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Zovich B, Block SJ, Borondy-Jenkins F, Moraras K, Chen T, Adedokun R, Hua D, Cohen C. The role of culturally appropriate interpersonal communication strategies to reduce hepatitis B and liver cancer disparities. Front Public Health 2024; 12:1377096. [PMID: 39185121 PMCID: PMC11341449 DOI: 10.3389/fpubh.2024.1377096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/16/2024] [Indexed: 08/27/2024] Open
Abstract
Introduction Asian and Pacific Islander (API), African, and Caribbean immigrant groups in the U.S. are disproportionately impacted by chronic hepatitis B and hepatocellular carcinoma (primary liver cancer). Creating educational communication campaigns about hepatitis B and liver cancer for these communities is necessary to increase disease-related awareness and prompt health-promoting behaviors. Identifying interpersonal communication (IPC) preferences within diverse communities for integration into an educational campaign that emphasizes the link between hepatitis B and liver cancer can ultimately promote uptake of screening, vaccination and linkage to appropriate care. Methods Fifteen focus groups and two key informant interviews were conducted with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis. Results Findings demonstrate that all communities preferred that materials be offered in both English and native languages and emphasized that campaigns highlight the connection between hepatitis B and liver cancer. Educational sessions should take place in settings where communities feel safe, including community-based organizations, religious establishments, and healthcare offices, and should be facilitated by trusted messengers, including patient navigators, doctors and faith leaders. Presenting accurate information and dispelling myths and misconceptions around hepatitis B, liver cancer, and their connection were the biggest needs identified across all focus groups. Discussion This study provides insight into community-specific preferences for learning about hepatitis B and liver cancer through IPC methods. The findings from this study can be used to design multi-platform, culturally and linguistically appropriate health education campaigns to facilitate improved diagnosis, prevention, and management of hepatitis B and liver cancer among heavily impacted communities in the U.S.
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Affiliation(s)
| | - Suzanne J. Block
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - Kate Moraras
- Hepatitis B Foundation, Doylestown, PA, United States
| | - Thomas Chen
- Department of Internal Medicine, The Mount Sinai Hospital, New York, NY, United States
| | | | - Dung Hua
- Vital Access Care Foundation, Fountain Valley, CA, United States
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, PA, United States
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Zovich B, Block SJ, Borondy-Jenkins F, Chen T, Moraras K, Afoakwah J, Dong M, Cohen C. The Role of Culturally Appropriate Mediated Communication Strategies to Reduce Hepatitis B and Liver Cancer Disparities. JOURNAL OF HEALTH COMMUNICATION 2024; 29:440-449. [PMID: 38832597 DOI: 10.1080/10810730.2024.2362882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Asian, Pacific Islander, African, and Caribbean communities in the U.S. are heavily impacted by chronic hepatitis B (HBV) and hepatocellular carcinoma (HCC). Educating these groups about the link between the two diseases is imperative to improve screening rates and health outcomes. This study aims to identify and incorporate preferred mediated communication methods into community-specific educational campaigns which emphasize the connection between the conditions, to promote uptake of prevention and management behaviors for HBV and HCC. Fifteen focus groups and two key informant interviews were conducted with Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis. Findings demonstrate that all communities preferred materials be offered in both English and native languages and requested that materials highlight the connection between HBV and HCC. Delivery channel preferences and messaging themes varied by group. This study provides insight into community-specific preferences for learning about HBV and HCC. The findings can be used to design culturally and linguistically tailored, multi-platform, health education campaigns to facilitate improved HBV screening and vaccination rates and increase knowledge about HCC risk among highly impacted communities in the U.S.
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Affiliation(s)
- Beatrice Zovich
- Public Health Research, Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Suzanne J Block
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Thomas Chen
- Department of Internal Medicine, The Mount Sinai Hospital, New York, New York, USA
| | - Kate Moraras
- Public Health Research, Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Janet Afoakwah
- Public Health Research, Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Mi Dong
- Public Health Research, Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Chari Cohen
- Public Health Research, Hepatitis B Foundation, Doylestown, Pennsylvania, USA
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He C, Pei C, Ma J. Developing an evaluation indicators of health literacy for cervical cancer among Chinese women: a modified Delphi method study. BMC Cancer 2023; 23:863. [PMID: 37700262 PMCID: PMC10498636 DOI: 10.1186/s12885-023-11208-3] [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] [Received: 03/13/2023] [Accepted: 07/22/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Increasing women's health literacy is the key to preventing cervical cancer, and various tools have been developed to assess women's cancer health literacy. However, many of these tools come from other countries and have not been adapted to Chinese requirements. Furthermore, a system for evaluating cervical cancer health literacy among Chinese women has not been developed. Therefore, we sought to establish an evaluation index system for cervical cancer health literacy among Chinese women and to provide an effective evaluation tool for tertiary prevention of cervical cancer in China. METHODS We invited 20 recognized experts to participate in two rounds of Delphi expert consultation, and the modified Delphi process with percentage weighting and multiplication was used. A literature review identified 67 potential indicators. Subsequent discussions within our research team led to the retention of 48 indicators following a rigorous screening process. On this basis, two rounds of Delphi expert consultation were conducted to rate and screen the indexes. Percentage weighting and multiplication were used to determine index weights. RESULTS Twenty experts participated in the first-round Delphi consultations (95.23% recovery rate). In the second-round Delphi consultations, 20 questionnaires were returned (100%), and the expert authority coefficient was 0.93 ± 0.02. After both rounds of Delphi consultation, 4 first-level indicators, 9 second-level indicators, and 32 third-level indicators were identified for cervical cancer literacy among Chinese women. On a five-point scale, importance ratings ranged from 3.76 to 4.95 points, with variation coefficients ranging from 0.06 to 0.25, while sensitivity ratings ranged from 3.71 to 4.83 points, with variation coefficients ranging from 0.08 to 0.24. Across both rounds, Kendall's W coefficients ranged from 0.168 to 0.248. The weights of first-level indicators of basic knowledge and attitudes about cervical cancer, primary prevention of cervical cancer literacy, secondary prevention of cervical cancer literacy, and tertiary prevention of cervical cancer literacy were 0.257, 0.249, 0.251, and 0.243, respectively. CONCLUSIONS We have developed the first tertiary prevention-based, comprehensive evaluation index system for cervical cancer literacy among Chinese women, which will provide theoretical support for cervical cancer prevention and health education programs.
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Affiliation(s)
- Chanchan He
- Institute for Hospital Management of Tsinghua University, Shenzhen, 518055, China
| | - Chenyang Pei
- School of Health Policy Management, Peking Union Medical College, Beijing, 100730, China
| | - Jing Ma
- Institute for Hospital Management of Tsinghua University, Shenzhen, 518055, China.
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Blanc J, Hahn K, Oliveira B, Phillips R, Duthely LM, Francois L, Carrasco M, Moore J, Sternberg CA, Jean-Louis G, Seixas AA. Bringing Health Care Equity to Diverse and Underserved Populations in Sleep Medicine and Research Through a Digital Health Equity Framework. Sleep Med Clin 2023; 18:255-267. [PMID: 37532367 PMCID: PMC10300114 DOI: 10.1016/j.jsmc.2023.05.009] [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: 08/04/2023]
Abstract
Individuals from minoritized groups are less likely to receive sleep medicine care and be the focus of sleep research. Several barriers may explain under-representation and low participation. The coronavirus disease 2019 (COVID-19) pandemic highlighted a digital divide that exacerbated disproportionate sleep health outcomes and access to sleep medicine and research opportunities among minoritized groups. The authors' team developed a digital health equity and inclusion model and revamped its culturally-tailored community outreach program to advance sleep health equity among minoritized groups. This article describes how the authors implemented their digital sleep health equity and inclusion model during the COVID-19 pandemic.
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Affiliation(s)
- Judite Blanc
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Center for Translational Sleep and Circadian Sciences (TSCS), Clinical Research Building, 14th Floor 1120 Northwest 14th Street, Room 1448, Miami, FL 33136, USA
| | - Kaitlyn Hahn
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Bruno Oliveira
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 Northwest 14th Street, 14th Floor, Suite 1451A, Miami, FL 33136, USA
| | - Ro'Mya Phillips
- Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, USA
| | - Lunthita M Duthely
- Obstetrics, Gynecology & Reproductive Sciences, Department of Public Health Sciences, University of Miami Miller School of Medicine, Don Soffer Clinical Research Center 1162
| | - Laura Francois
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine
| | - Mary Carrasco
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; Department of Informatics and Health Data Science, The Media and Innovation Lab, 1120 Northwest 14th Street, Room 1452, Miami, FL 33136, USA
| | - Jesse Moore
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; Department of Informatics and Health Data Science, The Media and Innovation Lab, 1120 Northwest 14th Street, Room 1452, Miami, FL 33136, USA
| | - Candice A Sternberg
- Department of Infectious Diseases, University of Miami Miller School of Medicine, Clinical Research Building, 1120 Northwest 14th Street #858, Miami, FL 33136, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, CRB, Translational Sleep and Circadian Sciences (TSCS), 14th Floor 1120 Northwest 14th Street, Room 1449, Miami, FL 33136, USA
| | - Azizi A Seixas
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Center for Translational Sleep and Circadian Sciences (TSCS), Clinical Research Building, 14th Floor 1120 Northwest 14th Street, Room 1448, Miami, FL 33136, USA; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine; Department of Informatics and Health Data Science, The Media and Innovation Lab, 1120 Northwest 14th Street, Room 1452, Miami, FL 33136, USA.
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Molina R, Enriquez M. Enhancing Diabetes Health Outcomes Among Haitian Migrants Living in Dominican Bateyes. Sci Diabetes Self Manag Care 2023; 49:281-290. [PMID: 37313730 DOI: 10.1177/26350106231178838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study was to better understand the factors that influence the ability of batey adults to self-manage their type 2 diabetes mellitus (T2DM). METHODS A qualitative descriptive approach was used to conduct in-depth, individual interviews in Spanish. Participants (n = 12) were health care workers and members of a nongovernmental organization (NGO) that provides direct diabetes care to batey residents via free, pop-up, mobile medical clinics. Conventional content analysis was used to identify categories and common themes in the data. RESULTS Participants described daily existence in the bateyes as a constant "scarcity of resources." Additionally, four themes and one subtheme emerged that participants felt impacted diabetes health outcomes and the ability of NGO health care workers to provide diabetes care. CONCLUSIONS NGO members, while committed to serve and improve health outcomes for the batey population, often felt overwhelmed. Findings from this qualitative descriptive study may be used to inform novel interventions, which are needed, to enhance the diabetes outcomes of the batey residents who are living with T2DM. In addition, strategies are needed to build diabetes care infrastructure in the batey community.
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Affiliation(s)
- Rosalia Molina
- Research College of Nursing, Kansas City, Missouri
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
| | - Maithe Enriquez
- Research College of Nursing, Kansas City, Missouri
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri
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Farinha MN, Semedo CS, Diniz AM, Herédia V. Individual and Contextual Variables as Predictors of MRI-Related Perceived Anxiety. Behav Sci (Basel) 2023; 13:458. [PMID: 37366710 DOI: 10.3390/bs13060458] [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: 03/02/2023] [Revised: 05/13/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) generates patient anxiety (PA) and, therefore, it is important to understand individual and contextual variables that may cause it. In study one, we explored those anxiety predictors. In study two, we examined the effect of the experience of MRI on PA comparing anxiety pre- to post-MRI. METHODS PA was measured with an anxiety and stress scale in an interview format. Data collection occurred at a public hospital with MRI outpatients aged 18 or older. In study one (n = 204), participants answered the questionnaire immediately after experiencing the MRI and the data were analyzed through structural equation modeling. In study two (n = 242), participants answered the questionnaire before and after the examination and the data were analyzed through Bayesian statistics. RESULTS Being female, having a higher education level (EL), and not receiving information about the examination predicts higher PA after MRI. Patients with prior information have a decrease in PA from pre- to post-MRI. Those who do not have no change in PA. In low-educated patients, PA also decreases and no changes occur in highly educated patients. CONCLUSION This study provides health professionals with valuable indicators about patients who are more likely to perceive and express anxiety during MRI.
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Affiliation(s)
- Margarida N Farinha
- Department of Psychology, School of Social Sciences, University of Évora, 7000-803 Évora, Portugal
| | - Carla S Semedo
- Research Centre in Education and Psychology (CIEP-UÉ), Department of Psychology, School of Social Sciences, University de Évora, 7000-803 Évora, Portugal
| | - António M Diniz
- Research Centre in Education and Psychology (CIEP-UÉ), Department of Psychology, School of Social Sciences, University de Évora, 7000-803 Évora, Portugal
| | - Vasco Herédia
- Radiology Department, Hospital do Espírito Santo, EPE, Évora and Affidea-Évora, 9500-370 Évora, Portugal
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Wang Q, Tao C, Yuan Y, Zhang S, Liang J. Current Situations and Challenges in the Development of Health Information Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2706. [PMID: 36768072 PMCID: PMC9915875 DOI: 10.3390/ijerph20032706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/18/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Health information literacy (HIL) is a significant concept that has gradually become known to the broader public in recent years. Although the definitions of HIL and health literacy seem to overlap, as an independent subconcept, HIL still shows a unique influence on improvements in people's health and health education. Remarkable evidence indicates that online health information (OHI) can effectively enrich people's knowledge and encourage patients to actively join the medical process, which is also accompanied by the emergence of various assessment tools. Although the current assessment tools, to a certain extent, can help people identify their shortcomings and improve their HIL, many studies have indicated that the deficiencies of the scales induce incomplete or unreal results of their HIL. In addition, continuing research has revealed an increasing number of influencing factors that have great effects on HIL and even regulate the different trends in doctor-patient relationships. Simultaneously, most of the uncensored OHI broadcasts have also affected the improvement in HIL in various ways. Thus, this review aims to summarize the assessment tools, influencing factors and current situations and challenges related to HIL. Further studies are required to provide more trusted and deeper references for the development of HIL.
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Affiliation(s)
- Qiulin Wang
- College of Physical Education, Yangzhou University, Yangzhou 225009, China
| | - Chunhua Tao
- School of Nursing and School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Yuan Yuan
- School of Nursing and School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Song Zhang
- School of Nursing and School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Jingyan Liang
- School of Medicine, Yangzhou University, Yangzhou 225009, China
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225009, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225009, China
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Ezeife DA, Padmore G, Vaska M, Truong TH. Un accès équitable aux soins contre le cancer pour les personnes noires au Canada. CMAJ 2023; 195:E51-E55. [PMID: 36623855 PMCID: PMC9829072 DOI: 10.1503/cmaj.212076-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Doreen A Ezeife
- Départements d'oncologie (Ezeife, Padmore, Vaska) et de chirurgie oncologique (Padmore), Université de Calgary, Centre de cancérologie Tom Baker; Département d'oncologie pédiatrique (Truong), Université de Calgary, Hôpital pour enfants de l'Alberta, Calgary, Alb.
| | - Greg Padmore
- Départements d'oncologie (Ezeife, Padmore, Vaska) et de chirurgie oncologique (Padmore), Université de Calgary, Centre de cancérologie Tom Baker; Département d'oncologie pédiatrique (Truong), Université de Calgary, Hôpital pour enfants de l'Alberta, Calgary, Alb
| | - Marcus Vaska
- Départements d'oncologie (Ezeife, Padmore, Vaska) et de chirurgie oncologique (Padmore), Université de Calgary, Centre de cancérologie Tom Baker; Département d'oncologie pédiatrique (Truong), Université de Calgary, Hôpital pour enfants de l'Alberta, Calgary, Alb
| | - Tony H Truong
- Départements d'oncologie (Ezeife, Padmore, Vaska) et de chirurgie oncologique (Padmore), Université de Calgary, Centre de cancérologie Tom Baker; Département d'oncologie pédiatrique (Truong), Université de Calgary, Hôpital pour enfants de l'Alberta, Calgary, Alb
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Ezeife DA, Padmore G, Vaska M, Truong TH. Ensuring equitable access to cancer care for Black patients in Canada. CMAJ 2022; 194:E1416-E1419. [PMID: 36280246 PMCID: PMC9616139 DOI: 10.1503/cmaj.212076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Doreen A Ezeife
- Departments of Oncology (Ezeife, Padmore, Vaska) and Surgical Oncology (Padmore), University of Calgary, Tom Baker Cancer Centre; Department of Oncology and Pediatrics (Truong), University of Calgary, Alberta Children's Hospital, Calgary, Alta.
| | - Greg Padmore
- Departments of Oncology (Ezeife, Padmore, Vaska) and Surgical Oncology (Padmore), University of Calgary, Tom Baker Cancer Centre; Department of Oncology and Pediatrics (Truong), University of Calgary, Alberta Children's Hospital, Calgary, Alta
| | - Marcus Vaska
- Departments of Oncology (Ezeife, Padmore, Vaska) and Surgical Oncology (Padmore), University of Calgary, Tom Baker Cancer Centre; Department of Oncology and Pediatrics (Truong), University of Calgary, Alberta Children's Hospital, Calgary, Alta
| | - Tony H Truong
- Departments of Oncology (Ezeife, Padmore, Vaska) and Surgical Oncology (Padmore), University of Calgary, Tom Baker Cancer Centre; Department of Oncology and Pediatrics (Truong), University of Calgary, Alberta Children's Hospital, Calgary, Alta
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Fleary SA, Joseph PL, Gonçalves C, Somogie J, Angeles J. The Relationship Between Health Literacy and Mental Health Attitudes and Beliefs. Health Lit Res Pract 2022; 6:e270-e279. [DOI: 10.3928/24748307-20221018-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Chakraverty D, Baumeister A, Aldin A, Seven ÜS, Monsef I, Skoetz N, Woopen C, Kalbe E. Gender differences of health literacy in persons with a migration background: a systematic review and meta-analysis. BMJ Open 2022; 12:e056090. [PMID: 37667874 PMCID: PMC9301804 DOI: 10.1136/bmjopen-2021-056090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 07/03/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate gender differences of health literacy in individuals with a migration background. DESIGN Systematic review and meta-analysis. OVID/MEDLINE, PsycINFO and CINAHL were searched in March 2018 and July 2020. SETTING Studies had to provide health literacy data for adult women and men with a migration background, collected with a standardised instrument, or report results that demonstrated the collection of such data. Health literacy data were extracted from eligible studies or requested from the respective authors. Using a random-effects model, a meta-analysis was conducted to assess standardised mean differences (SMDs) of health literacy in men and women. Two researchers independently assessed risk of bias for each included study using the Appraisal Tool for Cross-Sectional Studies. RESULTS Twenty-four studies were included in this systematic review. Thereof, 22 studies (8012 female and 5380 male participants) were included in the meta-analyses. In six studies, gender-specific health literacy scores were reported. The authors of additional 15 studies provided their data upon request and for one further study data were available online. Women achieved higher health literacy scores than men: SMD=0.08, 95% CI 0.002 to 0.159, p=0.04, I2=65%. Another 27 studies reported data on female participants only and could not be included due to a lack of comparable studies with male participants only. Authors of 56 other eligible studies were asked for data, but without success. CONCLUSION Men with a migration background-while being much less frequently examined-may have lower health literacy than women. As heterogeneity between studies was high and the difference became statistically insignificant when excluding studies with a high risk of bias, this result must be interpreted with caution. There is a paucity of research on the social and relational aspects of gender in relation to health literacy among people with a migration background, especially for men. PROSPERO REGISTRATION NUMBER CRD42018085555.
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Affiliation(s)
- Digo Chakraverty
- Medical Psychology | Neuropsychology and Gender Studies and Centre for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Annika Baumeister
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES),University of Cologne and Research Unit Ethics, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Angela Aldin
- Evidence-Based Oncology, Department I of Internal Medicine, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Ümran Sema Seven
- Medical Psychology | Neuropsychology and Gender Studies and Centre for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Ina Monsef
- Evidence-Based Oncology, Department I of Internal Medicine, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Nicole Skoetz
- Evidence-Based Oncology, Department I of Internal Medicine, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (CERES),University of Cologne and Research Unit Ethics, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies and Centre for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
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Hassan S, Louis SJ, Fethiere M, Dure D, Rosen J, Morrison BW. The prevalence of nonmelanoma skin cancer in a population of patients with oculocutaneous albinism in Haiti. Int J Dermatol 2022; 61:867-871. [PMID: 35393655 DOI: 10.1111/ijd.16199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/04/2022] [Accepted: 03/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Multiple studies have examined the prevalence of nonmelanoma skin cancers (NMSC) in patients with oculocutaneous albinism (OCA). However, to date, no studies have examined this data in Caribbean populations. METHODS This study is a cross-sectional study of 106 patients with OCA who were seen at the Oculocutaneous Albinism Clinic in Port-au-Prince and Gros Morne, Haiti, between the dates of February 2017 and June 2018. RESULTS In our population, 31/106 (29%) patients were found to have NMSC, 10/31 (32%) had BCC, 12/31 (39%) had SCC, and 9/31 (29%) had both types of NMSC. The most common age groups were 31-40 years, with the overall range of ages being 18-63 years. Also, 60/106 (57%) of the patients had actinic keratoses (AK). CONCLUSIONS Our study provides new data examining the prevalence of NMSC within a population of patients with OCA in Haiti. Overall, it shows that patients with albinism develop NMSC at an earlier age compared with the rest of the population. Therefore, appropriate skin cancer screening and surveillance should be implemented within this high-risk population group.
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Affiliation(s)
- Shahzeb Hassan
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Shesly J Louis
- Department of Dermatology and Sexually Transmitted Diseases, Hospital of the State University of Haiti, Port-Au-Prince, Haiti
| | | | - Danie Dure
- General Dermatology and Pediatric Dermatology, Hopital Universitaire de Mirebalais, Mirebalais, Haiti
| | - Jordan Rosen
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Brian W Morrison
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Khalid A, Haque S, Alvi S, Ferdous M, Genereux O, Chowdhury N, Turin TC. Promoting Health Literacy About Cancer Screening Among Muslim Immigrants in Canada: Perspectives of Imams on the Role They Can Play in Community. J Prim Care Community Health 2022; 13:21501319211063051. [PMID: 35118911 PMCID: PMC8819818 DOI: 10.1177/21501319211063051] [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: 12/04/2022] Open
Abstract
Purpose: Immigrants tend to have lower rates of cancer screening
than non-immigrants in Canada. Inequity in screening rates may stem from
religious factors, which religious leaders can influence. This study aimed to
explore the knowledge and attitudes held by Muslim religious leaders about
cancer screening, as well as the role religious leaders perceive they can play
in improving cancer screening health literacy among South Asian Muslim immigrant
women. Methods: We conducted interviews with 8 Muslim religious
leaders in Calgary, Canada. Participants’ knowledge and attitudes were
inductively summarized using descriptive analysis, while practices were
deductively thematically analyzed using the Socioecological Model and the
Communication for Development approaches. Results: We found
participants mostly had some knowledge of cancer, but lesser knowledge of
different screening tests and of low screening rates among immigrants.
Participants proposed that their role as a speaker, access to facilities and
community networks, and collaboration with universities and healthcare
professionals could help overcome religious misinterpretations and promote
cancer screening among South Asian Muslim immigrant women.
Conclusion: Religious leaders were highly supportive of
incorporating health messaging into faith-based messaging. Future work should
focus on implementing the practices recommended in this study with South Asian
Muslim immigrant women’s voices at their center.
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Affiliation(s)
- Ayisha Khalid
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sarika Haque
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Saad Alvi
- Department of Biological Sciences, University of Calgary, Calgary, AB, Canada
| | - Mahzabin Ferdous
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Olivia Genereux
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nashit Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,The O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Cudjoe J, Budhathoki C, Roter D, Gallo JJ, Sharps P, Han HR. Exploring Health Literacy and the Correlates of Pap Testing Among African Immigrant Women: Findings from the AfroPap Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:441-451. [PMID: 32410109 PMCID: PMC7666038 DOI: 10.1007/s13187-020-01755-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
African immigrant (AI) women have low rates of Pap testing. Health literacy plays a pivotal role in health behaviors. Sources and types of health information could shape health literacy and inform the Pap testing behaviors of AI women. However, the influences of health literacy, sources, and types of health information along with cultural and psychosocial correlates on the Pap testing behaviors of AI women are poorly understood. To examine how sources and types of health information impact health literacy, and in turn, how health literacy and cultural and psychosocial factors influence the Pap testing behaviors of AI women. An adapted Health Literacy Skills Framework guided the selection of variables for this cross-sectional study. Convenience sampling was used to recruit 167 AI women, 21-65 years. Multivariate logistic regression was used to assess correlates of Pap testing after adjusting for covariates (age, education, English proficiency, employment, income, health insurance, access to primary care, marital status, and healthcare provider recommendation). Most participants (71%) had received a Pap test in the past and used multiple (two or more) sources (65%) and types (57%) of health information. Using multiple sources of health information (aOR 0.11, p < 0.01) but not types of health information was associated with Pap testing. Having negative cultural beliefs (aOR 0.17, p = 0.01) and having high self-efficacy (aOR 9.38, p < 0.01) were significantly associated with Pap testing after adjusting for covariates. High health literacy (OR 3.23, p < 0.05) and high decisional balance (OR 5.28, p < 0.001) were associated with Pap testing in bivariate models but did not remain significant after controlling for covariates. Cultural beliefs was a significant correlate of AI women's Pap testing behaviors regardless of other known social determinants of health (education, English proficiency, age, access to primary care). Disseminating health information through various sources has the potential to promote Pap testing among AI women. Larger studies which utilize a robust sampling strategy and include a diverse group of AI women are needed in order to optimize health interventions aimed at improving Pap test screening behaviors among AI women.
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Affiliation(s)
- Joycelyn Cudjoe
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA.
- Inova Health System, 8110 Gatehouse Road Suite 200W, Falls Church, VA, 22042, USA.
| | - Chakra Budhathoki
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Debra Roter
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Joseph J Gallo
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Phyllis Sharps
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21205, USA
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15
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Özkan S, Tüzün H, Dikmen AU, Aksakal NB, Çalışkan D, Taşçı Ö, Güneş SC. The Relationship Between Health Literacy Level and Media Used as a Source of Health-Related Information. Health Lit Res Pract 2021; 5:e109-e117. [PMID: 34251938 PMCID: PMC8241229 DOI: 10.3928/24748307-20210330-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous studies have not shown the level of health literacy or associated factors on a national level in Turkey using a scale that has been adapted to the country and its culture. OBJECTIVE This study aimed to determine health literacy levels in Turkey and to investigate the association of health literacy with socioeconomic factors as well as with the instruments used as sources of health-related information. METHODS This cross-sectional, nationally representative study was conducted using a computer-assisted personal interview approach and included 6,228 households (response rate, 70.9%). The Turkey Health Literacy Scale was used to measure health literacy. Sources of health-related information, such as newspapers, television, internet, and smartphones, were included in the regression model for health literacy. KEY RESULTS The proportion of participants with inadequate and problematic health literacy was 30.9% and 38%, respectively, showing that approximately 7 of 10 participants had limited health literacy. The frequencies of inadequate and problematic health literacy were higher in the disease prevention and promotion domains (37.4% and 34.2%, respectively) compared with those in the health care domain (27.1% and 31.3%, respectively). The most frequently used medium as a source of health-related information was the internet (48.6%), followed by television (33%). In controlled models, higher health literacy scores were associated with higher education and income levels. The effects of television (β = 1,917), internet (β = 2,803), newspapers (β = 1,489), and smartphones (β = 1,974) as sources of health-related information were statistically significant in the general health literacy index model. CONCLUSIONS Health literacy in Turkey reflects social inequalities. The model accounting for socioeconomic variables demonstrated the relevance of sources of health information to level of health literacy. These findings emphasize the importance of improving sources of health information to improve health literacy. [HLRP: Health Literacy Research and Practice. 2021;5(2):e109-e117.] Plain Language Summary: This is a cross-sectional study that is representative of the population of Turkey. We reported that health literacy scores were higher for people in higher levels of socioeconomic status. We showed that using the television, internet, newspapers, and smartphones as a source of health-related information is associated with health literacy even when accounting for socioeconomic variables.
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Affiliation(s)
| | - Hakan Tüzün
- Address correspondence to Hakan Tüzün, MD, Ministry of Health, General Directorate of Health Promotion, Sağlik Bakanliği, Bilkent Yerleşkesi, Ankara, Turkey;
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Li C, Guo Y. The Effect of Socio-Economic Status on Health Information Literacy among Urban Older Adults: Evidence from Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3501. [PMID: 33800562 PMCID: PMC8036692 DOI: 10.3390/ijerph18073501] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/19/2021] [Accepted: 03/24/2021] [Indexed: 11/18/2022]
Abstract
The present study aimed to observe the effect of socio-economic status on health information literacy and to identify whether there is a social gradient for health information literacy among urban older adults in Western China. This study employed a cross-sectional research design, and 812 urban participants aged 60 and older were enrolled in Western China. In the current study, only 16.7% of urban older adults reported having adequate health information literacy. Binary logistic regression analysis showed that socio-economic status factors including educational attainment, ethnicity, and financial strain were significantly and tightly associated with health information literacy. Additionally, other factors including suffering from chronic diseases, information-seeking activity, reading magazines and books, and watching television were also significantly linked to health information literacy. Consistent with existing studies, the findings indicate the health information literacy deficit and demonstrate the crucial impact of socio-economic status on health information literacy, which implies a social gradient in health information literacy. The importance of other factors related to health information literacy are discussed as well. The results suggest that reducing the health information literacy deficit and social gradient in health information literacy must be considered as an important priority when developing public health and health education strategies, programs, and actions among urban older adults in Western China.
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Affiliation(s)
- Chengbo Li
- School of Journalism and communication, Chongqing University, Chongqing 400044, China
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17
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Ye Y, Wang R, Feng D, Wu R, Li Z, Long C, Feng Z, Tang S. The Recommended and Excessive Preventive Behaviors during the COVID-19 Pandemic: A Community-Based Online Survey in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196953. [PMID: 32977538 PMCID: PMC7579150 DOI: 10.3390/ijerph17196953] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 01/10/2023]
Abstract
COVID-19 presents unprecedented challenges to the global public health response. Preventive behaviors and keeping social distance are regarded as compelling ways to prevent COVID-19. This study focused on the sociological and psychological factors associated with proper and excessive preventive behaviors of the COVID-19 outbreak in China. For the sample, we collected the data of 4788 participants who were surveyed between 4 April and 15 April 2020 from eight provinces in China. This study designed a self-filled questionnaire that included demographic information, six components of the Health Belief Model, and target preventive behaviors. Descriptive analysis, Chi-square test, logistic regression analysis, Mantel-Haenszel hierarchical analysis, and propensity score matching were employed in this study. The results showed that 54.7% of the participants had adequate basic prevention, 63.6% of the participants had adequate advanced prevention, and 5.8% of the participants practiced excessive prevention. The elder participants were less likely to engage in proper preventive behaviors. Perceived susceptibility, perceived benefits, perceived barriers, cues to action, and knowledge levels were associated with preventive behaviors. Excessive preventive behaviors in high-risk groups with suspected symptoms were associated with their extreme psychological condition, while the support from the community and family plays an important role in avoiding these behaviors.
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Affiliation(s)
- Yisheng Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; (Y.Y.); (R.W.); (C.L.)
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, Hubei, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; (Y.Y.); (R.W.); (C.L.)
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, Hubei, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China;
| | - Ruijun Wu
- China National Center for Biotechnology Development, Beijing 100039, China; (R.W.); (Z.L.)
| | - Zhifei Li
- China National Center for Biotechnology Development, Beijing 100039, China; (R.W.); (Z.L.)
| | - Chengxu Long
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; (Y.Y.); (R.W.); (C.L.)
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, Hubei, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; (Y.Y.); (R.W.); (C.L.)
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, Hubei, China
- Correspondence: (Z.F.); (S.T.)
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; (Y.Y.); (R.W.); (C.L.)
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, Hubei, China
- Correspondence: (Z.F.); (S.T.)
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18
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Kuyinu YA, Femi-Adebayo TT, Adebayo BI, Abdurraheem-Salami I, Odusanya OO. Health literacy: Prevalence and determinants in Lagos State, Nigeria. PLoS One 2020; 15:e0237813. [PMID: 32790756 PMCID: PMC7425911 DOI: 10.1371/journal.pone.0237813] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 08/02/2020] [Indexed: 02/07/2023] Open
Abstract
Background Poor health literacy has been associated with poorer physical and mental health function, and higher emergency department and hospital utilizations. The study was conducted to measure the prevalence of health literacy and its determinants among Lagos State residents. Methods A descriptive cross-sectional study was conducted in three local government areas in Lagos State. Health literacy was assessed using the Brief Health Literacy Screening tool (BHLS), a three-item tool with possible scores ranging between 3 and 15. Health literacy was classified as inadequate (≤ 9) or adequate (>9). Results A total of 1831 respondents participated in the study, among whom, 952 (52%) were women. The mean age of respondents was 31.7 (±10.5) years. Three-quarters (74.8%) of respondents had adequate health literacy. Adequate levels of health literacy were associated with being female (OR, 1.35; 95% CI, 1.07–1.71), frequent use of the broad cast media as source of information (OR, 1.33; 95% CI, 1.03–1.70), frequent use of the internet as source of information (OR, 1.49; 95% CI, 1.13–1.96). Adequate health literacy was also associated with having knowledge of a frequently prescribed antibiotic (OR, 1.67; 95% CI, 1.32–2.12) and being more comfortable with the use of the English language (OR, 1.71; 95% CI, 1.32–2.22). Conclusion Gender, the use of broadcast media and the internet are predictive of adequate health literacy and should be taken into consideration in planning health interventions.
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Affiliation(s)
- Yetunde Abiola Kuyinu
- Department of Community Health and Primary Healthcare, Lagos State University Teaching Hospital, Ikeja, Nigeria
- Department of Community Health and Primary Healthcare, Lagos State University College of Medicine, Ikeja, Nigeria
- * E-mail:
| | | | - Bisola Ibironke Adebayo
- Department of Community Health and Primary Healthcare, Lagos State University College of Medicine, Ikeja, Nigeria
| | - Ibipo Abdurraheem-Salami
- Department of Community Health and Primary Healthcare, Lagos State University Teaching Hospital, Ikeja, Nigeria
| | - Olumuyiwa Omotola Odusanya
- Department of Community Health and Primary Healthcare, Lagos State University Teaching Hospital, Ikeja, Nigeria
- Department of Community Health and Primary Healthcare, Lagos State University College of Medicine, Ikeja, Nigeria
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19
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Zimmerman MS, Shaw G. Health information seeking behaviour: a concept analysis. Health Info Libr J 2020; 37:173-191. [PMID: 32052549 DOI: 10.1111/hir.12287] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/04/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND In 2007, Lambert and Loiselle conducted an extensive concept analysis of the term health information seeking behaviour (HISB) to examine the concept's level of maturity and critically analyse its characteristics. Since their groundbreaking work, HISB has evolved with the proliferation of ICTs. The Internet is now a common and often preferred medium for the pursuit of health information. OBJECTIVES The previous analysis spanned 42 years of literature; this article describes an analysis of the last 10 years of literature on HISB and how online seeking has caused the concept to evolve in the literature. METHODS This study used the concept analysis methodology employed by Lambert and Loiselle in the original analysis. It also included a systematic search conducted in five databases to identify studies from 2007 to 2017, using similar inclusion criteria from the original study. RESULTS Of the more than 500 articles retrieved, 85 journal articles met the inclusion criteria. Consistent with the original work, articles that included outcomes were identified as either behavioural or cognitive. CONCLUSION Most of the attention of the works studied focused on individuals and their information source preferences. This HISB analysis can be incorporated with studies to understand how various communities seek information in online versus non-online contexts.
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Affiliation(s)
- Margaret S Zimmerman
- School of Library and Information Science, University of Iowa, Iowa City, IA, USA
| | - George Shaw
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA
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20
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Todorovic N, Jovic-Vranes A, Djikanovic B, Pilipovic-Broceta N, Vasiljevic N, Lucic-Samardzija V, Peric A. Assessment of health literacy in the adult population registered to family medicine physicians in the Republic of Srpska, Bosnia and Herzegovina. Eur J Gen Pract 2019; 25:32-38. [PMID: 30794048 PMCID: PMC6394335 DOI: 10.1080/13814788.2019.1571579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Health literacy is an important determinant of health. This concept is under-researched in the Republic of Srpska, Bosnia and Herzegovina. Objectives: To assess health literacy and its association with sociodemographic variables, self-perception of health and the presence of chronic conditions in primary healthcare setting. Methods: In May 2016, a cross-sectional study was executed in two primary healthcare centres. Out of approximately 1500 patients who visited both health centres during four consecutive days, about 800 were eligible. Of these, 110 patients agreed to complete the translated Short Test of Functional Health Literacy in Adults (S-TOFHLA). The influence of demographic, social, economic, and health characteristics (independent variables) on the S-TOFHLA score (dependent variable) was assessed by multiple logistic regression analysis. Results: One questionnaire was incomplete and therefore 109 questionnaires were analysed. Inadequate, marginal, and adequate health literacy were present in 19 (17.4%), 16 (14.7%) and 74 (67.9%) respondents. Adequate health literacy was found predominantly among respondents younger than 55 years and those with a high level of education. Regression analyses showed that low level of education (OR: 5.3), age 55 years and over (OR: 3.9), living in a rural area (OR: 3.7) and having three or more chronic diseases (OR: 2) were independently associated with inadequate or marginal health literacy. Conclusion: In this study performed in two primary healthcare centres in the Republic of Srpska, Bosnia and Herzegovina, low health literacy was associated with low level of education, older age, living in a rural area, and having more chronic diseases.
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Affiliation(s)
- Nevena Todorovic
- a Faculty of Medicine, Family Medicine Department , University of Banja Luka , Banja Luka , Bosnia and Herzegovina
| | - Aleksandra Jovic-Vranes
- b Faculty of Medicine, Institute of Social Medicine , University of Belgrade , Belgrade , Serbia
| | - Bosiljka Djikanovic
- b Faculty of Medicine, Institute of Social Medicine , University of Belgrade , Belgrade , Serbia
| | - Natasa Pilipovic-Broceta
- a Faculty of Medicine, Family Medicine Department , University of Banja Luka , Banja Luka , Bosnia and Herzegovina
| | - Nadja Vasiljevic
- c Faculty of Medicine, Institute of Hygiene and Medical Ecology , University of Belgrade , Belgrade , Serbia
| | | | - Aleksandar Peric
- d Primary Healthcare Center Banja Luka , Banja Luka , Bosnia and Herzegovina
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21
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A model for point of care testing for non-communicable disease diagnosis in resource-limited countries. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2019; 4:e7. [PMID: 31555457 PMCID: PMC6749552 DOI: 10.1017/gheg.2019.6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 08/15/2019] [Accepted: 08/18/2019] [Indexed: 12/29/2022]
Abstract
Non-communicable disease diagnosis frequently relies on biochemical measurements but laboratory infrastructure in low-income settings is often insufficient and distances to clinics may be vast. We present a model for point of care (POC) epidemiology as used in our study of chronic disease in the Haiti Health Study, in rural and urban Haiti. Point of care testing (POCT) of creatinine, cholesterol, and hemoglobin A1c as well as physical measurements of weight, height, and waist circumference allowed for diagnosis of diabetes, chronic kidney disease, dyslipidemias, and obesity. Methods and troubleshooting techniques for the data collection of this study are presented. We discuss our method of community-health worker (CHW) training, community engagement, study design, and field data collection. We also discuss the machines used and our quality control across CHWs and across geographical regions. Pitfalls tended to include equipment malfunction, transportation issues, and cultural differences. May this paper provide information for those attempting to perform similar diagnostic and screening studies using POCT in resource poor settings.
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22
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Bazaz M, Shahry P, Latifi SM, Araban M. Cervical Cancer Literacy in Women of Reproductive Age and Its Related Factors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:82-89. [PMID: 28799072 DOI: 10.1007/s13187-017-1270-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cancer health literacy, which is the ability to search, understand, and use health information to make appropriate health decisions, plays an important role in the use of preventative and screening information. The present study aims to evaluate cervical cancer health literacy in women of reproductive age and its related factors. In this cross-sectional study, 231 women of reproductive age who referred to health centers of Khuzestan Province, Iran, were selected via convenience sampling. A valid and reliable measure was employed to collect information about various dimensions of cervical cancer health literacy, including having access to, reading, understanding, appraising, using, and communicating it. The data collected were analyzed using SPSS 16. Data analysis was conducted by independent sample t test, one-way ANOVA, Spearman's correlation, chi-square, and linear regression. The participants' average health literacy score was 97.88 ± 12.7 (from 135 points), and 47.2% of the participants had limited health literacy. Health literacy was associated with education, employment, income, searching, mothers' and young friends' counseling, and duration of the study time (p < 0.05). In linear regression model, there was a significant association between income (p = 0.011), searching (p = 0.01), study time (p = 0.009), and young friends' counseling (p = 0.002) and cervical cancer literacy scores. In this study, no significant association was observed between age and health literacy. This study indicated that the cervical cancer literacy in women of reproductive age was not at good levels. Health workers should pay more attention to groups who are at greater risk of having low health literacy. Moreover, targeting and tailoring educational interventions with respect to different levels of cervical cancer literacy might increase cervical cancer screening.
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Affiliation(s)
- Maryam Bazaz
- Department of Health Education and Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Shahry
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sayed Mahmood Latifi
- Department of Biostatistics, Diabetes Research Center, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Araban
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Health Education and Health Promotion, Public Health School, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
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Mahdizadeh M, Solhi M. Relationship between self-care behaviors and health literacy among elderly women in Iran, 2015. Electron Physician 2018; 10:6462-6469. [PMID: 29765570 PMCID: PMC5942566 DOI: 10.19082/6462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 02/22/2017] [Indexed: 11/20/2022] Open
Abstract
Background and aim Self-care is a basic concept in health promotion, regarding the importance of health literacy as a key factor in self-care. This study aimed to identify the relationship between self-care behaviors and health literacy among elderly women in Iran. Methods This descriptive and analytic study was performed between October and December 2015. A total of 360 participants were selected from elderly women referred to health centers. Data was collected by test of functional health literacy in adults (S-TOFHLA) and a checklist for assessment of self-care behaviors, and health information seeking. Data were analyzed by SPSS software (version 22) with One-Way Analysis of Variance, and the Pearson correlation coefficient, t-test and regression test. Results The mean score of functional health literacy was 41.30±6.29. Of the participants, 73.6% had inadequate health literacy, 20.8% borderline health literacy, and 5.6% enough health literacy. The mean score of health information seeking was 1.791. Also, 31.9% of elderly women had poor self-care behaviors, 56.9% moderate, and 11.1% high. A significant difference was observed in mean score of health literacy between different levels of self-care (F=30.087, p<0.001). Based on regression analysis, health literacy and health information seeking predicted 19.9% of the variance of self-care behaviors. Conclusion This study highlights the necessity of promoting health literacy and attention to its influencing factors to improve self-care ability of elderly women. In conclusion, Planning interventions to improve health literacy is essential for health promotion among elderly women.
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Affiliation(s)
- Mehrsadat Mahdizadeh
- PhD Candidate in Health Education and Health Promotion, Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Solhi
- PhD., Associate Professor of Health Education and Health Promotion, Department of Health Services and Health Education, School of Health, Iran University of Medical Sciences, Tehran, Iran
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Geboers B, Uiters E, Reijneveld SA, Jansen CJM, Almansa J, Nooyens ACJ, Verschuren WMM, de Winter AF, Picavet HSJ. Health literacy among older adults is associated with their 10-years' cognitive functioning and decline - the Doetinchem Cohort Study. BMC Geriatr 2018; 18:77. [PMID: 29558890 PMCID: PMC5859753 DOI: 10.1186/s12877-018-0766-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/12/2018] [Indexed: 11/11/2022] Open
Abstract
Background Many older adults have low levels of health literacy which affects their ability to participate optimally in healthcare. It is unclear how cognitive decline contributes to health literacy. To study this, longitudinal data are needed. The aim of this study was therefore to assess the associations of cognitive functioning and 10-years’ cognitive decline with health literacy in older adults. Methods Data from 988 participants (mean age = 65.3) of the Doetinchem Cohort Study were analyzed. Health literacy was measured by the Brief Health Literacy Screening. Memory, mental flexibility, information processing speed, and global cognitive functioning were assessed at the same time as health literacy and also 10 years earlier. Logistic regression analyses were performed, adjusted for age, gender, and educational level. Results Higher scores on tests in all cognitive domains were associated with a lower likelihood of having low health literacy after adjustment for confounders (all ORs < 0.70, p-values<.001). Similar associations were found for past cognitive functioning (all ORs < 0.75, p-values<.05). Before adjustment, stronger cognitive decline was associated with a greater likelihood of having low health literacy (all ORs > 1.37, p-values<.05). These associations lost significance after adjustment for educational level, except for the association of memory decline (OR = 1.40, p = .023, 95% CI: 1.05 to 1.88). Conclusion Older adults with poorer cognitive functioning and stronger cognitive decline are at risk for having low health literacy, which can affect their abilities to promote health and self-manage disease. Low health literacy and declining cognitive functioning might be a barrier for person-centered care, even in relatively young older adults.
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Affiliation(s)
- Bas Geboers
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Ellen Uiters
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Carel J M Jansen
- Department of Communication and Information Studies, Faculty of Arts, University of Groningen, Groningen, the Netherlands
| | - Josué Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Astrid C J Nooyens
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Chen X, Hay JL, Waters EA, Kiviniemi MT, Biddle C, Schofield E, Li Y, Kaphingst K, Orom H. Health Literacy and Use and Trust in Health Information. JOURNAL OF HEALTH COMMUNICATION 2018; 23:724-734. [PMID: 30160641 PMCID: PMC6295319 DOI: 10.1080/10810730.2018.1511658] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
There is a need to investigate which health information sources are used and trusted by people with limited health literacy to help identify strategies for addressing knowledge gaps that can contribute to preventable illness. We examined whether health literacy was associated with people's use of and trust in a range of potential health information sources. Six hundred participants from a GfK Internet survey panel completed an online survey. We assessed health literacy using the Newest Vital Sign, the sources participants used to get health information, and the extent to which participants trusted health information from these sources. We performed multivariable regressions, controlling for demographic characteristics. Lower health literacy was associated with lower odds of using medical websites for health information and with higher odds of using television, social media, and blogs or celebrity webpages. People with lower health literacy were less likely to trust health information from specialist doctors and dentists, but more likely to trust television, social media, blogs/celebrity webpages, friends, and pharmaceutical companies. People with limited health literacy had higher rates of using and trusting sources such as social media and blogs, which might contain lower quality health information compared to information from healthcare professionals. Thus, it might be necessary to enhance the public's ability to evaluate the quality of health information sources. The results of this study could be used to improve the reach of high-quality health information among people with limited health literacy and thereby increase the effectiveness of health communication programs and campaigns.
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Affiliation(s)
- Xuewei Chen
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Jennifer L. Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Erika A. Waters
- Department of Surgery (Division of Public Health Sciences), Washington University Medical School, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63130 USA
| | - Marc T. Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Caitlin Biddle
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
| | - Elizabeth Schofield
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Yuelin Li
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA
| | - Kimberly Kaphingst
- Department of Communication, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112 USA
| | - Heather Orom
- Department of Community Health and Health Behavior, University at Buffalo, 3435 Main St. Buffalo, NY 14214, USA
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Massey PM, Langellier BA, Sentell T, Manganello J. Nativity and language preference as drivers of health information seeking: examining differences and trends from a U.S. population-based survey. ETHNICITY & HEALTH 2017; 22:596-609. [PMID: 27766894 PMCID: PMC5547013 DOI: 10.1080/13557858.2016.1244745] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine differences in health information seeking between U.S.-born and foreign-born populations in the U.S. DESIGN Data from 2008 to 2014 from the Health Information National Trends Survey were used in this study (n = 15,249). Bivariate analyses, logistic regression, and predicted probabilities were used to examine health information seeking and sources of health information. RESULTS Findings demonstrate that 59.3% of the Hispanic foreign-born population reported looking for health information, fewer than other racial/ethnic groups in the sample. Compared with non-Hispanic White, non-Hispanic Black (OR = 0.62) and Hispanic foreign-born individuals (OR = 0.31) were the least likely to use the internet as a first source for health information. Adjustment for language preference explains much of the disparity in health information seeking between the Hispanic foreign-born population and Whites; controlling for nativity, respondents who prefer Spanish have 0.25 the odds of using the internet as a first source of health information compared to those who prefer English. CONCLUSION Foreign-born nativity and language preference are significant determinants of health information seeking. Further research is needed to better understand how information seeking patterns can influence health care use, and ultimately health outcomes. To best serve diverse racial and ethnic minority populations, health care systems, health care providers, and public health professionals must provide culturally competent health information resources to strengthen access and use by vulnerable populations, and to ensure that all populations are able to benefit from evolving health information sources in the digital age.
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Affiliation(s)
- Philip M. Massey
- Department of Community Health and Prevention, Drexel University, Philadelphia, PA, USA
| | - Brent A. Langellier
- Department of Health Management and Policy, Drexel University, Philadelphia, PA, USA
| | - Tetine Sentell
- Department of Health Policy and Management, University of Hawaii, Honolulu, HI, USA
| | - Jennifer Manganello
- Department of Health Policy, Management, and Behavior, University at Albany, Rensselaer, NY, USA
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Bergner EM, Nelson LA, Rothman RL, Mayberry L. Text Messaging May Engage and Benefit Adults with Type 2 Diabetes Regardless of Health Literacy Status. Health Lit Res Pract 2017; 1:e192-e202. [PMID: 29214241 PMCID: PMC5714586 DOI: 10.3928/24748307-20170906-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Technology-delivered interventions have the potential to improve diabetes self-care and glycemic control among adults with type 2 diabetes (T2D). However, patients who do not engage with interventions may not reap benefits, and there is little evidence on how engagement with mobile health interventions varies by health literacy status. Objective: This study explored how patients with limited health literacy engaged with and experienced Rapid Education/Encouragement and Communications for Health (REACH), a text messaging intervention designed to support the self-care adherence of disadvantaged patients with T2D. We recruited adults with T2D from federally qualified health centers and used mixed methods to examine (1) associations between users' health literacy status and their prior mobile phone use and their engagement with REACH and (2) similarities and differences in users' self-reported benefits by health literacy status. Methods: Participants (N = 55) completed a survey, including measures of health literacy and prior mobile phone use. For 2 weeks, participants experienced REACH, which included daily text messages promoting self-care and asking about medication adherence, and weekly text messages providing medication adherence feedback. After 2 weeks, participants completed a semi-structured telephone interview about their experiences. Key Results: Participants with limited health literacy were less likely to have used cell phones to access the Internet (48% vs. 90%, p = .001) or email (36% vs. 87%, p < .001), but equally as likely to have used text messaging and to respond to REACH text messages (p = .12 and p = .40, respectively) compared to participants with adequate health literacy. Participants responded to 93% of text messages on average and reported benefits of the intervention, including reminders and accountability, convenience and accessibility, and information and motivation. Participants with limited health literacy described a unique benefit of receiving social support from the intervention. Conclusions: Text messaging interventions may engage and benefit patients with T2D, regardless of health literacy status. Text messaging may have the potential to reduce T2D health disparities related to limited health literacy. [Health Literacy Research and Practice. 2017;1(4):e192–e202.] Plain Language Summary: Limited health literacy is associated with less engagement with health information technology, but there is little evidence on how engagement with text messaging interventions varies by health literacy status. This intervention engaged and benefited adults with type 2 diabetes in safety-net clinics, regardless of health literacy status. Participants with limited health literacy described a unique intervention benefit of social support.
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Affiliation(s)
- Erin M Bergner
- Senior Research Specialist, Center for Health Behavior and Health Education, Vanderbilt University Medical Center
| | - Lyndsay A Nelson
- Research Assistant Professor, Center for Health Behavior and Health Education, Vanderbilt University Medical Center
| | - Russell L Rothman
- Professor of Medicine, and the Director, Center for Health Services Research, Vanderbilt University Medical Center
| | - Lindsay Mayberry
- Assistant Professor, Department of Medicine, Center for Health Behavior and Health Education, Vanderbilt University Medical Center
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Stonbraker S, Befus M, Lerebours Nadal L, Halpern M, Larson E. Factors Associated with Health Information Seeking, Processing, and Use Among HIV Positive Adults in the Dominican Republic. AIDS Behav 2017; 21:1588-1600. [PMID: 27714522 DOI: 10.1007/s10461-016-1569-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Effective treatment and management of human immunodeficiency virus (HIV) depend on patients' ability to locate, comprehend, and apply health information. This study's purpose was to identify characteristics associated with these skills among HIV positive adults in the Dominican Republic. An information behavior survey was administered to 107 participants then three logistic regressions were conducted to identify characteristics associated with information seeking, processing, and use. Never having cared for someone who was sick was significantly associated with less information seeking, processing, and use. Males were more likely to be active information seekers and those who had attended the clinic for six or fewer years were less likely to actively seek information. Younger individuals had increased odds of higher information processing and those without comorbidities had increased odds of more information use. Results may inform researchers, organizations, and providers about how patients interact with health information in limited resource settings.
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Affiliation(s)
- Samantha Stonbraker
- Columbia University School of Nursing, 617 W. 168th St. Rm 330, New York, NY, 10032, USA.
| | - Montina Befus
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Elaine Larson
- Columbia University School of Nursing, 617 W. 168th St. Rm 330, New York, NY, 10032, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
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Sentell T, Pitt R, Buchthal OV. Health Literacy in a Social Context: Review of Quantitative Evidence. Health Lit Res Pract 2017; 1:e41-e70. [PMID: 31294251 PMCID: PMC6607851 DOI: 10.3928/24748307-20170427-01] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 04/27/2017] [Indexed: 11/20/2022] Open
Abstract
Background Conceptual literature has consistently noted that health literacy exists within a social context. This review examined how the intersection of social context and health literacy has been operationalized in quantitative, empirical research. Methods Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched seven databases, including PubMed and CINAHL (The Cumulative Index to Nursing and Allied Health Literature), using a range of potentially relevant keywords, and we hand-searched bibliographies. Inclusion criteria were quantitative studies of any design in which measurement of health literacy and measurement of social context intersected. We identified 1,052 unduplicated articles; 34 met inclusion criteria. Key Results We found three distinct perspectives on the intersection between health literacy and social context. Most common (n = 23) were studies measuring an association between individual health literacy and individual social capital, social support, or social engagement, particularly whether social support varied by health literacy and/or if this relationship mediated health outcomes. Another group of studies (n = 6) took the perspective that being health literate by definition included social context, including access to and/or use of social support as a domain in individual health literacy assessment. Five studies considered the social context of health literacy as an independent property measured beyond the individual level; two measured community-level health literacy and three measured health literacy capacity/concordance in caregiving dyads. The studies showed significant definitional and measurement complexity and overlap. In the most dramatic example, a similar question was used across various studies to measure (1) health literacy, (2) a social support domain in health literacy, (3) social support, and (4) a study outcome distinct from, but associated with, health literacy. Potential useful methods, such as social network analyses, were missing from the literature. Discussion Existing quantitative research on health literacy in a social context supports more attention to this topic. This review quantified evidence, revealed gaps, noted limitations, and identified important questions for future research. [Health Literacy Research and Practice . 2017;1(2):e41-e70.]. Plain Language Summary This study systemically compiles existing quantitative empirical research (34 articles) focusing on the intersection of health literacy in the social context. We find considerable measurement complexity in the current body of work on this topic and identify three distinct perspectives that researchers have taken while considering this topic. This information will be useful for future development of this important research area.
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Abstract
OBJECTIVE To introduce the concept 'nutrition activation' (the use of health and nutrition information when making food and diet decisions) and to assess the extent to which nutrition activation varies across racial/ethnic groups and explains dietary disparities. DESIGN Cross-sectional sample representative of adults in the USA. Primary outcome measures include daily energy intake and consumption of sugar-sweetened beverages (SSB), fast foods and sit-down restaurant foods as determined by two 24 h dietary recalls. We use bivariate statistics and multiple logistic and linear regression analyses to assess racial/ethnic disparities in nutrition activation and food behaviour outcomes. SETTING USA. SUBJECTS Adult participants (n 7825) in the 2007-2010 National Health and Nutrition Examination Survey. RESULTS Nutrition activation varies across racial/ethnic groups and is a statistically significant predictor of SSB, fast-food and restaurant-food consumption and daily energy intake. Based on the sample distribution, an increase from the 25th to 75th percentile in nutrition activation is associated with a decline of about 377 kJ (90 kcal)/d. Increased nutrition activation is associated with a larger decline in SSB consumption among whites than among blacks and foreign-born Latinos. Fast-food consumption is associated with a larger 'spike' in daily energy intake among blacks (+1582 kJ (+378 kcal)/d) than among whites (+678 kJ (+162 kcal)/d). CONCLUSIONS Nutrition activation is an important but understudied determinant of energy intake and should be explicitly incorporated into obesity prevention interventions, particularly among racial/ethnic minorities.
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Coughlin SS, Lubetkin EI, Hay JL, Raphael R, Smith SA. Promoting colorectal cancer screening among Haitian Americans. JOURNAL OF THE GEORGIA PUBLIC HEALTH ASSOCIATION 2015; 5:149-152. [PMID: 26819972 PMCID: PMC4725319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns. METHODS In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research. RESULTS Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of the curability of colorectal cancer, preventive practices, and preferred sources of information among Haitian Americans and other ethnic subgroups of U.S. Blacks. Awareness of colorectal cancer screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening are suboptimal among Haitian Americans and other subgroups. In preliminary quantitative studies, Haitian immigrants have been found to have lower colorectal cancer screening rates than other groups such as African Americans. CONCLUSIONS Culturally appropriate educational interventions are needed to encourage Haitian American adults aged ≥ 50 years to undergo screening for colorectal cancer and to ensure that they are well informed about the value of healthy eating and physical activity.
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Affiliation(s)
- Steven S Coughlin
- Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Lowell, MA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Erica I Lubetkin
- Sophie Davis School of Biomedical Education at The City College of New York, Department of Community Health and Social Medicine, New York, NY
| | - Jennifer L Hay
- Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY
| | - Renald Raphael
- Haitian American Public Health Initiatives, Mattapan, MA
| | - Selina A Smith
- Institute of Public and Preventive Health, and Department of Family Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA
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