Solidarity Economy and Ecologically Based Agriculture: An action plan for the development of educational materials

BACKGROUND Limited English proficiency (LEP) is an important driver of health disparities. Many successful patient-level interventions to prevent chronic disease progression and complications have used automated telephone self-management support, which relies on patient activation and communication to achieve improved health outcomes. It is not clear whether these interventions are similarly applicable to patients with LEP compared to patients with English proficiency. OBJECTIVE The objectives of this study were as follows: (1) To examine the impact of LEP on patient engagement (primary outcome) with a 12-month language-concordant self-management program that included automated telephone self-management support, designed for patients with chronic kidney disease (CKD). (2) To assess the impact of LEP on change in systolic blood pressure (SBP) and albuminuria (secondary outcomes) resulting from the self-management program. METHODS This was a secondary analysis of the Kidney Awareness Registry and Education (KARE) pilot trial (NCT01530958) which was funded by the National Institutes of Health in August 2011, approved by the University of California Institutional Review Board in October 2011 (No. 11-07399), and executed between 2013 and 2015. Multivariable logistic and linear models were used to examine various facets of patient engagement with the CKD self-management support program by LEP status. Patient engagement was defined by patient’s use of educational materials, completion of a health coaching action plan, and degree of participation with automated telephone self-management support. Changes in SBP and albuminuria at 12 months by LEP status were determined using multivariable linear mixed models. RESULTS Of 137 study participants, 53 (38.7%) reported LEP, of which 45 (85%) were Spanish speaking and 8 (15%) Cantonese speaking. While patients with LEP and English proficiency similarly used the program’s educational materials (85% [17/20] vs 88% [30/34], P=.69) and completed an action plan (81% [22/27] vs 74% [35/47], P=.49), those with LEP engaged more with the automated telephone self-management support component. Average call completion was 66% among patients with LEP compared with 57% among those with English proficiency; patients with LEP requested more health coach telephone calls (P=.08) and had a significantly longer average automated call duration (3.3 [SD 1.4] min vs 2.2 [1.1 min], P<.001), indicating higher patient engagement. Patients with LEP randomized to self-management support had a larger, though nonstatistically significant (P=.74), change in SBP (–4.5 mmHg; 95% CI –9.4 to 0.3) and albuminuria (–72.4 mg/dL; 95% CI –208.9 to 64.1) compared with patients with English proficiency randomized to self-management support (–2.1 mmHg; 95% CI –8.6 to 4.3 and –11.1 mg/dL; 95% CI –166.9 to 144.7). CONCLUSIONS Patients with LEP with CKD were equally or more engaged with a language-concordant, culturally appropriate telehealth intervention compared with their English-speaking counterparts. Augmented telehealth may be useful in mitigating communication barriers among patients with LEP. CLINICALTRIAL ClinicalTrials.gov NCT01530958; https://clinicaltrials.gov/ct2/show/NCT01530958

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Strategies to promote public engagement around deprescribing

Therapeutic Advances in Drug Safety ◽

10.1177/2042098618794165 ◽

2018 ◽

Vol 9 (11) ◽

pp. 653-665 ◽

Cited By ~ 3

Author(s):

Justin P. Turner ◽

Janet Currie ◽

Johanna Trimble ◽

Cara Tannenbaum

Keyword(s):

Public Awareness ◽

Action Plan ◽

Inappropriate Medication ◽

Community Dwelling ◽

Educational Materials ◽

The Public ◽

Needs Assessments ◽

Inappropriate Medication Use ◽

Included Patient ◽

Patient Advocates

Many seniors remain unaware that certain medications may be harmful, despite high rates of polypharmacy and inappropriate medication use among community-dwelling older adults. Patient education is an effective method for reducing the use of inappropriate medications. Increasing public awareness and engagement is essential for promoting shared decision-making to deprescribe. The Canadian Deprescribing Network was created to address the lack of a systematic pan-Canadian initiative to implement deprescribing among older Canadians. The Canadian Deprescribing Network deliberately included patient advocates in its organization from the outset, in order to ensure a key strategic focus on public awareness and education. In this paper, we present the processes and activities rolled out by the Canadian Deprescribing Network as a blueprint model for engaging the public on deprescribing. Embedded within the structure of the network, the subcommittee on public awareness and engagement implements an action plan that includes needs assessments, population surveys, focus groups, deprescribing fairs, national stakeholders’ meetings, public lectures and monthly exchanges with community champions and seniors’ organizations. Educational materials and online media have been developed based on the answers to the questions: what information do seniors need about deprescribing? who should this information be delivered to? who needs to deliver the message? and how should seniors be engaged in deprescribing? In conjunction with seniors’ organizations, members of the Network have iteratively refined key deprescribing messages, disseminated information about deprescribing, engaged the press and created a grass roots-driven public awareness and education campaign across Canada. Over 3000 seniors and seniors’ organizations are involved, with over 25,000 educational tools being distributed across the country.

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Analyzing the Potential Benefit of Microcomputer Use for Teaching Figurative Language

American Journal of Speech-Language Pathology ◽

10.1044/1058-0360.0102.36 ◽

1992 ◽

Vol 1 (2) ◽

pp. 36-43 ◽

Cited By ~ 5

Author(s):

Marilyn A. Nippold ◽

Ilsa E. Schwarz ◽

Molly Lewis

Keyword(s):

Language Learning ◽

Children And Adolescents ◽

Standardized Tests ◽

Figurative Language ◽

Language Intervention ◽

School Age Children ◽

Educational Materials ◽

Language Learning Disabilities ◽

Promising Application ◽

Experience Difficulty

Microcomputers offer the potential for increasing the effectiveness of language intervention for school-age children and adolescents who have language-learning disabilities. One promising application is in the treatment of students who experience difficulty comprehending figurative expressions, an aspect of language that occurs frequently in both spoken and written contexts. Although software is available to teach figurative language to children and adolescents, it is our feeling that improvements are needed in the existing programs. Software should be reviewed carefully before it is used with students, just as standardized tests and other clinical and educational materials are routinely scrutinized before use. In this article, four microcomputer programs are described and evaluated. Suggestions are then offered for the development of new types of software to teach figurative language.

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