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Mastroianni F, Chen YC, Vellar L, Cvejic E, Smith JK, McCaffery KJ, Muscat DM. Implementation of an organisation-wide health literacy approach to improve the understandability and actionability of patient information and education materials: A pre-post effectiveness study. Patient Educ Couns 2019; 102:1656-1661. [PMID: 30962076 DOI: 10.1016/j.pec.2019.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Limited examples exist globally of coordinated, organisation-wide health literacy approaches to systematically improve the understandability and actionability of patient health information. Even fewer have been formally evaluated. The aim of this study was to use the Patient Education Materials Assessment Tool (PEMAT) to evaluate the effectiveness of an organisation-wide, evidence-based approach to improve the understandability and actionability of patient information materials in regional health service in New South Wales, Australia. METHODS Two independent raters (blinded to the document version) evaluated pre- and post-implementation versions of 50 randomly-selected patient information materials using the PEMAT, with differences in understandability and actionability analysed using paired samples tests. RESULTS Mean (±SD) overall scores for understandability increased significantly by 5% (95% CI 2-8; p = 0.002) up to 77%±10%, and mean actionability (±SD) increased significantly by 4% (95% CI 0-8; p = 0.046) up to 56%±22%. CONCLUSION These results demonstrate that organisation-wide approaches with standardised processes for staff to prepare, review and store written patient information and education materials can be successfully implemented to address the impacts and risks of low health literacy. PRACTICE IMPLICATIONS The success of this approach provides a framework for other health organisations to work in partnership with patients to make health information more understandable and actionable.
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Affiliation(s)
- Fiorina Mastroianni
- Illawarra Shoalhaven Local Health District, Clinical Governance Unit, NSW, Australia.
| | - Yen-Chia Chen
- University of Sydney, Faculty of Medicine and Health, School of Public Health, NSW, Australia
| | - Lucia Vellar
- Illawarra Shoalhaven Local Health District, Clinical Governance Unit, NSW, Australia
| | - Erin Cvejic
- University of Sydney, Faculty of Medicine and Health, School of Public Health, NSW, Australia
| | - Jessica Kathleen Smith
- University of Sydney, Faculty of Medicine and Health, School of Public Health, NSW, Australia
| | - Kirsten J McCaffery
- University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, NSW, Australia
| | - Danielle Marie Muscat
- University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, NSW, Australia
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Porter KJ, Alexander R, Perzynski KM, Kruzliakova N, Zoellner JM. Using the Clear Communication Index to Improve Materials for a Behavioral Intervention. Health Commun 2019; 34:782-788. [PMID: 29419320 PMCID: PMC6384153 DOI: 10.1080/10410236.2018.1436383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ensuring that written materials used in behavioral interventions are clear is important to support behavior change. This study used the Clear Communication Index (CCI) to assess the original and revised versions of three types of written participant materials from the SIPsmartER intervention. Materials were revised based on original scoring. Scores for the entire index were significantly higher among revised versions than originals (57% versus 41%, p < 0.001); however, few revised materials (n = 2 of 53) achieved the benchmark of ≥90%. Handouts scored higher than worksheets and slide sets for both versions. The proportion of materials scored as having "a single main message" significantly increased between versions for worksheets (7% to 57%, p = 0.003) and slide sets (33% to 67%, p = 0.004). Across individual items, most significant improvements were in Core, with four-items related to the material having a single main message. Findings demonstrate that SIPsmartER's revised materials improved after CCI-informed edits. They advance the evidence and application of the CCI, suggesting it can be effectively used to support improvement in clarity of different types of written materials used in behavioral interventions. Implications for practical considerations of using the tool and suggestions for modifications for specific types of materials are presented.
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Krishnan A, Rabinowitz M, Ziminsky A, Scott SM, Chretien KC. Addressing Race, Culture, and Structural Inequality in Medical Education: A Guide for Revising Teaching Cases. Acad Med 2019; 94:550-555. [PMID: 30640269 DOI: 10.1097/acm.0000000000002589] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PROBLEM Sociodemographic identities, including race, culture, ethnicity, gender, and sexual orientation (race and culture), are recognized as important determinants of health, with significant impacts on patients' health outcomes, but teaching medical students about this is challenging. The authors sought to identify areas for improvement in delivery of critical content about race, culture, structural inequalities, and health disparities within a set of virtual patient cases used by U.S. medical schools and develop revision guidelines. APPROACH A workgroup (medical students and faculty) conducted a literature review in 2017 to identify challenges and best practices for teaching and learning about race and culture in medicine. Using an analytic framework informed by this review, they analyzed 63 Aquifer virtual patient teaching cases for effectiveness of the presentation of race and culture, resulting in six main themes describing common mistakes or pitfalls. They then developed an evidence-based guide for systematic case revision. OUTCOMES The authors present a novel, practical guide for medical educators to use to revise existing teaching cases and improve the delivery of critical concepts surrounding race and culture. This guide includes fundamental definitions and six sections to guide structured case revision based on the main themes. It includes examples of language, suggested edits, and the rationale and evidence for recommendations. NEXT STEPS Feedback from faculty and students regarding implementation of the guide and delivery of revised content in Aquifer cases will be critical in determining the guide's effectiveness. This structured guide may be adapted to a variety of teaching modalities in medicine.
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Affiliation(s)
- Aparna Krishnan
- A. Krishnan is a fourth-year medical student, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Rabinowitz is a first-year pediatric resident, Kaiser Permanente Northern California, Oakland, California. A. Ziminsky is production associate, Aquifer, Lebanon, New Hampshire. S.M. Scott is senior associate dean for educational affairs and accreditation and professor of medical education, Texas Christian University and University of North Texas Health Science Center School of Medicine, Fort Worth, Texas. K.C. Chretien is associate dean for student affairs and professor of medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Bonner C, Patel P, Fajardo MA, Zhuang R, Trevena L. Online decision aids for primary cardiovascular disease prevention: systematic search, evaluation of quality and suitability for low health literacy patients. BMJ Open 2019; 9:e025173. [PMID: 30872547 PMCID: PMC6429890 DOI: 10.1136/bmjopen-2018-025173] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES Recent guideline changes for cardiovascular disease (CVD) prevention medication have resulted in calls to implement shared decision-making rather than arbitrary treatment thresholds. Less attention has been paid to existing tools that could facilitate this. Decision aids are well-established tools that enable shared decision-making and have been shown to improve CVD prevention adherence. However, it is unknown how many CVD decision aids are publicly available for patients online, what their quality is like and whether they are suitable for patients with lower health literacy, for whom the burden of CVD is greatest. This study aimed to identify and evaluate all English language, publicly available online CVD prevention decision aids. DESIGN Systematic review of public websites in August to November 2016 using an environmental scan methodology, with updated evaluation in April 2018. The decision aids were evaluated based on: (1) suitability for low health literacy populations (understandability, actionability and readability); and (2) International Patient Decision Aids Standards (IPDAS). PRIMARY OUTCOME MEASURES Understandability and actionability using the validated Patient Education Materials Assessment Tool for Printed Materials (PEMAT-P scale), readability using Gunning-Fog and Flesch-Kincaid indices and quality using IPDAS V.3 and V.4. RESULTS A total of 25 unique decision aids were identified. On the PEMAT-P scale, the decision aids scored well on understandability (mean 87%) but not on actionability (mean 61%). Readability was also higher than recommended levels (mean Gunning-Fog index=10.1; suitable for grade 10 students). Four decision aids met criteria to be considered a decision aid (ie, met IPDAS qualifying criteria) and one sufficiently minimised major bias (ie, met IPDAS certification criteria). CONCLUSIONS Publicly available CVD prevention decision aids are not suitable for low literacy populations and only one met international standards for certification. Given that patients with lower health literacy are at increased risk of CVD, this urgently needs to be addressed.
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Affiliation(s)
- Carissa Bonner
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
| | - Pinika Patel
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
| | - Michael Anthony Fajardo
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ruixuan Zhuang
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lyndal Trevena
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
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Spence B. Using Manipulatives to Teach Digital Image Histograms. Radiol Technol 2019; 90:405-406. [PMID: 30886037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Katayama A, Nakazawa H, Tokumine J, Lefor AK, Watanabe K, Asao T, Yorozu T. A high-fidelity simulator for needle cricothyroidotomy training is not associated with increased proficiency compared with conventional simulators: A randomized controlled study. Medicine (Baltimore) 2019; 98:e14665. [PMID: 30813212 PMCID: PMC6408010 DOI: 10.1097/md.0000000000014665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A high-fidelity task simulator for cricothyroidotomy was created using data from a 3-dimensional (3D) computed tomography scan using a 3D printer. We hypothesized that this high-fidelity cricothyroidotomy simulator results in increased proficiency for needle cricothyroidotomy compared with conventional simulators. METHODS Cricothyroidotomy-naive residents were recruited and randomly assigned to 2 groups, including simulation training with a conventional simulator (Group C) and with a high-fidelity simulator (Group 3D). After simulation training, participants performed cricothyroidotomy using an ex vivo porcine larynx fitted with an endoscope to record the procedure. The primary outcomes were success rate and procedure time. The secondary outcome was a subjective measure of the similarity of the simulator to the porcine larynx. RESULTS Fifty-two residents participated in the study (Group C: n = 27, Group 3D: n = 25). There was no significant difference in the success rate or procedure time between the 2 groups (success rate: P = .24, procedure time: P = .34). There was no significant difference in the similarity of the simulators to the porcine larynx (P = .81). CONCLUSION We developed a high-fidelity simulator for cricothyroidotomy from 3D computed tomography data using a 3D printer. This anatomically high-fidelity simulator did not have any advantages compared with conventional dry simulators.
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Affiliation(s)
- Atsuko Katayama
- Department of Anesthesiology, Kyorin University School of Medicine, Sinkawa, Mitaka, Tokyo
| | - Harumasa Nakazawa
- Department of Anesthesiology, Kyorin University School of Medicine, Sinkawa, Mitaka, Tokyo
| | - Joho Tokumine
- Department of Anesthesiology, Kyorin University School of Medicine, Sinkawa, Mitaka, Tokyo
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi
| | - Kunitaro Watanabe
- Department of Anesthesiology, Kyorin University School of Medicine, Sinkawa, Mitaka, Tokyo
| | - Takayuki Asao
- Big Data Center for Integrative Analysis, Gunma University Initiative for Advance Research, Maebashi, Gunnma, Japan
| | - Tomoko Yorozu
- Department of Anesthesiology, Kyorin University School of Medicine, Sinkawa, Mitaka, Tokyo
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Saunders CH, Petersen CL, Durand MA, Bagley PJ, Elwyn G. Bring on the Machines: Could Machine Learning Improve the Quality of Patient Education Materials? A Systematic Search and Rapid Review. JCO Clin Cancer Inform 2018; 2:1-16. [PMID: 30652611 PMCID: PMC6874040 DOI: 10.1200/cci.18.00010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Clear and trustworthy information is essential for people who are ill. People with cancer, in particular, are targeted with vast quantities of patient education material, but of variable quality. Machine learning technologies are popular across industries for automated tasks, like analyzing language and spotting readability issues. With the experience of patients with cancer in mind, we reviewed whether anyone has proposed, modeled, or applied machine learning technologies for the assessment of patient education materials and explored the utility of this application. METHODS We systematically searched the literature to identify English-language articles published in peer-reviewed journals or as conference abstracts that proposed, used, or modeled the use of machine learning technology to assess patient education materials. Specifically, we searched MEDLINE, Web of Science, CINAHL, and Compendex. Two reviewers assessed study eligibility and performed study screening. RESULTS We identified 1,570 publications in our search after duplicate removal. After screening, we included five projects (detailed in nine articles) that proposed, modeled, or used machine learning technology to assess the quality of patient education materials. We evaluated the utility of each application across four domains: multidimensionality (2 of 5 applications), patient centeredness (1 of 5 applications), customizability (0 of 5 applications), and development stage (theoretical, 1 of 5 applications; in development, 3 of 5 applications; complete and available, 1 of 5 applications). Combining points across each domain, the mean utlity score across included projects was 1.8 of 5 possible points. CONCLUSION Given its potential, machine learning has not yet been leveraged substantially in the assessment of patient education materials. We propose machine learning systems that can dynamically identify problematic language and content by assessing the quality of patient education materials across a range of flexible, customizable criteria. Assessment may help patients and families decide which materials to use and encourage developers to improve materials overall.
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Affiliation(s)
- Catherine H. Saunders
- Catherine H. Saunders, Curtis L. Petersen, Marie-Anne Durand, and Glyn Elwyn, The Dartmouth Institute for Health Policy & Clinical Practice; Curtis L. Petersen, Geisel School of Medicine at Dartmouth; and Pamela J. Bagley, Dartmouth College, Lebanon, NH
| | - Curtis L. Petersen
- Catherine H. Saunders, Curtis L. Petersen, Marie-Anne Durand, and Glyn Elwyn, The Dartmouth Institute for Health Policy & Clinical Practice; Curtis L. Petersen, Geisel School of Medicine at Dartmouth; and Pamela J. Bagley, Dartmouth College, Lebanon, NH
| | - Marie-Anne Durand
- Catherine H. Saunders, Curtis L. Petersen, Marie-Anne Durand, and Glyn Elwyn, The Dartmouth Institute for Health Policy & Clinical Practice; Curtis L. Petersen, Geisel School of Medicine at Dartmouth; and Pamela J. Bagley, Dartmouth College, Lebanon, NH
| | - Pamela J. Bagley
- Catherine H. Saunders, Curtis L. Petersen, Marie-Anne Durand, and Glyn Elwyn, The Dartmouth Institute for Health Policy & Clinical Practice; Curtis L. Petersen, Geisel School of Medicine at Dartmouth; and Pamela J. Bagley, Dartmouth College, Lebanon, NH
| | - Glyn Elwyn
- Catherine H. Saunders, Curtis L. Petersen, Marie-Anne Durand, and Glyn Elwyn, The Dartmouth Institute for Health Policy & Clinical Practice; Curtis L. Petersen, Geisel School of Medicine at Dartmouth; and Pamela J. Bagley, Dartmouth College, Lebanon, NH
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Iguenane J, Sawadogo I, Marchand C, Beugny A. [Designing and evaluating therapeutic education tools for people living with HIV]. Sante Publique 2018; 30:263-271. [PMID: 30148314 DOI: 10.3917/spub.182.0263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In the context of therapeutic education for people living with HIV in Africa, educational tools must be adapted to their living environment. OBJECTIVES To describe the process of designing education tools for patients living with HIV and evaluate their use by African caregivers-educators. METHODS An eight-step participatory and formative process was carried out to design educational tools. Twenty-one caregivers-educators from nine French-speaking African countries in three focus groups were interviewed on the way in which they used these tools. RESULTS Fourteen people were trained in the process of designing the tools and training caregivers-educators in their use. Two toolkits were developed (adults and children/adolescents). The image folder was the tool most commonly used. Educators in all countries used tools to address self-care and psychosocial coping skills. The criteria for choosing the tools were linked to their attractiveness, ease of use, their adaptation to the patient's needs and characteristics, and the degree of mastery by the caregiver-educator. The tools helped to structure the education sessions. Brakes to their use were organizational and lack of experience or mastery. CONCLUSION The participatory and formative approach enabled educators working with patients living with HIV in French-speaking Africa to appropriate the tools. Training was a crucial step in enabling caregiver-educators to master and disseminate the tools, and design new tools.
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Affiliation(s)
- Charlotte Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia.
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Vishnevetsky J, Walters CB, Tan KS. Interrater reliability of the Patient Education Materials Assessment Tool (PEMAT). Patient Educ Couns 2018; 101:490-496. [PMID: 28899713 PMCID: PMC5839932 DOI: 10.1016/j.pec.2017.09.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/14/2017] [Accepted: 09/04/2017] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the interrater reliability (IRR) and usability of the Patient Education Materials Assessment Tool (PEMAT) and the relationship between PEMAT scores and readability levels. METHODS One hundred ten materials (80 print, 30 audiovisual) were evaluated, each by two raters, using the PEMAT. IRR was calculated using Gwet's AC1 and summarized across items in each PEMAT domain (understandability and actionability) and by material type. A survey was conducted to solicit raters' experience using the PEMAT. Readability of each material was assessed using the SMOG Index. RESULTS The median IRR was 0.92 for understandability and 0.93 for actionability across all relevant items, indicating good IRR. Eight PEMAT items had Gwet's AC1 values less than 0.81. PEMAT and SMOG Index scores were inversely correlated, with a Spearman's rho of -0.20 (p=0.081) for understandability and -0.15 (p=0.194) for actionability. While 92% of raters agreed the PEMAT was easy to use, survey results suggested specific items for clarification. CONCLUSION While the PEMAT demonstrates moderate to excellent IRR overall, amendments to items with lower IRR may increase the usefulness of the tool. PRACTICE IMPLICATIONS The PEMAT is a useful supplement to reading level alone in the assessment of educational materials.
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Affiliation(s)
- Julia Vishnevetsky
- Patient and Caregiver Engagement, Memorial Sloan Kettering Cancer Center, New York, USA.
| | | | - Kay See Tan
- Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA
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Harris VC, Links AR, Hong P, Walsh J, Schoo DP, Tunkel DE, Stewart CM, Boss EF. Consulting Dr. Google: Quality of Online Resources About Tympanostomy Tube Placement. Laryngoscope 2018; 128:496-501. [PMID: 28842989 PMCID: PMC5771888 DOI: 10.1002/lary.26824] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Tympanostomy tube (TT) placement is common in children; however, family-centeredness and utility of online information used for decision making and understanding is unknown. We evaluate the quality of leading Internet resources describing TT placement. STUDY DESIGN Cross-sectional descriptive design. METHODS We performed a Google (Menlo Park, CA) search for terms related to TTs. We defined quality using scaled readability measures (Flesch Reading Ease and Flesch-Kincaid Grade-Level), understandability and actionability (Patient Education Materials Assessment Tool), shared decision-making centrality (Center for Medicare and Medicaid Services informed consent guidelines), and clinical practice guideline (CPG) compatibility. Three reviewers coded each measure. Fleiss κ interrater reliability analysis was performed. RESULTS Ten most frequently encountered websites were analyzed. One of 10 met national health literacy standards (mean 10th-grade level reading, median 9th, range 6-15th). All sites were understandable (mean understandability 81.9%, range 73%-92%). Most had low actionability scores (7 of 10, median 47%, mean 44.6%, range 0-80). Shared decision-making centrality was high (mean 5, range 4-6), but most did not list alternative treatment options. Although CPG compatibility was high (mean 3.4, range 1-4), many websites contained inconsistent recommendations about tube duration, follow-up, and water precautions. There was inter-rater agreement for understandability scoring (κ = 0.20; P = 0.02). CONCLUSION Internet resources about TT placement vary in quality pertaining to health literacy, principles of shared decision making, and consistency with practice guidelines. With growing emphasis on patient-/family-centered engagement in healthcare decision making, standardization of content and improved usability of educational materials for common surgical procedures in children such as tympanostomy tube placement should be a public health priority. LEVEL OF EVIDENCE NA. Laryngoscope, 128:496-501, 2018.
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Affiliation(s)
- Vandra C. Harris
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Anne R. Links
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Paul Hong
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jonathan Walsh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Desi P. Schoo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - David E. Tunkel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Charles M. Stewart
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Emily F. Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Medical Institutions, Baltimore, Maryland
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Grabeel KL, Russomanno J, Oelschlegel S, Tester E, Heidel RE. Computerized versus hand-scored health literacy tools: a comparison of Simple Measure of Gobbledygook (SMOG) and Flesch-Kincaid in printed patient education materials. J Med Libr Assoc 2018; 106:38-45. [PMID: 29339932 PMCID: PMC5764592 DOI: 10.5195/jmla.2018.262] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 09/01/2017] [Indexed: 11/20/2022] Open
Abstract
Objective The research compared and contrasted hand-scoring and computerized methods of evaluating the grade level of patient education materials that are distributed at an academic medical center in east Tennessee and sought to determine if these materials adhered to the American Medical Association’s (AMA’s) recommended reading level of sixth grade. Methods Librarians at an academic medical center located in the heart of Appalachian Tennessee initiated the assessment of 150 of the most used printed patient education materials. Based on the Flesch-Kincaid (F-K) scoring rubric, 2 of the 150 documents were excluded from statistical comparisons due to the absence of text (images only). Researchers assessed the remaining 148 documents using the hand-scored Simple Measure of Gobbledygook (SMOG) method and the computerized F-K grade level method. For SMOG, 3 independent reviewers hand-scored each of the 150 documents. For F-K, documents were analyzed using Microsoft Word. Reading grade levels scores were entered into a database for statistical analysis. Inter-rater reliability was calculated using intra-class correlation coefficients (ICC). Paired t-tests were used to compare readability means. Results Acceptable inter-rater reliability was found for SMOG (ICC=0.95). For the 148 documents assessed, SMOG produced a significantly higher mean reading grade level (M=9.6, SD=1.3) than F-K (M=6.5, SD=1.3; p<0.001). Additionally, when using the SMOG method of assessment, 147 of the 148 documents (99.3%) scored above the AMA’s recommended reading level of sixth grade. Conclusions Computerized health literacy assessment tools, used by many national patient education material providers, might not be representative of the actual reading grade levels of patient education materials. This is problematic in regions like Appalachia because materials may not be comprehensible to the area’s low-literacy patients. Medical librarians have the potential to advance their role in patient education to better serve their patient populations.
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Moulton ST, Türkay S, Kosslyn SM. Does a presentation's medium affect its message? PowerPoint, Prezi, and oral presentations. PLoS One 2017; 12:e0178774. [PMID: 28678855 PMCID: PMC5497950 DOI: 10.1371/journal.pone.0178774] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 05/18/2017] [Indexed: 11/24/2022] Open
Abstract
Despite the prevalence of PowerPoint in professional and educational presentations, surprisingly little is known about how effective such presentations are. All else being equal, are PowerPoint presentations better than purely oral presentations or those that use alternative software tools? To address this question we recreated a real-world business scenario in which individuals presented to a corporate board. Participants (playing the role of the presenter) were randomly assigned to create PowerPoint, Prezi, or oral presentations, and then actually delivered the presentation live to other participants (playing the role of corporate executives). Across two experiments and on a variety of dimensions, participants evaluated PowerPoint presentations comparably to oral presentations, but evaluated Prezi presentations more favorably than both PowerPoint and oral presentations. There was some evidence that participants who viewed different types of presentations came to different conclusions about the business scenario, but no evidence that they remembered or comprehended the scenario differently. We conclude that the observed effects of presentation format are not merely the result of novelty, bias, experimenter-, or software-specific characteristics, but instead reveal a communication preference for using the panning-and-zooming animations that characterize Prezi presentations.
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Affiliation(s)
- Samuel T. Moulton
- Department of Psychology, Harvard University, Cambridge, Massachusetts, United States of America
- Harvard Initiative for Learning and Teaching, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Selen Türkay
- Harvard Initiative for Learning and Teaching, Harvard University, Cambridge, Massachusetts, United States of America
| | - Stephen M. Kosslyn
- Minerva Schools at the Keck Graduate Institute, San Francisco, California, United States of America
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Pare JR, Kothari AH, Schneider JI, Jacquet GA. Does the location of a narrative comment section affect feedback on a lecture evaluation form? Int J Med Educ 2017; 8:133-134. [PMID: 28437247 PMCID: PMC5420454 DOI: 10.5116/ijme.58e2.96c3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 04/03/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Joseph R. Pare
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Abbas H. Kothari
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
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Morony S, McCaffery KJ, Kirkendall S, Jansen J, Webster AC. Health Literacy Demand of Printed Lifestyle Patient Information Materials Aimed at People With Chronic Kidney Disease: Are Materials Easy to Understand and Act On and Do They Use Meaningful Visual Aids? J Health Commun 2017; 22:163-170. [PMID: 28121226 DOI: 10.1080/10810730.2016.1258744] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
People with chronic kidney disease (CKD) need usable information on how to live well and slow disease progression. This information is complex, difficult to communicate, and changes during the course of the disease. We examined lifestyle-related printed CKD patient education materials focusing on actionability and visual aids. From a previous systematic review assessing readability of CKD patient information, we identified materials targeting nutrition, exercise, and self-management. We applied the Suitability Assessment of Materials (SAM) and Patient Education Materials Assessment Tool (PEMAT) to evaluate how easy materials were to understand (understandability) and act on (actionability). We created the 5C image checklist and systematically examined all visual aids for clarity, contribution, contradiction, and caption. Of the 26 materials included, one fifth (n = 5, 19%) were rated "not suitable" on SAM and fewer than half (n = 11, 42%) were rated "superior." PEMAT mean subdomain scores were suboptimal for actionability (52) and visuals (37). Overall, more than half of all 223 graphics (n = 127, 57%) contributed no meaning to the text. Images in three documents (12%) directly contradicted messaging in the text. CKD lifestyle information materials require focused improvements in both actionability of advice given and use of visual aids to support people with CKD to self-manage their condition. The fifth C is culture and is best evaluated by user-testing.
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Affiliation(s)
- Suzanne Morony
- a Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED) , Sydney School of Public Health, University of Sydney , Sydney , Australia
| | - Kirsten J McCaffery
- a Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED) , Sydney School of Public Health, University of Sydney , Sydney , Australia
| | - Suzanne Kirkendall
- b Sydney School of Public Health , The University of Sydney , Sydney , Australia
| | - Jesse Jansen
- a Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED) , Sydney School of Public Health, University of Sydney , Sydney , Australia
| | - Angela C Webster
- b Sydney School of Public Health , The University of Sydney , Sydney , Australia
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Andrade I, Silva C, Martins AC. Application of the Health Literacy INDEX on the development of a manual for prevention of falls for older adults. Patient Educ Couns 2017; 100:154-159. [PMID: 27516436 DOI: 10.1016/j.pec.2016.07.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 07/21/2016] [Accepted: 07/31/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The Health Literacy INDEX tool has been developed for creating accessible and readable health information materials for people of all literacy levels. To increase knowledge of falls risk factors and actively engage older adults, we developed an improved manual for prevention of falls for low-health literacy older people entitled "Preventing falls-I can do it",with the aid of INDEX. METHODS First time application of the INDEX tool for assessing the health literacy demands of available manuals for prevention of falls for older adults and subsequent development of an improved manual using the INDEX tool as a checklist, supported by a pretest phase involving sixteen adults ≥65, living in the community, with literacy ≤4th grade and limited functional health literacy. RESULTS The engagement of older adults from the target audience and their feedback obtained during the validation process contributed to the development of an improved health literacy- and age-friendly manual for prevention of falls. CONCLUSION By offering effective health information materials, older adults can play a more active role in their health care. PRACTICE IMPLICATIONS The manual developed to be health literacy- and age-friendly is available to be included in any multifactorial program for the prevention of falls in older adults.
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Affiliation(s)
- Isabel Andrade
- Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Rua 5 Outubro, S. Martinho do Bispo, Apartado 7006, 3046-854 Coimbra, Portugal.
| | - Catarina Silva
- Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Rua 5 Outubro, S. Martinho do Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
| | - Anabela Correia Martins
- Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Rua 5 Outubro, S. Martinho do Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
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Goodman H, Peters E, Matthews R, Geraghty A, Godden J, Shuldham C. A Pilot Study Using a Newly Devised Manual in a Programme of Education and Support for Patients Waiting for Coronary Artery bypass Surgery. Eur J Cardiovasc Nurs 2016; 2:27-37. [PMID: 14622646 DOI: 10.1016/s1474-5151(02)00044-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background: Cardiac rehabilitation programmes are widely accepted as being of benefit to patients with cardiac disease. The time spent waiting for cardiac surgery can be extremely stressful but can be used to address risk factors and provide information to reduce anxiety and prepare the patient for surgery. Aims: To pilot the usefulness of a manual for pre-operative cardiac surgical patients, and assess the feasibility and usefulness to both nurses and patients of a monthly education and support programme for patients waiting for cardiac surgery. Methods: A pilot study of 42 patients followed up for 3 months. Research tools included patient questionnaires and telephone interviews, risk factor measurements and nurse focus groups. Results: Nurses and patients evaluated the manual and overall programme favourably, although the nurses found it was very labour intensive. Changes to risk factors made during the study were small but patients valued the opportunity to raise questions which fell into the categories of medical concerns, hospital procedure and risk factors. Conclusion: The manual is a useful tool for patients waiting for cardiac surgery. The programme is useful and feasible but could be targeted more specifically to patients with raised risk factors.
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Affiliation(s)
- Helen Goodman
- Nursing Research Department/Cardiac Surgical Unit, Royal Brompton and Harefield NHS Trust, Sydney Street, London SW3 6NP, UK.
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Ballet D. [Analysis of trainers’ « effective practice » in patient therapeutic education]. Rech Soins Infirm 2016:65-70. [PMID: 28169813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Introduction : development of Therapeutic Patient Education (TPE) incites healthcare professionals to introduce in their pratices an educational dimension. Objective : existing few works on the « effective » practices of the TPE trainers, this exploratory research aims at giving a perspective on what cancharacterize their pratices in teaching situation. Method : by taking support on the workson teaching pratices observation in Educational sciences, several sessions of TPE were observed, recorded and analysed by focusing on the forms and the contents of the verbal interactions near the trainers. Results : the results underline variations intra and interpersonal on guidance model of the trainers. Discussion : these results are to be put in links to the design of the sessions, professionals training and public receipted. Conclusion : effective practices observation, complemented withdeclared practices, is a tool of analysis susceptible to inform educationnal posture of the trainer in aim of knowledge and professionalization.
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Abstract
This study compared the effects of a the oretically focused audiotape and a standard educational booklet on asthma preventive medication adherence and other asthma outcomes. Forty-six adult asthmatics were randomly assigned to receive either an experimental audiotape incorporating components of protection motivation theory, a standard asthma management booklet, both, or no educational materials. Outcomes were assessed at baseline, 3 months, and 6 months. Mean pharmacy-verified adherence improved 15% to 19% in the intervention groups and declined 22% in the control group at 6 months. Using analysis of covariance (ANCOVA) to control for baseline adherence, these changes were significant between the control and booklet group (t = 2.47; p = .02) and between control and combined group (t = 2.07; p = .04). Providing a minimal educational intervention can have a beneficial effect on asthma medication adherence that persists at least 6 months.
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Abstract
This study explored whether an action video game about cancer would be acceptable to adolescent and young adult cancer patients as a tool for learning about cancer and self-care during treatment. Interviews about a proposed video game were conducted with 43 young cancer patients, who also completed questionnaires measuring personality and adaptive style. Data were analyzed to assess the overall acceptability of the proposed video game and to reveal any factors associated with measures of acceptability. Most participants expressed willingness to play the game and a moderate degree of interest in it. Cancer content in the game was not a deterrent for most participants. Game acceptability was not affected by personality variables or adaptive style. It is concluded that an action video game using cancer themes could be useful to nurses as a tool to improve understanding and self care of adolescent and young adult cancer patients.
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Abstract
Background: A supply–demand mismatch with respect to cardiac catheterization (CATH) often results in patients experiencing waiting times that vary from a few weeks to several months. Long delays can impose both physical and psychological distress for patients. Purpose: The purpose of this study was to examine the effect of a psychoeducational nursing intervention at the beginning of the waiting period on patient anxiety during the waiting time for elective CATH. Methods: This was a 2-group randomized controlled trial. Intervention patients received a nurse-delivered, detailed information/education session within 2 weeks of being placed on the waiting list for elective CATH. Control group patients received usual care. Results: The mean waiting time for CATH was 13.4±7.2 weeks, which did not differ between groups ( P=0.509). Anxiety increased in both groups over the waiting time ( P=0.028). Health-related quality of life deteriorated over the waiting time in both groups ( P<0.05). On a visual analogue scale, there was a significant difference ( P=0.002) between the intervention (4.0±2.7) and control (5.2±3.0) groups in self-reported anxiety 2 weeks prior to CATH. Conclusions: The waiting period prior to elective CATH has a negative impact on patients’ perceived anxiety and quality of life and a simple intervention, provided at the beginning of the waiting period, may positively affect the experience of waiting.
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Lacey EA, Musgrave RJ, Freeman JV, Tod AM, Scott P. Psychological Morbidity after Myocardial Infarction in an Area of Deprivation in the UK: Evaluation of a Self-Help Package. Eur J Cardiovasc Nurs 2016; 3:219-24. [PMID: 15350231 DOI: 10.1016/j.ejcnurse.2004.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2003] [Revised: 06/01/2004] [Accepted: 06/14/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Psychological morbidity after an acute myocardial infarction (AMI) is known to be common, but can be addressed by appropriate rehabilitation. The area in which this research was conducted experiences high rates of deprivation and of coronary heart disease and limited access to hospital-based rehabilitation. Responding to concern about psychological needs of AMI patients, a self-help package was introduced and evaluated alongside standard hospital-based cardiac rehabilitation. AIMS To evaluate the impact of a home-based self-help package (the Heart Manual), alongside existing cardiac rehabilitation provision, on psychological morbidity and health status after AMI. A secondary aim was to assess the suitability of the Heart Manual for older patients aged over 80 years. METHODS A controlled observational study, comparing two cohorts of patients discharged from hospital after AMI. The intervention group was given the self-help package in addition to standard care. The control group received standard care alone. Outcome measures used were the Hospital Anxiety and Depression Scale and the EuroQol. RESULTS The intervention group showed significant improvement in anxiety and depression scores after 3 months and nonsignificant improvement in general health status. Patients who attended hospital-based rehabilitation classes, and those aged over 80 years, also benefited from the intervention. CONCLUSION A home-based self-help rehabilitation package is an effective tool alongside hospital-based rehabilitation classes and can be given to all age groups.
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Affiliation(s)
- E Anne Lacey
- ScHARR, University of Sheffield, 30 Regent Street, Sheffield S1 4DA, UK.
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Meischke H, Diehr P, Rowe S, Cagle A, Eisenberg M. Evaluation of a Public Education Program Delivered by Firefighters on Early Recognition of a Heart Attack. Eval Health Prof 2016; 27:3-21. [PMID: 14994556 DOI: 10.1177/0163278703261199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Heart Attack Survival Kit (HASK) project is a prospective, randomized trial, testing the effectiveness of an intervention delivered door-to-door by firefighters to increase use of 911 and ingestion of aspirin for symptoms of acute myocardial infarction (AMI) among seniors in King County, Washington. Firefighters visited 24,582seniors in King County, Washington and delivered a Heart Attack Survival Kit. Another 24,191 senior households served as the control group. Outcomes of the program were measured by tracking 911 calls as well as survey data. This study reports on the results of the telephone survey with a random sample of seniors (N = 323) to assess their knowledge of and intentions to act during a heart emergency. Results of a logistic regression analysis showed that being female, be ing younger, and remembering the kit was significantly related to intentions to act appropriately to AMI symptoms. The results are discussed in terms of public education around AMI.
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Ballonoff Suleiman A, Lin JS, Constantine NA. Readability of Educational Materials to Support Parent Sexual Communication With Their Children and Adolescents. J Health Commun 2016; 21:534-543. [PMID: 27116292 DOI: 10.1080/10810730.2015.1103334] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Sexual communication is a principal means of transmitting sexual values, expectations, and knowledge from parents to their children and adolescents. Many parents seek information and guidance to support talking with their children about sex and sexuality. Parent education materials can deliver this guidance but must use appropriate readability levels to facilitate comprehension and motivation. This study appraised the readability of educational materials to support parent sexual communication with their children. Fifty brochures, pamphlets, and booklets were analyzed using the Flesch-Kincaid, Gunning Fog, and Simple Measure of Gobbledygook (SMOG) index methods. Mean readability grade-level scores were 8.3 (range = 4.5-12.8), 9.7 (range = 5.5-14.9), and 10.1 (range = 6.7-13.9), respectively. Informed by National Institutes of Health-recommended 6th to 7th grade levels and American Medical Association-recommended 5th to 6th grade levels, percentages falling at or below the 7.0 grade level were calculated as 38%, 12%, and 2% and those falling at or below the 6.0 grade level were calculated as 12%, 2%, and 0% based on the Flesch-Kincaid, Gunning Fog, and SMOG methods, respectively. These analyses indicate that the majority of educational materials available online to support parents' communication with their children about sex and sexuality do not meet the needs of many or most parents. Efforts to improve the accessibility of these materials are warranted.
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Affiliation(s)
- Ahna Ballonoff Suleiman
- a School of Public Health , University of California, Berkeley , Berkeley , California , USA
| | - Jessica S Lin
- b Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
| | - Norman A Constantine
- a School of Public Health , University of California, Berkeley , Berkeley , California , USA
- b Center for Research on Adolescent Health and Development , Public Health Institute , Oakland , California , USA
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26
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Tian K. [Science of Acupuncture and Moxibustion should include standards related to acupuncture and moxibustion]. Zhongguo Zhen Jiu 2016; 36:315-318. [PMID: 27344845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The development of Science of Acupuncture and Moxibustion should be in accord with the trend of standardization and internationalization of the science of acupuncture and moxibustion. Based on the arrangement of chapters and sections in the textbook, 29 national standards, 6 standards or guidelines made by World Health Or- ganization(WHO) and 1 standard out of International Standardization Organization (ISO) are classified and intro- duced. It is suggested that the above contents should be considered as the evidence when the textbook is reedited. Also, it is proposed that humanization should be supplemented and the newest research findings should be traced.
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Nasser SC, Saad AH, Karaoui LR. Mapping of the biomedical literature evaluation competencies based on pharmacy students' feedback. BMC Med Educ 2016; 16:59. [PMID: 26869056 PMCID: PMC4751754 DOI: 10.1186/s12909-016-0583-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 02/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND This study aims to map the learned curriculum based on students' feedback regarding the biomedical literature evaluation competencies in a pharmacy curriculum, to evaluate teaching methods and to report students' longitudinal self-assessment of their achievement of related learning outcomes as they progress from didactic to experiential courses. METHODS The biomedical literature evaluation competencies were mapped in three courses delivered during different pharmacy professional years (PPY): Drug Information and Literature Evaluation (PHA421) offered in the second PPY, Pharmacoeconomics (PHA557) and Professional Pharmacy Practice Experience-Hospital/Drug Information Services (PHA570) offered in the third PPY. A unified survey was developed to collect information from students at the beginning and completion of these courses. Survey results were then compared to school assessment data of identified courses for triangulation of findings. RESULTS Listed student learning outcomes are consistently achieved through all three courses with more assertion from the students at the completion of the applied experiential course PHA 570 (>90 % agree or strongly agree). In terms of delivery methods, 84 % of students perceived the benefits of active learning methods in reinforcing acquired skills and increasing confidence in knowledge and critical thinking in a less stressful learning environment. Results shown at the end of each course indicate a favorable student response from one course to the next where almost all students replied with 'agree to strongly agree' to survey questions assessing their readiness to critically evaluating trials (72 %, 96 % and 92 %) in PHA421, PHA557 and PHA570, respectively. Study findings are in congruence with school assessment database of the selected courses. CONCLUSION Formative assessment results demonstrated acquisition of required analytical skills, and completion of course learning outcomes as students progressed from introductory to advanced courses covering the biomedical literature component.
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Affiliation(s)
- Soumana C Nasser
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box: 36 (S23), Byblos, Lebanon.
| | - Aline Hanna Saad
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box: 36 (S23), Byblos, Lebanon.
| | - Lamis R Karaoui
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box: 36 (S23), Byblos, Lebanon.
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Garnweidner-Holme LM, Dolvik S, Frisvold C, Mosdøl A. Suitability Assessment of Printed Dietary Guidelines for Pregnant Women and Parents of Infants and Toddlers From 7 European Countries. J Nutr Educ Behav 2016; 48:146-51.e1. [PMID: 26603301 DOI: 10.1016/j.jneb.2015.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/14/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To evaluate selected European printed dietary guidelines for pregnant women and parents of infants and toddlers using the suitability assessment of materials (SAM) method. METHODS A descriptive study to determine the suitability of 14 printed dietary guidelines from 7 European countries based on deductive quantitative analyses. RESULTS Materials varied greatly in format and content: 35.7% of materials were rated superior and 64.3% were rated adequate according to the overall SAM score for patient education material. None of the materials were scored not suitable. Among the categories, the highest average scores were for layout and typography and the lowest average scores were for cultural appropriateness and learning stimulation and motivation. Interrater reliability ranged from Cohen's kappa of 0.37 to 0.62 (mean, 0.41), indicating fair to moderate agreement among the 3 investigators. CONCLUSIONS AND IMPLICATIONS Overall, the suitability of the assessed printed dietary guidelines was adequate. Based on the SAM methodology, printed dietary guidelines may increase in suitability by emphasizing aspects related to health literacy and accommodating the needs of different food cultures within a population.
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Affiliation(s)
| | - Stina Dolvik
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Cathrine Frisvold
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Annhild Mosdøl
- Department of Evidence Summaries, Norwegian Knowledge Centre for Health Services, Oslo, Norway
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Corcoran N, Ahmad F. The readability and suitability of sexual health promotion leaflets. Patient Educ Couns 2016; 99:284-286. [PMID: 26492864 DOI: 10.1016/j.pec.2015.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 06/18/2015] [Accepted: 09/26/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the readability and suitability of sexual health promotion leaflets. METHOD Application of SMOG, FRY and SAM tests to assess the readability and suitability of a selection of sexual health leaflets. RESULTS SMOG and FRY scores illustrate an average reading level of grade 9. SAM scores indicate that 59% of leaflets are superior in design and 41% are average in design. Leaflets generally perform well in the categories of content, literacy demand, typography and layout. They perform poorly in use of graphics, learning stimulation/motivation and cultural appropriateness. CONCLUSION Sexual health leaflets have a reading level that is too high. Leaflets perform well on the suitability scores indicating they are reasonably suitable. There are a number of areas where sexual health leaflets could improve their design. PRACTICE IMPLICATIONS Numerous practical techniques are suggested for improving the readability and suitability of sexual health leaflets.
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Affiliation(s)
- Nova Corcoran
- Faculty of Life Sciences and Education, University of South Wales, Lower Glyntaf Campus, Pontypridd, CF37 1DL Wales, United Kingdom.
| | - Fatuma Ahmad
- Faculty of Life Sciences and Education, University of South Wales, Lower Glyntaf Campus, Pontypridd, CF37 1DL Wales, United Kingdom
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Stokx J, Dochez C, Ochieng P, Bahl J, Were F. Evaluation of a training DVD on pneumococcal conjugate vaccine for Kenyan EPI healthcare workers. Educ Health (Abingdon) 2016; 29:35-41. [PMID: 26996797 DOI: 10.4103/1357-6283.178929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND The Kenyan Ministry of Public Health and Sanitation was the first in Africa to introduce the new 10-valent Pneumococcal Conjugate Vaccine, PCV-10, in 2011. For successful implementation and to avoid adverse events following immunisation, specific training on handling and storage of the PCV-10 vaccine was required. Therefore, a training DVD was recorded in English and partly in Kiswahili to be used in combination with in-classroom training. Since the Kenyan Immunisation Programme was the first to use a DVD for training healthcare workers, an evaluation was done to obtain feedback on content, format and use, and propose suggestions to improve quality and uptake of the DVD. METHODS Feedback was obtained from nurses and vaccinology course participants through the completion of a questionnaire. Nurses also participated in focus group discussions and trainers in key informant interviews. RESULTS Twelve trainers, 72 nurses and 26 international vaccinology course participants provided feedback, with some notable differences between the three study groups. The survey results confirmed the acceptability of the content and format, and the feasibility of using the DVD in combination with in-classroom teaching. To improve the quality and adoption of the DVD, key suggestions were: Inclusion of all EPI vaccines and other important health issues; broad geographic distribution of the DVD; and bilingual English/Kiswahili use of languages or subtitles. DISCUSSION The Kenyan DVD is appreciated by a heterogeneous and international audience rendering the DVD suitable for other Anglophone African countries. Differences between feedback from nurses and vaccinology course participants can be explained by the practical approach of the DVD and the higher education and service level of the latter. A drawback is the use of DVD players and televisions due to lack of electricity, but it is a matter of time before all rural health facilities in Africa will have access to electricity and modern technology.
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Affiliation(s)
| | - Carine Dochez
- Network for Education and Support in Immunisation, Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
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Pham DHT, Ibrahim JE, Kitching F, Bohensky M. Aged-Care Professionals' and Health Care Professionals' Self-Reported Impact of Printed Educational Material on Clinical Practice. J Contin Educ Health Prof 2016; 36:38-45. [PMID: 26954244 DOI: 10.1097/ceh.0000000000000030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study aimed to evaluate the impact of the printed educational material (PEM), the Residential Aged-Care (RAC) Communiqué, on the changing clinical practice of health and aged-care professionals. METHODS The RAC Communiqué is a PEM that contains case narratives from Coroners' investigations into potentially preventable deaths in nursing homes. A population-based cross-sectional study was conducted, using an anonymous electronic survey distributed to all subscribers of the RAC Communiqué. The questionnaire consisted of 40 questions in five sections, such as respondent characteristics, respondent preferences and reading behavior, respondent opinion about the RAC Communiqué content, and the mode of its delivery, impact of the RAC Communiqué, and the details of changes in professional practice. RESULTS The response rate was 58.3% (367/630). Respondents were mostly women aged 45 years and older (n = 319, 86.9%) with more than 10 years of experience (n = 241, 65.7%) in management (n = 171, 46.6%) or nursing (n = 65, 17.7%). Of the 367 respondents, 204 (55.6%) reported changing their practice. Multivariate analysis revealed that women (odds ratio [OR] = 2.10, 95% confidence interval [CI] = 1.01-4.35) aged between 45 and 54 (OR = 2.06, CI = 1.13-3.75), who read most of the RAC Communiqué (OR = 2.77, CI = 1.34-5.72) and were subscribed for more than 1 year (OR = 3.58, CI = 1.61-7.95) were significantly associated with practice change. DISCUSSION More than half of the survey respondents who read the RAC Communiqué self-reported a change in practice highlighting its impact and efficacy as PEM.
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Affiliation(s)
- Duc H T Pham
- Department of Forensic Medicine, Monash University, Victorian Institute of Forensic Medicine, Southbank, Victoria
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Nowak MK, Speakman E, Sayers P. Evaluating PowerPoint Presentations: A Retrospective Study Examining Educational Barriers and Strategies. Nurs Educ Perspect 2016; 37:28-31. [PMID: 27164774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED AIM To assess faculty adherence to best practices for PowerPoint presentations in nursing school curricula. BACKGROUND It is important to examine current educational methods and identify best educational practices that contribute to a high quality nursing curriculum. METHOD A retrospective study approach was used. Data were collected from 1,735 slide presentations from five universities. PowerPoint presentations were compared to a nine-point standardized scoring criterion for quality. RESULTS Findings provide evidence that indicated classroom presentations often fall short of providing best educational practices. CONCLUSION These findings can lead to greater faculty understanding of best practices and provide strategies to reinvent educational methods that engage students.
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Kuchma VR, Stepanova MI, Sazanyuk ZI, Aleksandrova IE, Polenova MA, Lashneva IP, Berezina NO. [HYGIENIC EVALUATION OF STUDIES OF PRESCHOOLERS WITH THE USE OF PC TABLETS]. Gig Sanit 2016; 95:387-391. [PMID: 27430073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In the article there are presented the results ofphysiological and hygienic evaluation of studies in kindergarten with the use of educational games on an electronic PC tablet. The study involved 44 foster-children. In one of the groups children in the classroom used the interactive game software on electronic PC tablets "Samsung", the same time while working with the PC tablet did not exceed 10 minutes, in the other--the classes were held traditionally. There were investigated the state of health, psychosomatic and psycho-emotional state of children, determined their functional readiness for systematic training in school, mental performance, the functional state of the central nervous system (CNS) by simple visual-motor reaction (SVMR) and reactions to a moving object (RDO). Developing ofgame sessions with the use of electronic PC tablets for 10 minutes were established to contribute to the activation of the central nervous system and increase in children resistance to the development of fatigue.
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Lloyd ST, D'Errico E, Bristol ST. Use of the Iowa Model of Research in Practice as a Curriculum Framework for Doctor of Nursing Practice (DNP) Project Completion. Nurs Educ Perspect 2016; 37:51-53. [PMID: 27164780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Doctoral education requires academic motivation and persistence on the part of nursing students; commitment to the process is essential and should be linked to programmatic structure. Programmatic issues in doctor of nursing practice (DNP) programs may be barriers to completion of the final project and lead to attrition. A large, private health care university developed an infrastructure for the DNP curriculum and final project utilizing the Iowa Model of Research in Practice. The purpose was to ensure competency fulfillment, retention and timely completion, and implementation of evidence-based practice and translation science utilizing a leadership approach. The program has experienced a high completion rate to date.
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Delgado AJ, Walter R, Behar-Horenstein LS, Boushell LW. Are All Dentiform Teeth with Simulated Caries the Same? A Six-Year Retrospective Study in Preclinical Operative Dentistry. J Dent Educ 2015; 79:1330-1338. [PMID: 26522639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Dentiform teeth with simulated caries (DTSC), frequently used in preclinical courses, should show no variability in the amount of simulated caries from tooth to tooth. However, the level of caries variability among DTSC is currently unknown. The aim of this study was to assess the variation in simulated caries levels in one group of DTSC and determine whether variation among DTSC impacted the preclinical performance of dental students. In the study, 80 commercially available mandibular first molar DTSC with simulated mesio-occluso-distal caries were sectioned in coronal (n=40) and sagittal (n=40) planes where the caries depth/width was greatest. Section images were analyzed for variation in levels of simulated caries using image-processing software. Three years of practical performance data using DTSC were compared with three years of practical performance data using dentiform teeth without simulated caries, for a total of six years (students' performance on two exams, Practical 1 and Practical 2). The results showed that 70% of the coronally sectioned teeth had manufacturing defects that resulted in caries overextension at the dentino-enamel junctions (DEJs). Overextensions were found at the DEJ in 41.3% of the sagittally sectioned teeth. There was a statistically significant decrease in Practical 1 performance of the students who used DTSC as compared with students who used teeth without simulated caries (p=0.0001); there was no statistically significant difference on Practical 2 performance. Of the DTSC evaluated in this study, 56.6% contained manufacturing defects, and more than 80% were found to have excessive caries variation. Prediction of which DTSC will have caries overextension is not possible. Students preparing DTSC that contain caries overextension are therefore at increased risk of receiving undeserved negative summative assessment on practical examinations.
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Affiliation(s)
- Alex J Delgado
- Dr. Delgado is Clinical Assistant Professor, Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Walter is Clinical Associate Professor and DDS3 Group Director, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, School of Human Development and Organizational Studies in Education and Affiliate Professor, Department of Community Dentistry and Behavioral Science, College of Dental Education, University of Florida; and Dr. Boushell is Associate Professor, Program Director of Graduate Operative Dentistry, Director of Introduction to Graduate Operative Dentistry, and Director of Conservative Operative Dentistry, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill.
| | - Ricardo Walter
- Dr. Delgado is Clinical Assistant Professor, Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Walter is Clinical Associate Professor and DDS3 Group Director, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, School of Human Development and Organizational Studies in Education and Affiliate Professor, Department of Community Dentistry and Behavioral Science, College of Dental Education, University of Florida; and Dr. Boushell is Associate Professor, Program Director of Graduate Operative Dentistry, Director of Introduction to Graduate Operative Dentistry, and Director of Conservative Operative Dentistry, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill
| | - Linda S Behar-Horenstein
- Dr. Delgado is Clinical Assistant Professor, Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Walter is Clinical Associate Professor and DDS3 Group Director, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, School of Human Development and Organizational Studies in Education and Affiliate Professor, Department of Community Dentistry and Behavioral Science, College of Dental Education, University of Florida; and Dr. Boushell is Associate Professor, Program Director of Graduate Operative Dentistry, Director of Introduction to Graduate Operative Dentistry, and Director of Conservative Operative Dentistry, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill
| | - Lee W Boushell
- Dr. Delgado is Clinical Assistant Professor, Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, University of Florida; Dr. Walter is Clinical Associate Professor and DDS3 Group Director, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill; Dr. Behar-Horenstein is Distinguished Teaching Scholar and Professor, School of Human Development and Organizational Studies in Education and Affiliate Professor, Department of Community Dentistry and Behavioral Science, College of Dental Education, University of Florida; and Dr. Boushell is Associate Professor, Program Director of Graduate Operative Dentistry, Director of Introduction to Graduate Operative Dentistry, and Director of Conservative Operative Dentistry, Department of Operative Dentistry, School of Dentistry, University of North Carolina at Chapel Hill
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Tian H, Yang C, Tang J, Qin Q, Zhao M, Zhao J. [Standardizing the manipulation procedure of acupuncture-moxibustion, reinforcing the training of' clinical skill: learning experience of Acupuncture-moxibustion Clinical Skills Training: Chapter of Commonly Used Needling and Moxibustion Techniques]. Zhongguo Zhen Jiu 2015; 35:741-743. [PMID: 26521599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The book Acupuncture-moxibustion Clinical Skills Training is one of "Twelfth Five-Year Plan" in novative teaching materials, which is published by People's Medical Publishing House. Through learning the first half of the book commonly used needling and moxibustion techniques, it is realized that the selection of book content is reasonable and much attention is paid to needling and moxibustion techniques; the chapter arrangement is well-organized, and the form is novel, which is concise and intuitive; for every technique, great attention is paid to standardize the manipulation procedure and clarify the technique key, simultaneously the safety of acupuncture and moxibustion is also emphasized. The characteristics of the book, including innovativeness, practicability, are highlighted, and it greatly helps to improve students' clinical skills and examination ability.
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Tuot DS, Cavanaugh KL. Evaluating the Merits of CKD Patient Educational Materials: Readability Is Necessary But Not Sufficient. Am J Kidney Dis 2015; 65:814-6. [PMID: 26003608 DOI: 10.1053/j.ajkd.2015.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Delphine S Tuot
- University of California San Francisco, San Francisco, California.
| | - Kerri L Cavanaugh
- Vanderbilt University School of Medicine and Vanderbilt University Medical Center, Nashville, Tennessee
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Taddio A, Shah V, Wang J, Parikh C, Smart S, Ipp M, Riddell RP, Franck LS. Usability and knowledge testing of educational tools about infant vaccination pain management directed to postnatal nurses. BMC Med Educ 2015; 15:45. [PMID: 25881321 PMCID: PMC4490667 DOI: 10.1186/s12909-015-0305-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Adapting educational tools to meet user needs is a critical aspect of translating research evidence into best clinical practices. The objectives of this study were to evaluate usability and effectiveness of educational tools about infant vaccination pain management directed to postnatal nurses. METHODS Mixed methods design. A template pamphlet and video included in a published clinical practice guideline were subjected to heuristic usability evaluation and then the revised tools were reviewed by postnatal hospital nurses in three rounds of interviews involving 8 to 12 nurses per round. Nurses' knowledge about evidence-based pain management interventions was evaluated at three time points: baseline, after pamphlet review, and after video review. RESULTS Of 32 eligible postnatal nurses, 29 agreed to participation and data were available for 28. Three overarching themes were identified in the interviews: 1) utility of information, 2) access to information, and 3) process for infant procedures. Nurses' knowledge improved significantly (p < 0.05) from the baseline phase to the pamphlet review phase, and again from the pamphlet review phase to the video review phase. CONCLUSIONS This study demonstrated usability and knowledge uptake from a nurse-directed educational pamphlet and video about managing infant vaccination pain. Future studies are needed to determine the impact of implementing these educational tools in the postnatal hospital setting on parental utilization of analgesic interventions during infant hospitalization and future infant vaccinations.
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Affiliation(s)
- Anna Taddio
- Clinical Social and Administrative Pharmacy, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON, M5S 3M2, Canada.
- Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Vibhuti Shah
- Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
| | - Jane Wang
- Undergraduate Pharmacy Division, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON, M5S 3M2, Canada.
| | - Chaitya Parikh
- Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, 144, College Street, Toronto, ON, M5S 3M2, Canada.
| | - Sarah Smart
- Graduate Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, 144, College Street, Toronto, ON, M5S 3M2, Canada.
| | - Moshe Ipp
- Department of Paediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Rebecca Pillai Riddell
- Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Linda S Franck
- Department of Family Health Care Nursing, University of California, San Francisco, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
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Vogel WV, Lam MGEH, Vegt E, Prompers L, Roef MJ. [The quality of patient information brochures can be improved: a discussion using radium-223 therapy as an example]. Ned Tijdschr Geneeskd 2015; 159:A8948. [PMID: 26288138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Patients and their peers need to be adequately informed to ensure proper treatment selection, and to facilitate optimal realisation and outcome of treatment. Written patient information can contribute, but only when brochures are of sufficient quality. An evaluation of patient brochures for radium-223 therapy in the Netherlands revealed significant differences in the information provided, as well as discrepancies between the brochures and national guidelines and product documentation. This potentially leads to confusion, false expectations, wrong treatment decisions, suboptimal realisation and outcome of treatment, and unnecessary toxicity and in radiation hygiene risks. Here we discuss the option of national patient information brochures that can be used by all centres in order to circumvent such issues. This would require collaboration between all medical professions, patient organisations and other groups involved, and responsibilities for medical information, distribution and updates must be properly defined. A national patient information brochure of this kind is currently under development for radium-223 therapy.
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Affiliation(s)
- Wouter V Vogel
- Antoni van Leeuwenhoek, afd. Nucleaire Geneeskunde, Amsterdam
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Brega AG, Freedman MAG, LeBlanc WG, Barnard J, Mabachi NM, Cifuentes M, Albright K, Weiss BD, Brach C, West DR. Using the Health Literacy Universal Precautions Toolkit to Improve the Quality of Patient Materials. J Health Commun 2015; 20 Suppl 2:69-76. [PMID: 26513033 PMCID: PMC5085259 DOI: 10.1080/10810730.2015.1081997] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Patient materials are often written above the reading level of most adults. Tool 11 of the Health Literacy Universal Precautions Toolkit ("Design Easy-to-Read Material") provides guidance on ensuring that written patient materials are easy to understand. As part of a pragmatic demonstration of the Toolkit, we examined how four primary care practices implemented Tool 11 and whether written materials improved as a result. We conducted interviews to learn about practices' implementation activities and assessed the readability, understandability, and actionability of patient education materials collected during pre- and postimplementation site visits. Interview data indicated that practices followed many action steps recommended in Tool 11, including training staff, assessing readability, and developing or revising materials, typically focusing on brief documents such as patient letters and information sheets. Many of the revised and newly developed documents had reading levels appropriate for most patients and--in the case of revised documents--better readability than the original materials. In contrast, the readability, understandability, and actionability of lengthier patient education materials were poor and did not improve over the 6-month implementation period. Findings guided revisions to Tool 11 and highlighted the importance of engaging multiple stakeholders in improving the quality of patient materials.
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Affiliation(s)
- Angela G. Brega
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Megan A. G. Freedman
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - William G. LeBlanc
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Juliana Barnard
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Natabhona M Mabachi
- American Academy of Family Physicians, Kansas City, Kansas, USA
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Maribel Cifuentes
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Karen Albright
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Barry D. Weiss
- Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, USA
| | - Cindy Brach
- Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland, USA
| | - David R. West
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Abstract
This study investigated the frequency, nature and experience of urinary incontinence in post-natal women. Surveys were completed by 224 women, 50% of whom indicated that they had experienced accidental urine loss. The majority of women who had experienced any symptoms were moderately to greatly bothered by them. A variety of strategies were used to manage the problem; however, 42% of the women who experienced accidental urine loss had taken no action to ease the problem. Women received information about urinary incontinence and pelvic floor exercises from a variety of health care professionals, but this was not consistently provided. The implications of these findings are discussed.
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Affiliation(s)
- Bev O'Connell
- Cabrini Hospital/Deakin University Nursing, Professorial Unit, Malvern, Victoria
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Kovalev AV, Shmarov LA, Ten'kov AA. [Classifications in forensic medicine and their logical basis]. Sud Med Ekspert 2014; 57:49-52. [PMID: 25764904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of the present study was to characterize the main requirements for the correct construction of classifications used in forensic medicine, with special reference to the errors that occur in the relevant text-books, guidelines, and manuals and the ways to avoid them. This publication continues the series of thematic articles of the authors devoted to the logical errors in the expert conclusions. The preparation of further publications is underway to report the results of the in-depth analysis of the logical errors encountered in expert conclusions, text-books, guidelines, and manuals.
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Suebnukarn S, Chaisombat M, Kongpunwijit T, Rhienmora P. Construct validity and expert benchmarking of the haptic virtual reality dental simulator. J Dent Educ 2014; 78:1442-1450. [PMID: 25281678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this study was to demonstrate construct validation of the haptic virtual reality (VR) dental simulator and to define expert benchmarking criteria for skills assessment. Thirty-four self-selected participants (fourteen novices, fourteen intermediates, and six experts in endodontics) at one dental school performed ten repetitions of three mode tasks of endodontic cavity preparation: easy (mandibular premolar with one canal), medium (maxillary premolar with two canals), and hard (mandibular molar with three canals). The virtual instrument's path length was registered by the simulator. The outcomes were assessed by an expert. The error scores in easy and medium modes accurately distinguished the experts from novices and intermediates at the onset of training, when there was a significant difference between groups (ANOVA, p<0.05). The trend was consistent until trial 5. From trial 6 on, the three groups achieved similar scores. No significant difference was found between groups at the end of training. Error score analysis was not able to distinguish any group at the hard level of training. Instrument path length showed a difference in performance according to groups at the onset of training (ANOVA, p<0.05). This study established construct validity for the haptic VR dental simulator by demonstrating its discriminant capabilities between that of experts and non-experts. The experts' error scores and path length were used to define benchmarking criteria for optimal performance.
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Affiliation(s)
- Siriwan Suebnukarn
- Dr. Suebnukarn is Associate Professor, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand; Dr. Chaisombat is a dentist, Nonnarai Hospital, Surin, Thailand; Dr. Kongpunwijit is a dentist, Sriboonruang Hospital, Nongbualumphu, Thailand; and Dr. Rhienmora is a faculty member, School of Science and Technology, Bangkok University, Bangkok, Thailand.
| | - Monthalee Chaisombat
- Dr. Suebnukarn is Associate Professor, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand; Dr. Chaisombat is a dentist, Nonnarai Hospital, Surin, Thailand; Dr. Kongpunwijit is a dentist, Sriboonruang Hospital, Nongbualumphu, Thailand; and Dr. Rhienmora is a faculty member, School of Science and Technology, Bangkok University, Bangkok, Thailand
| | - Thanapohn Kongpunwijit
- Dr. Suebnukarn is Associate Professor, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand; Dr. Chaisombat is a dentist, Nonnarai Hospital, Surin, Thailand; Dr. Kongpunwijit is a dentist, Sriboonruang Hospital, Nongbualumphu, Thailand; and Dr. Rhienmora is a faculty member, School of Science and Technology, Bangkok University, Bangkok, Thailand
| | - Phattanapon Rhienmora
- Dr. Suebnukarn is Associate Professor, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand; Dr. Chaisombat is a dentist, Nonnarai Hospital, Surin, Thailand; Dr. Kongpunwijit is a dentist, Sriboonruang Hospital, Nongbualumphu, Thailand; and Dr. Rhienmora is a faculty member, School of Science and Technology, Bangkok University, Bangkok, Thailand
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Abstract
BACKGROUND The objective of this study was to analyse the readability of paediatric oral health education leaflets available in Australia. METHODS Forty paediatric oral health education materials were analysed for general readability according to the following parameters: Thoroughness; Textual framework; Terminology; and Readability (Flesch-Kincaid grade level (FKGL), Gunning Fog index (Fog) and Simplified Measure of Gobbledygook (SMOG)). RESULTS Leaflets produced by the industry were among the hardest to read with an average readability at the 8th grade (8.4 ± 0.1). The readability of leaflets produced by the commercial sector was at the 7th grade (7.1 ± 1.7) and the government at the 6th grade (6.3 ± 1.9). The FKGL consistently yielded readabilities 2 grades below the Fog and SMOG indexes. In the content analyses, 14 essential paediatric oral health topics were noted and Early Childhood Caries (ECC) was identified as the most commonly used jargon term. CONCLUSION Paediatric oral health education materials are readily available, yet their quality and readability vary widely and may be difficult to read for disadvantaged populations in Australia. A redesign of these leaflets while taking literacy into consideration is suggested.
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Affiliation(s)
- Amit Arora
- Centre for Primary Health Care and Equity, Faculty of Medicine, UNSW Australia, Room 345, Level 3, AGSM Building, Gate 11, Botany Street, Randwick NSW 2052, Australia
- Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia
- Sydney and Sydney South West Local Health District, Sydney, NSW, Australia
| | - Andy SF Lam
- Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia
| | - Zahra Karami
- Faculty of Dentistry, University of Sydney, Westmead, NSW, Australia
| | - Loc Giang Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - Mark Fort Harris
- Centre for Primary Health Care and Equity, Faculty of Medicine, UNSW Australia, Room 345, Level 3, AGSM Building, Gate 11, Botany Street, Randwick NSW 2052, Australia
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Abstract
BACKGROUND Faculty who want to develop e-learning materials face pedagogical challenges of transforming instruction for the online environment, especially as many have never experienced online learning themselves. They face technical challenges of learning new software and time challenges of not all being able to be in the same place at the same time to learn these new skills. The objective of the Any Day Any Place Teaching (ADAPT) faculty development program was to create an online experience in which faculty could learn to produce e-learning materials. METHODS The ADAPT curriculum included units on instructional design, copyright principles and peer review, all for the online environment, and units on specific software tools. Participants experienced asynchronous and synchronous methods, including a learning management system, PC-based videoconferencing, online discussions, desktop sharing, an online toolbox and optional face-to-face labs. Project outcomes were e-learning materials developed and participants' evaluations of the experience. Likert scale responses for five instructional units (quantitative) were analyzed for distance from neutral using one-sample t-tests. Interview data (qualitative) were analyzed with assurance of data trustworthiness and thematic analysis techniques. RESULTS Participants were 27 interprofessional faculty. They evaluated the program instruction as easy to access, engaging and logically presented. They reported increased confidence in new skills and increased awareness of copyright issues, yet continued to have time management challenges and remained uncomfortable about peer review. They produced 22 new instructional materials. DISCUSSION Online faculty development methods are helpful for faculty learning to create e-learning materials. Recommendations are made to increase the success of such a faculty development program.
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Affiliation(s)
- Virginia Niebuhr
- Department of Pediatrics, University of Texas Medical Branch, Texas, USA
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Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns 2014; 96:395-403. [PMID: 24973195 PMCID: PMC5085258 DOI: 10.1016/j.pec.2014.05.027] [Citation(s) in RCA: 467] [Impact Index Per Article: 46.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 05/28/2014] [Accepted: 05/30/2014] [Indexed: 05/04/2023]
Abstract
OBJECTIVE To develop a reliable and valid instrument to assess the understandability and actionability of print and audiovisual materials. METHODS We compiled items from existing instruments/guides that the expert panel assessed for face/content validity. We completed four rounds of reliability testing, and produced evidence of construct validity with consumers and readability assessments. RESULTS The experts deemed the PEMAT items face/content valid. Four rounds of reliability testing and refinement were conducted using raters untrained on the PEMAT. Agreement improved across rounds. The final PEMAT showed moderate agreement per Kappa (Average K=0.57) and strong agreement per Gwet's AC1 (Average=0.74). Internal consistency was strong (α=0.71; Average Item-Total Correlation=0.62). For construct validation with consumers (n=47), we found significant differences between actionable and poorly-actionable materials in comprehension scores (76% vs. 63%, p<0.05) and ratings (8.9 vs. 7.7, p<0.05). For understandability, there was a significant difference for only one of two topics on consumer numeric scores. For actionability, there were significant positive correlations between PEMAT scores and consumer-testing results, but no relationship for understandability. There were, however, strong, negative correlations between grade-level and both consumer-testing results and PEMAT scores. CONCLUSIONS The PEMAT demonstrated strong internal consistency, reliability, and evidence of construct validity. PRACTICE IMPLICATIONS The PEMAT can help professionals judge the quality of materials (available at: http://www.ahrq.gov/pemat).
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Affiliation(s)
| | - Michael S Wolf
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Cindy Brach
- Agency for Healthcare Research and Quality (AHRQ), Rockville, USA
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Smith F, Carlsson E, Kokkinakis D, Forsberg M, Kodeda K, Sawatzky R, Friberg F, Öhlén J. Readability, suitability and comprehensibility in patient education materials for Swedish patients with colorectal cancer undergoing elective surgery: a mixed method design. Patient Educ Couns 2014; 94:202-209. [PMID: 24290242 DOI: 10.1016/j.pec.2013.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 08/20/2013] [Accepted: 10/26/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To characterize education materials provided to patients undergoing colorectal cancer surgery to gain a better understanding of how to design readable, suitable, comprehensible materials. METHOD Mixed method design. Deductive quantitative analysis using a validated suitability and comprehensibility assessment instrument (SAM+CAM) was applied to patient education materials from 27 Swedish hospitals, supplemented by language technology analysis and deductive and inductive analysis of data from focus groups involving 15 former patients. RESULTS Of 125 patient education materials used during the colorectal cancer surgery process, 13.6% were rated 'not suitable', 76.8% 'adequate' and 9.6% 'superior'. Professionally developed stoma care brochures were rated 'superior' and 44% of discharge brochures were 'not suitable'. Language technology analysis showed that up to 29% of materials were difficult to comprehend. Focus group analysis revealed additional areas that needed to be included in patient education materials: general and personal care, personal implications, internet, significant others, accessibility to healthcare, usability, trustworthiness and patient support groups. CONCLUSION Most of the patient education materials were rated 'adequate' but did not meet the information needs of patients entirely. Discharge brochures particularly require improvement. PRACTICE IMPLICATIONS Using patients' knowledge and integrating manual and automated methods could result in more appropriate patient education materials.
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Affiliation(s)
- Frida Smith
- Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden.
| | - Eva Carlsson
- Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden
| | | | - Markus Forsberg
- Språkbanken/Department of Swedish language, University of Gothenburg, Sweden
| | - Karl Kodeda
- Department of Colorectal Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Richard Sawatzky
- Trinity Western University, School of Nursing, Providence Health Care, Centre for Health Evaluation and Outcomes Sciences, Vancouver, Canada
| | - Febe Friberg
- Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden; Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Norway
| | - Joakim Öhlén
- Institute of Health and Care Sciences,Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-centred Care (GPCC), Sweden; Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden
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Genova J, Nahon-Serfaty I, Dansokho SC, Gagnon MP, Renaud JS, Giguère AMC. The Communication AssessmenT Checklist in Health (CATCH): a tool for assessing the quality of printed educational materials for clinicians. J Contin Educ Health Prof 2014; 34:232-242. [PMID: 25530293 DOI: 10.1002/chp.21257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION There is little guidance available on strategies to improve the communication quality of printed educational materials (PEMs) for clinicians. The purposes of this study were to conceptualize PEM communication quality, develop a checklist based on this conceptualization, and validate the checklist with a selection of PEMs. METHODS From a literature review of the strategies influencing communication quality, we generated a conceptual map and developed the Communication AssessmenT Checklist in Health (CATCH) consisting of 55 items nested in 12 concepts. Two raters independently applied CATCH to 45 PEMs evaluated in the studies included in a Cochrane systematic review. From these results, we conducted an item analysis and assessed content validity of CATCH using a hierarchical cluster analysis to explore the extent to which our CATCH operationalization truly represented the communication quality concepts. RESULTS Some concepts were better covered in the studied PEMs, whereas others were not covered consistently. We observed 3 contrasting PEM clusters. A first cluster (n = 22) was characterized by longer PEMs and comprised mostly high-impact peer-reviewed scientific articles or clinical practice guidelines. A second cluster (n = 22) consisted of PEMs shorter than 4 pages that used special fonts, color, pictures, and graphics. A third cluster consisted of a single brief PEM. DISCUSSION With CATCH it is possible to categorize and understand the mechanisms that can trigger a change in behavior in health care providers. Additional research is needed to validate CATCH before it can be recommended for use.
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White RO, Thompson JR, Rothman RL, McDougald Scott AM, Heerman WJ, Sommer EC, Barkin SL. A health literate approach to the prevention of childhood overweight and obesity. Patient Educ Couns 2013; 93:612-618. [PMID: 24001660 PMCID: PMC3904952 DOI: 10.1016/j.pec.2013.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 07/24/2013] [Accepted: 08/10/2013] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To describe a systematic assessment of patient educational materials for the Growing Right Onto Wellness (GROW) trial, a childhood obesity prevention study targeting a low health literate population. METHODS Process included: (1) expert review of educational content, (2) assessment of the quality of materials including use of the Suitability Assessment of Materials (SAM) tool, and (3) material review and revision with target population. RESULTS 12 core modules were developed and assessed in an iterative process. Average readability was at the 6th grade reading level (SMOG Index 5.63 ± 0.76, and Fry graph 6.0 ± 0.85). SAM evaluation resulted in adjustments to literacy demand, layout & typography, and learning stimulation & motivation. Cognitive interviews with target population revealed additional changes incorporated to enhance participant's perception of acceptability and feasibility for behavior change. CONCLUSION The GROW modules are a collection of evidence-based materials appropriate for parents with low health literacy and their preschool aged children, that target the prevention of childhood overweight/obesity. PRACTICE IMPLICATIONS Most trials addressing the treatment or prevention of childhood obesity use written materials. Due to the ubiquitous prevalence of limited health literacy, our described methods may assist researchers in ensuring their content is both understood and actionable.
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Affiliation(s)
- Richard O White
- Department of Community Internal Medicine, Mayo Clinic, Jacksonville, USA; Department of Family Medicine, Mayo Clinic, Jacksonville, USA.
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Agarwal N, Hansberry DR, Sabourin V, Tomei KL, Prestigiacomo CJ. A comparative analysis of the quality of patient education materials from medical specialties. JAMA Intern Med 2013; 173:1257-9. [PMID: 23689468 DOI: 10.1001/jamainternmed.2013.6060] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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