Does Lower Level of Education and Health Literacy Affect Successful Outcomes in Bariatric Surgery?

A national sample of noninstitutionalized adult Americans is used to test two hypotheses and their relation to fear of death, The first hypothesis, referred to as the high risk hypothesis (i.e., groups with higher mortality rates will express more fear of death than groups with lower rates of mortality), is rejected. The second hypothesis, referred to as the social loss hypothesis, is developed and tested across six status categories—race, sex, age, religion, level of education, and health status. Zero order differences did appear for sex and race, however, these differences were eliminated with the introduction of controls. Both hypotheses are rejected.

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Preoperative bariatric surgery programme barriers facing Pacific patients in Auckland, New Zealand as perceived by health sector professionals: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2019-029525 ◽

2019 ◽

Vol 9 (11) ◽

pp. e029525

Author(s):

Tamasin Taylor ◽

Wendy Wrapson ◽

Ofa Dewes ◽

Nalei Taufa ◽

Richard J Siegert

Keyword(s):

Bariatric Surgery ◽

New Zealand ◽

Health Literacy ◽

Health Professionals ◽

Health Sector ◽

Publicly Funded ◽

Attrition Rates ◽

Pacific Health ◽

Emotional Safety ◽

Minority Ethnic

Minority ethnic patient groups typically have the highest bariatric surgery preoperative attrition rates and lowest surgery utilisation worldwide. Eligible patients of Pacific Island ethnicity (Pacific patients) in New Zealand (NZ) follow this wider trend.ObjectivesThe present study explored structural barriers contributing to Pacific patients’ disproportionately high preoperative attrition rates from publicly-funded bariatric surgery in Auckland, NZ.SettingPublicly-funded bariatric surgery programmes based in the wider Auckland area, NZ.DesignSemi-structured interviews with health sector professionals (n=21) were conducted.Data were analysed using an inductive thematic approach.ResultsTwo primary themes were identified: (1) Confidence negotiating the medical system, which included Emotional safety in clinical settings and Relating to non-Pacific health professionals and (2) Appropriate support to achieve preoperative goals, which included Cultural considerations, Practical support and Relating health information. Clinical environments and an under-representation of Pacific staff were considered to be barriers to developing emotional safety, trust and acceptance of the surgery process with patients and their families. Additionally, economic deprivation and lower health literacy impacted preoperative goals.ConclusionsHealth professionals’ accounts indicated that Pacific patients face substantial levels of disconnection in bariatric surgery programmes. Increasing representation of Pacific ethnicity by employing more Pacific health professionals in bariatric teams and finding novel solutions to implement preoperative programme components have the potential to reduce this disconnect. Addressing cultural competency of staff, increasing consultancy times and working in community settings may enable staff to better support Pacific patients and their families. Programme structures could be more accommodating to practical barriers of attending appointments, managing patients’ preoperative health goals and improving patients’ health literacy. Given that Pacific populations, and other patients from minority ethnic backgrounds living globally, also face high rates of obesity and barriers accessing bariatric surgery, our findings are likely to have broader applicability.

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MIECZYSŁAW BIERNACKI – DOCTOR, FREEMASON, SOCIAL ACTIVIST

Wiadomości Lekarskie ◽

10.36740/wlek202008131 ◽

2020 ◽

Vol 73 (8) ◽

pp. 1756-1760

Author(s):

Waldemar Gniadek

Keyword(s):

Local Government ◽

Infectious Diseases ◽

Social Economic ◽

Doctor Who ◽

Political Organizations ◽

Social Activist ◽

Level Of Education ◽

Education And Health ◽

Political Activist ◽

Managerial Positions

The article presents the life and work of dr. Mieczysław Biernacki, a Polish doctor of medicine, freemason, social, economic and political activist unknown to the younger generation of Polish doctors, who was born in 1862, Throughout his life, he actively worked to raise the level of education and health of Lublin’s inhabitants. He held managerial positions in numerous associations, economic institutions, local government and political organizations. Above all, he was a doctor who effectively fought against infectious diseases, venereal diseases and tuberculosis. As an editor and publicist, he took the floor by writing on medical, economic and literary subjects. He died in 1948, at the age of eighty-eight.

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Advancing Health Literacy Among Hispanic Immigrants: The Intersection Between Education and Health

Health Promotion Practice ◽

10.1177/1524839918761865 ◽

2018 ◽

Vol 20 (2) ◽

pp. 251-257

Author(s):

Francisco Soto Mas ◽

Holly E. Jacobson

Keyword(s):

Health Literacy ◽

Minority Groups ◽

Hospital Admissions ◽

Spanish Speakers ◽

Hispanic Immigrants ◽

Education And Health ◽

Low Health Literacy ◽

Health Literacy Level ◽

Language Minorities ◽

Fundamental Research

Health literacy is a priority issue in both medicine and public health, as it refers to the capacity to obtain and understand basic health information and services and to make appropriate health decisions. Health literacy has been associated with a variety of health care and health outcomes such as hospital admissions, use of preventive services, management of chronic conditions, and mortality. There is also evidence of the connection between low health literacy and health disparities. Despite federal and private efforts, improving health literacy has proven to be an enormous challenge. The negative health consequences of low health literacy are being experienced by most minority groups; however, health literacy is particularly relevant to Spanish speakers. Although disparities in health literacy among language minorities have been sufficiently identified and reported, there continue to exist fundamental research gaps. This article discusses health literacy research and practice gaps affecting Spanish speakers and recommends educational opportunities as an effective strategy for improving the health literacy level of Hispanic immigrants.

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The impact of self-efficacy and health literacy on outcome after bariatric surgery in Sweden: a protocol for a prospective, longitudinal mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2018-027272 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027272 ◽

Cited By ~ 1

Author(s):

Maria Jaensson ◽

Karuna Dahlberg ◽

Ulrica Nilsson ◽

Erik Stenberg

Keyword(s):

Bariatric Surgery ◽

Mixed Methods ◽

Health Literacy ◽

Qualitative Study ◽

Self Efficacy ◽

Mixed Methods Study ◽

Inclusion Criteria ◽

Study Results ◽

Prospective Longitudinal ◽

The Impact

IntroductionA person-centred approach, to know about a person’s individual weaknesses and strengths, is warranted in today’s healthcare in Sweden. When a person suffers from obesity, there are not only risks for comorbidities but also increased risk for decreased health-related quality of life (HRQoL). After bariatric surgery, there are also risks for complications; however, healthcare service expects the person to have sufficient ability to handle recovery after surgery. The need is to investigate how a person’s self-efficacy and health literacy(HL) skills are important to determine their effect on recovery as well as HRQoL after bariatric surgery. It can, involve the person in the care, improve shared decision-making, and perhaps decrease complications and readmissions.Method and analysisThis is a prospective, longitudinal mixed-methods study with the intent of including 700 patients from three bariatric centres in Sweden (phase 1); 20 patients will be included in a qualitative study (phase 2). Inclusion criteria will be age >17 years, scheduled primary bariatric surgery and ability to read and understand the Swedish language in speech and in writing. Inclusion criteria for the qualitative study will be patients who reported a low self-efficacy, with a selection to ensure maximum variation regarding age and gender. Before bariatric surgery patients will answer a questionnaire including 20 items. Valid and reliable instruments will be used to investigate general self-efficacy (10 items) and functional and communicative and critical HL (10 items). This data collection will then be merged with data from the Scandinavian Obesity Surgery Registry. Analysis will be performed 30 days, 1 year and 2 years after bariatric surgery. One year after bariatric surgery the qualitative study will be performed. The main outcomes are the impact of a person’s self-efficacy and HL on recovery after bariatric surgery.Ethics and disseminationThe study has received approval from the ethical review board in Uppsala, Sweden (number 2018/256). The study results will be disseminated through peer-reviewed publications and conference presentations to the scientific community and social media.

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EDUCATION, LITERACY, NUMERACY AND HEALTH INFORMATION SEEKING IN LATER LIFE

Innovation in Aging ◽

10.1093/geroni/igz038.1174 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S322-S322

Author(s):

Takashi Yamashita ◽

Anthony R Bardo ◽

Roberto J Millar ◽

Shalini Sahoo ◽

Phyllis Cummins ◽

...

Keyword(s):

Health Status ◽

Health Literacy ◽

Health Information ◽

Information Seeking ◽

Information Sources ◽

Later Life ◽

Health Information Seeking ◽

Education And Health ◽

Nationally Representative ◽

Information Seeking Behaviors

Abstract Health information plays a critical role for health promotion and maintenance in later life. While health information seeking is primarily driven by need (e.g., health), significantly less is known about the roles of education and health-literacy. Thus, we examine complex pathways that link health information seeking behaviors with education and health literacy (decomposed into general literacy and numeracy), and how these pathways differ by health status among a nationally representative sample of Americans age 50 and older (n = 2,750). Data come from the 2012/2014 Program for International Assessment of Adult Competencies. Multi-group structural equation models were used to examine the use of eight health information sources (newspapers, magazines, internet, radio, TV, books, friends/family, and health professionals) by health status (good vs. poor). Findings showed that literacy and numeracy are significant mediators of the relationship between education and health professional as an information source. Additionally, the mediation effects on health professionals by literacy status [indirect-effect (good vs. poor health) = 0.48 vs. 2.13, p < 0.05] and numeracy [indirect-effect (good vs. poor health) = -0.47 vs. -1.81, p < 0.05] were significantly moderated by health. At the same time, no moderated mediation effect was observed in the use of any other information sources. This study provides some of the first nationally representative evidence regarding how education functions through health literacy components to shape health information seeking behaviors by health status. Explanations and implications for differing effects of education, literacy, and numeracy on health information seeking in later life were evaluated.

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Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17062082 ◽

2020 ◽

Vol 17 (6) ◽

pp. 2082 ◽

Cited By ~ 1

Author(s):

Ana Cristina Cabellos-García ◽

Enrique Castro-Sánchez ◽

Antonio Martínez-Sabater ◽

Miguel Ángel Díaz-Herrera ◽

Ana Ocaña-Ortiz ◽

...

Keyword(s):

Cardiovascular Disease ◽

Health Literacy ◽

Social Determinants ◽

Cardiovascular Health ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Structural Determinants ◽

Cross Sectional ◽

Level Of Education ◽

Individual Level

Background: Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease. Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. The Health Literacy Questionnaire was used. Results: 252 patients. Age was significantly related with the ability to participate with healthcare providers (p = 0.043), ability to find information (p = 0.022), and understanding information correctly to know what to do (p = 0.046). Level of education was significant for all HL dimensions. Patients without studies scored lower in all dimensions. The low- versus middle-class social relationship showed significant results in all dimensions. Conclusions: In patients with cardiovascular disease, level of education and social class were social determinants associated with HL scores. Whilst interventions at individual level might address some HL deficits, inequities in access to cardiovascular care and health outcomes would remain unjustly balanced unless structural determinants of HL are taken into account.

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