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Lin C, Mella-Velazquez A, Braund WE, Tu P. Disparities in Healthcare-Seeking Behavior and Decision Preference Among Hispanics: A Comparative Study Across Races/Ethnicities, SES, and Provider Types. J Multidiscip Healthc 2024; 17:3849-3862. [PMID: 39139698 PMCID: PMC11319094 DOI: 10.2147/jmdh.s476285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024] Open
Abstract
Purpose Hispanics, the largest minority in America, have increased risk of several medical issues and face noteworthy health disparities. This study compares care-seeking behaviors and choice experience among Hispanics, Asians, Blacks, and Whites, considering SES (income, education, and insurance status) and across five healthcare provider (HCP) types. Concurrent analysis provides a comprehensive view of how and where inequity manifests in healthcare. Methods A cross-sectional online survey assessed 1485 adults (Hispanic=314, Asian=313, Black=316, White=542, recruited through a panel agency) of the frequency of visiting primary care providers, dentists, optometrists, gynecologists, and specialists for chronic conditions. Participants also rated the importance of self-selecting a HCP and difficulty in finding one. Results Whites visited each HCP most regularly. Compared to Asians, more Hispanics saw specialists regularly (45.1% vs 56.5%, p=0.042), and Blacks saw dentists less (47.0% vs 38.3%, p=0.028) and gynecologists more often (21.2% vs 33.1%, p=0.024). No other frequency differences were observed among minorities. Low-income participants across four races saw dentists and gynecologists with comparable infrequency. Hispanics and Asians assigned similarly significantly lower self-choice importance and experienced more difficulty relative to Whites or Blacks. Participants with lower income or education visited HCPs less regularly yet perceived the same choice importance as higher-SES peers (p>0.05). Notably, discrepancies in visit frequency between Whites and minorities were more pronounced in higher-SES than lower-SES group. Differences in experiencing care-seeking difficulty were associated with income (p=0.029) and insurance type (p=0.009) but not education (p>0.05). Conclusion Higher income and education increase healthcare utilization; however, racial disparities persist, particularly among higher-SES groups. Despite similarities among minorities, the extent of disparities varied by SES and provider type. The findings help explain evident inequity in healthcare access and health outcomes. Tailored patient education, culturally-specific navigation support, and more inclusive services are needed to address barriers faced by minorities and disadvantaged populations.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC, USA
| | | | | | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC, USA
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2
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Duda-Sikuła M, Kurpas D. Enhancing Chronic Disease Management: Personalized Medicine Insights from Rural and Urban General Practitioner Practices. J Pers Med 2024; 14:706. [PMID: 39063960 PMCID: PMC11277769 DOI: 10.3390/jpm14070706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/18/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
Health policies worldwide emphasize managing chronic conditions like diabetes and hypertension through medication and lifestyle modifications. However, translating guidelines into practical application remains challenging, leading to suboptimal care and poor health outcomes, particularly in low-resource settings. This study aims to reveal significant differences between rural and urban patients requiring personalized approaches to chronic disease management based on geographical location and demographic data, considering the impact of emergencies such as the COVID-19 pandemic. Data were collected from rural and urban general practitioner (GP) practices in Poland, covering four years from 2018 to the first quarter of 2021, focusing on diabetes and hypertension epidemiology, risk factors, comorbidities, resource consumption, and disease burden. The findings revealed significant differences between rural and urban patients regarding age, number of patient visits, gender distribution, and types of diagnoses and visit modalities. Rural patients tended to be older, had a higher median number of visits, and exhibited different patterns of diagnoses and visit types compared to urban patients. The study also investigated the impact of the COVID-19 pandemic on chronic disease treatment, finding that while age at visits increased during the pandemic, there were no significant changes in gender distribution, but a noticeable shift in diagnoses and visit modalities with an increase in remote visits and changes in the prevalence of specific diagnoses. These disparities highlight the need for tailored approaches to chronic disease management based on geographic location and patient demographics. The study underscores the importance of understanding the unique challenges and opportunities in managing chronic diseases across different settings and during public health crises like the COVID-19 pandemic, aiding healthcare providers and policymakers in developing targeted interventions to improve chronic disease prevention and management, ultimately leading to better health outcomes for individuals and communities. Further research is needed to explore the long-term effects of the pandemic on chronic disease treatment and assess the effectiveness of interventions to mitigate its impact.
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Affiliation(s)
- Marta Duda-Sikuła
- Clinical Trial Support Centre, Wroclaw Medical University, 50-367 Wrocław, Poland
| | - Donata Kurpas
- Department of Family and Pediatric Nursing, Faculty of Health Sciences, Wroclaw Medical University, 50-996 Wrocław, Poland;
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3
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Ross SE, Severance JJ, Murphy SC, Yockey RA, Morkos J, Johnson S, Knebl JA. Primary care and community partnerships to promote age-friendly care for Hispanic older adults. J Am Geriatr Soc 2024. [PMID: 38828999 DOI: 10.1111/jgs.19034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/03/2024] [Accepted: 04/29/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Healthcare and community collaborations have the potential to address health-related social needs. We examined the implementation of an educational initiative and collaborative intervention between a geriatric clinic and Area Agency on Aging (AAA) to enhance age-friendly care for a Hispanic patient population. METHODS As part of a Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Program, a geriatric clinic partnered with AAA to embed an English- and Spanish-speaking Social Service Coordinator (SSC). The SSC met with patients during new and annual visits or by referral to address What Matters and Mentation in the patient's primary language, provide education, and make social service referrals. Patients aged 60 and older, who received SSC services during a 12-month period, were defined as the intervention group (n = 112). Using a retrospective chart review, we compared them to a non-intervention group (n = 228) that received primary care. We examined available demographic and clinical data within the age-friendly areas of What Matters and Mentation. Measures included cognitive health screenings, advance care planning, patient education, and community referrals. RESULTS Most of the intervention groups were eligible for AAA services and had the opportunity for service referrals to address identified needs. A higher proportion of patients within the intervention group completed screenings for cognitive health and advance care planning discussions. CONCLUSION Interagency partnerships between ambulatory care settings and community-based organizations have the potential to expand access to linguistically and culturally competent age-friendly primary care for older adults.
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Affiliation(s)
- Sarah E Ross
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Jennifer J Severance
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Sara C Murphy
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Robert A Yockey
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Johny Morkos
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Shakita Johnson
- United Way of Tarrant County's Area Agency on Aging, Fort Worth, Texas, USA
| | - Janice A Knebl
- Department of Internal Medicine and Geriatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Ginman H, Sitch M. Older adult's experiences of navigating healthcare whilst living with multimorbidity. Psychol Health 2024:1-19. [PMID: 38693663 DOI: 10.1080/08870446.2024.2339327] [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: 07/27/2023] [Accepted: 04/01/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE The way older adults navigate their healthcare is critical to supporting positive health outcomes. However, navigating healthcare with multimorbidity is typically disjointed due to complexities in treatment, management, and service provision. This study sought to examine how older patients navigate healthcare whilst living with multimorbidity. METHODS AND MEASURES Semi-structured interviews were undertaken with five older adults, aged 65 or older, living with multimorbidity in residential care in England. An Interpretive Phenomenological Analysis was undertaken. RESULTS Overall, participants experienced navigating healthcare whilst living with multimorbidity as challenging. Group Experiential Themes included 'Health knowledge and understanding', 'Relationships and expectations' and 'Navigating health care with a single lens'. Collectively these themes represented narratives involving how having limited understanding of health conditions, experiencing challenges in communication with health professionals, and receiving segmented care in a health care system driven by a single condition focus interfered with navigation. CONCLUSION These findings highlight experiences of older adults living with multimorbidity navigating healthcare and illustrate several ways older adults living with multimorbidity may be supported to navigate services with less challenges. The research also promotes the need for future research in this area.
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Ownby RL, Thomas-Purcell K, Purcell D, Caballero J, Tewary S, Davenport R, Simonson M. A mobile app providing individually-tailored psychoeducation about sleep for older adults with chronic health conditions and low health literacy. JOURNAL OF PSYCHIATRY RESEARCH REVIEWS & REPORTS 2024; 6:10.47363/jpsrr/2024(6)163. [PMID: 38770111 PMCID: PMC11103247 DOI: 10.47363/jpsrr/2024(6)163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Objective This paper reports on a study of a mobile app that provides tailored information about sleep to individuals aged 40 and older who have chronic health conditions and low health literacy. Methods The sleep module was a part of a multitopic app focused on chronic disease self-management. Participants were randomly assigned to receive sleep psychoeducation at reading levels equivalent to 3rd, 6th or 8th grade. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI), which was completed at baseline, after the intervention, and again three months later. Outcomes were assessed using repeated measures mixed effects models. Results Most participants were Black, Indigenous, or Other Persons of Color (BIPOC; 87%); they had average reading level at the 7th grade. Health literacy, socioeconomic status, and number of health conditions were related to the PSQI. The PSQI score decreased over the course of the three study visits for all groups, consistent with a small to medium effect size (d = 0.40). No effect of treatment group was observed. Participants were positive about the usefulness and helpfulness of the app. Conclusion Results suggest that a brief tailored information intervention may be beneficial for individuals aged 40 and older who have low health literacy and chronic health conditions. Further development of the intervention may enhance its clinical effectiveness.
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Affiliation(s)
- Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Kamilah Thomas-Purcell
- Department of Health Science, College of Health Care Sciences, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Donrie Purcell
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA. Now at Department of Community Health & Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Joshua Caballero
- Department of Clinical and Administrative Science, College of Pharmacy, Larkin University, Miami, Florida, USA. Now at Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, Georgia, USA
| | - Sweta Tewary
- Department of Geriatric Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Rosemary Davenport
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Michael Simonson
- Instructional Technology and Distance Education Program, Fischler College of Education, Nova Southeastern University, Fort Lauderdale Florida, USA
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Charlucien-Koech R, Brady J, Fryer A, Diaz-Gonzalez de Ferris ME. School Nurses Practices Promoting Self-Management and Healthcare Transition Skills for Adolescents with Chronic Conditions in Urban Public Schools: A Mixed Methods Study. J Sch Nurs 2024; 40:174-188. [PMID: 34928723 DOI: 10.1177/10598405211053266] [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] [Indexed: 11/17/2022] Open
Abstract
Background: Adolescents and young adults (AYA) with chronic conditions should acquire self-management skills as part of their healthcare transition (HCT) from pediatric to adult-focused care. HCT/self-management skills have the potential to help mitigate health disparities among minority AYA with chronic conditions. This study investigated school nurses' practices promoting HCT/self-management skills in urban public schools. Methods: Seventy-nine nurses from three urban school districts in Massachusetts completed a survey of 32 Likert-type questions on HCT/self-management skills, eight demographic questions, and five open-ended practice questions assessing how often they have asked students with chronic conditions about HCT/self-management skills, based on the UNC TRxANSITION IndexTM. Results: Among the 79 school nurses who participated (response rate 76%), 67% never or rarely assessed students' knowledge of HCT/self-management, and 90% would use a tool that promotes/measures HCT/self-management skills. Conclusion: In our study sample, most school nurses acknowledged the importance of assessing HCT/self-management skills. The majority favored using a tool to promote these skills.
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Affiliation(s)
- Roselaine Charlucien-Koech
- Department of Health Services, Boston Public Schools, Boston, Massachusetts
- Department of Nursing and Health Sciences, Regis College, Weston, Massachusetts
| | - Jacqueline Brady
- Department of Health Services, Boston Public Schools, Boston, Massachusetts
| | - Anne Fryer
- Department of Nursing and Health Sciences, Regis College, Weston, Massachusetts
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Yang MC, Clayton C, Harris D, Pelletier C, Schmidt J, Zwicker JG, Sakakibara BM. A Qualitative Investigation on Chronic Disease Management and Prevention Among Older Adults During the COVID-19 Pandemic. Am J Health Promot 2024; 38:384-393. [PMID: 38000140 PMCID: PMC10903114 DOI: 10.1177/08901171231218681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
PURPOSE To qualitatively describe experiences of chronic disease management and prevention in older adults (age ≥65 years) during COVID-19. APPROACH Qualitative descriptive approach. SETTING Data collected online via telephone and video-conferencing technologies to participants located in various cities in British Columbia, Canada. Data analyzed by researchers in the cities of Vancouver and Kelowna in British Columbia. PARTICIPANTS Twenty-four community-living older adults (n = 24) age ≥65 years. METHODS Each participant was invited to complete a 30-to-45-minute virtual, semi-structured, one-on-one interview with a trained interviewer. Interview questions focused on experiences managing health prior to COVID-19 and transitioning experiences of practicing health management and prevention strategies during COVID-19. Audio recordings of interviews were transcribed verbatim and analyzed thematically. RESULTS The sample's mean age was 73.4 years (58% female) with 75% reporting two or more chronic conditions (12.5% none, 12.5% one). Three themes described participants' strategies for chronic disease management and prevention: (1) having a purpose to optimize health (i.e., managing health challenges and maintaining independence); (2) internal self-control strategies (i.e., self-accountability and adaptability); and (3) external support strategies (i.e., informational support, motivational support, and emotional support). CONCLUSION Helping older adults identify purposes for their own health management, developing internal control strategies, and optimizing social support opportunities may be important person-centred strategies for chronic disease management and prevention during unprecedented times like COVID-19.
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Affiliation(s)
- Michelle C. Yang
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
| | - Cam Clayton
- Vancouver Fraser Medical Program, University of British Columbia, Vancouver, BC, Canada
| | - Devin Harris
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
- Interior Health Authority, Kelowna, BC, Canada
| | - Chelsea Pelletier
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Julia Schmidt
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Jill G. Zwicker
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Brodie M. Sakakibara
- Centre for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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8
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Ownby RL, Waldrop D, Davenport R, Simonson M, Caballero J, Thomas-Purcell K, Purcell D, Ayala V, Gonzalez J, Patel N, Kondwani K. A mobile app for chronic disease self-management for individuals with low health literacy: A multisite randomized controlled clinical trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.01.23288020. [PMID: 37066256 PMCID: PMC10104214 DOI: 10.1101/2023.04.01.23288020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Objective The purpose of this study was to evaluate the effects of a mobile app designed to improve chronic disease self-management in older adult patients with low health literacy and who had at least one chronic health condition, and to assess the impact of delivering information at different levels of reading difficulty. Methods A randomized controlled trial was completed at two sites. Individuals 40 years of age and older screened for low health literacy who had at least one chronic health condition were randomly assigned to a tailored information multimedia app with text at one of three grade levels. Four primary outcomes were assessed: patient activation, chronic disease self-efficacy, health-related quality of life, and medication adherence. Results All groups showed overall increases in activation, self-efficacy, and health-related quality of life, but no change in medication adherence. No between-group differences were observed. Conclusions The mobile app was effective in increasing participants' levels of several psychosocial variables, but reading difficulty level was not significantly related to outcomes.Registered at clinicaltrials.gov NCT02922439.
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Affiliation(s)
- Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Drenna Waldrop
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta GA
| | - Rosemary Davenport
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Michael Simonson
- Instructional Technology and Distance Education Program, Fischler College of Education, Nova Southeastern University, Fort Lauderdale FL
| | | | | | - Donrie Purcell
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Victoria Ayala
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Juan Gonzalez
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Neil Patel
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL
| | - Kofi Kondwani
- Department of Community Health & Preventive Medicine, Morehouse School of Medicine, Fort Lauderdale FL
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Patel N, Waldrop D, Ownby RL. Creating a Tailored Info App to Promote Self-Management Skills in Persons with Chronic Health Conditions: Development Strategies and User Experience. DISTANCE LEARNING (GREENWICH, CONN.) 2023; 20:9-18. [PMID: 38440090 PMCID: PMC10911517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Persons with chronic health conditions, such as heart disease, diabetes, hypertension, and others, often experience self-management problems that are not disease specific. These include disrupted sleep, pain, memory issues, and challenges in working with healthcare providers. These patients may benefit from information and skill development for these problems, but simply providing them information in brief sessions during clinical appointments or in handouts or pamphlets may not have a substantial impact on their behavior. Providing information tailored to persons' needs and individual characteristics has a greater impact on patients' behavior and may increase these persons' abilities to manage their health. Creating tailored information for each person, however, is labor intensive, making it difficult to use in everyday clinical practice. Computer-based tailoring is an alternative, allowing automated tailoring of information presented to patients based on their interactions with a computer app. The purpose of this article is to describe our process in developing a series of modules for chronic disease self-management for persons 40 years of age or older with one or more chronic health conditions.
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Affiliation(s)
- Neil Patel
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL USA
| | - Drenna Waldrop
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta GA USA
| | - Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale FL USA
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10
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Gan DRY, Wister AV, Best JR. Environmental Influences on Life Satisfaction and Depressive Symptoms Among Older Adults With Multimorbidity: Path Analysis Through Loneliness in the Canadian Longitudinal Study on Aging. THE GERONTOLOGIST 2022; 62:855-864. [PMID: 35034124 PMCID: PMC9290896 DOI: 10.1093/geront/gnac004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES More older adults with multimorbidity are aging in place than ever before. Knowing how the environment affects their mental well-being could enhance the efficacy of age-friendly interventions for multimorbidity resilience. With reference to the Transdisciplinary Neighborhood Health Framework, we construct and examine a priori models of environmental influences on life satisfaction and depressive symptoms. RESEARCH DESIGN AND METHODS Baseline and follow-up data (after 3 years) were drawn from the Canadian Longitudinal Study on Aging to identify a subsample (n = 14,301) of participants aged at least 65 years with at least 2 chronic diseases. Path analysis examined sociobehavioral attributes (i.e., social support, social participation, walking) and loneliness as primary and secondary mediators, controlling for age, sex, education, and outcomes during baseline. RESULTS Good model fit was found (TFI = 1.00; CFI = 1.00; RMSEA < 0.001; SRMR < 0.001). The total effects of housing quality (rtotal = 0.08, -0.07) and neighborhood cohesion (rtotal = 0.03, -0.06) were weak but statistically significant in the expected direction. The mediators explained 21%-31% of the total effects of housing quality and 67%-100% of the total effects of neighborhood cohesion. Loneliness mediated 27%-29% of these environmental influences on mental well-being, whereas walking mediated a mere 0.4%-0.9% of the total effects. Walking did not explain the relationship between housing quality and mental well-being. DISCUSSION AND IMPLICATIONS Data supported a priori pathways from environment to mental well-being through sociobehavioral attributes and loneliness. If these pathways from neighborhood cohesion to life satisfaction reflect causal effects, community-based age-friendly interventions should focus on enhancing neighborhood cohesion to mitigate loneliness among multimorbid older adults for their mental well-being.
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Affiliation(s)
- Daniel R Y Gan
- Address correspondence to: Daniel R. Y. Gan, PhD, Gerontology Research Centre, Simon Fraser University, #2800-515 West Hastings Street, Vancouver, BC V6B 5K3, Canada. E-mail:
| | - Andrew V Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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11
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Orellano-Colón EM, Goff-Molina ND, Ferré-Martínez AC, Acevedo-Santiago PA, Colón-Cartagena EJ, Lizama-Troncoso M, Jiménez-Velázquez IZ, Varas-Díaz N, Jutai JW, Rivero-Méndez M. Understanding the Multilevel Disability Self-Management Strategies of Puerto Rican Older Men. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021; 39:325-353. [DOI: 10.1080/02703181.2021.1880530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Elsa M. Orellano-Colón
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Nanichi D. Goff-Molina
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Andrea C. Ferré-Martínez
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Pedro A. Acevedo-Santiago
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Edgardo J. Colón-Cartagena
- Occupational Therapy Master Program, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | | | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, Florida, USA
| | - Jeffrey W. Jutai
- Interdisciplinary School of Science, University of Ottawa, Ottawa,Canada
| | - Marta Rivero-Méndez
- School of Nursing, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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12
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Rheault H, Coyer F, Bonner A. Chronic disease health literacy in First Nations people: A mixed methods study. J Clin Nurs 2021; 30:2683-2695. [PMID: 34180097 DOI: 10.1111/jocn.15757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 03/05/2021] [Indexed: 01/29/2023]
Abstract
AIM To explore chronic disease education, self-management and health literacy abilities from First Nations Australian adults with chronic disease through the integration of qualitative and quantitative findings. BACKGROUND Chronic disease management requires good health literacy abilities to manage long-term health needs. First Nations people have a higher burden of chronic disease although little is known regarding chronic disease health literacy of First Nations people. DESIGN A concurrent embedded mixed methods study reported using the Consolidated Criteria for Reporting Qualitative Research guidelines. METHODS Data were collected from First Nations people with one or more chronic diseases living in remote Australia between February-November 2017. Quantitative data (n = 200) were collected using the Health Literacy Questionnaire along with demographic and health data. Qualitative data (n = 20) were collected via face-to-face interviews to examine chronic disease education and self-management experiences. Data were analysed separately then integrated to develop meta-inferences. RESULTS Poor communication from healthcare providers coupled with low health literacy abilities is a major barrier to both active and successful management of chronic disease. Communicating in medical jargon resulted in individuals being placed in a power differential causing lack of trust and relationship breakdowns with healthcare providers affecting active chronic disease self-management. The perception of inevitability and ambivalence towards chronic disease and the notion of futility towards self-management were concurred with the low level of active engagement in health care. CONCLUSIONS Yarning is an important strategy used by First Nations people for communication. For nurses, understanding and developing skills in yarning will facilitate cultural safety, communication and understanding about chronic disease self-management in contexts where health literacy abilities are challenged. RELEVANCE TO CLINICAL PRACTICE Using yarning, and plain language visual aids, and teach-back will readdress the power differential experienced by First Nations people and may also improve understanding of chronic disease self-management.
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Affiliation(s)
- Haunnah Rheault
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.,NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Herston, Queensland, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Herston, Queensland, Australia
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13
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Ojinnaka CO, Adepoju OE. Racial and Ethnic Disparities in Health Information Technology Use and Associated Trends among Individuals Living with Chronic Diseases. Popul Health Manag 2021; 24:675-680. [PMID: 33989085 DOI: 10.1089/pop.2021.0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Health information technology (HIT) can enhance optimal health care access and utilization among individuals living with chronic diseases. This study aimed to provide population-level information on racial/ethnic disparities in HIT use and associated trends among those living with chronic diseases. The study sample consisted of adult respondents (≥18 years) of the 2011-2018 National Health Interview Survey living with at least 1 chronic condition. Binomial regression was used to analyze the association between race/ethnicity, year, and 4 measures of HIT use for patient-provider interaction. Regression parameter estimates were used to predict the trends in probability of the outcome variables across race/ethnicity. About 73% of the study sample were non-Hispanic Whites, 15% were non-Hispanic Blacks, and 13% were Hispanics. Compared to non-Hispanic Whites, there were decreased adjusted odds of any HIT use among non-Hispanic Blacks (OR = 0.72; 95% CI = 0.67, 0.76) and Hispanics (OR = 0.78; 95% CI = 0.72, 0.84). The likelihood of any HIT use increased with increasing year (OR: 1.16; 95% CI = 1.15, 1.18). Trends in racial/ethnic disparities were wider for email communication with provider and online prescription refill compared to online scheduling of appointment. The COVID-19 pandemic has led to accelerated adoption or expansion of HIT for patient care. Limited HIT use among non-Hispanic Blacks and Hispanics could worsen the disproportionate chronic disease burden, suboptimal clinical outcomes, and preventable health care costs experienced by this subpopulation. In conclusion, there is a need for intentional and strategic population-level interventions to increase HIT adoption and use among non-Hispanic Blacks and Hispanics living with chronic diseases.
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Affiliation(s)
- Chinedum O Ojinnaka
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Omolola E Adepoju
- Department of Health Systems and Population Health Sciences, Humana Integrated Health System Sciences Institute, University of Houston College of Medicine, Houston, Texas, USA
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14
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Moyce S, Velazquez M, Claudio D, Thompson S, Metcalf M, Aghbashian E, Vanderwood K, Sisson N. Exploring a rural Latino community's perception of the COVID-19 pandemic. ETHNICITY & HEALTH 2021; 26:126-138. [PMID: 33126820 PMCID: PMC7870520 DOI: 10.1080/13557858.2020.1838456] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/13/2020] [Indexed: 05/07/2023]
Abstract
OBJECTIVES The purpose of our study was to understand the perception of the Latino community in a rural state regarding COVID-19. Over one third of national COVID-19 cases are among Latinos, likely due to an increased prevalence of comorbid risk factors and social determinants of health that make following precautions difficult. DESIGN Respondents were recruited using snowball sampling as part of a previous effort to establish an academic-community partnership with Latinos in the area. In April 2020, we conducted 14 semi-structured interviews in Spanish with participants over the phone. Interviews were audio-recorded, transcribed into Spanish, and translated to English. We employed the framework approach in a thematic analysis using NVivo 12. RESULTS Common themes were a wariness of news appearing on social media, generalized worry, and the use of natural medicines to maintain health. Respondents followed recommended guidelines to protect their own health, though expressed concern that members of their community were not. CONCLUSIONS We offer insights into the perception of Latinos of the COVID-19 pandemic in a rural state. Our findings may influence communication techniques of local health departments and offer a way to understand how this often-overlooked community deals with the pandemic.
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Affiliation(s)
- Sally Moyce
- Montana State University, College of Nursing
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15
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Choi NG, Marti CN, Kunik ME. Predictors of CNS-Active Medication Use and Polypharmacy Among Homebound Older Adults With Depression. Psychiatr Serv 2020; 71:847-850. [PMID: 32340595 PMCID: PMC7528951 DOI: 10.1176/appi.ps.201900551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors assessed central nervous system (CNS) polypharmacy among low-income, racially diverse homebound older adults with depression (N=277) and its associations with the participants' ratings of depressive symptoms and pain. METHODS CNS-active and other psychotropic and analgesic medications intake was collected from patients' medication containers. Depressive symptoms were assessed with the 24-item Hamilton Depression Rating Scale, and pain intensity was measured on an 11-point numerical rating scale. Covariates were disability (World Health Organization Disability Assessment Schedule 2.0) and perceived social support (Multidimensional Scale of Perceived Social Support). RESULTS Of the patients, 16% engaged in CNS polypharmacy, taking three or more CNS-active medications. Of these, 69%, 69%, and 89% were using selective serotonin reuptake inhibitors, benzodiazepines, and opioids, respectively. Higher pain intensity ratings were associated with CNS polypharmacy. Benzodiazepine users were more likely than nonusers to use opioids. CONCLUSIONS Medication reviews and improved access to evidence-based psychotherapeutic treatments are needed for these older individuals with depression.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin (Choi, Marti); Behavioral Health and Implementation Program, U.S. Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Houston (Kunik); Department of Psychiatry, Baylor College of Medicine, Houston (Kunik)
| | - C Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin (Choi, Marti); Behavioral Health and Implementation Program, U.S. Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Houston (Kunik); Department of Psychiatry, Baylor College of Medicine, Houston (Kunik)
| | - Mark E Kunik
- Steve Hicks School of Social Work, University of Texas at Austin, Austin (Choi, Marti); Behavioral Health and Implementation Program, U.S. Department of Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Houston (Kunik); Department of Psychiatry, Baylor College of Medicine, Houston (Kunik)
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16
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Karasneh RA, Al-Azzam SI, Alzoubi KH, Rababah LK, Muflih SM. Health literacy and related health behaviour: a community-based cross-sectional study from a developing country. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2020. [DOI: 10.1111/jphs.12370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Abstract
Objectives
The concept of health literacy (HL) is globally evolving, and understanding its nature and impact is essential for disease prevention and treatment. Therefore, we aimed in this study to assess level of HL and predictors of inadequate HL in Jordanian population as an example case of a developing country.
Method
This cross-sectional study was conducted in a public tertiary hospital and community pharmacies in Jordan. All respondents answered a questionnaire, which included demographic data, Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R), Short Test of Functional HL in Adults (S-TOFHLA), and All Aspects of HL Scale (AAHLS). Chi-square test and logistic regression analysis were conducted to determine the relationship and significant predictors for HL.
Key findings
Among 310 participants, REALM-R showed that around 27.1% had limited HL. Similar findings with S-TOFHLA and AAHLS were shown with a mean score 25.6 out of 35 (SD = 3.54, Range = 16–33) for AAHLS. Functional and critical HL were comparably low. Education level, age, living area and chronic conditions were significant predictors of HL (P < 0.05).
Conclusions
Health literacy was inadequate among Jordanians. Further research is required to assess the effect of inadequate HL on healthcare access and health outcomes. Health education programmes are required to improve HL particularly for patients with chronic diseases.
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Affiliation(s)
- Reema A Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Sayer I Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Lana K Rababah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Suhaib M Muflih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Iaccarino JM, Steiling K, Slatore CG, Drainoni ML, Wiener RS. Patient characteristics associated with adherence to pulmonary nodule guidelines. Respir Med 2020; 171:106075. [PMID: 32658836 DOI: 10.1016/j.rmed.2020.106075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/19/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND While pulmonary nodule guidelines provide follow-up recommendations based on nodule size and malignancy risk, these are inconsistently followed in clinical practice. In this study, we sought to identify patient characteristics associated with guideline-concordant nodule follow-up. METHODS We conducted a retrospective cohort study of patients diagnosed with a pulmonary nodule between 2011 and 2014 at Boston Medical Center. Appropriate nodule follow-up evaluation was based upon the 2005 Fleischner Society Guidelines. In primary analysis, we compared patients with guideline-concordant follow-up to those with delayed or absent follow-up. In secondary analysis, we compared those with any follow-up to those without follow-up as well as the rate of guideline-concordant follow-up in patients seen by a pulmonologist. RESULTS Of 3916 patients diagnosed with a pulmonary nodule, 1117 were included for analysis. Overall, 598 (53.5%) patients received guideline-concordant follow-up. Lower rates of guideline concordance were seen in patients of Hispanic ethnicity (OR 0.60, 95% CI 0.36-1.00), while higher rates were seen for nodules 7-8 mm (OR 1.55, 95% CI 1.02-2.35) and nodules >8 mm (OR 1.49, 95% CI 1.01-2.20). Having a history of COPD (OR 1.75, 95% CI 1.26-2.43), and being seen by a pulmonologist (OR 1.97, 95% CI 1.51-2.58) were also associated with guideline concordance. Among patients seen by a pulmonologist, 62.2% received guideline-concordant follow-up. CONCLUSION Overall rates of pulmonary nodule follow-up are low. Patient ethnicity, COPD history, nodule size and involvement of a pulmonologist may impact follow-up rates and are potential targets for implementation interventions to improve pulmonary nodule follow-up.
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Affiliation(s)
| | - Katrina Steiling
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, USA
| | - Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA; Division of Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA
| | | | - Renda Soylemez Wiener
- The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA; Center for Healthcare Organization & Implementation Research, ENRM VA Hospital, Bedford, MA, USA
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Xiao X, Xiao J, Yao J, Chen Y, Saligan L, Reynolds NR, Wang H. The Role of Resilience and Gender in Relation to Infectious-Disease-Specific Health Literacy and Anxiety During the COVID-19 Pandemic. Neuropsychiatr Dis Treat 2020; 16:3011-3021. [PMID: 33324062 PMCID: PMC7733452 DOI: 10.2147/ndt.s277231] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/23/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Anxiety is one of the psychological problems being experienced by the general population during the current coronavirus disease 2019 (COVID-19) pandemic. Health literacy, such as infectious-disease-specific health literacy, is associated with anxiety, but the mechanism of such association is not clear. This study explored the relationship between infectious-disease-specific health literacy and anxiety. METHODS We conducted an online survey in Hubei province, the early epicenter of the COVID-19 pandemic. A total of 1038 COVID-19-negative participants accomplished a battery of online survey tools determining their sociodemographic characteristics, perceived risk of acquiring COVID-19, infectious-disease-specific health literacy, resilience, and anxiety symptoms. We examined the moderated mediation models, in which the mediator was resilience and the moderator was gender. RESULTS Most (63%) of the study participants experienced at least mild anxiety. The indirect effect of infectious-disease-specific health literacy on anxiety through resilience was -0.282 (95% confidence interval [CI] = [-0.511, -0.083]), contributing to 32.7% of the total effect of health literacy on anxiety. Resilience fully mediated the association. The mediation effect of resilience tended to be stronger for the male participants than for the female participants as the moderation effect of gender remained until we included perceived risk of acquiring COVID-19 in the model. CONCLUSION Resilience was found to mediate the association between infectious-disease-specific health literacy and anxiety. Individuals with good infectious-disease-specific health literacy are more likely to acquire higher resilience, which may in turn decrease their anxiety level. Males may benefit more from the mediation effect of resilience during the current pandemic. Infectious-disease-specific health literacy programs may help reduce the anxiety of the program participants by enhancing their resilience during a pandemic.
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Affiliation(s)
- Xueling Xiao
- Xiangya Nursing School of Central South University, Changsha, Hunan, People's Republic of China
| | - Jinshun Xiao
- School of Information Engineering, Wuhan College, Wuhan, Hubei, People's Republic of China
| | - Juqin Yao
- Xiangya Nursing School of Central South University, Changsha, Hunan, People's Republic of China
| | - Yaling Chen
- Nursing Department, Medical School of Wuhan University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Leorey Saligan
- National Institute of Nursing Research/National Institute of Health, Bethesda, MD, USA
| | | | - Honghong Wang
- Xiangya Nursing School of Central South University, Changsha, Hunan, People's Republic of China
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Jager M, de Zeeuw J, Tullius J, Papa R, Giammarchi C, Whittal A, de Winter AF. Patient Perspectives to Inform a Health Literacy Educational Program: A Systematic Review and Thematic Synthesis of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4300. [PMID: 31694299 PMCID: PMC6862529 DOI: 10.3390/ijerph16214300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 01/22/2023]
Abstract
Patient-centred care is tailored to the needs of patients and is necessary for better health outcomes, especially for individuals with limited health literacy (LHL). However, its implementation remains challenging. The key to effectively address patient-centred care is to include perspectives of patients with LHL within the curricula of (future) healthcare providers (HCP). This systematic review aimed to explore and synthesize evidence on the needs, experiences and preferences of patients with LHL and to inform an existing educational framework. We searched three databases: PsychInfo, Medline and Cinahl, and extracted 798 articles. One-hundred and three articles met the inclusion criteria. After data extraction and thematic synthesis, key themes were identified. Patients with LHL and chronic diseases encounter multiple problems in the care process, which are often related to a lack of person-centeredness. Patient perspectives were categorized into four key themes: (1) Support system; (2) Patient self-management; (3) Capacities of HCPs; (4) Barriers in healthcare systems. "Cultural sensitivity" and "eHealth" were identified as recurring themes. A set of learning outcomes for (future) HCPs was developed based on our findings. The perspectives of patients with LHL provided valuable input for a comprehensive and person-centred educational framework that can enhance the relevance and quality of education for (future) HCPs, and contribute to better person-centred care for patients with LHL.
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Affiliation(s)
- Margot Jager
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
| | - Janine de Zeeuw
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
- Department of Medical Sciences, Educational Institute, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Janne Tullius
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
| | - Roberta Papa
- Regional Health Agency Marche Region, 60125 Ancona, Italy; (R.P.); (C.G.)
- IRCCS INRCA, 60124 Ancona, Italy
| | - Cinzia Giammarchi
- Regional Health Agency Marche Region, 60125 Ancona, Italy; (R.P.); (C.G.)
- IRCCS INRCA, 60124 Ancona, Italy
| | - Amanda Whittal
- Department of Psychology & Methods, Jacobs University, 28759 Bremen, Germany;
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
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20
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Choudhry FR, Ming LC, Munawar K, Zaidi STR, Patel RP, Khan TM, Elmer S. Health Literacy Studies Conducted in Australia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1112. [PMID: 30925706 PMCID: PMC6479782 DOI: 10.3390/ijerph16071112] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/08/2019] [Accepted: 02/12/2019] [Indexed: 02/07/2023]
Abstract
Health literacy (HL) is an essential component of various literacies mentioned in the field of health and education, including cultural, technological, media and scientific literacies. It is important for motivating higher consumer engagement. We aimed to review previous studies of HL in Australia to inform future studies, extend current knowledge and further enhance HL. Using search strings, a systematic search of four databases (i.e., MEDLINE; Embase; CINAHL and Eric) was carried out. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) based search strategy led to identification of a total of N = 9696 records, that were further screened for inclusion in the review. The review findings were categorized into three major themes: (1) HL and health numeracy; (2) contrast of: knowledge deficiency, knowledge gained, problems of current health care system and (3) HL measurement methods and its domains. The findings from this scoping review show a dearth of measurement tools with sound psychometric properties for assessing HL. The findings also reveal low levels of HL in consumers which is in turn affecting health-related behaviors, utilization of health services and navigation of the health system. More recent developments have tried to integrate vital aspects, including introduction of applications to increase HL and exploring HL in Aboriginal communities.
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Affiliation(s)
- Fahad Riaz Choudhry
- National Institute of Psychology, Quaid-i-Azam University, Islamabad 44000, Pakistan.
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur 53100, Malaysia.
| | - Long Chiau Ming
- Pharmacy, School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7005, Australia.
- Faculty of Pharmacy, Quest International University Perak, Ipoh 30250, Perak, Malaysia.
| | - Khadeeja Munawar
- Department of Psychology, Jeffrey Cheah School of Medicine & Health Sciences, Monash University, Sunway City 47500, Selangor, Malaysia.
- Department of Psychology, University of Wah, Punjab 47000, Pakistan.
| | | | - Rahul P Patel
- Faculty of Pharmacy, Quest International University Perak, Ipoh 30250, Perak, Malaysia.
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Science, University of Veterinary & Animal Sciences, Lahore 54700, Pakistan.
- School of Pharmacy, Monash University Malaysia, Sunway City 45700, Selangor, Malaysia.
| | - Shandell Elmer
- School of Medicine, College of Health and Medicine, University of Tasmania, Launceston 7250, Australia.
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21
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Thomas-Purcell KB, Jacobs RJ, Seidman TL, Acevedo A, Waldrop-Valverde D, Ownby RL. A mixed analysis approach to elucidate the multiple chronic condition experience of English- and Spanish-speaking older adults. Clin Interv Aging 2019; 14:407-418. [PMID: 30863035 PMCID: PMC6388757 DOI: 10.2147/cia.s193215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Having multiple chronic conditions (MCCs) is the most common health condition in older adults. The management of each condition presents many challenges. A key factor in patients’ ability to manage their own health care is their level of health literacy. Purpose The purpose of this mixed analysis study was to elucidate the experience of older adults living with MCCs and identify associations among the experiences to determine targets for future mobile health (mHealth) interventions focused on MCCs and health literacy. Participants and methods Using the Abilities, Skills, and Knowledge Model as a framework, semi-structured interviews were completed with 25 older adults in English and Spanish. Interviews were analyzed using inductive thematic analysis and hierarchical cluster analysis. Results The main themes from these results included 1) Reflections of chronic disease; 2) Emotional aspects of chronic disease; 3) Physical barriers to well-being; 4) Quality-of-care factors; and 5) Cognitive strategies for self-management. Qualitative results highlighted the importance of a multi-targeted approach to chronic disease self-management (CDSM). Cluster analysis identified associations within the qualitative data, revealing the importance of the subthemes related to coping with pain and the impact of the patient–provider relationship on treatment adherence. Conclusion Results support the utility of mHealth interventions to improve health literacy and promote CDSM.
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Affiliation(s)
- Kamilah B Thomas-Purcell
- Department of Health Science, College of Health Care Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA, .,Department of Psychiatry and Behavioral Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA,
| | - Robin J Jacobs
- Department of Medical Education, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Tyler L Seidman
- Department of Psychiatry and Behavioral Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA,
| | - Amarilis Acevedo
- Department of Psychiatry and Behavioral Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA,
| | | | - Raymond L Ownby
- Department of Psychiatry and Behavioral Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA,
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Rooks RN, Kapral CG, Mathis AL. Chronic Conditions May Be More Important Than Race or Ethnicity in Relation to Health Information Seeking and Use. J Aging Health 2017; 31:611-630. [PMID: 29254425 DOI: 10.1177/0898264317744643] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This research examines health information (HI) seeking and use among middle-aged and older adults with chronic health conditions. METHOD We used logistic regression models to analyze HI seeking ( N = 7,822) and use (N = 4,541-4,547) among participants (aged 45+ years) with chronic conditions from the nationally-representative Health Tracking Household Survey. RESULTS Adults aged 45+ years with chronic conditions were significantly more likely to seek and use HI; however, these results varied based on the age and education. Compared with Whites, Latinos were less likely to seek HI but more likely to use HI to treat illness, and African Americans were more likely to use HI to maintain health. CONCLUSION Middle-aged and older adults with chronic conditions are prominent HI seekers and users. Proficient HI seeking and use may have the potential to enhance control over one's own health, maintain independence in the community, and reduce the impact of negative health consequences on the health care system.
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