Pub Date : 2022-04-01DOI: 10.3928/24748307-20220518-02
J. Holcomb, Gayla M. Ferguson, Logan R. Thornton, L. Highfield
Background: Effective provider communication skills are important for patient decision-making and understanding, particularly for those with low health literacy. A gap exists in training methods and curriculum for community health workers (CHWs). Brief description of activity: Through a clinical and academic partnership, pilot training curriculum focused on patient communication skills was developed to align with CHW scope of work. Implementation: The curriculum was implemented in three 2-hour training sessions over WebEx with seven state-certified CHWs. The goal was for CHWs to understand the key elements and application of active listening, Teach Back, and action planning in a clinical setting. The sessions included didactic and skills practice modules for each skill. Results: A survey was distributed to CHWs to evaluate knowledge, skills, and attitudes and reactions to training methods, instructors, and relevance using the Kirkpatrick's evaluation model (Reaction and Learning). Although CHWs agreed that they had actively participated in the training and that the instructors were well-prepared, there was less agreement that the course was relevant. CHWs reported an increase in understanding of active listening and action planning, capability of using Teach Back and providing social support, and ability to teach, whereas a decrease was reported in the capability to use action planning. When probed about training relevance, CHWs felt action listening and Teach Back were relevant, but that action planning was not relevant to their responsibilities. This gap in responsibilities was also acknowledged by the clinical leadership. Lessons learned: The training allowed the CHWs to build on subsequent skills from previous sessions and to discuss struggles. A need for tools for integrating the skills in the clinical workflow were requested by CHWs and clinical leadership. These tools offer the opportunity to tailor future trainings on communication skills or patient scenarios. Future trainings should include CHWs to provide insight into scope of work. [HLRP: Health Literacy Research and Practice. 2022;6(2):e142–e150.] Plain Language Summary: It is important for community health workers to communicate with patients so that patients can understand information and make their own decisions. There is not enough known about the best way to train CHWs in patient communication. This training was created to help CHWs use three patient communication skills in their clinic.
{"title":"Development of Training Curriculum to Improve Patient Communication Skills and Social Support Among Community Health Workers","authors":"J. Holcomb, Gayla M. Ferguson, Logan R. Thornton, L. Highfield","doi":"10.3928/24748307-20220518-02","DOIUrl":"https://doi.org/10.3928/24748307-20220518-02","url":null,"abstract":"Background: Effective provider communication skills are important for patient decision-making and understanding, particularly for those with low health literacy. A gap exists in training methods and curriculum for community health workers (CHWs). Brief description of activity: Through a clinical and academic partnership, pilot training curriculum focused on patient communication skills was developed to align with CHW scope of work. Implementation: The curriculum was implemented in three 2-hour training sessions over WebEx with seven state-certified CHWs. The goal was for CHWs to understand the key elements and application of active listening, Teach Back, and action planning in a clinical setting. The sessions included didactic and skills practice modules for each skill. Results: A survey was distributed to CHWs to evaluate knowledge, skills, and attitudes and reactions to training methods, instructors, and relevance using the Kirkpatrick's evaluation model (Reaction and Learning). Although CHWs agreed that they had actively participated in the training and that the instructors were well-prepared, there was less agreement that the course was relevant. CHWs reported an increase in understanding of active listening and action planning, capability of using Teach Back and providing social support, and ability to teach, whereas a decrease was reported in the capability to use action planning. When probed about training relevance, CHWs felt action listening and Teach Back were relevant, but that action planning was not relevant to their responsibilities. This gap in responsibilities was also acknowledged by the clinical leadership. Lessons learned: The training allowed the CHWs to build on subsequent skills from previous sessions and to discuss struggles. A need for tools for integrating the skills in the clinical workflow were requested by CHWs and clinical leadership. These tools offer the opportunity to tailor future trainings on communication skills or patient scenarios. Future trainings should include CHWs to provide insight into scope of work. [HLRP: Health Literacy Research and Practice. 2022;6(2):e142–e150.] Plain Language Summary: It is important for community health workers to communicate with patients so that patients can understand information and make their own decisions. There is not enough known about the best way to train CHWs in patient communication. This training was created to help CHWs use three patient communication skills in their clinic.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"2 1","pages":"e142 - e150"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81195059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220523-02
Ava Sadat Hoseini, T. Dehdari, M. Solhi, L. Janani, S. T. Rahideh
Background: Health literacy is one of the important social determinants of health. Objective: The aim of this study was to develop an instrument to measure Dietary Supplement Health Literacy (DSHL) of Iranian women. Methods: In this psychometrics study, an initial nine-factor instrument was developed. Face validity and content validity of the instrument were evaluated. The factor structure of the instrument was explored by the Exploratory Factor Analysis (EFA) among 400 women taking Dietary supplement. Confirmatory Factor Analysis (CFA) was done to determine the underlying factor structure of the instrument in this population. The internal and external reliability of the instrument was evaluated. Key Results: According to expert panel opinions, 16 items were deleted. The results of the EFA showed that the Kaiser-Meyer-Olkin and Bartlett's test of sphericity were significant. EFA showed that 30 items could be grouped into nine factors that accounted for 60.84% of the variance. Since two items in the ability to actively engage with health care providers factor were loaded in factor 1, this factor was labeled Engaging in receiving informational supports from health care providers. In addition, one item of the dimension was loaded in factor 3. Given that the one item of factor 5 and 1 item of factor 6 were loaded in a new factor 9, this factor was labeled Applying information to decision-making. The CFA indicated that the nine-factor structure of the DSHL instrument had a poor fit. To modify indices, factor 9 with 2 items and 1 item of factor 6 were deleted. The Cronbach's alpha and intraclass correlation coefficient of the instrument were acceptable. Finally, a 27-item instrument with 8 dimensions was confirmed. Conclusions: The results of the study showed that the instrument developed was a valid tool for identifying the DSHL of Iranian women. [HLRP: Health Literacy Research and Practice. 2022;6(2):e159–e166.] Plain Language Summary: This study sought to develop and validate a multidimensional instrument to measure the health literacy of Iranian women about dietary supplements that was performed from July 2019 to May 2020 in Iran. Findings showed that the 30-item instrument developed in this study is a valid instrument to be used for identifying the health literacy of Iranian women about dietary supplements.
{"title":"Development of an Instrument to Measure Dietary Supplement Health Literacy","authors":"Ava Sadat Hoseini, T. Dehdari, M. Solhi, L. Janani, S. T. Rahideh","doi":"10.3928/24748307-20220523-02","DOIUrl":"https://doi.org/10.3928/24748307-20220523-02","url":null,"abstract":"Background: Health literacy is one of the important social determinants of health. Objective: The aim of this study was to develop an instrument to measure Dietary Supplement Health Literacy (DSHL) of Iranian women. Methods: In this psychometrics study, an initial nine-factor instrument was developed. Face validity and content validity of the instrument were evaluated. The factor structure of the instrument was explored by the Exploratory Factor Analysis (EFA) among 400 women taking Dietary supplement. Confirmatory Factor Analysis (CFA) was done to determine the underlying factor structure of the instrument in this population. The internal and external reliability of the instrument was evaluated. Key Results: According to expert panel opinions, 16 items were deleted. The results of the EFA showed that the Kaiser-Meyer-Olkin and Bartlett's test of sphericity were significant. EFA showed that 30 items could be grouped into nine factors that accounted for 60.84% of the variance. Since two items in the ability to actively engage with health care providers factor were loaded in factor 1, this factor was labeled Engaging in receiving informational supports from health care providers. In addition, one item of the dimension was loaded in factor 3. Given that the one item of factor 5 and 1 item of factor 6 were loaded in a new factor 9, this factor was labeled Applying information to decision-making. The CFA indicated that the nine-factor structure of the DSHL instrument had a poor fit. To modify indices, factor 9 with 2 items and 1 item of factor 6 were deleted. The Cronbach's alpha and intraclass correlation coefficient of the instrument were acceptable. Finally, a 27-item instrument with 8 dimensions was confirmed. Conclusions: The results of the study showed that the instrument developed was a valid tool for identifying the DSHL of Iranian women. [HLRP: Health Literacy Research and Practice. 2022;6(2):e159–e166.] Plain Language Summary: This study sought to develop and validate a multidimensional instrument to measure the health literacy of Iranian women about dietary supplements that was performed from July 2019 to May 2020 in Iran. Findings showed that the 30-item instrument developed in this study is a valid instrument to be used for identifying the health literacy of Iranian women about dietary supplements.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"60 1","pages":"e159 - e166"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72514831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220420-01
Cori Gibson, Danielle Smith, Andrea K Morrison
Background: Ensuring that health care professionals are knowledgeable about the influence limited health literacy has on health outcomes and how to apply health literate strategies is crucial to transform quality and safety in care settings. Although many organizational efforts to address health literacy have focused on hospital settings, few have focused on primary care. The designation of a patient-centered medical home requires the need to address integrating health literacy and the training needs of primary care settings. Brief description of activity: An interactive health literacy training intervention was developed, implemented, and evaluated for 25 primary care clinics. This included an online educational module, in-person application activities, and a sustainability plan to continue skill building, reinforce behaviors, and support practice.
Implementation: Using a descriptive pre- and post-training design, three survey measures were used to rate health literacy knowledge, behaviors, and confidence levels of more than 475 primary care staff. A pre-training survey was completed prior to completion of an interactive online health literacy module and attendance at an in-person training session which followed. A post-training survey was then completed. Sustainment activities, including lunch and learns, and reinforcement activities by clinic leaders, were initiated to promote use of the strategies in practice. A 1-year follow-up survey was then administered to measure sustainability.
Results: The interactive training intervention improved primary care staff's knowledge, behaviors, and confidence in using health literacy strategies with patients and families. Common barriers and facilitators around the use of these strategies were also identified.
Lessons learned: Careful consideration should be taken when developing health literacy training to ensure it will be effective, efficient, and sustainable. Using elements that facilitate the transfer of training to practice will help improve success. Addressing barriers and promoting facilitators, as well as integrating and connecting health literacy strategies with existing organizational goals and initiatives offer additional ways to reinforce and sustain the practice change. [HLRP: Health Literacy Research and Practice. 2022;6(2):e113-e120.] Plain Language Summary: Clinic staff can improve how they provide information and education to children and families. Interactive training about health literacy led clinic staff to (1) know more about health literacy, (2) use health literacy strategies more, and (3) feel more confident using health literacy strategies. Training over time, supporting staff, and connecting to organizational goals are important for sustainment.
{"title":"Improving Health Literacy Knowledge, Behaviors, and Confidence with Interactive Training.","authors":"Cori Gibson, Danielle Smith, Andrea K Morrison","doi":"10.3928/24748307-20220420-01","DOIUrl":"https://doi.org/10.3928/24748307-20220420-01","url":null,"abstract":"<p><strong>Background: </strong>Ensuring that health care professionals are knowledgeable about the influence limited health literacy has on health outcomes and how to apply health literate strategies is crucial to transform quality and safety in care settings. Although many organizational efforts to address health literacy have focused on hospital settings, few have focused on primary care. The designation of a patient-centered medical home requires the need to address integrating health literacy and the training needs of primary care settings. Brief description of activity: An interactive health literacy training intervention was developed, implemented, and evaluated for 25 primary care clinics. This included an online educational module, in-person application activities, and a sustainability plan to continue skill building, reinforce behaviors, and support practice.</p><p><strong>Implementation: </strong>Using a descriptive pre- and post-training design, three survey measures were used to rate health literacy knowledge, behaviors, and confidence levels of more than 475 primary care staff. A pre-training survey was completed prior to completion of an interactive online health literacy module and attendance at an in-person training session which followed. A post-training survey was then completed. Sustainment activities, including lunch and learns, and reinforcement activities by clinic leaders, were initiated to promote use of the strategies in practice. A 1-year follow-up survey was then administered to measure sustainability.</p><p><strong>Results: </strong>The interactive training intervention improved primary care staff's knowledge, behaviors, and confidence in using health literacy strategies with patients and families. Common barriers and facilitators around the use of these strategies were also identified.</p><p><strong>Lessons learned: </strong>Careful consideration should be taken when developing health literacy training to ensure it will be effective, efficient, and sustainable. Using elements that facilitate the transfer of training to practice will help improve success. Addressing barriers and promoting facilitators, as well as integrating and connecting health literacy strategies with existing organizational goals and initiatives offer additional ways to reinforce and sustain the practice change. <b>[<i>HLRP: Health Literacy Research and Practice</i>. 2022;6(2):e113-e120.]</b> Plain Language Summary: Clinic staff can improve how they provide information and education to children and families. Interactive training about health literacy led clinic staff to (1) know more about health literacy, (2) use health literacy strategies more, and (3) feel more confident using health literacy strategies. Training over time, supporting staff, and connecting to organizational goals are important for sustainment.</p>","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"6 2","pages":"e113-e120"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/00/hlrp0522gibsonbp-prt.PMC9126053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10250945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220516-01
Teresa Wagner, C. Howe, Brennan Lewis, Tracine Adame
Background: There exists a paucity of literature about teenager health literacy in general and teenagers are likely to turn to the internet for health information. Therefore, they need good e-health literacy to properly understand and apply the information obtained. Yet, many have limited e-health literacy, lacking the knowledge and skills to filter and distinguish reliable from unreliable health information and searches return large amounts of information, making it difficult to recognize whether information is reputable and raising concerns regarding teenagers' safety. Brief Description of Activity: We developed a toolkit in collaboration with community-based organizations serving teenagers and teenagers themselves usable with brief training to present a 1-hour, interactive workshop. We transformed current adult information for locating and appraising online health information into a teenager friendly format using relevant health topics to engage participants. Implementation: We met teenagers in teenager-friendly settings where they already gather to engage them and leverage the relationship fostered within those settings to bridge positive and negative social determinant influences on health literacy and e-health literacy as well as cross potential cultural, economic, political, and demographic barriers. Using the “train the trainer” method to build sustainability, we trained teenagers and group leaders to use the toolkit to run workshops with teenagers and placed the components in an easily available online format. Results: After completing the workshop, teenager participants expressed a high level of confidence in using Medline Plus, locating health information online, identifying Truth versus Trash and making health decisions. Most teenagers reported they would recommend the WebLitLegit workshop to their friends and it improved their ability to find credible online health information. Lessons Learned: The workshop's practical application provided participants with real-life examples for evaluating online information using the “LEGIT” acronym. The integration of this community-based program fostered relationships between the teenager participants, community organizations, and university students and faculty. All of the organizations involved benefited through exposure to health literacy concepts and knowledge of evaluation criteria, which may help expand e-health literacy in the community because the students, teenagers, and community partners are able to sustainably share the toolkit within their social network. [HLRP: Health Literacy Research and Practice. 2022;6(2):e151–e158.] Plain Language Summary: Teenagers use the internet to find health information but have difficulty deciding if the information is correct and safe. WebLitLegit workshops help teenagers find correct and safe information to make health decisions. Teenagers completing the workshop thought their ability to find correct information and make good health decisions improved.
{"title":"Is Your WebLitLegit? Finding Safe and Good Health Information on the Internet","authors":"Teresa Wagner, C. Howe, Brennan Lewis, Tracine Adame","doi":"10.3928/24748307-20220516-01","DOIUrl":"https://doi.org/10.3928/24748307-20220516-01","url":null,"abstract":"Background: There exists a paucity of literature about teenager health literacy in general and teenagers are likely to turn to the internet for health information. Therefore, they need good e-health literacy to properly understand and apply the information obtained. Yet, many have limited e-health literacy, lacking the knowledge and skills to filter and distinguish reliable from unreliable health information and searches return large amounts of information, making it difficult to recognize whether information is reputable and raising concerns regarding teenagers' safety. Brief Description of Activity: We developed a toolkit in collaboration with community-based organizations serving teenagers and teenagers themselves usable with brief training to present a 1-hour, interactive workshop. We transformed current adult information for locating and appraising online health information into a teenager friendly format using relevant health topics to engage participants. Implementation: We met teenagers in teenager-friendly settings where they already gather to engage them and leverage the relationship fostered within those settings to bridge positive and negative social determinant influences on health literacy and e-health literacy as well as cross potential cultural, economic, political, and demographic barriers. Using the “train the trainer” method to build sustainability, we trained teenagers and group leaders to use the toolkit to run workshops with teenagers and placed the components in an easily available online format. Results: After completing the workshop, teenager participants expressed a high level of confidence in using Medline Plus, locating health information online, identifying Truth versus Trash and making health decisions. Most teenagers reported they would recommend the WebLitLegit workshop to their friends and it improved their ability to find credible online health information. Lessons Learned: The workshop's practical application provided participants with real-life examples for evaluating online information using the “LEGIT” acronym. The integration of this community-based program fostered relationships between the teenager participants, community organizations, and university students and faculty. All of the organizations involved benefited through exposure to health literacy concepts and knowledge of evaluation criteria, which may help expand e-health literacy in the community because the students, teenagers, and community partners are able to sustainably share the toolkit within their social network. [HLRP: Health Literacy Research and Practice. 2022;6(2):e151–e158.] Plain Language Summary: Teenagers use the internet to find health information but have difficulty deciding if the information is correct and safe. WebLitLegit workshops help teenagers find correct and safe information to make health decisions. Teenagers completing the workshop thought their ability to find correct information and make good health decisions improved.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"21 1","pages":"e151 - e158"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81508676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220418-02
Flaviane Cristina Rocha Cesar, K. L. Moraes, V. Brasil, Angela Gilda Alves, M. Barbosa, L. Oliveira
Background: Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the characteristics and interventions that make health care professionals responsive to the patient's health literacy. Methods: Medline (PubMed), CINAHL (EBSCO), PsycInfo, ERIC (ProQuest), Lilacs (BVS) and EMBASE (Elsevier) were searched using a combination of controlled descriptors. The selected studies needed to address the concept or main focus of the study among health care professionals in the care or academic environment. Key Results: After reviewing 34 articles, 14 definitions and 10 subcategories of responsiveness were identified, and a broad characterization of health professional responsiveness to health literacy was proposed. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy, classified as (A) expository (n = 18; 94.7%), (B) interactive (n = 9; 47.4%), (C) practice with educational materials (n = 2; 10.5%), (D) practice with standardized patient or simulation (n = 8; 42.1%), and (E) practice with actual patients (n = 4; 21.1%). Discussion: These characteristics and interventions provide a useful taxonomy for the development of curricula and professional education programs, and for the validation and use of measures to evaluate the health workforce. [HLRP: Health Literacy Research and Practice. 2022;6(2):e96–e103.] Plain Language Summary: We found 14 definitions and 10 categories of professional responsiveness to health literacy. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy.
{"title":"Professional Responsiveness to Health Literacy: A Scoping Review","authors":"Flaviane Cristina Rocha Cesar, K. L. Moraes, V. Brasil, Angela Gilda Alves, M. Barbosa, L. Oliveira","doi":"10.3928/24748307-20220418-02","DOIUrl":"https://doi.org/10.3928/24748307-20220418-02","url":null,"abstract":"Background: Difficulty in understanding and using health information can harm the patient and increase the cost of care provided. So, this study classified and mapped the characteristics and interventions that make health care professionals responsive to the patient's health literacy. Methods: Medline (PubMed), CINAHL (EBSCO), PsycInfo, ERIC (ProQuest), Lilacs (BVS) and EMBASE (Elsevier) were searched using a combination of controlled descriptors. The selected studies needed to address the concept or main focus of the study among health care professionals in the care or academic environment. Key Results: After reviewing 34 articles, 14 definitions and 10 subcategories of responsiveness were identified, and a broad characterization of health professional responsiveness to health literacy was proposed. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy, classified as (A) expository (n = 18; 94.7%), (B) interactive (n = 9; 47.4%), (C) practice with educational materials (n = 2; 10.5%), (D) practice with standardized patient or simulation (n = 8; 42.1%), and (E) practice with actual patients (n = 4; 21.1%). Discussion: These characteristics and interventions provide a useful taxonomy for the development of curricula and professional education programs, and for the validation and use of measures to evaluate the health workforce. [HLRP: Health Literacy Research and Practice. 2022;6(2):e96–e103.] Plain Language Summary: We found 14 definitions and 10 categories of professional responsiveness to health literacy. Professional responsiveness to health literacy was characterized as knowing the definition and implications of health literacy for the patient's well-being and being able to develop, adapt, implement, and evaluate health education strategies. Nineteen strategies were mapped for education to ensure professional responsiveness to health literacy.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"8 1","pages":"e96 - e103"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82516311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220518-01
Diana Singer, C. Howe, Tracine Adame, Brennan Lewis, Teresa Wagner, Danielle R. Walker
The concept of a Health Literate Healthcare Organization (HLHO) is a relatively new approach to health literacy that moves the focus from the individual patient to the overarching health care system. The HLHO-10 questionnaire was developed internationally to assess the 10 Attributes of HLHOs as described by participants of the Institute of Medicine Roundtable on Health Literacy. The purpose of this study was to establish reliability and validity of the HLHO-10 among a sample of United States hospitals. Reliability and validity were established through assessing the factor structure for the HLHO-10 and psychometric evaluation. The HLHO-10 was found to be reliable with a Cronbach's alpha of .855 and a two-factor structure was revealed through exploratory factor analysis. Additional research is needed to further validate use of the HLHO-10 in the U.S., but initial findings of this emerging tool are promising and timely as the issue of health literacy comes to the forefront of U.S. health care systems and associated regulatory agencies. [HLRP: Health Literacy Research and Practice. 2022;6(2):e137–e141.]
{"title":"A Psychometric Analysis of the Health Literate Health Care Organization-10 Item Questionnaire","authors":"Diana Singer, C. Howe, Tracine Adame, Brennan Lewis, Teresa Wagner, Danielle R. Walker","doi":"10.3928/24748307-20220518-01","DOIUrl":"https://doi.org/10.3928/24748307-20220518-01","url":null,"abstract":"The concept of a Health Literate Healthcare Organization (HLHO) is a relatively new approach to health literacy that moves the focus from the individual patient to the overarching health care system. The HLHO-10 questionnaire was developed internationally to assess the 10 Attributes of HLHOs as described by participants of the Institute of Medicine Roundtable on Health Literacy. The purpose of this study was to establish reliability and validity of the HLHO-10 among a sample of United States hospitals. Reliability and validity were established through assessing the factor structure for the HLHO-10 and psychometric evaluation. The HLHO-10 was found to be reliable with a Cronbach's alpha of .855 and a two-factor structure was revealed through exploratory factor analysis. Additional research is needed to further validate use of the HLHO-10 in the U.S., but initial findings of this emerging tool are promising and timely as the issue of health literacy comes to the forefront of U.S. health care systems and associated regulatory agencies. [HLRP: Health Literacy Research and Practice. 2022;6(2):e137–e141.]","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"19 1","pages":"e137 - e141"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89979203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.3928/24748307-20220418-01
Hua Ou
Background: Health literacy describes an individuals' ability to maximize their potential in health care, including one's ability to understand information needed to make informed health decisions. A variety of general and condition-specific health literacy assessment tools have been created to help health professionals assess patients' health literacy skills and tailor the need for health care communication or education; however, there are no such tools available for the audiology field. Objective: The purpose of the study was to develop an objective reading recognition audiology-related health literacy assessment tool, the Rapid Estimate of Adult Literacy in Audiology (REALA). Methods: This was a cross-sectional study (N = 200). The initial version of the REALA contained 99 words specifically related to audiology. The final version, revised to have improved clinical utility, contained a total of 48 words that were selected based on item difficulty, item discrimination score, and point-biserial index using classical item analysis. Key Results: The total pass rate for the final version of the 48-word REALA was 0.72 (standard deviation = 0.45) and the Cronbach coefficient alpha was 0.93. Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. Conclusion: Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. [HLRP: Health Literacy Research and Practice. 2022;6(2):e88–e95.] Plain Language Summary: A health literacy assessment tool, the REALA, was developed in the study. The final version of REALA contained 48 words relative to hearing healthcare. The results suggested that REALA can help health professionals assess patients' hearing related health literacy and tailor the need for hearing health care communication or education.
{"title":"A Pilot Study to Develop the Rapid Estimate of Adult Literacy in Audiology","authors":"Hua Ou","doi":"10.3928/24748307-20220418-01","DOIUrl":"https://doi.org/10.3928/24748307-20220418-01","url":null,"abstract":"Background: Health literacy describes an individuals' ability to maximize their potential in health care, including one's ability to understand information needed to make informed health decisions. A variety of general and condition-specific health literacy assessment tools have been created to help health professionals assess patients' health literacy skills and tailor the need for health care communication or education; however, there are no such tools available for the audiology field. Objective: The purpose of the study was to develop an objective reading recognition audiology-related health literacy assessment tool, the Rapid Estimate of Adult Literacy in Audiology (REALA). Methods: This was a cross-sectional study (N = 200). The initial version of the REALA contained 99 words specifically related to audiology. The final version, revised to have improved clinical utility, contained a total of 48 words that were selected based on item difficulty, item discrimination score, and point-biserial index using classical item analysis. Key Results: The total pass rate for the final version of the 48-word REALA was 0.72 (standard deviation = 0.45) and the Cronbach coefficient alpha was 0.93. Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. Conclusion: Once the comprehension component is added to the tool, the REALA can be a valuable health literacy assessment tool that health professionals use to evaluate patients' audiology-related health literacy. [HLRP: Health Literacy Research and Practice. 2022;6(2):e88–e95.] Plain Language Summary: A health literacy assessment tool, the REALA, was developed in the study. The final version of REALA contained 48 words relative to hearing healthcare. The results suggested that REALA can help health professionals assess patients' hearing related health literacy and tailor the need for hearing health care communication or education.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"5 1","pages":"e88 - e95"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84160610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-04DOI: 10.3928/24748307-20220309-01
Rishtya M. Kakar, R. Combs, Malea Hoepf Young, Nida M. Ali, Baraka Muvuka
Background: Despite increases in the number of insured Americans, consumers continue to face barriers in accessing care. Low levels of health insurance literacy (HIL) are associated with suboptimal use of health insurance coverage. There remains a need to further contextualize the relationship between HIL and access to care, especially among insured working-class people. Objective This study was conducted to understand the pathways through which HIL affects health care decision-making and access to care in an urban working-class population. Methods: Using a qualitative descriptive approach, we conducted five focus groups with 45 adult residents of South Louisville, Kentucky. The questions explored participants' experiences of insurance enrollment, use, and health care system navigation, as well as their perceptions and needs regarding accessing health insurance information. Using inductive thematic analysis, transcripts were open coded independently by team members, a focused coding framework was agreed upon, and emergent themes were identified through constant comparison techniques. Key Results: Most participants placed high value on their insurance, considering it the most important benefit employers offer. Despite having adequate HIL, most participants expressed frustration with the amount of time and effort they spent to determine the best insurance plan, obtain covered health services, and settle claims, often with ineffective results. Despite having insurance, cost considerations influenced many participants' decisions to accept certain tests or treatments, in some cases resulting in delayed or foregone care. Conclusions: The findings of this qualitative study indicate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system. Interventions to improve HIL should include practical examples and real-life scenarios, because HIL gained from experiential narratives was the most useful in navigating the health care system.[HLRP: Health Literacy Research and Practice. 2022;6(2):e61–e69.] Plain Language Summary: By conducting focus groups with a working-class population, this study contextualizes the pathways through which HIL affects consumers' health care decision-making and access to care. Findings demonstrate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system.
{"title":"Health Insurance Literacy Perceptions and the Needs of a Working-Class Community","authors":"Rishtya M. Kakar, R. Combs, Malea Hoepf Young, Nida M. Ali, Baraka Muvuka","doi":"10.3928/24748307-20220309-01","DOIUrl":"https://doi.org/10.3928/24748307-20220309-01","url":null,"abstract":"Background: Despite increases in the number of insured Americans, consumers continue to face barriers in accessing care. Low levels of health insurance literacy (HIL) are associated with suboptimal use of health insurance coverage. There remains a need to further contextualize the relationship between HIL and access to care, especially among insured working-class people. Objective This study was conducted to understand the pathways through which HIL affects health care decision-making and access to care in an urban working-class population. Methods: Using a qualitative descriptive approach, we conducted five focus groups with 45 adult residents of South Louisville, Kentucky. The questions explored participants' experiences of insurance enrollment, use, and health care system navigation, as well as their perceptions and needs regarding accessing health insurance information. Using inductive thematic analysis, transcripts were open coded independently by team members, a focused coding framework was agreed upon, and emergent themes were identified through constant comparison techniques. Key Results: Most participants placed high value on their insurance, considering it the most important benefit employers offer. Despite having adequate HIL, most participants expressed frustration with the amount of time and effort they spent to determine the best insurance plan, obtain covered health services, and settle claims, often with ineffective results. Despite having insurance, cost considerations influenced many participants' decisions to accept certain tests or treatments, in some cases resulting in delayed or foregone care. Conclusions: The findings of this qualitative study indicate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system. Interventions to improve HIL should include practical examples and real-life scenarios, because HIL gained from experiential narratives was the most useful in navigating the health care system.[HLRP: Health Literacy Research and Practice. 2022;6(2):e61–e69.] Plain Language Summary: By conducting focus groups with a working-class population, this study contextualizes the pathways through which HIL affects consumers' health care decision-making and access to care. Findings demonstrate that obtaining health care is strongly influenced both by the individual context of HIL knowledge, experience, and life circumstances, and by the structural context of the complex, bureaucratic, and costly health care system.","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"36 1","pages":"e62 - e69"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81386874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Medication literacy encompasses the cognitive and social skills necessary for individuals to obtain, comprehend, communicate, calculate, and process medication-related information necessary to make informed decisions. Personal and contextual factors are widely recognized to influence the way that individuals acquire and maintain medication literacy skills. Despite a growing number of studies on medication literacy, current definitions remain general, lacking consideration for the specificities of older adults and hospitalization. Objective: The project was conducted to identify, compare, and summarize the attributes, antecedents, and consequences of medication literacy in hospitalized older adults and to propose a refined definition. Methods: A three-phase hybrid model of concept development was performed that included a literature review and focus groups with hospital nurses. In the final analytic phase, findings from the literature and focus groups were compared, and a refined definition of the concept was elaborated. Key Results: From the synthesis of 24 publications and the narrative data of 14 hospital nurses, 19 themes were described: 4 related to attributes, 8 to antecedents, and 7 to consequences. Medication literacy of hospitalized older adults has been further defined as the degree to which older adults and/or their natural caregivers can develop and maintain multidimensional skills, namely functional, interactive, and critical medication literacy skills. Adjustment of these skills is characterized by a dynamic and potentially complex process. In practice, optimal medication literacy might be achieved through control of and involvement in the medication regimen and the decisions related to it, and/or by using practical means to facilitate medication self-management (e.g., using lists, notes, reminders). Conclusions: The proposed refined definition might enhance professionals' common understanding of the concept and its application in practice, policy, and research. Managing a medication regimen is a complex activity that requires a high level of integration and coordination of cognitive and social skills. [HLRP: Health Literacy Research and Practice. 2022;6(2):e70–e83.] Plain Language Summary: Based on the literature on medication literacy and the experiences of nurses working in hospitals, this article defines medication literacy in hospitalized older adults. This definition will help professionals to better understand challenges related to medication literacy in older patients and to propose adequate support (i.e., provide education, simplify medication prescriptions, propose practical aids such as a pillbox).
{"title":"Medication Literacy in Hospitalized Older Adults: Concept Development","authors":"Jenny Gentizon, Emilie Bovet, Elise Rapp, Cédric Mabire","doi":"10.3928/24748307-20220309-02","DOIUrl":"https://doi.org/10.3928/24748307-20220309-02","url":null,"abstract":"Background: Medication literacy encompasses the cognitive and social skills necessary for individuals to obtain, comprehend, communicate, calculate, and process medication-related information necessary to make informed decisions. Personal and contextual factors are widely recognized to influence the way that individuals acquire and maintain medication literacy skills. Despite a growing number of studies on medication literacy, current definitions remain general, lacking consideration for the specificities of older adults and hospitalization. Objective: The project was conducted to identify, compare, and summarize the attributes, antecedents, and consequences of medication literacy in hospitalized older adults and to propose a refined definition. Methods: A three-phase hybrid model of concept development was performed that included a literature review and focus groups with hospital nurses. In the final analytic phase, findings from the literature and focus groups were compared, and a refined definition of the concept was elaborated. Key Results: From the synthesis of 24 publications and the narrative data of 14 hospital nurses, 19 themes were described: 4 related to attributes, 8 to antecedents, and 7 to consequences. Medication literacy of hospitalized older adults has been further defined as the degree to which older adults and/or their natural caregivers can develop and maintain multidimensional skills, namely functional, interactive, and critical medication literacy skills. Adjustment of these skills is characterized by a dynamic and potentially complex process. In practice, optimal medication literacy might be achieved through control of and involvement in the medication regimen and the decisions related to it, and/or by using practical means to facilitate medication self-management (e.g., using lists, notes, reminders). Conclusions: The proposed refined definition might enhance professionals' common understanding of the concept and its application in practice, policy, and research. Managing a medication regimen is a complex activity that requires a high level of integration and coordination of cognitive and social skills. [HLRP: Health Literacy Research and Practice. 2022;6(2):e70–e83.] Plain Language Summary: Based on the literature on medication literacy and the experiences of nurses working in hospitals, this article defines medication literacy in hospitalized older adults. This definition will help professionals to better understand challenges related to medication literacy in older patients and to propose adequate support (i.e., provide education, simplify medication prescriptions, propose practical aids such as a pillbox).","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"15 1","pages":"e70 - e83"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78723614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-04DOI: 10.3928/24748307-20220315-01
Angélica Maria Cupertino Lopes Marinho, C. Baur, Lucas Emanuel Oliveira Costa, J. Mambrini, F. Ferreira, A. Borges-Oliveira, M. D. de Abreu
The Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI) was cross-culturally adapted to Brazilian Portuguese (BR). It was necessary to analyze the reliability and validity of the BR-CDC-CCI for its use in Brazil. This study aimed to evaluate the psychometric properties of the instrument in its Brazilian version. Four specialists in health education used the BR-CDC-CCI to evaluate a population-level health education material. Primary health care professionals (n = 105) evaluated the same health material using the BRCDC-CCI, and 30 professionals performed the retest 15 to 20 days after the first assessment. Cohen Kappa and area under the receiver operating characteristic (ROC) curve analyses were developed. Inter-rater agreement ranged from moderate to almost perfect, with 90% of the items almost perfect. The percentage of agreement ranged from 8.6% to 98.1%. For the analyzed questions, the area on the ROC curve was 0.9412 (confidence interval [CI] 95%; [0.8259, 1.000]). The BR-CDC-CCI had sufficient validity and reliability for its use in the evaluation of educational/informational materials in health in the Brazilian context. In view of the good results from this psychometric assessment, we anticipated the BR-CDC-CCI could contribute to improvements in Brazilian professionals' skills in developing health communication materials, thereby improving the quality of education and, possibly health outcomes. [HLRP: Health Literacy Research and Practice. 2022;6(2):e84–e87.]
{"title":"Some Psychometric Properties of the Brazilian CDC Clear Communication Index","authors":"Angélica Maria Cupertino Lopes Marinho, C. Baur, Lucas Emanuel Oliveira Costa, J. Mambrini, F. Ferreira, A. Borges-Oliveira, M. D. de Abreu","doi":"10.3928/24748307-20220315-01","DOIUrl":"https://doi.org/10.3928/24748307-20220315-01","url":null,"abstract":"The Centers for Disease Control and Prevention (CDC) Clear Communication Index (CCI) was cross-culturally adapted to Brazilian Portuguese (BR). It was necessary to analyze the reliability and validity of the BR-CDC-CCI for its use in Brazil. This study aimed to evaluate the psychometric properties of the instrument in its Brazilian version. Four specialists in health education used the BR-CDC-CCI to evaluate a population-level health education material. Primary health care professionals (n = 105) evaluated the same health material using the BRCDC-CCI, and 30 professionals performed the retest 15 to 20 days after the first assessment. Cohen Kappa and area under the receiver operating characteristic (ROC) curve analyses were developed. Inter-rater agreement ranged from moderate to almost perfect, with 90% of the items almost perfect. The percentage of agreement ranged from 8.6% to 98.1%. For the analyzed questions, the area on the ROC curve was 0.9412 (confidence interval [CI] 95%; [0.8259, 1.000]). The BR-CDC-CCI had sufficient validity and reliability for its use in the evaluation of educational/informational materials in health in the Brazilian context. In view of the good results from this psychometric assessment, we anticipated the BR-CDC-CCI could contribute to improvements in Brazilian professionals' skills in developing health communication materials, thereby improving the quality of education and, possibly health outcomes. [HLRP: Health Literacy Research and Practice. 2022;6(2):e84–e87.]","PeriodicalId":36651,"journal":{"name":"Health literacy research and practice","volume":"13 1","pages":"e84 - e87"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74303865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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