Exploring Canadian pharmacy students’ e-health literacy: a mixed methods study

IntroductionHealth literacy research has focused predominantly on the adult population, and much less is understood about this concept from an adolescent perspective. The tools currently available to measure adolescent health literacy have been adapted from adult versions. This limits their applicability to young people because of the developmental characteristics that impact on adolescents’ behaviour, including impulse control and judgement skills. This protocol describes the intended development and validity testing of a questionnaire to measure health literacy in adolescents.Methods and analysisThis protocol describes this mixed methods study that has three phases: the first phase will involve grounded research with adolescents using qualitative group interviews, co-design and concept mapping workshops to understand what health and healthy behaviours mean to adolescents and to explore their health literacy needs and the potential domains for the questionnaire. The draft health literacy domains identified will be presented to the youth advisory panel, and the questionnaire will be altered based on their feedback. Cognitive pretesting of the questionnaire items will also be conducted. Phase 2 will involve piloting the questionnaire to a two-stage random sample of young people in five urban and rural schools in Ireland. Test–retest reliability will be conducted using Pearson correlation coefficient. Confirmatory factor analysis will also be conducted to analyse the psychometric properties of the questionnaire. Phase 3 will involve the questionnaire being rolled out to a nationally representative sample of adolescents (n=6052) in Ireland to assess their levels of health literacy.Ethics and disseminationEthical approval to conduct this study has been granted from the University College Dublin Human Research Ethics Committee – Sciences (LS-20–08). Informed assent from adolescents and informed consent from parents/guardians will be sought. The findings of this research will be disseminated at national and international conferences, as well as through publication in peer-reviewed journals.

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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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Health literacy in pressure injury: Findings from a mixed-methods study of community-based patients and carers

Nursing and Health Sciences ◽

10.1111/nhs.12429 ◽

2018 ◽

Vol 21 (1) ◽

pp. 37-43 ◽

Cited By ~ 3

Author(s):

Lisa A. Durrant ◽

James Taylor ◽

Helen Thompson ◽

Kim Usher ◽

Debra Jackson

Keyword(s):

Mixed Methods ◽

Health Literacy ◽

Mixed Methods Study ◽

Community Based ◽

Pressure Injury

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Health Literacy among Swedish Patients in Opioid Substitution Treatment: A Mixed-Methods Study

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2020.108186 ◽

2020 ◽

Vol 214 ◽

pp. 108186

Author(s):

Disa Dahlman ◽

Malin Ekefäll ◽

Lars Garpenhag

Keyword(s):

Mixed Methods ◽

Health Literacy ◽

Mixed Methods Study ◽

Substitution Treatment ◽

Opioid Substitution Treatment ◽

Opioid Substitution

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Dissonances in communication with sexual health consumers in an inner‐Sydney sexual health clinic in relation to health literacy: A mixed‐methods study

Health Promotion Journal of Australia ◽

10.1002/hpja.429 ◽

2020 ◽

Author(s):

Heather McCormack ◽

Sally Nathan ◽

Rick Varma ◽

Bridget Haire

Keyword(s):

Mixed Methods ◽

Health Literacy ◽

Sexual Health ◽

Mixed Methods Study ◽

Health Clinic ◽

Health Consumers

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Health literacy and health information behavior of Florida public library users: A mixed methods study

Journal of Librarianship and Information Science ◽

10.1177/0961000614531159 ◽

2014 ◽

Vol 47 (1) ◽

pp. 17-29

Author(s):

Yong J. Yi

Keyword(s):

Mixed Methods ◽

Health Literacy ◽

Health Information ◽

Information Behavior ◽

Public Library ◽

Mixed Methods Study ◽

Library Users ◽

Public Library Users

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Deaf Adults’ Health Literacy and Access to Health Information: Protocol for a Multicenter Mixed Methods Study

JMIR Research Protocols ◽

10.2196/14889 ◽

2019 ◽

Vol 8 (10) ◽

pp. e14889 ◽

Cited By ~ 1

Author(s):

Michael M McKee ◽

Peter C Hauser ◽

Sara Champlin ◽

Michael Paasche-Orlow ◽

Kelley Wyse ◽

...

Keyword(s):

Mixed Methods ◽

Health Literacy ◽

Data Collection ◽

Health Information ◽

Visual Learning ◽

Mixed Methods Study ◽

Web Based ◽

Literacy Interventions ◽

Limited Health Literacy ◽

Limited Health

Background Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population. Objective This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions. Methods This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants’ ownership and use of computer and mobile devices and their level of Web-based information use, including health information. Results Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals. Conclusions The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills. International Registered Report Identifier (IRRID) PRR1-10.2196/14889

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Reduced Hospitalizations, Emergency Room Visits, and Costs Associated with a Web-Based Health Literacy, Aligned-Incentive Intervention: Mixed Methods Study (Preprint)

10.2196/preprints.14772 ◽

2019 ◽

Author(s):

Jeffrey C Greene ◽

Jolie N Haun ◽

Dustin D French ◽

Susan L Chambers ◽

Robert H Roswell

Keyword(s):

Mixed Methods ◽

Health Literacy ◽

Emergency Room ◽

Health Information ◽

Program Implementation ◽

Perceived Value ◽

Mixed Methods Study ◽

Health Improvement ◽

Emergency Room Visits ◽

Web Based

BACKGROUND The association between health literacy and health care costs, particularly for hospitalizations and emergency room services, has been previously observed. Health information interventions aimed at addressing the negative impacts of inadequate health literacy are needed. The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is a Web-based system designed to improve health and lower costs by aligning patient-doctor incentives. OBJECTIVE In this mixed methods study of a Web-based patient-doctor aligned-incentive, information therapy program conducted in an 1800-member employee health plan, we aimed to (1) determine the program’s quantitative impact on hospitalization and emergency room utilization and costs, and (2) assess survey responses about the program’s perceived value. METHODS We used a mixed methods, single within-group, pre-post, descriptive study design. We analyzed quantitative data using pre-post mean utilization and cost differences and summarized the data using descriptive statistics. We used open-ended electronic survey items to collect descriptive data and analyzed them using thematic content analysis. RESULTS Hospitalizations and emergency room visits per 1000 decreased 32% (26.5/82.4) and 14% (31.3/219.9), respectively, after we implemented the program in 2015-2017, relative to 2013-2014. Correspondingly, the plan’s annual per capita expenditures declined US $675 (95% CI US $470-865), or 10.8% ($675/$6260), after program implementation in 2015-2017 (US $5585 in 2013-2014 dollars), relative to the baseline years of 2013-2014 (US $6260; <italic>P</italic><.05). Qualitative findings suggested that respondents valued the program, benefiting from its educational and motivational aspects to better self-manage their health. CONCLUSIONS Analyses suggested that the reported reductions in hospitalizations, emergency room visits, and costs were associated with the program. Qualitative findings indicated that targeted users perceived value in participating in the MAIT Program. Further research with controls is needed to confirm these outcomes and more completely understand the health improvement and cost-containment capabilities of this Web-based health information, patient-doctor, aligned-incentive program.

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Who is at risk for palliative care misconceptions and how do we address them? A mixed-methods study of metastatic lung cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.67 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 67-67

Author(s):

Laurie McLouth ◽

Jennifer Gabbard ◽

Beverly J Levine ◽

Chandylen L Nightingale ◽

Kate Furgurson ◽

...

Keyword(s):

Lung Cancer ◽

Palliative Care ◽

African American ◽

Mixed Methods ◽

Health Literacy ◽

Cancer Patients ◽

Mixed Methods Study ◽

Lung Cancer Patients ◽

Definition Of ◽

Inadequate Health Literacy

67 Background: A major misperception of palliative care (PC) is that it is only for people who are about to die. We recently identified this misperception as a barrier to PC in metastatic non-small cell lung cancer (mNSCLC) patients, patients who should all receive early PC per guidelines. The goal of this study was to assess patient characteristics associated with misperceptions about PC and to elicit patient perspectives on how to address them. Methods: We conducted a mixed-methods study of mNSCLC patients on immunotherapy or chemo-immunotherapy. A survey assessed sociodemographics, health literacy, and PC misperceptions. Semi-structured interviews queried perceptions of PC, experiences discussing PC with providers, and reactions to our institutional definition of PC. Qualitative data from interviews were analyzed using directed content analysis approach. Results: Sixty patients (Mean age = 63, 40% male; 18% African American, 45% inadequate health literacy) completed the survey. Twelve of the survey participants (Mean age = 65, 50% male, 25% African American, 67% inadequate health literacy; 50% with caregivers participating) also completed a semi-structured interview. Quantitative survey results showed equating PC with death and/or hospice did not differ based on gender, health literacy, rural vs. urban residence, or time since diagnosis (p’s > .05). Qualitative results showed patients and caregivers consistently associated PC with death (e.g., “the next step to the graveyard”) and hospice. Though some patients noted differences between our institution’s definition of PC and their perceptions (e.g., “delivered at any stage”), the definition did not increase interest and sometimes reinforced misperceptions (e.g., “See, that's a death spiral”). To address misconceptions, patients and caregivers suggested distinguishing PC from end of life and hospice, presenting it positively, and discussing it early into treatment. Conclusions: Lung cancer patients may associate PC with death even if they have adequate health literacy. Commonly used definitions of PC may not quell patient fears. PC needs to be presented as a positive service to patients early into treatment.

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