Identifying and Assisting Low-Literacy Patients with Medication Use: A Survey of Community Pharmacies

2005 ◽  
Vol 39 (9) ◽  
pp. 1441-1445 ◽  
Author(s):  
Jessica L Praska ◽  
Sunil Kripalani ◽  
Antoinette L Seright ◽  
Terry A Jacobson
Keyword(s):  
Medication Adherence ◽  
Response Rate ◽  
Literacy Skills ◽  
Low Literacy ◽  
Functional Literacy ◽  
Low Health Literacy ◽  
Limited Literacy ◽  
To Receive ◽  
Patient Literacy ◽  
Poor Medication Adherence

BACKGROUND: Nearly one-half of adult Americans have limited functional literacy skills. Low patient literacy is associated with poor medication adherence and health outcomes. However, little is known about how pharmacies address literacy-related needs among patrons. OBJECTIVE: To determine the frequency with which pharmacies identify and provide appropriate assistance to patients with limited literacy skills and provide specific recommendations to help improve pharmacists' recognition of low health literacy, as well as strategies to improve adherence in this population. METHODS: Through a telephone-based survey of Atlanta-area pharmacies, we obtained information on (1%) whether the pharmacy attempted to identify patients with limited literacy skills, (2%) what measures were taken by the pharmacy to optimize the health care of low-literacy patients, especially with regard to medication adherence, and (3%) what services the pharmacy offered to improve adherence in general. RESULTS: The response rate among eligible pharmacies was 96.8% (N = 30%). Only 2 (7%) pharmacies reported attempting to identify literacy-related needs among their patrons. One of these facilities provided additional verbal counseling to assist low-literacy patients, and the other pharmacy involved family members, provided verbal counseling, and had patients repeat instructions to confirm comprehension. Most pharmacies reported availability of adherence aids that could help low-literacy patients if such patients were identified and targeted to receive additional assistance. These included verbal and written counseling (offered at 73% of pharmacies), packaging or organizing aids (27%), refill services (17%), and graphic or multimedia aids (13%). CONCLUSIONS: Pharmacies infrequently attempt to identify and assist patients with limited literacy skills.

scholarly journals Utility of medicines information leaflets in hypertensive care in a setting with low health literacy: A cross-sectional study

2020 ◽  
Vol 4 ◽  
pp. 239920262091003
Author(s):  
Mtungwazi Kudzinesta ◽  
Mwangana Mubita ◽  
Francis Kalemeera ◽  
Brian Godman ◽  
Ester Hango ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Health Literacy ◽  
Health Information ◽  
Short Form ◽  
Literacy Skills ◽  
Public Health Care ◽  
Hypertensive Patients ◽  
Information Leaflets ◽  
Medicines Information ◽  
Low Health Literacy

Introduction: Higher levels of health literacy improve utilization of health information, medication adherence and outcomes. Few studies evaluate the utility of medicines information in hypertensive care in settings with low health literacy. Aim: To determine the level of health literacy and utility of medicines information leaflets (MILs) among hypertensive patients in public health care in Namibia. Methods: A hospital-based survey among hypertensive patients receiving care at a referral hospital in Namibia from the 8 June 2018 to 29 June 2018. Patient’s health literacy and utility of MIL were assessed using three literacy tools and a survey questionnaire. Quantitative data were analysed using descriptive statistics and qualitative thematic content analysis for factors associate with the utility of the MIL. Results: Of the 139 patients, 63% were female and the mean age was 45.7 (range: 19.0–84.0) years. Over 85.6% had of low literacy skills (Rapid Estimate of Literacy in Medicine (REALM) score <44, that is, unable to read simple health materials), 38.8% had positive Single Item Literacy Screener (SILS) scores (⩾2, require help to read medicines information) and 66.9% had inadequate skills for comprehension, appraisal and decision-making with regard to health information (Health Literacy Skills Instrument-Short Form (HLSI-SF) score <70%). The level of access to and utility of MIL were low, 32.4% and 34.6%, respectively. The main factors associated with poor utility of the MIL were low patient health literacy, lack of guidelines on the use of MIL and MIL written in non-native languages. Conclusion: Low rates of health literacy and utility of MIL were observed among hypertensive patients in Namibia. The integration of health literacy programmes, and MIL guidelines are needed to promote utility of medicine information and improve medication adherence.

Development and Psychometric Evaluation of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) in Low-Literacy Patients With Chronic Disease

2007 ◽  
Vol 15 (3) ◽  
pp. 203-219 ◽  
Author(s):  
Jessica Risser ◽  
Terry A. Jacobson ◽  
Sunil Kripalani
Keyword(s):  
Chronic Disease ◽  
Medication Adherence ◽  
Disease Management ◽  
Internal Consistency ◽  
Self Efficacy ◽  
Chronic Disease Management ◽  
Medication Use ◽  
Literacy Skills ◽  
The Self ◽  
Low Literacy

Medication nonadherence remains a significant obstacle to achieving improved health outcomes in patients with chronic disease. Self-efficacy, the confidence in one’s ability to perform a given task such as taking one’s medications, is an important determinant of medication adherence, indicating the need for reliable and valid tools for measuring this construct. This study sought to develop a self-efficacy scale for medication adherence in chronic disease management that can be used in patients with a broad range of literacy skills. The Self-efficacy for Appropriate Medication Use (SEAMS) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. Its psychometric properties were evaluated among 436 patients with coronary heart disease and other comorbid conditions. Reliability was evaluated by measuring internal consistency and test-retest reliability. Principal component factor analysis was performed to evaluate the validity of the SEAMS. Reliability and validity analyses were also performed separately among patients with low and higher literacy levels. The final 13-item scale had good internal consistency reliability (Cronbach’s α = 0.89). A two-factor solution was found, explaining 52.3% of the scale’s variance. The scale performed similarly across literacy levels. The SEAMS is a reliable and valid instrument that may provide a valuable assessment of medication self-efficacy in chronic disease management, and appears appropriate for use in patients with low literacy skills.

scholarly journals Context-Sensitive Ecological Momentary Assessment: Application of User-Centered Design for Improving User Satisfaction and Engagement During Self-Report (Preprint)

2018 ◽  
Author(s):  
Preethi Srinivas ◽  
Kunal Bodke ◽  
Susan Ofner ◽  
NiCole R Keith ◽  
Wanzhu Tu ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Design Research ◽  
Response Rate ◽  
Self Report ◽  
User Engagement ◽  
User Centered Design ◽  
Context Sensitive ◽  
Low Health Literacy ◽  
Auditory Alerts ◽  
To Receive

BACKGROUND Ecological momentary assessment (EMA) can be a useful tool for collecting real-time behavioral data in studies of health and health behavior. However, EMA administered through mobile technology can be burdensome, and it tends to suffer from suboptimal user engagement, particularly in low health-literacy populations. OBJECTIVE This study aimed to report a case study involving the design and evaluation of a mobile EMA tool that supports context-sensitive EMA-reporting of location and social situations accompanying eating and sedentary behavior. METHODS An iterative, user-centered design process with obese, middle-aged women seeking care in a safety-net health system was used to identify the preferred format of self-report measures and the look, feel, and interaction of the mobile EMA tool. A single-arm feasibility field trial with 21 participants receiving 12 prompts each day for momentary self-reports over a 4-week period (336 total prompts per participant) was used to determine user satisfaction with interface quality and user engagement, operationalized as response rate. A second trial among 38 different participants randomized to receive or not to receive a feature designed to improve engagement was conducted. RESULTS The feasibility trial results showed high interface satisfaction and engagement, with an average response rate of 50% over 4 weeks. Qualitative feedback pointed to the need for auditory alerts. We settled on 3 alerts at 10-min intervals to accompany each EMA-reporting prompt. The second trial testing this feature showed a statistically significant increase in the response rate between participants randomized to receive repeat auditory alerts versus those who were not (60% vs 40%). CONCLUSIONS This paper reviews the design research and a set of design constraints that may be considered in the creation of mobile EMA interfaces personalized to users’ preferences. Novel aspects of the study include the involvement of low health-literacy adults in design research, the capture of data on time, place, and social context of eating and sedentary behavior, and reporting prompts tailored to an individual’s location and schedule. CLINICALTRIAL ClinicalTrials.gov NCT03083964; https://clinicaltrials.gov/ct2/show/NCT03083964

scholarly journals Equity and inclusivity in research: co-creation of a digital platform with representatives of marginalized populations to enhance the involvement in research of people with limited literacy skills

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Christine Loignon ◽  
Sophie Dupéré ◽  
Caroline Leblanc ◽  
Karoline Truchon ◽  
Amélie Bouchard ◽  
...  
Keyword(s):  
Health Research ◽  
Academic Research ◽  
Literacy Skills ◽  
Structural Barriers ◽  
Community Members ◽  
Low Literacy ◽  
Major Barrier ◽  
Equity In Health ◽  
Digital Platform ◽  
Limited Literacy

AbstractTo improve health equity, as well as equity in research, community-engaged research and participatory research needs to be inclusive. Equity in health research refers to the principle that anyone affected by research or who can benefit from its outcomes should have equal opportunities to contribute to it. Many researchers advocate the importance of promoting equity in research and engage in processes that foster the research involvement of lay persons, patients, and community members who are otherwise “absent” or “silent”. Still, people with limited literacy skills who experience unwarranted structural barriers to healthcare access have little involvement in research. Low literacy is a major barrier to equity in health research. Yet there exist approaches and methods that promote the engagement in research of people with literacy challenges. Building on our previous research projects conducted with community members using participatory visual and sound methods (participatory mapping, photovoice, digital storytelling, etc.), we embarked on the co-creation of a digital platform in 2017. Our aim in this commentary is to report on this co-creation experience that was based on a social justice-oriented partnership. The development of the online platform was overseen by a steering committee made up of workers from community organizations involved with people with limited literacy skills, students, and researchers. In the development process, the co-creation steps included a literature review, informal interviews with key informants, and discussion and writing sessions about format and content. After numerous challenges raised and addressed during co-creation, the Engage digital platform for engagement in research went live in the winter of 2020. This platform presents, on an equal footing, approaches and methods from academic research as well as from the literacy education community engaged with people with limited literacy skills.

Quality Improvement Pilot Study of the Living Your Best Weight Program: A Health at Every Size Approach

2020 ◽  
Vol 81 (2) ◽  
pp. 91-93
Author(s):  
Anna Angelinas ◽  
Roseann Nasser ◽  
Amanda Geradts ◽  
Justine Herle ◽  
Kristen Schott ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pilot Study ◽  
Response Rate ◽  
Participant Satisfaction ◽  
Health At Every Size ◽  
Outpatient Program ◽  
To Receive

Purpose: Living Your Best Weight (LYBW) is an outpatient program based on Health at Every Size (HAES) principles for adults interested in managing their weight. The purpose of this pilot study was to determine perceptions of participants and their satisfaction with the LYBW program. Methods: A survey was developed to determine participant satisfaction of the LYBW program. Fifty-six participants who completed the LYBW program from June 2017 to February 2018 were contacted via telephone and invited to participate in the study. Forty-five participants agreed to receive the survey by mail or email. Results: Thirty-four participants completed the survey for a response rate of 61%. The average age of respondents was 52 years. Seventy-nine percent of respondents agreed that the program helped them to focus on health instead of weight. Eighty-two percent agreed that the program helped them respond to internal cues of hunger and fullness, and 94% were satisfied with the program. Conclusion: Participants reported that they were satisfied with the LYBW program and perceived improvements in their health. Future programming may benefit from using a HAES-based approach with adults.

Coding Is Lit: Integrating Coding and Literacy in Early Childhood Inclusive Settings

2021 ◽  
pp. 004005992110101
Author(s):  
Nicole S. Fenty ◽  
Abby Pierce ◽  
Julia Schildwachter
Keyword(s):  
Early Childhood ◽  
Critical Thinking ◽  
Young Children ◽  
21St Century ◽  
Grade Level ◽  
Literacy Skills ◽  
Inclusive Settings ◽  
Hands On ◽  
Common Grade ◽  
To Receive

There has been an increased emphasis in recent years on supporting young children with building 21st century literacy skills such as critical thinking and collaboration. Unfortunately, young children with or at risk for disabilities are unlikely to receive access to experiences that build 21st century literacies. Pre-coding activities, which include hands-on coding games and stories appropriate for young children, are one way to provide access to this population of students. The purpose of this article is to provide details about how educators in early childhood inclusive settings may integrate pre-coding activities with everyday routines and procedures as well as with common grade level appropriate read alouds. Fundamentals of pre-coding are provided along with guidelines for planning and instruction.

scholarly journals Disaster Literacy

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 694-694
Author(s):  
Lisa Brown ◽  
Lindsay Peterson
Keyword(s):  
Older Adults ◽  
Health Literacy ◽  
Disaster Preparedness ◽  
Research Data ◽  
Literacy Skills ◽  
Public Health Issue ◽  
Low Literacy ◽  
Social Marketing Campaign ◽  
Life Saving ◽  
Response And Recovery

Abstract People who plan ahead typically fare better during the response and recovery phases of a disaster. However, problems arise when the needs, wants, abilities, and resources of vulnerable people are not adequately considered. The lack of alignment between the literacy demands of existing materials and the literacy skills of many vulnerable subgroups limits their ability to understand and effectively use potentially life-saving information. Existing health literacy models that have demonstrated effectiveness in changing health behaviors and improving outcomes is a first step to reducing disaster-related morbidity and mortality in low resource and low literacy areas. This presentation will 1) describe how interdisciplinary collaborations can be used to address this public health issue, 2) explain how health literacy techniques can be applied when developing disaster materials, and 3) present research data on a social marketing campaign to improved disaster preparedness of older adults. Part of a symposium sponsored by Disasters and Older Adults Interest Group.

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