scholarly journals An Integrated Framework to Conceptualize and Develop the Vancouver Airways Health Literacy Tool (VAHLT)

2021 ◽  
Vol 18 (16) ◽  
pp. 8646
Author(s):  
Iraj Poureslami ◽  
Jacek Kopec ◽  
Noah Tregobov ◽  
Jessica Shum ◽  
Rick Sawatzky ◽  
...  
Keyword(s):  
Health Literacy ◽  
Airway Disease ◽  
Functional Health ◽  
Self Management ◽  
Measurement Tool ◽  
Key Informants ◽  
Key Stakeholders ◽  
Chronic Airway Disease ◽  
Literacy Tool ◽  
Improve Patient

There is currently no comprehensive tool to assess the functional health literacy (HL) skills of chronic airway disease (CAD) patients. The purpose of this article is to describe the development of a new HL measure, the Vancouver Airways Health Literacy Tool (VAHLT). The tool was developed through the following phases: (1) Tool conceptualization, consisting of: (A) a systematic review (SR), (B) focus group sessions with CAD patients to understand barriers and facilitators to CAD management, (C) a survey with key-informants to obtain strategies to mitigate self-management barriers and validate patient-derived topics, and (D) respiratory physicians’ review of the topics; (2) Scenario and item development; and (3) Tool testing and content validation. The SR identified the lack of a valid HL measurement tool for CAD patients. Patients provided an initial shortlist of disease-related self-care topics. Key-informants helped to finalize topics for inclusion. Respiratory physicians and patients contributed to the development of a scenario-based questionnaire, which was refined during three rounds of testing to develop a 44-item instrument comprising nine self-management passages. We highlight the holistic process of integrating information from the literature with knowledge gained from key stakeholders into our tool framework. Our approach to stakeholder engagement may be of interest to researchers developing similar tools, and could facilitate the development and testing of HL-based interventions to ultimately improve patient outcomes and reduce the burden on the healthcare system.

scholarly journals A conceptual model of functional health literacy to improve chronic airway disease outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iraj Poureslami ◽  
Noah Tregobov ◽  
Jessica Shum ◽  
Austin McMillan ◽  
Alizeh Akhtar ◽  
...  
Keyword(s):  
Health Literacy ◽  
Disease Management ◽  
Health Outcomes ◽  
Health System ◽  
Conceptual Model ◽  
Management Practices ◽  
Airway Disease ◽  
Self Management ◽  
Chronic Airway Disease ◽  
Socio Demographic Factors

Abstract Background Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework. Methods Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist’s on the ideal functional HL skills for asthma and COPD patients. Results Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT, including application of the obtained information; OUTCOME, covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. Conclusions We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. Trial registration NCT01474928- Date of registration: 11/26/2017.

scholarly journals A conceptual model of functional health literacy to improve chronic airway disease outcomes

2020 ◽  
Author(s):  
Iraj Poureslami ◽  
Noah Tregobov ◽  
Jessica Shum ◽  
Austin McMillan ◽  
Alizeh Akhtar ◽  
...  
Keyword(s):  
Health Literacy ◽  
Disease Management ◽  
Health Outcomes ◽  
Health System ◽  
Conceptual Model ◽  
Management Practices ◽  
Airway Disease ◽  
Self Management ◽  
Chronic Airway Disease ◽  
Socio Demographic Factors

Abstract Background: Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework.Methods: Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist’s on the ideal functional HL skills for asthma and COPD patients.Results: Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT, including application of the obtained information; OUTCOME, covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. Conclusions: We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. Trial Registration Number: NCT01474928- Date of registration: 11/26/2017

scholarly journals Effects of an eHealth Intervention on Patient-Provider Interaction and Functional Health Literacy in Adults With Hypertension

2021 ◽  
Vol 7 ◽  
pp. 237796082110058
Author(s):  
Ronald L. Hickman ◽  
John M. Clochesy ◽  
Marym Alaamri
Keyword(s):  
Health Literacy ◽  
Community Dwelling ◽  
Attention Control ◽  
Functional Health ◽  
Self Management ◽  
Functional Health Literacy ◽  
Convenience Sample ◽  
Management Interventions ◽  
Modifiable Factors

Introduction Hypertension is a life-limiting, chronic condition affecting millions of Americans. Modifiable factors, quality of the patient-provider interaction and functional health literacy, have been linked to effective hypertension self-management. However, there has been limited interventional research targeting these modifiable factors. Electronic hypertension self-management interventions, in particular those incorporating virtual simulation, may positively influence the quality of the patient-provider interaction and functional health literacy status of adults with hypertension. Yet there is a dearth of evidence examining the efficacy of eHealth interventions targeting these modifiable factors of hypertension self-management. Objective Evaluate the effects of two electronic hypertension self-management interventions on the quality of the patient-provider interaction and functional health literacy in adults with hypertension. Methods A convenience sample of community-dwelling adults (>18 years) with hypertension were recruited and randomized to an avatar-based simulation (eSMART-HTN) or a video presentation on hypertension self-management (attention control). Participants were administered questionnaires to capture demographic characteristics, the quality of the patient-provider interaction, and functional health literacy. Questionnaire data were collected at baseline, and then monthly across three months. Two separate repeated measures analysis of covariance models were conducted to assess the effects of the interventions across the time points. Results The sample included 109 participants who were predominately middle-aged and older, nonwhite, and female. Scores for the quality of the patient-provider interaction demonstrated significant within-group changes across time. However, there were no significant differences in the quality of the patient-provider interaction or functional health literacy scores between experimental conditions while adjusting for covariates. Conclusion An avatar-based simulation (eSMART-HTN) intervention proved to have a positive effect on patient-provider interaction compared to an attention control condition. Although the results are promising, future research is needed to optimize the effectiveness of eSMART-HTN and enhance its efficacy and scalability in a larger cohort of adults with hypertension.

Defining Taiwanese children’s health literacy abilities from a health promotion perspective

2016 ◽  
Vol 24 (4) ◽  
pp. 69-80 ◽  
Author(s):  
Li-Ling Liao ◽  
Chieh-Hsing Liu ◽  
Chi-Chia Cheng ◽  
Tzu-Chau Chang
Keyword(s):  
Health Promotion ◽  
Health Literacy ◽  
Health Education ◽  
Life Experiences ◽  
Real Life ◽  
Operational Definition ◽  
Children's Health ◽  
Functional Health ◽  
Children’S Health ◽  
Measurement Tool

Background: Health literacy is related to health inequality, health behaviors, and health status. Globally, health literacy has primarily focused on adults and has been based on the medical model. It is necessary to understand children’s life experiences as they relate to health; thus, this study attempted to evaluate and describe the health literacy abilities of sixth-graders in Taiwan. Methods: Interviews were conducted with 10 teachers and 11 caregivers, and focus groups were conducted with 32 children. Health literacy abilities corresponding to real-life situations were identified from life skills and the Taiwanese Curriculum Guidelines for health education. Three expert meetings were held to redefine children’s health literacy using a health promotion perspective and confirmed indicators. Results: An operational definition of three aspects of children’s health literacy and 25 abilities was proposed: 11 functional health literacy abilities (e.g. understands the connection between personal health care behaviors and health); seven interactive health literacy abilities (e.g. obtains and understands information from various channels); and seven critical health literacy abilities (e.g. analyzes the relationship between personal needs and diet choices for a balanced diet). These indicators cover 10 health education categories. Conclusions: These findings highlight the importance of understanding Taiwanese children’s health literacy, and the urgency of developing an appropriate measurement tool. The definition and indicators in this study were identified using a child-centered approach focusing on children’s real-life experiences. The result serves as a solid basis for the development of the Taiwan Children’s Health Literacy Scale, and provides information for the decision-making sector on health education.

scholarly journals Does Health Literacy Reinforce Disease Knowledge Gain? A Prospective Observational Study of Hungarian COPD Patients

2021 ◽  
Vol 10 (17) ◽  
pp. 3990
Author(s):  
Orsolya Papp-Zipernovszky ◽  
Márta Csabai ◽  
Peter J. Schulz ◽  
János T. Varga
Keyword(s):  
Health Status ◽  
Health Literacy ◽  
Functional Health ◽  
Self Management ◽  
Knowledge Gain ◽  
Subjective Health Status ◽  
Disease Knowledge ◽  
Objective Health ◽  
Copd Patients ◽  
The Relationship

We set out to measure the health literacy (HL) of COPD patients using the Short Test of Functional Health Literacy (S-TOFHLA), perception-based screening questions (BHLS), and a specific disease knowledge test (COPD-Q). Our main focus is the relationship between functional HL and patients’ disease-knowledge, which contributes to the clarification of the relationship between the different kinds of HL. In two prospective observational studies, 151 COPD patients (80 males, mean age: 62 ± 9 years) completed a questionnaire containing HL measurements, psychological tests (e.g., the Self-Control and Self-Management Scale), and questions regarding subjective health status. Medical data of the patients from the MedSole system were added. The HL scores of the COPD patients were compared to a representative sample using a t-test. Furthermore, correlations of HL with demographic, psychological, and medical variables were calculated within the patient group. The relations among the different HL measurements were tested by chi-square trials. COPD patients had significantly lower HL, as measured by S-TOFHLA. Younger and higher educated patients possessed higher S-TOFHLA scores. Unlike the demographic variables, general self-management showed significant correlations with both BHLS and with COPD-Q. Out of the medical variables, objective health status was associated with BHLS and COPD-Q. Neither BHLS nor S-TOFHLA had a correlation with COPD-Q, but they correlated with each other. We found S-TOFHLA to be a better tool in the medical context. There is a clear gap between self-perceived/functional HL and the necessary disease knowledge. Rehabilitation care for patients with lower HL was more advantageous.

Acceptance of illness mediate the effects of health literacy on self-management behaviour

2019 ◽  
Vol 19 (5) ◽  
pp. 411-420 ◽  
Author(s):  
Chen Qiu ◽  
Xiaonan Zhang ◽  
Xiaoying Zang ◽  
Yue Zhao
Keyword(s):  
Health Literacy ◽  
Pressure Control ◽  
Functional Health ◽  
Self Management ◽  
Cross Sectional ◽  
Pharmacological Management ◽  
Mediation Effects ◽  
Critical Health Literacy ◽  
Management Behaviour ◽  
Acceptance Of Illness

Background: Self-management is crucial for blood pressure control and subsequent disease prevention. Health literacy and acceptance of illness may contribute to self-management behaviour; in addition, acceptance of illness may mediate the effects of health literacy on self-management behaviour among patients with hypertension. Objective: The aims of the research were to examine whether health literacy and acceptance of illness were associated with both pharmacological and non-pharmacological management behaviour and examine the possible mediating effects of the acceptance of illness in patients with hypertension. Methods: Hierarchical regression analysis was conducted to analyse the relationships between health literacy, acceptance of illness, pharmacological and non-pharmacological management behaviours. Mediation effects were examined by the PROCESS macro. Results: This was a cross-sectional study. A total of 478 hypertensive patients completed measures of health literacy, acceptance of illness, self-management, social support, depression, physical function and demographic and clinical characteristics. Functional, communicative, critical health literacy and acceptance of illness showed positive associations to pharmacological and non-pharmacological management behaviour. Acceptance of illness mediated the relationships between three types of health literacy, pharmacological and non-pharmacological management but the effects size and pathway differed. In detail, functional health literacy influenced pharmacological and non-pharmacological management behaviour mainly by indirect effects mediated by the acceptance of illness, but communicative and critical health literacy influenced pharmacological and non-pharmacological management behaviour mainly by direct effects. Conclusions: Acceptance of illness mediated the relationships between three types of health literacy and self-management. Health literacy and acceptance of illness should be addressed when taking measures to improve patients’ self-management behaviour.

scholarly journals Cognitive impairment no dementia and associations with health literacy, self-management skills, and functional health status

2020 ◽  
Vol 103 (9) ◽  
pp. 1805-1811 ◽  
Author(s):  
Rebecca M. Lovett ◽  
Laura M. Curtis ◽  
Stephen D. Persell ◽  
James W. Griffith ◽  
Derin Cobia ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Health Status ◽  
Health Literacy ◽  
Functional Health ◽  
Self Management ◽  
Functional Health Status ◽  
Management Skills ◽  
Cognitive Impairment No Dementia

Social inequalities in the self-management of type 1 diabetes: A serial multiple mediation analysis

2021 ◽  
pp. 140349482110418
Author(s):  
Sabina Wagner ◽  
Kasper Olesen
Keyword(s):  
Social Support ◽  
Type 1 Diabetes ◽  
Health Literacy ◽  
Glycaemic Control ◽  
The Self ◽  
Functional Health ◽  
Self Management ◽  
Social Disparities ◽  
Functional Health Literacy

Aims Diabetes requires complex self-management. Due to this complexity, social disparities exist in the self-management of type 1 diabetes. Various pathways to describe associations between socio-economic factors and health outcomes have been suggested. We sought to elucidate the potential of health literacy and social support to reduce social disparities in diabetes self-management. Methods Questionnaire responses were linked to data from electronic medical records, yielding a study population of 1186 people with type 1 diabetes. Mediation analyses using adjusted linear regressions were used to establish pathways between self-reported educational attainment, social support, functional health literacy and clinically obtained measures of glycaemic control. Results We found evidence of an association between education and glycated haemoglobin, partially mediated by functional health literacy and social support. However, the direct association between social support and glycaemic control was not statistically significant. Conclusions Whilst both functional health literacy and social support play a role in glycaemic control, our findings did not explain the main impact of social disparities on glycaemic control. Interventions to reduce disparities in glycaemic control related to educational attainment should focus beyond functional health literacy and social support.

scholarly journals A Conceptual Model of Functional Health Literacy to Improve Chronic Airway Disease Outcomes

2020 ◽  
Author(s):  
Iraj Poureslami ◽  
J. Mark Fitzgerald ◽  
Noah Tregobov ◽  
Jessica Shum ◽  
Alizeh Akhtar ◽  
...  
Keyword(s):  
Health Literacy ◽  
Disease Management ◽  
Health Outcomes ◽  
Health System ◽  
Conceptual Model ◽  
Patient Population ◽  
Airway Disease ◽  
Population Groups ◽  
Chronic Airway Disease ◽  
Chronic Airway

Abstract Background: Current conceptual models of health literacy (HL) illustrate the link between HL skills and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into a comprehensive framework. This article summarizes the process of developing a Chronic Airway Disease Management and Health Literacy (CADMaHL) conceptual model.Methods: The proposed CADMaHL model is developed within the following six stages: (1) Systematic review of HL measurement tools. (2) Patient-oriented focus group sessions. (3) HL and health professions (key-informants) interviews. (4) Attain perspectives and feedback of respirologists. (5) Develop a HL measurement tool for chronic airway disease (CAD) patients (e.g., asthma and COPD), pilot test, and tool modification. (6) Tool validation with asthma and COPD patients. Results: Throughout the study process, patient population groups, an advisory panel of HL experts, clinician scientists, and researchers reviewed the information acquired. This review process enabled us to organize the CADMaHL model into 6 primary modules, including INPUT, consists of four HL core components (access, understand, communicate, evaluate) and numeracy skill; OUTPUT, includes use/application of the obtained information; OUTCOME, covers patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, comprises HL assessment tools and strategies; IMPACT, includes mediators between HL and health outcomes; and CROSSCUTTING FACTORS, consists of diverse socio-demographics and health-system factors with applicability across the HL domains.Conclusions: We developed and validated the proposed HL tool using the CADMaHL model. We anticipate that the model may inform development of interventions aiming to improve HL and disease management outcomes of CAD patients, by properly identifying and mitigating HL gaps among these patient population groups.

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