Evaluation of a mammography decision aid for women 75 and older at risk for lower health literacy in a pretest-posttest trial

2021 ◽  
Author(s):  
Tamara Cadet ◽  
Gianna Aliberti ◽  
Maria Karamourtopoulos ◽  
Alicia Jacobson ◽  
Elizabeth A. Gilliam ◽  
...  
Keyword(s):  
At Risk ◽  
Health Literacy ◽  
Decision Aid ◽  
Lower Health ◽  
Lower Health Literacy

Drug Use and Life Chaos as Potential Factors Contributing to HIV Viral Load among People with Lower Health Literacy

2021 ◽  
Vol 56 (5) ◽  
pp. 606-614
Author(s):  
Seth C. Kalichman ◽  
Moira O. Kalichman ◽  
Ellen Banas ◽  
Marnie Hill ◽  
Harold Katner
Keyword(s):  
Viral Load ◽  
Health Literacy ◽  
Drug Use ◽  
Hiv Viral Load ◽  
Lower Health ◽  
Potential Factors ◽  
Lower Health Literacy

scholarly journals Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

2015 ◽  
Vol 23 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Lyndsay A Nelson ◽  
Shelagh A Mulvaney ◽  
Tebeb Gebretsadik ◽  
Yun-Xian Ho ◽  
Kevin B Johnson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
Health Literacy ◽  
Low Income ◽  
Mhealth Intervention ◽  
Lower Health ◽  
The Relationship ◽  
Lower Health Literacy

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Materials and Methods Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants’ baseline characteristics and the probability of engaging with texts and calls. Results On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age ( Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Conclusions Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement.

scholarly journals Citizen Responses to Government Restrictions in Switzerland During the COVID-19 Pandemic: Cross-Sectional Survey

10.2196/20871 ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. e20871 ◽  
Author(s):  
Kevin Selby ◽  
Marie-Anne Durand ◽  
Alexandre Gouveia ◽  
Francesca Bosisio ◽  
Gaia Barazzetti ◽  
...  
Keyword(s):  
Health Literacy ◽  
Sex Education ◽  
Mitigation Measures ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Literacy Knowledge ◽  
Lower Health ◽  
The Government ◽  
Lower Health Literacy

Background The success of government-recommended mitigation measures during the COVID-19 pandemic depends largely on information uptake and implementation by individual citizens. Objective Our aim was to assess citizens’ knowledge and perceptions about COVID-19 recommendations in the Canton of Vaud, Switzerland. Methods A cross-sectional electronic survey with open and closed questions was disseminated by community-based partners prior to the relaxation of government restrictions. Outcomes included citizen knowledge (9-question measure) and worry about the virus, perception of government measures, and recommendations for improvements. Comparisons used linear regression, controlling for age, sex, education, and health literacy. Free-text answers were analyzed thematically. Results Of 807 people who accessed the survey, 684 (85%) completed all questions and 479 (60%) gave free-text recommendations. Overall, 75% were female, the mean age was 48 years, and 93% had high health literacy. Knowledge scores were high, with a median score of 8 out of 9. Mean levels of worry about the COVID-19 pandemic were higher in women than men (55/100 versus 44/100, P<.001), and in respondents with lower health literacy (57/100 versus 52/100, P=.03). Self-reported adherence to recommendations was high (85%) and increased with age and worry (both P<.001). Respondents rated their own adherence higher than others (85% versus 61%, P<.001). Moreover, 34% of respondents reported having self-quarantined; this rose to 52% for those aged ≥75 years. Those who had self-quarantined reported higher levels of fear. Nearly half (49%) of respondents felt the government response had been adequate, though younger age and higher levels of worry were associated with considering the response to be insufficient (both P<.001). Analysis of open-text answers revealed 4 major themes: access to and use of masks, gloves, and hand sanitizer; government messaging; lockdown and lockdown exit plan communication; and testing for COVID-19. Conclusions Knowledge, adherence, and satisfaction regarding government recommendations and response were high in this sample, but many desired greater access to personal protective equipment. Those with lower health literacy and those who have been in self-isolation reported greater concerns about the pandemic.

scholarly journals Online decision aids for primary cardiovascular disease prevention: systematic search, evaluation of quality and suitability for low health literacy patients

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025173 ◽  
Author(s):  
Carissa Bonner ◽  
Pinika Patel ◽  
Michael Anthony Fajardo ◽  
Ruixuan Zhuang ◽  
Lyndal Trevena
Keyword(s):  
Cardiovascular Disease ◽  
Decision Making ◽  
Health Literacy ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Low Health Literacy ◽  
Lower Health ◽  
Cvd Prevention ◽  
Lower Health Literacy

ObjectivesRecent 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.DesignSystematic 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 measuresUnderstandability 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.ResultsA 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).ConclusionsPublicly 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.

scholarly journals Disparities in COVID-19 related knowledge, attitudes, beliefs and behaviours by health literacy

2020 ◽  
Author(s):  
KJ McCaffery ◽  
RH Dodd ◽  
E Cvejic ◽  
J Ayre ◽  
C Batcup ◽  
...  
Keyword(s):  
Health Literacy ◽  
Social Inequalities ◽  
Severe Disease ◽  
Social Inequalities In Health ◽  
Cross Sectional ◽  
Adequate Health Literacy ◽  
Health Advice ◽  
Lower Health ◽  
Socio Demographic Factors ◽  
Lower Health Literacy

ABSTRACTObjectivesTo explore the variation in understanding, attitudes and uptake of COVID-19 health advice during the 2020 pandemic lockdown by health literacy.Study designNational cross sectional community survey.SettingAustralian general public.ParticipantsAdults aged over 18 years (n = 4362).Main outcome measuresKnowledge, attitudes and behaviours related to COVID-19; health literacy and socio-demographic factors.ResultsPeople with inadequate health literacy had poorer understanding of COVID-19 symptoms (49% vs 68%; p<0.001), were less able to identify behaviours to prevent infection (59% vs 72%; p<0.001), and experienced more difficulty finding information and understanding government messaging about COVID-19 than people with adequate health literacy. They were less likely to rate social distancing as important (6.1 vs 6.5, p<0.001) and reported more difficulty remembering/accessing medication since lockdown (3.6 vs 2.7, p<0.001). Importantly there was higher endorsement of misinformation beliefs related to COVID-19 and vaccination in people with lower health literacy. Similar results were observed among people who primarily speak a language other than English at home.ConclusionOur findings show important disparities by health literacy and language in COVID-19 related knowledge, attitudes and behaviours that have the potential to undermine efforts to reduce viral transmission and may lead to social inequalities in health outcomes in Australia. Those with the greatest burden of chronic disease are most disadvantaged, and most likely to experience severe disease and die from COVID-19. Addressing the health literacy needs of the community in public health messaging about COVID-19 must now be a priority in Australia.

scholarly journals Citizen Responses to Government Restrictions in Switzerland During the COVID-19 Pandemic: Cross-Sectional Survey (Preprint)

2020 ◽  
Author(s):  
Kevin Selby ◽  
Marie-Anne Durand ◽  
Alexandre Gouveia ◽  
Francesca Bosisio ◽  
Gaia Barazzetti ◽  
...  
Keyword(s):  
Health Literacy ◽  
Sex Education ◽  
Mitigation Measures ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Literacy Knowledge ◽  
Lower Health ◽  
The Government ◽  
Lower Health Literacy

BACKGROUND The success of government-recommended mitigation measures during the COVID-19 pandemic depends largely on information uptake and implementation by individual citizens. OBJECTIVE Our aim was to assess citizens’ knowledge and perceptions about COVID-19 recommendations in the Canton of Vaud, Switzerland. METHODS A cross-sectional electronic survey with open and closed questions was disseminated by community-based partners prior to the relaxation of government restrictions. Outcomes included citizen knowledge (9-question measure) and worry about the virus, perception of government measures, and recommendations for improvements. Comparisons used linear regression, controlling for age, sex, education, and health literacy. Free-text answers were analyzed thematically. RESULTS Of 807 people who accessed the survey, 684 (85%) completed all questions and 479 (60%) gave free-text recommendations. Overall, 75% were female, the mean age was 48 years, and 93% had high health literacy. Knowledge scores were high, with a median score of 8 out of 9. Mean levels of worry about the COVID-19 pandemic were higher in women than men (55/100 versus 44/100, <i>P</i>&lt;.001), and in respondents with lower health literacy (57/100 versus 52/100, <i>P</i>=.03). Self-reported adherence to recommendations was high (85%) and increased with age and worry (both <i>P</i>&lt;.001). Respondents rated their own adherence higher than others (85% versus 61%, <i>P</i>&lt;.001). Moreover, 34% of respondents reported having self-quarantined; this rose to 52% for those aged ≥75 years. Those who had self-quarantined reported higher levels of fear. Nearly half (49%) of respondents felt the government response had been adequate, though younger age and higher levels of worry were associated with considering the response to be insufficient (both <i>P</i>&lt;.001). Analysis of open-text answers revealed 4 major themes: access to and use of masks, gloves, and hand sanitizer; government messaging; lockdown and lockdown exit plan communication; and testing for COVID-19. CONCLUSIONS Knowledge, adherence, and satisfaction regarding government recommendations and response were high in this sample, but many desired greater access to personal protective equipment. Those with lower health literacy and those who have been in self-isolation reported greater concerns about the pandemic.

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