scholarly journals Positive Outcomes of a Comprehensive Health Literacy Communication Training for Health Professionals in Three European Countries: A Multi-centre Pre-post Intervention Study

2019 ◽  
Vol 16 (20) ◽  
pp. 3923 ◽  
Author(s):  
Marise S. Kaper ◽  
Andrea F. de Winter ◽  
Roberta Bevilacqua ◽  
Cinzia Giammarchi ◽  
Anne McCusker ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Literacy ◽  
Health Professionals ◽  
Intervention Study ◽  
Self Management ◽  
Shared Decision ◽  
Post Intervention ◽  
Self Rated Health ◽  
Comprehensive Health

Many professionals have limited knowledge of how to address health literacy; they need a wider range of health literacy competencies to enhance empowerment and person-centred prevention. We evaluated whether: (1) a comprehensive health literacy training increased self-rated competencies of health professionals to address health literacy related problems and support the development of people’s autonomy and self-management abilities after training and 6–12 weeks later, (2) professionals were satisfied with the training, (3) outcomes differed for the three participating European countries. Health professionals (N = 106) participated in a multicentre pre-post intervention study in Italy, the Netherlands and Northern Ireland. The 8-hour training-intervention involved health literacy knowledge, the practice of comprehensible communication skills, shared decision-making, and enhancing self-management. Self-rated health literacy competencies and training satisfaction were assessed at baseline, immediately after training and 6-12 weeks later, and analysed by multi-level analysis. Professionals’ self-rated health literacy competencies significantly improved following training in all three countries; this increase persisted at 6-12 weeks follow-up. The strongest increase regarded professional’s skills to enhance shared-decision making and enabling self-management after training and follow-up respectively. Professionals perceived the training as relevant for practice. Competency increases seemed to be consistent across countries. In three countries, professionals’ self-rated health literacy competencies increased following this comprehensive training. These promising findings should be confirmed in a further full effect study. Implementation of this training in European education and health care may improve person-centred communication by professionals and might help to tackle health literacy related problems and to strengthen people’s abilities in achieving better health outcomes.

Interactive Media for Diabetes Self-Management: Issues in Maximizing Public Health Impact

2010 ◽  
Vol 30 (6) ◽  
pp. 745-758 ◽  
Author(s):  
Russell E. Glasgow
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Interactive Media ◽  
Health Impact ◽  
Self Management ◽  
Public Health Impact ◽  
Shared Decision

Background . Diabetes self-management presents a series of challenging tasks, and primary care, where the majority of cases of adult diabetes are treated, is hard-pressed to address these issues given competing demands. This article discusses how interactive media (IM) can be used to support diabetes self-management. Methods . Following a brief review of the literature, the 5 As framework for enhancing the effectiveness of health behavior counseling and the RE-AIM model for estimating and enhancing public health impact are used to frame discussion of the strengths and limitations of IM for diabetes shared decision making and self-management support. Results . Data and lessons learned from a series of randomized trials of IM for diabetes self-management education are summarized around 2 key issues. The first is enhancing patient engagement in decision making and includes enhancing user experience and engagement, improving quality of care, and promoting collaborative action planning and follow-up. The second is getting such resources into place and sustaining them in real-world primary care settings and involves enhancing participation at patient, clinician, and health care system levels and enhancing the generalizability of results. Conclusions . Key opportunities for IM to support diabetes self-management include assessment of information for shared decision making, assistance with problem-solving self-management challenges, and provision of follow-up support. A key current challenge is the linkage of IM supports to the rest of the patient’s care, and collection of cost-effectiveness data is a key need for future research.

scholarly journals Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: results of the randomized trial AEQUALIS

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sergi Blancafort Alias ◽  
Rosa Monteserín Nadal ◽  
Irene Moral ◽  
Marta Roqué Fígols ◽  
Xavier Rojano i Luque ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Health Literacy ◽  
Primary Outcome ◽  
Perceived Health ◽  
Self Management ◽  
Analog Scale ◽  
Post Intervention ◽  
Community Assets

Abstract Background Evidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality. Methods Pragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015 and 2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention. Results 390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (− 0.62 [− 1.10, − 0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (− 1.26 [− 1.90, − 0.63]), and at follow-up (− 0.95 [− 1.62, − 0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG. Conclusions This study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas. Trial registration ClinicalTrials.gov, NCT02733523. Registered 11 April 2016 - Retrospectively registered

scholarly journals Promoting Social Capital, Self-management and Health Literacy in Older Adults Through a Group-based Intervention Delivered in Low-income Urban Areas: Results of the Randomized Trial AEQUALIS

2020 ◽  
Author(s):  
Sergi Blancafort ◽  
Rosa Monteserín Nadal ◽  
Irene Moral ◽  
Marta Roqué Fígols ◽  
Xavier Rojano i Luque ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Health Literacy ◽  
Primary Outcome ◽  
Perceived Health ◽  
Self Management ◽  
Analog Scale ◽  
Post Intervention ◽  
Community Assets

Abstract BackgroundEvidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality. MethodsPragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015-2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention. Results390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (-0.62 [-1.10, -0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (-1.26 [-1.90, -0.63]), and at follow-up (-0.95 [-1.62, -0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG. ConclusionsThis study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas.Trial registration: ClinicalTrials.gov, NCT02733523. Registered 11 April 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02733523

scholarly journals The content and conduct of GP consultations for dermatology problems: a cross-sectional study

2020 ◽  
Vol 70 (699) ◽  
pp. e723-e730
Author(s):  
Emma Le Roux ◽  
Peter J Edwards ◽  
Emily Sanderson ◽  
Rebecca K Barnes ◽  
Matthew J Ridd
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Patient Involvement ◽  
Cross Sectional Study ◽  
Self Management ◽  
Shared Decision ◽  
Cross Sectional ◽  
Management Advice

BackgroundSkin complaints are common in primary care, and poor outcomes in long-term conditions are often due to low adherence to treatment. Shared decision making and self-management support may help, yet there is little understanding of patient involvement or the support provided by GPs.AimTo describe the content of primary care consultations for skin problems, including shared decision making practice, delivery of self-management advice, and follow-up.Design and settingCross-sectional study of video-recorded UK adult GP consultations and linked data.MethodA coding tool was developed and applied to all consultations with skin problems. Shared decision making was assessed using the observer OPTION5 scale.ResultsA total of 45/318 consultations (14.2%) related to one or more skin problems, which were discussed alongside other problems in 71.1% (32/45) of consultations. Of the 100 different problems discussed in these consultations, 51 were dermatological. The mean amount of time spent on skin problems in the consultations was 4 minutes 16 seconds. Medication was recommended for 66.7% (34/51) of skin problems, with low shared decision making (mean OPTION5 score = 10.7). Self-management advice (verbal only) was given for 47.1% (24/51) of skin problems. Most skin problems (84.3%; 43/51) were not referred to secondary care; 32.6% (14/43) of the skin problems not referred were seen again in primary care within 12 weeks, of which 35.7% (5/14) follow-up appointments were not planned.ConclusionIn this study, skin problems were usually presented alongside other complaints and resulted in a medication recommendation. Shared decision making was uncommon and self-management advice not consistently given, with re-attendance for the same problem common. GPs’ training should reflect how frequently skin problems are seen and seek to improve patient involvement in decision making and support self-management.

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