useful starting point for discussing how to integrate health literacy into elementary school curriculum. An interdisciplinary team developed integrated health literacy materials that acknowledged the needs of teachers, the resources available, and the developmental stages of children. This intervention serves as a model for future health literacy initiatives in schools.
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Affiliation(s)
- Sarah A Aghazadeh
- Communication, University of Maryland, Skinner Building, 4300 Chapel Drive, College Park, MD, 20740
| | - Linda Aldoory
- College of Arts and Humanities, University of Maryland, 4282 Chapel Lane, College Park, MD, 20742
| | - Tamara Mills
- Worcester County Public Schools, 6270 Worcester Highway, Newark, MD, 21841
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de Buhr E, Tannen A. Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey. BMC Public Health 2020; 20:1096. [PMID: 32660459 PMCID: PMC7359277 DOI: 10.1186/s12889-020-08881-5] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/10/2020] [Indexed: 11/16/2022] Open
Abstract
Background Health literacy (HL) is closely associated with leading health indicators such as engaging in healthy behaviours and experiencing a healthy social environment. Parents represent a critical subgroup among the adult population since they are not only responsible for their own health but also for the health of their children. Previous research suggests that parents with low HL are less likely to meet the preventive and health care needs of their children but there are gaps in the available information and there is not any data available yet for the German context. Methods In preparation of an implementation study, a cross-sectional survey was conducted in 28 elementary and secondary schools in Germany. The parent questionnaire was completed by 4217 parents and included the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). The child questionnaire examined children’s health knowledge, behaviours and outcomes. For children between 6 and 10 years, a parent reported on behalf of their children (N = 1518). Students 11 years and older completed a self-administered questionnaire (N = 2776). Bivariate and multivariate analyses were carried out. Spearman’s Rho correlations assess the relationships between household characteristics, parental HL and the health behaviour and outcomes in children. Results Among the participating parents, 45.8% showed problematic or inadequate HL. The major determinants of high parental HL were high socio-economic status (SES) (r = .088***, 95% CI [.052, .124]), living in West Germany (r = .064***, 95% CI [.032, .096]) and older parental age (r = .057**, 95% CI [.024, .090]). In the multivariate model, only SES remained significant. High parental HL was associated with positive health behaviours in children including healthier nutrition, regular tooth brushing and more physical activity. The relationships between parental HL and smoking, alcohol, sexual activity among children and children’s weight were not significant. Conclusions The results confirm a relationship between low parental HL, SES and some child health behaviours likely to negatively impact their health and wellbeing including less healthy nutrition and less exercise. Strengthening the health knowledge and competencies of parents may contribute to improved child outcomes particularly in the areas of nutrition, exercise and dental health.
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Affiliation(s)
- Elke de Buhr
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and Nursing Science, Augustenburger Platz 1, D-13353, Berlin, Germany. .,Tulane University, School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.
| | - Antje Tannen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and Nursing Science, Augustenburger Platz 1, D-13353, Berlin, Germany
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Cormier E, Park H, Schluck G. eMental Health Literacy and Knowledge of Common Child Mental Health Disorders among Parents of Preschoolers. Issues Ment Health Nurs 2020; 41:540-551. [PMID: 32400237 DOI: 10.1080/01612840.2020.1719247] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The purpose of the study was to assess the eMental health literacy of parents of preschool children and explore the relationships between their eMental health literacy skills and their knowledge of common child mental health disorders and their child difficulties. Online survey data were collected using Mechanical Turk (MTurk). Parents of preschool children completed questionnaires related to internet-based mental health information seeking behavior, knowledge of common child mental health disorders using case vignettes, and child difficulties. Data were analyzed using descriptive statistical methods. eMental health literacy of parents was high but knowledge of the child mental health disorders was low. Only 14% of parents correctly identified all three disorders; 41.1% identified attention deficit hyperactivity disorder (ADHD), 64.9% recognized autism spectrum disorder (ASD), and 19.1% identified separation anxiety disorder (SAD). Parents with high eMental health literacy (≥30) were more likely to endorse professional help and seek information on how to manage problem behaviors for all three disorders. Parents with low eMental health literacy (<30) were more likely to have a child with a high risk of a mental health disorder. The findings will be used to inform educational initiatives on the use of online resources and recognition of child mental health disorders to promote early intervention and appropriate help seeking.
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Affiliation(s)
- Eileen Cormier
- Florida State University College of Nursing, Tallahassee, Florida, USA
| | - Hyejin Park
- Florida State University College of Nursing, Tallahassee, Florida, USA
| | - Glenna Schluck
- Florida State University College of Nursing, Tallahassee, Florida, USA
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de Buhr E, Ewers M, Tannen A. Potentials of School Nursing for Strengthening the Health Literacy of Children, Parents and Teachers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2577. [PMID: 32283733 PMCID: PMC7178108 DOI: 10.3390/ijerph17072577] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022]
Abstract
Health literacy (HL) plays a key role in explaining health disparities. School nurses (SN) provide health related expertise within the school setting. A positive effect on the HL of children but also their teachers and parents has been suggested by some research, but gaps persist in the available information. As a pilot project, SN, which are not common in German schools, were placed in 28 public elementary and secondary schools in two German states. Children (11+ years, n = 2773), parents (n = 3978) and teachers (n = 420) participated in a 2017 baseline (T0) survey. Data collection was repeated in 2018 (T1). HL was measured using the Health Literacy for School-Aged Children scale (HLSAC) (children) and the European Health Literacy Short Scale (HLS-EU-Q16) (adults). Descriptive and multivariate data analyses were carried out. The HL of all groups increased between T0 and T1. Low child HL decreased from 17.9% to 14.9%. Problematic and inadequate HL dropped from 43.8% to 38.8% among parents and from 49.9% to 45.8% among teachers. Improvements were significant for children and parents but not for the teachers. Despite the relatively short intervention period and a relatively non-specific spectrum of interventions, there is some evidence that SN may contribute to strengthening HL within the school setting. The longer-term effects of SN on health literacy and child health should be further examined. For this, a clearer conceptualization of the scope of work of the SN in Germany including their educational interventions is imperative.
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Affiliation(s)
- Elke de Buhr
- Berlin Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (M.E.); (A.T.)
- School of Public Health and Tropical Medicine, Tulane University of New Orleans, New Orleans, LA 70112, USA
| | - Michael Ewers
- Berlin Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (M.E.); (A.T.)
| | - Antje Tannen
- Berlin Institute of Health and Nursing Science, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (M.E.); (A.T.)
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Hoffman S, Rueda HA, Beasley L. Health-Related Quality of Life and Health Literacy among Mexican American and Black American Youth in a Southern Border State. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:114-124. [PMID: 32248757 DOI: 10.1080/19371918.2020.1747584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Among adults, health literacy and health-related quality of life are highly correlated constructs that are associated with tangible health outcomes. While the connection between these concepts and health outcomes among youth is still unclear, studying these factors among at-risk adolescent populations can provide researchers, policy-creators, and educators a quantifiable summary of the challenge they face in their efforts to reduce health disparities. The purpose of this study was to better understand the health of minority youth living in a Southern state near the US-Mexico border. Specifically, we sought to describe their health literacy and health-related quality of life, and identify how those concepts may be interrelated. Results indicated that our sample of primarily Mexican American and Black American youth living along the US-Mexico border may be struggling more than other known high-risk groups in terms of health literacy and health-related quality of life. Practical implications for families, schools, and border communities are discussed.
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Affiliation(s)
- Steven Hoffman
- School of Social Work, Brigham Young University, Provo, Utah, USA
| | - Heidi Adams Rueda
- Department of Social Work, University of Texas at San Antonio, San Antonio, Texas, USA
| | - Lauren Beasley
- Knoxville Department of Kinesiology, Recreation and Sport Studies, University of Tennessee, Knoxville, Tennessee, USA
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Dutra LDC, de Lima LCM, Neves ÉTB, Gomes MC, de Araújo LJS, Forte FDS, Paiva SM, Ferreira FM, Granville-Garcia AF. Adolescents with worse levels of oral health literacy have more cavitated carious lesions. PLoS One 2019; 14:e0225176. [PMID: 31774850 PMCID: PMC6880994 DOI: 10.1371/journal.pone.0225176] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/30/2019] [Indexed: 11/25/2022] Open
Abstract
The aim of the present study was to investigate whether the ability to recognize and read oral health terms is associated with the number of teeth with cavitated carious lesions in adolescents. A population-based cross-sectional study was conducted involving a sample of 746 adolescents representative of students aged 15 to 19 years at the public and private school systems in a city in northeast Brazil. Two examiners who had undergone a training and calibration exercise (inter-examiner and intra-examiner Kappa coefficient: 0.87 to 0.93) performed the diagnosis of caries using the Nyvad Index and evaluated the level of OHL (BREALD-30) of the adolescents. The participants answered questions regarding their history of visits to the dentist and the parents/caregivers answered a questionnaire addressing socioeconomic characteristics. A directed acyclic graph was created to direct the selection of covariables for adjustments in the Poisson multiple regression analysis to test the association between dental caries and OHL (α = 5%). Cavitated carious lesions (codes 3 to 6 on the Nyvad index) were found in 41.6% of the adolescents. Only 29.4% had a high level of OHL (BREALD-30 scores between 23 and 30); 42.3% of the families belonged to the A-B social class and 93% of the adolescents had been to the dentist at least once in their lifetimes. In the multivariate analysis, adolescents with inadequate (PR: 1.69; 95% CI: 1.18–2.41; p = 0.004) and marginal (PR; 1.42; 95% CI: 1.01–1.99; p = 0.042) OHL and those in the lower social classes (C-D-E) (PR: 1.85; 95% CI: 1.39–2.47; p<0.001) had more teeth with cavitated carious lesions. In conclusion, adolescents aged 15 to 19 years with poorer levels of OHL had a larger number of teeth with cavitated carious lesions, independently of their socioeconomic status and history of visiting a dentist.
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Affiliation(s)
- Laio da Costa Dutra
- Graduate Program in Dentistry, State University of Paraiba (UEPB), Campina Grande, Paraiba, Brazil
| | | | | | - Monalisa Cesarino Gomes
- Graduate Program in Dentistry, State University of Paraiba (UEPB), Campina Grande, Paraiba, Brazil
| | | | | | - Saul Martins Paiva
- Graduate Program in Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Morais Ferreira
- Graduate Program in Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Otsuka-Ono H, Hori N, Ohta H, Uemura Y, Kamibeppu K. A childhood immunization education program for parents delivered during late pregnancy and one-month postpartum: a randomized controlled trial. BMC Health Serv Res 2019; 19:798. [PMID: 31690298 PMCID: PMC6833181 DOI: 10.1186/s12913-019-4622-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 10/09/2019] [Indexed: 11/16/2022] Open
Abstract
Background Improved immunization rates have reduced the incidence of vaccine-preventable diseases (VPDs) in advanced nations. Japan’s unique vaccination system classifies vaccines into routine vaccines ostensibly required under the Preventive Vaccination Law and recommended but optional vaccines, although all vaccines are in fact voluntary. In Japan, low immunization rates, particularly for optional vaccines, have resulted in high rates of sequelae and death. The decision as to whether a child will receive a vaccine depends on the parents, who must obtain information, make inquiries, and make the required payment, the last of which is a major barrier. This randomized, controlled trial was conducted to evaluate the effectiveness of an immunization education program designed to meet mothers’ needs. Methods This randomized controlled trial assigned pregnant women to intervention or control groups. The intervention was individual education sessions involving the children’s fathers in shared decision-making on whether or not to immunize their child. A survey was conducted before and after the intervention. Data were analyzed using the intention-to-treat principle. Results Of 225 pregnant women, 175 (78%) participated and 171 replied to the post-survey. At age 3 months, intervention infants had higher self-reported immunization rates for hepatitis B virus vaccine (76% vs. 49%; P < 0.001) and rotavirus vaccine (84% vs. 68%; P = 0.019) than control group infants. The percentage of parents intending to vaccinate their infants was higher in the intervention group (77% vs. 52%; P < 0.01). Improvements in scores for basic knowledge (mean [SD]: 5.5 [3.6] vs. 3.0 [3.8], range: 10–30; P < 0.001), advanced knowledge (mean [SD]: 5.1 [2.4] vs. 2.8 [2.5], range: 5–15; P < 0.001), and health literacy regarding immunization (mean [SD]: 0.5 [0.8] vs. 0.2 [0.6], range: 1–5; P < 0.01) were higher in the intervention group. The rate of decision making by both parents (68% vs. 52%; P < 0.05) was higher in the intervention group. Conclusions Our findings confirmed the program’s effectiveness. The intervention improved immunization rates, the percentage of parents intending to vaccinate their infants and knowledge scores. Interventions which directly and indirectly involved fathers in shared decision-making on whether to immunize their child were effective, as were individualized interventions that provided parents with access to up-to-date information. Trial registration UMIN000012575. Registered 14 December 2013 (The study was prospectively registered).
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Affiliation(s)
- Hiroko Otsuka-Ono
- Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
| | - Narumi Hori
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Yukari Uemura
- Biostatistics Division, Central Coordinating Unit, Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan
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Bröder J, Okan O, Bollweg TM, Bruland D, Pinheiro P, Bauer U. Child and Youth Health Literacy: A Conceptual Analysis and Proposed Target-Group-Centred Definition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183417. [PMID: 31540040 PMCID: PMC6765952 DOI: 10.3390/ijerph16183417] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
(1) Background: This article adopts an interdisciplinary perspective to analyse, examine, and reflect upon prominent health literacy (HL) understandings in childhood and youth. (2) Method: The conceptual analysis combined Rodgers’ and Jabareen’s approaches to conceptual analysis in eight phases. (3) Results: First, we present exploratory entry points for developing a child-specific HL understanding based on the six dimensions of a ‘health-literacy 6D model’. Second, we describe and reflect upon five meta-level dimensions covering the HL definitions and models for children and youth found in the conceptual analysis. Third, we integrate our findings into a target-group-centred HL definition for children and youth. (4) Discussion/Conclusion: This article raises awareness for the heterogeneity of the current conceptual HL debate. It offers a multidisciplinary approach for advancing the existing understanding of HL. Four recommendations for future actions are deduced from the following four principles, which are inherent to the proposed target-group-centred HL definition: (a) to characterize HL from an asset-based perspective, (b) to consider HL as socially embedded and distributed, (c) to recognize that HL develops both in phases and in flexible ways, and (d) to consider the multimodal nature of health-related information. Further research is necessary to test the feasibility and applicability of the proposed definition and conceptual understanding in both research and practice.
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Affiliation(s)
- Janine Bröder
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Orkan Okan
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Torsten M Bollweg
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Dirk Bruland
- Institute for Education and Care research in the health sector (InBVG), University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany.
| | - Paulo Pinheiro
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
| | - Ullrich Bauer
- Centre for Prevention and Intervention in Childhood and Adolescence (CPI), Bielefeld University, 33615 Bielefeld, Germany.
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Lima LCMD, Neves ÉTB, Dutra LDC, Firmino RT, Araújo LJSD, Paiva SM, Ferreira FM, Granville-Garcia AF. Psychometric properties of BREALD-30 for assessing adolescents' oral health literacy. Rev Saude Publica 2019; 53:53. [PMID: 31432910 PMCID: PMC6703894 DOI: 10.11606/s1518-8787.2019053000999] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/24/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the psychometric properties of the Brazilian Portuguese version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) administered to adolescents. METHODS The study included 750 adolescents: 375 aged 12 years and 375 aged 15–19 years, attending public and private schools in Campina Grande, state of Paraíba, Brazil, in 2017. Reliability was measured based on internal consistency and test-retest reliability. Convergent validity was measured based on correlations between BREALD-30 and Functional Literacy Indicator scores. Divergent validity was measured by comparing BREALD-30 scores with sociodemographic variables. For predictive validity, the association between BREALD-30 scores and the presence of cavitated carious lesions was tested using a multiple logistic regression model. All statistical tests were performed with a significance level of 5%. RESULTS BREALD-30 showed good internal consistency for the 12 year olds and 15 to19 year olds (Cronbach’s alpha = 0.871 and 0.834, respectively) and good test-retest reliability [intraclass correlation coefficient (ICC) = 0.898 and 0.974; kappa = 0.804 and 0.808, respectively]. Moreover, item-total correlation was satisfactory for all items. BREALD-30 had convergent validity with the Functional Literacy Indicator for 12 year olds (rs = 0.558, p < 0.001) and for 15 to 19 year olds (rs = 0.652, p < 0.001). Participants with higher oral health literacy levels who attended private schools (p < 0.001), belonged to economic classes A and B2 (p < 0.001), and who had parents with higher education levels (p < 0.001) were included, indicating the divergent validity of the BREALD-30. Participants with lower BREALD-30 scores were more likely to have cavitated carious lesions [12 year olds: odds ratio (OR) = 2.37; 95% confidence interval (95%CI): 1.48–3.80; 15 to 19 year olds: OR = 1.96; 95%CI 1.24–3.11]. CONCLUSIONS BREALD-30 shows satisfactory psychometric properties for use on Brazilian adolescents and can be applied as a fast, simple, and reliable measure of oral health literacy.
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Affiliation(s)
| | | | - Laio da Costa Dutra
- Universidade Estadual da Paraíba. Programa de Pós-Graduação em Odontologia. Campina Grande, PB, Brasil
| | - Ramon Targino Firmino
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Programa de Pós-Graduação em Odontologia. Belo Horizonte, MG, Brasil
| | | | - Saul Martins Paiva
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontopediatria e Ortodontia. Belo Horizonte, MG, Brasil
| | - Fernanda Morais Ferreira
- Universidade Federal de Minas Gerais. Faculdade de Odontologia. Departamento de Odontopediatria e Ortodontia. Belo Horizonte, MG, Brasil
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