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Xi Y, Zhang W. Moral expression of "experts" and public engagement: Communicating COVID-19 vaccines on Facebook public pages in Chinese. PUBLIC UNDERSTANDING OF SCIENCE (BRISTOL, ENGLAND) 2025; 34:459-478. [PMID: 39861942 DOI: 10.1177/09636625241310147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2025]
Abstract
This research investigates the moral frames employed by diverse Chinese-speaking "experts" on their Facebook public pages in relation to COVID-19 vaccines, leveraging Moral Foundations Theory for analysis. The analysis highlights that experts predominantly employ moral frames emphasizing care and authority in communicating COVID-19 vaccines. However, the moral frames of care, loyalty, and fairness are more effective in garnering public support. The research thus identifies a disparity between the moral rhetoric commonly espoused by different expert groups and the rhetoric that substantively influences public engagement. The implications of diverse experts' moral framing in public health crises are also discussed.
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Affiliation(s)
- Yipeng Xi
- School of Media and Communication, Shanghai Jiao Tong University, China
| | - Weiyu Zhang
- Department of Communications and New Media, National University of Singapore, Singapore
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2
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Ro SS, Saini A, Morrow G, Ketchum D, Kreeger J, Michelfelder E. Utility of serial fetal echocardiograms in detecting in-utero changes for single-ventricle lesions: an 11-year experience. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2025; 65:575-580. [PMID: 40150909 DOI: 10.1002/uog.29206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 12/16/2024] [Accepted: 02/12/2025] [Indexed: 03/29/2025]
Abstract
OBJECTIVE Current guidelines in fetal echocardiography recommend serial evaluation every 4 weeks for single-ventricle lesions. However, there are limited data on the type and frequency of in-utero cardiac changes seen on fetal echocardiograms (FEs) based on the type of single-ventricle lesion. We aimed to evaluate the utility of serial FEs in detecting cardiac changes during gestation and how these changes impact postnatal management. METHODS We performed a retrospective review of all FEs for fetuses diagnosed with a single-ventricle lesion at the Children's Healthcare of Atlanta, between January 2012 and January 2023. All patients included in the study had two or more FEs and were evaluated for in-utero cardiac changes based on eight cardiac categories: atrioventricular (AV) valve regurgitation; systemic ventricular dysfunction; ductus arteriosus flow; atrial-level restriction; umbilical artery Doppler pattern; umbilical vein Doppler pattern; evidence of hydrops; and evidence of arrhythmias. All in-utero cardiac changes were classified into three categories: improving, worsening or critical. Any changes noted on serial FEs that altered the fetal cardiac diagnosis were also recorded. Fisher's exact test was used to determine whether the proportion of fetuses with in-utero cardiac changes differed significantly between different segmental findings and single-ventricle lesion subtype. RESULTS A total of 721 FEs were performed for 248 patients over the 11-year study period. The majority of fetuses had hypoplastic left heart syndrome (HLHS) (63.7%) and most changes were seen in the third trimester (median gestational age, 29.3 (range, 17.4-38.4) weeks). In-utero cardiac changes observed on serial FEs were reported in 38 (15.3%) fetuses, with a total of 42 changes noted throughout the study period. However, only eight (3.2%) fetuses had a critical change that impacted perinatal management. All eight fetuses had HLHS, of which the majority developed hydrops (4/8) or atrial-level restriction (3/8). In addition, there were 34 non-critical changes seen in 30 (12.1%) fetuses, largely in the form of intermittent premature atrial contractions, AV valve regurgitation or ventricular dysfunction. There were 12 (2.5%) follow-up FEs that resulted in a change to the fetal cardiac diagnosis, confirmed by postnatal echocardiography. CONCLUSION In fetuses with single-ventricle lesions, there was a low rate of in-utero cardiac changes that led to alterations in perinatal management. However, fetuses with HLHS were most likely to develop critical changes affecting delivery-room management, often in the form of atrial-level restriction and/or evolving hydrops. It is important to consider these factors when considering the timing of visits for families who face a prenatal diagnosis of a single-ventricle lesion. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S S Ro
- Emory University School of Medicine, Atlanta, GA, USA
| | - A Saini
- Emory University School of Medicine, Atlanta, GA, USA
| | - G Morrow
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - D Ketchum
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - J Kreeger
- Children's Healthcare of Atlanta, Atlanta, GA, USA
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Lungu DA, Røislien J, Smeets I, Wiig S, Brønnick KK. Individual Characteristics in the Comprehension of Pandemic Video Communication: Randomized Controlled Between-Subjects Design. J Med Internet Res 2024; 26:e48882. [PMID: 39631064 DOI: 10.2196/48882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 03/08/2024] [Accepted: 09/27/2024] [Indexed: 12/07/2024] Open
Abstract
BACKGROUND Video played an important role in health communication throughout the COVID-19 pandemic. It was used to communicate pandemic information to the public, with a variety of formats, presenters, and topics. Evidence regarding the effectiveness of video features is available, while how individual characteristics of recipients influence communication comprehension is still limited. OBJECTIVE This study aimed to test 6 individual characteristics and assess their effect on the comprehension of pandemic video communication. METHODS Short health communication videos were presented to a large sample of subjects, receiving questionnaire responses from 1194 participants. Individual characteristics consisted of age, sex, living area, education level, income level, and belief in science. Communication comprehension consisted of both perceived and objective comprehension. The data were analyzed by multiple linear regression. RESULTS Age had a negative effect on both perceived and objective comprehension-age was negatively associated with comprehension. There were sex differences, with higher perceived comprehension and lower objective comprehension among female than male individuals. Living in an urban or a rural area had no significant effect (all P>.05). The level of education and income had a positive effect on both subjective and objective comprehension. Finally, the belief in science had a positive effect on perceived comprehension (P<.001) but did not have a statistically significant effect on objective comprehension (P=.87). CONCLUSIONS The main differences between those who think they understand pandemic communication and those who comprehend it better are sex (female individuals have a higher perception of having comprehended, while male individuals have higher levels of objective comprehension) and belief in science (higher belief in science leads to higher perceived comprehension, while it does not have any impact on objectively understanding the message conveyed).
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Affiliation(s)
- Daniel Adrian Lungu
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jo Røislien
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ionica Smeets
- Science Communication and Society, Institute of Biology, Leiden University, Leiden, Netherlands
| | - Siri Wiig
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Kallesten Brønnick
- SHARE - Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Hu HT, Jiang YJ, Shao XX, Lu YM, Tian YT, Xu Q. Investigation and analysis of the status of cancer health popularization in China, 2023. World J Clin Oncol 2024; 15:1269-1279. [DOI: 10.5306/wjco.v15.i10.1269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/13/2024] [Accepted: 09/14/2024] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND Cancer presents a significant public health challenge in China, necessitating broad collaboration across society. The Chinese government has articulated a goal to increase the overall five-year survival rate for cancer by 15% by 2030. Achieving this objective requires not only advances in medical technology, but also an improvement in the dissemination of knowledge pertaining to cancer prevention and treatment.
AIM To provide a comprehensive understanding of the status of cancer prevention and level of popularization in China in 2023.
METHODS From January 2023 to May 2023, online questionnaires were distributed to 3000 participants, including medical personnel, patients with cancer, their families, and the general public. There were 2711 valid responses, covering the entire nation.
RESULTS A total of 1020 medical personnel and 1691 patients with cancer, their family members, and the general public participated in the survey. Among medical personnel, 93.2% had popularized cancer health. Commonly addressed topics included cancer prevention (85.9%) and cancer screening (77.8%). Primary challenges included time constraints (73.9%), insufficient personnel and material support (66.7%), and uncertainty as to where to begin (49.3%). Among patients with cancer, their family members, and the general public, 93.4% reported reading or watching cancer science popularization materials and 56.9% expressed a desire for deeper understanding. The most sought-after topics in cancer science popularization included cancer screening (80.2%) and cancer prevention (75.8%). The greatest challenge encountered in accessing cancer health popularization was an abundance of misinformation (67.5%).
CONCLUSION Most clinical doctors, patients, family, and the general public wish to participate in cancer education. However, improvement in the quality of content in cancer prevention and treatment education is required.
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Affiliation(s)
- Hai-Tao Hu
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yu-Juan Jiang
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xin-Xin Shao
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yi-Ming Lu
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yan-Tao Tian
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Quan Xu
- Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Liu O, van Gelderen E, Giwa G, Biswas A, Nair S, Garcia AV, Chidiac C, Rhee DS. A Scoping Review of Limited English Proficiency and Immigration in Pediatric Surgery. J Surg Res 2024; 302:540-554. [PMID: 39178570 DOI: 10.1016/j.jss.2024.07.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/03/2024] [Accepted: 07/19/2024] [Indexed: 08/26/2024]
Abstract
INTRODUCTION With increasing globalization and diversity, the intersection of immigration and language barriers can impact patient outcomes. This scope review aims to summarize current evidence on immigration and language barriers on pediatric surgical outcomes. METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Four databases were searched with Medical Subject Heading terms describing pediatric surgery, immigration, limited English proficiency (LEP), and refugees between 2000-2023. Four independent reviewers screened and analyzed texts for final inclusion. RESULTS Thirty-three studies were included. Ten studies described disease incidence and severity, finding that LEP, immigrant, and refugee patients were more likely to present with severe disease in appendicitis and traumatic injuries. five studies described pain management, finding patients with LEP received fewer pain assessments, waited longer for analgesia, and had more discrepancies in pain scores. Seventeen studies investigated treatment receipt and delay, finding that immigrants and patients with LEP had longer time to and reduced rates of treatment. Seventeen studies described surgical outcomes, finding that patients with LEP have longer length of stay and more postoperative emergency department visits but fewer follow-up appointments. In kidney transplants, patients with LEP and immigrants had worse outcomes, but these trends are not seen in immigrants from Europe. Overall, immigrants and refugees have higher rates of complications and mortality. CONCLUSIONS Immigrants and patients with LEP and are more likely to present with advanced disease and severe injuries, receive inadequate pain management, experience delays in surgery, and suffer more complications. There is continued need to assess the impact of LEP and immigration on pediatric surgery outcomes.
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Affiliation(s)
- Olivia Liu
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Ganiat Giwa
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Arushi Biswas
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Shuait Nair
- Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Alejandro V Garcia
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Charbel Chidiac
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel S Rhee
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Akin Belli A, Omarufilo F, Birnbaum J, Emeasoba EU, Sigal SH. The challenges of integrating an immigrant population with chronic hepatitis B into long-term hepatology care: Lessons learned from a Bronx West African screening program. IJID REGIONS 2024; 12:100385. [PMID: 39070138 PMCID: PMC11278613 DOI: 10.1016/j.ijregi.2024.100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/30/2024]
Abstract
Objectives Hepatitis B virus (HBV) is endemic in West Africa. Because of immigration to the United States, screening and transition to long-term care is a significant public health concern. We describe the challenges of integrating individuals identified in a screening program into long-term care and the spectrum of disease severity. Methods Between 2019 and 2023, 749 individuals were screened. Beginning 2022, all were offered a free serologic evaluation. Details of the previous diagnosis, HBV care, the serologic evaluation, aspartate aminotransferase to platelet ratio index, and Fibrosis index-4 scores were recorded. The results of transient elastography (TE) were correlated with the serologic evaluation. Results A total of 75 (10%) individuals were hepatitis B surface antigen-positive, including 58 (77.3%) previously and 17 (22.7%) newly diagnosed. Despite attempts at linkage to care, only 14 (37.8%) of those diagnosed before the offer continued and/or entered long-term care. A total of 63 of 75 (84%) returned for the evaluation. Among 56 HBV treatment-naïve individuals, 66.1% had a serologic profile consistent with the carrier state. A total of 10 (18.2%) individuals met the criteria for HBV therapy, and 10 (21.7%) had ≥F2 fibrosis on TE. There was no correlation between aspartate aminotransferase to platelet ratio index and Fibrosis index-4 scores and TE. Eight (29.6%) of 27 patients with a profile of the HBV carrier state had ≥F2 fibrosis. Conclusion Integration of individuals with HBV from West Africa identified in a screening program into long-term care is challenging. Inclusion of a serologic evaluation in programs for immigrant communities should be considered. Up to 30% of individuals with a serologic profile consistent with the HBV carrier state may have ≥F2 fibrosis.
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Affiliation(s)
- Asli Akin Belli
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Fatima Omarufilo
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Jessie Birnbaum
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Emmanuel U. Emeasoba
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
| | - Samuel H. Sigal
- Albert Einstein College of Medicine, Montefiore Medical Center, Department of Medicine, Division of Hepatology, New York, USA
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Tore G, Green JG, Noguchi J, Echevarría-Ramos M, Peters JL, Levy JI, Botana Martinez MP, Ceballos DM. Development and evaluation of two educational sessions on take-home lead exposure prevention for construction workers and their families. Ann Work Expo Health 2024; 68:702-712. [PMID: 38843454 DOI: 10.1093/annweh/wxae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 05/15/2024] [Indexed: 08/09/2024] Open
Abstract
Take-home exposures occur when workers accidentally bring workplace contaminants home. Regular job responsibilities may expose construction workers to lead, which extends to their households via the take-home pathway. The present study aimed to develop and evaluate 2 educational sessions addressing take-home lead exposure tailored to construction workers and their families. Educational materials on take-home lead exposure and prevention strategies were designed following guidance from US government institutions and experts on construction work, lead exposure, and educational interventions. The educational materials were pilot-tested with construction workers and their family members during in-person or online sessions in English or Spanish. Changes in knowledge of take-home lead exposure were assessed through pre- and post-testing and open-ended feedback was collected from both participants and session facilitators. The study sample comprised 44 participants, including 33 workers and 11 family members. Among all participants, 81% were male, 46% were Hispanic or Latino, and the average age was 29 years. Post-test scores (µ = 93%, SD = 10%) were higher than pre-test scores (µ = 82%, SD = 19%), and younger participants (<30 years) were more likely to have a lower pre-test score compared to older participants (≥30 years). Overall, feedback from participants and facilitators was positive, indicating appropriate duration, appealing visuals, and ease of engagement through the training activities. Effective public health education for lead-exposed construction workers and their families is needed to reduce lead exposure disparities, especially among children of workers. Interventions must recognize that take-home exposures are not isolated to occupational or home environments.
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Affiliation(s)
- Grant Tore
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jennifer Greif Green
- Wheelock College of Education and Human Development, Boston University, Boston, MA, United States
| | - Julia Noguchi
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, United States
| | | | - Junenette L Peters
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, United States
| | - Jonathan I Levy
- Department of Environmental Health, School of Public Health, Boston University, Boston, MA, United States
| | | | - Diana M Ceballos
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, United States
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Haizel-Cobbina J, Boumi AE, Chung E, Sobboh J, Rose JM, Mwangi E, Johnson R, Oni RB, Wanduragala D, Stauffer Iii WM. Leveraging community advisory boards within travel medicine to help reduce malaria incidence in refugees, immigrants and migrants visiting friends and relatives abroad: reflections from the Minnesota Malaria Community Advisory Board on patient-provider interactions. J Travel Med 2024; 31:taae018. [PMID: 38307519 DOI: 10.1093/jtm/taae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/16/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
Refugees, immigrants and migrants often have barriers to travel medicine. Community Advisory Boards (CAB) are a vital but underutilized tool for understanding and meeting healthcare needs and challenges, providing communities with a voice, and finding solutions. The paper discusses a malaria prevention community-based participatory research project informed by a CAB.
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Affiliation(s)
- Joseline Haizel-Cobbina
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ama Eli Boumi
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
- Minnesota Department of Human Services, St Paul, MN, USA
| | - Erica Chung
- Minnesota Department of Health, St Paul, MN, USA
| | - James Sobboh
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
- Hennepin County Human Services and Public Health Department, Minneapolis, MN, USA
| | - Jonathan M Rose
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
| | - Esther Mwangi
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
| | - Rebecca Johnson
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
- Minnesota Department of Human Services, St Paul, MN, USA
| | - Richard B Oni
- Malaria Community Advisory Board, Minneapolis/Saint Paul, MN 55164, USA
- Progressive Individual Resources Inc, St Paul, MN, USA
| | | | - William M Stauffer Iii
- Department of Medicine, Pediatrics, Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA
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Saleem A, Steadman KJ, La Caze A. Health literacy in Pakistani migrants in Australia-An emerging and neglected culturally and linguistically diverse community. Health Promot J Austr 2024; 35:321-331. [PMID: 37252730 DOI: 10.1002/hpja.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/31/2023] Open
Abstract
ISSUE ADDRESSED Pakistani migrants are one of the fastest-growing culturally and linguistically diverse (CALD) communities in Australia, but there is currently a lack of information regarding their health literacy. This study aimed to investigate the health literacy of Pakistani migrants residing in Australia. METHODS Using a cross-sectional study design, health literacy was measured using the Urdu version of Health Literacy Questionnaire (HLQ). Descriptive statistics and linear regression were used to describe the health literacy profile of respondents and to examine its association with their demographic characteristics. RESULTS The responses of 202 Pakistani migrants were included. The median age of the respondents was 36 years, 61.8% were males and 87.6% had a university education. The majority spoke Urdu at home and almost 80% were Australian permanent residents or citizens. Pakistani respondents scored high on HLQ domains; feeling understood by health providers (Scale 1), social support for health care (Scales 4), engaging with health care providers (Scale 6) and understanding health information (Scale 9). The respondents scored low on HLQ domains; having sufficient information (Scale 2), actively managing health (Scale 3), appraisal of health information (Scale 5), navigating the health care system (Scale 7) and ability to find information (Scale 8). In the regression model, university education and age were significantly associated with health literacy in almost all the domains, but the effect size was small for age. Speaking English at home and being a permanent resident were also associated with better health literacy in two to three HLQ domains. CONCLUSIONS Health literacy strengths and weaknesses of Pakistani migrants residing in Australia were identified. Health care providers and organisations may use these findings to tailor health information and services to better support health literacy in this community. SO WHAT?: This study will inform future interventions to better support health literacy and reduce health disparities in Pakistani migrants residing in Australia.
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Affiliation(s)
- Ahsan Saleem
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
- Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Victoria, Australia
| | - Kathryn J Steadman
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
| | - Adam La Caze
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
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Mandal B, Pradhan KC. A comparative study of health outcomes between elderly Migrant and non-migrant population in India: Exploring health disparities through propensity score matching. SSM Popul Health 2024; 25:101619. [PMID: 38371497 PMCID: PMC10869293 DOI: 10.1016/j.ssmph.2024.101619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/28/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024] Open
Abstract
Migrants constitute a vulnerable segment of the population, particularly susceptible to various health challenges. Despite this, limited research has delved into the comparative health statuses of migrants and non-migrants in the rising elderly population. This study aims to bridge this gap by exploring health disparities between these two groups. Leveraging data from a nationally representative, large-scale Longitudinal Ageing Study in India (LASI) survey (n = 29002; 3103 Migrants and 25899 Non-migrants), this research focuses on four health indicators: self-rated health (SRH), depression, multimorbidity, and functional limitations. The study undertakes descriptive and bivariate analyses for migrant and non-migrant groups and employs propensity score matching techniques to fulfil its objectives. The findings reveal that for respective migrant and non-migrant populations, the prevalence of poor-SRH was 24.04 % and 16.29 %; depression was 12.32 % and 6.62 %; multimorbidity was 26.78 % and 15.71 %, and functional limitation was 28.35 % and 23.13 %. The study uncovers a 2.4 percentage point increase in poor self-rated health, a 1.0 percentage point rise in depression, and notably, a 4.2 and 1.0 percentage point elevation in multimorbidity and functional limitations among migrants relative to non-migrants. Evident from the outcomes is a stark health disparity, emphasising migrants' heightened vulnerability across multiple health dimensions. The implication of this research highlights the necessity for policy interventions aimed at eliminating health inequalities between migrant and non-migrant populations.
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Affiliation(s)
- Bittu Mandal
- School of Humanities and Social Sciences, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore, 453552, India
| | - Kalandi Charan Pradhan
- School of Humanities and Social Sciences, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore, 453552, India
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Abdi N, Flores M, Hara-Hubbard KK, Turner AM, Gudino J, Jafry S, Harris JR, Hannon PA, Baquero B, Meischke H. Bridging Culture and Language: Encouraging Bilingual/Multicultural Individuals to Act as Information Navigators for Their Loved-Ones and Communities during the COVID-19 Pandemic. JOURNAL OF HEALTH COMMUNICATION 2024; 29:34-48. [PMID: 37961888 DOI: 10.1080/10810730.2023.2279670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Linguistically diverse communities face barriers to receiving appropriate health information. COVID-19 exacerbated these health-communication inequities. University of Washington researchers surveyed bilingual staff, students, and medical interpreters - desiring training to become effective communicators of COVID-19 information to their social networks and language communities. In response, the COVID-19 Information Navigator Training was developed and pre-tested with professional networks and members of the target audience. The final training comprised three interactive modules and short quizzes. Evaluation surveys measured Information Navigators' confidence in providing COVID-19 information to their social networks. Surveys included questions on the participants' language or cultural community, the perceived value of the training, and their ability to communicate COVID-19 information. Among 393 participants who enrolled in the training, 284 completed the survey. Significant differences in confidence before and after the course were found in detecting COVID misinformation in the news and social media (pre-course mean: 3.83, post-course mean: 4.63; absolute mean difference was 0.82 points higher in the post-evaluation on the 5-point likert scale, 95% CI: 0.70-0.93, p < .01). Training multicultural volunteers to disseminate information to their social networks is a promising strategy for reaching linguistically diverse communities with up-to-date information during health emergencies.
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Affiliation(s)
- Najma Abdi
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Miriam Flores
- School of Public Health, University of Washington, Seattle, Washington, USA
| | | | - Anne M Turner
- School of Public Health, University of Washington, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Juan Gudino
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Sheharbano Jafry
- College of Arts and Sciences, University of Washington, Seattle, Washington, USA
| | - Jeffrey R Harris
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Peggy A Hannon
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Barbara Baquero
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Hendrika Meischke
- School of Public Health, University of Washington, Seattle, Washington, USA
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Ohayagha C, Perrin PB, Arango-Lasprilla JC, Jones SCT. Influence of Foreign Versus US Nativity on the Trajectory of Functional Independence Over the 10 Years After Traumatic Brain Injury: A Model Systems Study. J Head Trauma Rehabil 2023; 38:E394-E403. [PMID: 36854103 DOI: 10.1097/htr.0000000000000858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Although racial/ethnic disparities have been documented in numerous outcomes after traumatic brain injury (TBI), research has yet to explore differences in rehabilitation outcomes based upon nativity (foreign-born vs US-born individuals). The purpose of this study was to compare the functional outcomes over the first 10 years after TBI for individuals born in the United States with those who were foreign-born. SETTING/PARTICIPANTS A sample of 10 695 individuals in the TBI Model Systems database with a coding for country of birth the United States ( n = 9435) versus other than the United States ( n = 1260) was used. DESIGN/MAIN MEASURES Outcome measures at 1, 2, 5, and 10 years after TBI included the Motor and Cognitive subscales of the Functional Independence Measure and the Supervision Rating Scale. RESULTS Foreign-born individuals exhibited lower motor functional independence trajectories than those born in the United States, even after controlling for demographic and injury-related covariates. However, foreign-born individuals generally showed a stronger upward quadratic trajectory in motor functional independence with the greatest gains between the 5- and 10-year time points, whereas those born in the United States improved more quickly but then plateaued between the 5- and 10-year time points; these differential effects over time dissipated with the addition of demographic and injury-related covariates. Foreign-born individuals also exhibited lower cognitive functional independence trajectories, as well as greater supervision needs trajectories, than those born in the United States, even after controlling for demographic and injury-related covariates. CONCLUSION These findings dovetail with literature suggesting that racially/ethnically diverse groups exhibit reduced functional independence after TBI. The findings may also suggest potential systematic barriers such as healthcare access and language barriers that may influence the frequency, rate, and quality of care received. The results highlight the importance of uncovering cultural distinctions and can aid in facilitating research examining foreign nativity-based disparities following TBI.
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Affiliation(s)
- Chimdindu Ohayagha
- Virginia Commonwealth University, Richmond (Ms Ohayagha and Drs Arango-Lasprilla and Jones); University of Virginia, Charlottesville (Dr Perrin); and Central Virginia Veterans Affairs Health Care System, Richmond (Dr Perrin)
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13
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Stanikić M, Braun J, Ajdacic-Gross V, Manjaly ZM, Yaldizli Ö, Ineichen BV, Kamm CP, Iaquinto S, Gobbi C, Zecca C, Calabrese P, von Wyl V. Self-reports by persons with multiple sclerosis are an adequate surrogate for healthcare provider data on disease-modifying therapy and multiple sclerosis type. Mult Scler Relat Disord 2023; 80:105097. [PMID: 39491413 DOI: 10.1016/j.msard.2023.105097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/29/2023] [Accepted: 10/19/2023] [Indexed: 11/05/2024]
Abstract
INTRODUCTION Self-reports are a valuable and cost-effective method of data collection, though they can be influenced by bias. Limited evidence exists on the quality of self-reports by persons with multiple sclerosis (pwMS), particularly since more potent disease-modifying therapies (DMTs) have been introduced. This study aimed to assess the reliability and validity of self-reported DMT use and multiple sclerosis (MS) type in the Swiss Multiple Sclerosis Registry (SMSR) by comparing self-reports with reimbursement approval requests from the Swiss Association for Joint Tasks of Health Insurers. METHODS The self-reported and reimbursement approval data were linked using privacy-preserving methods based on information available in both databases, i.e., date of birth, canton of residence, sex, and year of MS diagnosis. The SMSR baseline questionnaire data was utilized for the main analysis, while the SMSR follow-up survey data was utilized for the sensitivity analysis. For both analyses, we compared self-reported data with reimbursement approval data that corresponded to the respective periods of the SMSR data collection. Thus, the main analysis included the entirety of the data over the six-year period, while the sensitivity analysis captured a more recent snapshot of the data. To assess reliability, we estimated agreement using Cohen's kappa, and for validity, we estimated accuracy parameters using reimbursement approvals as the reference standard. Univariable and multivariable logistic regression models were employed to investigate factors associated with discordance between self-reports and reimbursement approvals in the main analysis. RESULTS The main analysis included 446 participants, and the sensitivity analysis included 193 participants. The agreement between self-reported and reimbursement approval data for medication use was near-perfect in both analyses (κ = 0.87, 95% confidence interval (CI) 0.85, 0.90 and κ = 0.82, 95% CI 0.76, 0.88). However, the agreement between self-reported and reimbursement approval-documented MS types ranged from fair to moderate (κ = 0.37, 95% CI 0.25, 0.48 to κ = 0.61, 95% CI 0.46, 0.77). The accuracy estimates for self-reported DMT use were generally high (≥ 0.80) with narrow CIs, except for less frequently reported drugs. While the sensitivity and specificity for RRMS were high, there was a notable possibility of false-negative self-reports for RRMS (NPV = 0.33, 95% CI 0.22, 0.45), and false-positive reports for SPMS (PPV = 0.36, 95% CI 0.21, 0.54). Multivariable logistic regression models showed that age (OR = 1.07, 95% CI 1.04, 1.10 per year) and education level (OR = 0.27, 95% CI 0.11, 0.65) were associated with discordance in reported and documented MS types, whereas possession of Swiss citizenship (OR = 0.32, 95% CI 0.14, 0.72) was associated with discordance in DMT use. CONCLUSION Self-reported DMT use in pwMS is a reliable and valid information source, with near-perfect agreement and high accuracy. Self-reported MS types showed fair to moderate agreement and varying accuracy, likely reflecting the complexity of diagnosing progressive forms of MS and access to DMTs. In population-based MS research, self-reports of MS types, and particularly DMT use, can serve as a suitable surrogate for healthcare provider data.
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Affiliation(s)
- Mina Stanikić
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland; Institute for Implementation Science in Health Care, University of Zurich (UZH), Zurich, Switzerland
| | - Julia Braun
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland
| | - Vladeta Ajdacic-Gross
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland
| | - Zina-Mary Manjaly
- Department of Neurology, Schulthess Clinic, Zurich, Switzerland; Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Özgür Yaldizli
- Neurology Clinic and Policlinic, Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland; Translational Imaging in Neurology (ThINK) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | | | - Christian P Kamm
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Neurocentre, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Stefania Iaquinto
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland
| | - Claudio Gobbi
- Department of Neurology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Chiara Zecca
- Department of Neurology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, EOC, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Pasquale Calabrese
- Neuropsychology and Behavioral Neurology Unit, Division of Cognitive and Molecular Neuroscience, University of Basel, Switzerland
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich (UZH), Zurich, Switzerland; Institute for Implementation Science in Health Care, University of Zurich (UZH), Zurich, Switzerland.
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Son H, Han G. Development and evaluation of a tailored mHealth parenting program for multicultural families: a three-arm cluster randomized controlled trial. Front Public Health 2023; 11:1182310. [PMID: 37886055 PMCID: PMC10598694 DOI: 10.3389/fpubh.2023.1182310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023] Open
Abstract
Objective Health management of children during early childhood requires substantial information. Multicultural families find it difficult to obtain and use parenting-relevant information for their young children. This study aimed to develop, implement, and evaluate a tailored Health parenting program and lay-health workers' support to improve children's health in multicultural families in Korea. Methods In this study, we employed the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model as the conceptual framework, guiding the creation of a tailored mHealth application supplemented by a lay-health worker support module. The efficacy of the program was assessed through an experimental three-arm cluster randomized controlled trial. A total of 101 participants were stratified into three distinct groups as follows: (1) Experimental Group A, which received the mHealth program alongside the lay-health worker support component; (2) Experimental Group B, exposed solely to the mHealth program; and (3) Control Group, devoid of any intervention. Within these groups, 101 marriage migrant women hailing from Vietnam, the Philippines, and China were incorporated, with each group comprising 33, 30, and 38 participants, respectively. The study's primary endpoint encompassed a comprehensive assessment of health-promoting behaviors, proficiency in eHealth literacy, and the family strength. Results The analysis revealed noteworthy interactions among the three distinct groups over the course of time, with implications for health-promotion behaviors (p = 0.041), eHealth literacy (p = 0.037), and family strength (p = 0.044). Specifically, the experimental groups exhibited substantially elevated levels of the specified outcome variables when contrasted with the control group. Notably, the positive effects persisted even up to 12 weeks subsequent to the conclusion of the intervention, underscoring the program's capacity to foster enduring improvements in the observed metrics. Conclusion This study highlights the benefits of offering contextually appropriate information to target groups constrained by challenges in information access, evaluation, and utilization. Notably, drawing from their positive experiences in this process, we underscore the importance of employing lay health workers. These workers play a crucial role in fostering and ensuring sustained behavioral changes.
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Affiliation(s)
| | - Gyumin Han
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan-si, Gyeongsangnam-do, Republic of Korea
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Mengesha Z, Weber D, Smith M, Harris P, Haigh F. 'Fragmented care': Asylum seekers' experience of accessing health care in NSW. Health Promot Int 2023; 38:daad123. [PMID: 37864803 DOI: 10.1093/heapro/daad123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023] Open
Abstract
Medicare is central to accessing health care in Australia, yet many asylum seekers are ineligible for this scheme. In NSW, Medicare ineligible asylum seekers have some access to public health care under the Medicare Ineligible Asylum Seekers - Provision of Specified Public Health Services policy. This policy was updated in November 2020 to clarify services where a fee waiver applies for asylum seekers without Medicare. We examined the experiences of Medicare ineligible asylum seekers in accessing health care in New South Wales (NSW) in light of the revised policy. Employing qualitative methods, we conducted semi-structured interviews with asylum seekers (n = 7) and service providers (n = 6) in South Western Sydney. The interviews were analysed using thematic analysis and the socio-ecological model was used to interpret the data. Participants identified that chronic and mental health conditions are the main health issues for asylum seekers. Factors across the four levels of the socio-ecological model were identified as influencing the health care of asylum seekers, including a lack of awareness about health care rights at the individual level, support from relatives and friends at the interpersonal level, providers' lack of awareness of fee waivers at the organizational level and limited access to primary health care at the policy level. The results imply that Medicare ineligible asylum seekers in NSW do not have optimal access to health care which may worsen existing health disparities. Educational initiatives that improve service providers' and asylum seekers' awareness of the revised policy are needed to improve asylum seeker health equity in NSW.
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Affiliation(s)
- Zelalem Mengesha
- Centre for Health Equity Training, Research & Evaluation (CHETRE); UNSW Australia Research Centre for Primary Health Care & Equity; A Unit of Population Health; member of the Ingham Institute, Sydney, NSW, Australia
| | - Danielle Weber
- NSW Refugee Health Service, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Mitchell Smith
- NSW Refugee Health Service, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Patrick Harris
- Centre for Health Equity Training, Research & Evaluation (CHETRE); UNSW Australia Research Centre for Primary Health Care & Equity; A Unit of Population Health; member of the Ingham Institute, Sydney, NSW, Australia
| | - Fiona Haigh
- Health Equity Research Development Unit, UNSW Sydney; A unit of Clinical Services Integration and Population Health, Sydney Local Health District, Sydney, NSW, Australia
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Sepassi A, Garcia S, Tanjasiri S, Lee S, Bounthavong M. Predicted Health Literacy Disparities Between Immigrant and US-Born Racial/Ethnic Minorities: a Nationwide Study. J Gen Intern Med 2023; 38:2364-2373. [PMID: 36849863 PMCID: PMC10406741 DOI: 10.1007/s11606-023-08082-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Racial/ethnic minorities in the USA exhibit reduced health literacy (HL) proficiency, leading to increased health disparities. It is unclear how the effect of birth status (immigrant/US-born) affects HL proficiency among racial/ethnic minorities. OBJECTIVE To identify the direct, indirect, and total effects of birth status on HL proficiency among a nationally representative population of racial/ethnic minority adults in the USA. DESIGN A cross-sectional study of 2019 data from the Medial Expenditure Panel Survey. PARTICIPANTS Participants aged 18 or older reporting as racial/ethnic minorities (Black, Asian, or Hispanic) with non-missing data. MAIN MEASURES We predicted HL proficiency for each participant using a previously published model. Path analysis was used to estimate the direct, indirect, and total effects of birth status on HL proficiency, accounting for several other covariates. Prevalence ratios were estimated using adjusted Poisson regression to evaluate differences in the "Below Basic" HL category. KEY RESULTS An estimated weighted 81,092,505 participants were included (57.5% US-born, 42.5% immigrant). More racial/ethnic minority immigrant participants fell into the lowest category of HL proficiency, "Below Basic" (14.3% vs 5.5%, p < 0.05). Results of the path analysis indicated a significant, negative direct effect of birth status on HL proficiency (standardized coefficient = - 0.24, SE = 0.01, 95%CI: - 0.26, - 0.23) in addition to an indirect effect mediated through insurance status, health-system resource use, and English proficiency. The total effect of birth status on HL proficiency was found to be - 0.29. The immigrant participant group had 81% higher prevalence of falling into the "Below Basic" HL category compared to US-born participants (prevalence ratio = 1.81, 95%CI: 1.52, 2.16). CONCLUSIONS Immigrant status has a strong, negative, direct effect on HL proficiency among racial/ethnic minorities in the USA. This may be a result of barriers that prevent equitable access to resources that improve proper HL proficiency. US policymakers may consider several methods to reduce this disparity at the health-system-, provider-, and patient-levels.
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Affiliation(s)
- Aryana Sepassi
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, 802 W Peltason Dr., Irvine, CA, 92617, USA.
| | - Samantha Garcia
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Keck School of Medicine, Los Angeles, CA, USA
| | - Sora Tanjasiri
- Department of Epidemiology & Biostatistics, Program of Public Health, University of California, Irvine, Irvine, CA, USA
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Mark Bounthavong
- Division of Clinical Pharmacy, Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA, USA
- Department of Veteran Affairs, Health Economic Resource Center, Menlo Park, CA, USA
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17
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Corr M, McKeaveney C, Wurm F, Courtney A, Noble H. Patient education interventions for adolescent and young adult kidney transplant recipients- a scoping review. PLoS One 2023; 18:e0288807. [PMID: 37459325 PMCID: PMC10351733 DOI: 10.1371/journal.pone.0288807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Adolescence and young adulthood are high risk periods for kidney transplant recipients. The reasons for this are complex; but are predominantly thought to be due to poor adherence to immunosuppressive medications. Patient education can help support young recipients to reduce their risk of behaviour-related transplant loss. The aim of this review was to understand what is known about education interventions targeted at adolescent and young adult kidney transplant recipients. METHODS Systematic scoping review methodology was utilised. Six online databases were searched for suitable articles. Articles were selected for full text review following title and abstract screening. Articles deemed eligible to be included in the review had data extracted, which were qualitatively analysed using thematic analysis. Findings were validated through a consultation exercise with both young recipients and healthcare professionals. RESULTS 29 studies were eligible for inclusion in the review. There was a high level of heterogeneity in the content, mode, design, and measurement of efficacy of interventions in the selected studies. Traditional face-to-face education and transition clinics were the most common educational interventions. Using technology to enhance patient education was also a major theme identified. Few studies reported using educational theory or involving patients in intervention design. DISCUSSION Four key research gaps were identified. 1.) Lack of educational theory in intervention design 2.) Lack of patient/ stakeholder involvement 3.) Identifying best way to measure efficacy 4.) identifying novel future research questions within already well established paediatric and educational frameworks. Addressing these gaps in future research will help inform best-practice in this vulnerable population.
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Affiliation(s)
- Michael Corr
- School of Medicine- Queen’s University Belfast, Belfast, Northern Ireland
| | - Clare McKeaveney
- School of Nusring- Queen’s University Belfast, Belfast, Northern Ireland
| | - Fina Wurm
- School of Nusring- Queen’s University Belfast, Belfast, Northern Ireland
| | - Aisling Courtney
- Regional Nephrology & Transplant Unit-Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Helen Noble
- School of Nusring- Queen’s University Belfast, Belfast, Northern Ireland
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18
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Park S, Ahmed R. Communication Dimensions of Healthcare Engagement and Patient Health Literacy for Immigrant Populations: A Systematic Review. HEALTH COMMUNICATION 2023; 38:1359-1372. [PMID: 34894918 DOI: 10.1080/10410236.2021.2010328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Health literacy is an important social determinant of health. Achieving health literacy of immigrants can be critical to empower this disadvantaged population in healthcare communication. However, to achieve this goal, it is a prerequisite to examine the relationship between health literacy and patient engagement in healthcare communication. This systematic review conceptualizes behavioral, emotional, and cognitive dimensions of patient engagement in healthcare communication and examines how health literacy and patient engagement among immigrants shape each other. A systematic review was conducted to identify relevant articles from five databases between 2010 and 2020. The reviewers synthesized findings from 15 articles that met the inclusion criteria. The results indicate that communication researchers should be more attentive to the emotional dimension of patient engagement in healthcare communication and that more empirical studies are needed to evaluate the relationship between health literacy and patient engagement among immigrants. Practical implications and recommendations for future research are discussed.
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Affiliation(s)
- Seulgi Park
- Department of Communication, University at Albany, State University of New York
| | - Rukhsana Ahmed
- Department of Communication, University at Albany, State University of New York
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19
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Kleitman S, Fullerton DJ, Law MKH, Blanchard MD, Campbell R, Tait MA, Schulz J, Lee J, Stankov L, King MT. The Psychology of COVID-19 Booster Hesitancy, Acceptance and Resistance in Australia. Vaccines (Basel) 2023; 11:vaccines11050907. [PMID: 37243011 DOI: 10.3390/vaccines11050907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/21/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19 booster vaccinations have been recommended as a primary line of defence against serious illness and hospitalisation. This study identifies and characterises distinct profiles of attitudes towards vaccination, particularly the willingness to get a booster dose. A sample of 582 adults from Australia completed an online survey capturing COVID-related behaviours, beliefs and attitudes and a range of sociodemographic, psychological, political, social and cultural variables. Latent Profile Analysis (LPA) identified three subgroups: Acceptant (61%), Hesitant (30%) and Resistant (9%). Compared to the Acceptant group, the Hesitant and Resistant groups were less worried about catching COVID-19, used fewer official COVID-19 information sources, checked the news less, were lower on the agreeableness personality dimension and reported more conservatism, persecutory thinking, amoral attitudes and need for chaos. The Hesitant group also reported checking the legitimacy of information sources less, scored lower on the openness to new experiences personality dimension and were more likely than the Resistant and Acceptant groups to report regaining freedoms (e.g., travel) and work requirements or external pressures as reasons to get a booster. The Resistant group were higher on reactance, held more conspiratorial beliefs and rated their culture as being less tolerant of deviance than the Hesitant and Acceptant groups. This research can inform tailored approaches to increasing booster uptake and optimal strategies for public health messaging.
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Affiliation(s)
- Sabina Kleitman
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Dayna J Fullerton
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Marvin K H Law
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Matthew D Blanchard
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Rachel Campbell
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret-Ann Tait
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Jennifer Schulz
- Faculty of Law and Justice, University of New South Wales, Sydney, NSW 2052, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
- School of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand
| | - Jihyun Lee
- School of Education, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, NSW 2052, Australia
| | - Lazar Stankov
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
| | - Madeleine T King
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
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Barello S, Acampora M, Grimaldi L, Maccacaro C, Dell'Acqua S, Spina B, Giangreco D. "Health without Borders": Early Findings and Lessons Learned from a Health Promotion Program for Ethnic Minorities Living in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095646. [PMID: 37174165 PMCID: PMC10178414 DOI: 10.3390/ijerph20095646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
In multicultural contexts, health promotion can be challenging due to people's differences in beliefs, values, and practices regarding health and healthcare. Using the prototypical case scenario offered by the "Health without Borders" program, this study was generally aimed at summarizing the lessons learned and suggesting implications that are hopefully relevant to future culturally competent health promotion programs. This exploratory study used in-depth interviews, focus groups, and document analyses as primary methodological tools to gather data. A qualitative approach was chosen because it has the potential to explore, in depth, the main characteristics (values, operational domains, and action strategies) behind this prototypical case. The study findings suggest that the multicultural health promotion program under study is characterized by four main intertwined core values (i.e., empowerment; peer education; social embeddedness; tailor-made). In turn, these values are expressed in the ten main operational domains (i.e., proactive approach to health promotion; fostering interculturality in health promotion; fostering multidisciplinarity in health promotion; measuring the impact of initiatives; identifying, training, and activating key community members in the role of peer educators; promoting community engagement; fostering a "domino effect"; building institutional links with the organization of the territory; continuous training of the professionals involved in the initiatives; flexibility and a constant focus on projects' continuous redesign) that orient specific strategies of action. This program is based on a tailor-made principle for intervention design and delivery. This feature allows intervention providers to flexibly incorporate the target population's values in delivering health promotion activities. Therefore, the value of this prototypical case lies in the design of "adjustable" initiatives that fit the "program-as-designed" with the cultural characteristics of target populations involved in the intervention.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB-Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Marta Acampora
- EngageMinds HUB-Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Lorenzo Grimaldi
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Cecilia Maccacaro
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Sara Dell'Acqua
- EngageMinds HUB-Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Barbara Spina
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Daniela Giangreco
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
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Kim W, Kim J, Baltimore K, Kim I. Adaptation of the All Aspects of Health Literacy Scale (AAHLS) for Karen refugees: factor analysis. SOCIAL WORK IN HEALTH CARE 2023; 62:143-161. [PMID: 37036027 DOI: 10.1080/00981389.2023.2199795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/18/2023] [Accepted: 04/03/2023] [Indexed: 05/30/2023]
Abstract
Health literacy has been identified as a significant predictor of healthcare utilization among refugee and immigrant communities. Considering its potential impact on their health outcomes, accurately measuring levels of health literacy among limited English proficiency (LEP) populations is an important area of investigation. This study examined the psychometric properties of a modified version of the All Aspects of Health Literacy Scale (AAHLS), based on Nutbeam's model of health literacy, using an exploratory factor (EFA) and confirmatory factor (CFA) analysis among a sample of Karen refugees, an ethnic minority group from Burma. Results of the EFA confirmed a 3-factor model in our sample. CFA results indicated good model fits, demonstrating a promising use of the AAHLS in assessing health literacy among Karen refugees. The findings of this study support the validity of using this measure among this population and suggest some necessary adjustments to incorporate factors unique to the refugee experience that may affect the interpretation and application of items in the AAHLS. Further replication using other LEP samples is necessary to confirm the psychometric properties of the AAHLS and its ability to assess health literacy using Nutbeam's theoretical model of health literacy.
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Affiliation(s)
- Wooksoo Kim
- The Immigrant and Refugee Research Institute, School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Jangmin Kim
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Krisztina Baltimore
- The Immigrant and Refugee Research Institute, School of Social Work, University at Buffalo, Buffalo, New York, USA
| | - Isok Kim
- The Immigrant and Refugee Research Institute, School of Social Work, University at Buffalo, Buffalo, New York, USA
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Zhang L, Chung S, Shi W, Candelaria D, Gallagher R. Online Health Information-Seeking Behaviours and eHealth Literacy among First-Generation Chinese Immigrants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3474. [PMID: 36834164 PMCID: PMC9965195 DOI: 10.3390/ijerph20043474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Due to linguistic and cultural barriers, immigrants often have limited access to health information. Online health information is popular and accessible, but quality is questionable and its benefits dependent on an individual's eHealth literacy. This study examined online health information-seeking behaviours, eHealth literacy and its predictors among first-generation Chinese immigrants. A sample of 356 Chinese immigrants living in Australia completed an anonymous paper-based survey, including sociodemographic, clinical data, English proficiency, health literacy, online health information-seeking behaviours, and eHealth literacy. Linear regression models analyzed predictive factors of eHealth literacy. Participants were aged mean 59.3 years, female (68.3%), 53.1% completed university, and their English proficiency was rated fair/poor by 75.1%. Participants perceived online health information as useful (61.6%) and important (56.2%) to their health. Health information accessed was often related to lifestyle (61.2%), health resources (44.9%), diseases (36.0%), and medications (30.9%). Inadequate health literacy and eHealth literacy occurred in 48.3% and 44.9%, respectively. Age, number of technological devices used, education, and health status were independently associated with eHealth literacy. While most Chinese immigrants used online health information, many had inadequate eHealth literacy. Healthcare authorities and providers should support older immigrants, those with lower education and poorer health, and those less engaged with technology in online health information use by providing culturally and linguistically appropriate information, directing immigrants to credible websites, and involving them in health material development processes.
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Affiliation(s)
- Ling Zhang
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
| | - Sherrie Chung
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Wendan Shi
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
| | - Dion Candelaria
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
| | - Robyn Gallagher
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia
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Jacobsen FF, Glasdam S, Schopman LM, Sodemann M, van den Muijsenbergh ME, Ågotnes G. Migration and health: exploring healthy ageing of immigrants in European societies. Prim Health Care Res Dev 2023; 24:e10. [PMID: 36733211 PMCID: PMC9971849 DOI: 10.1017/s1463423623000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/08/2023] [Indexed: 02/04/2023] Open
Abstract
AIM The aim is to identify important factors for immigrants' health and well-being and for their use (or non-use) of primary health care (PHC) and other non-specialised services, and for possible ways that PHC can support healthy ageing of immigrants. BACKGROUND Older persons are an increasing share of the immigrant population in the global north, frequently in contact with various forms of health services, (PHC services most of all. Consequently, PHC services are in a particularly unique position to support healthy ageing of immigrants. METHODS The position paper builds on five international, multi-professional and cross-disciplinary small group discussions as well as an international workshop early summer. During the discussions and the workshop, topics were arrived at as to factors related to the health situation of older immigrants, their needs, and health-seeking behaviour, and to how PHC professionals could support healthy ageing in immigrants. Those main topics in turn guided search for relevant research literature and informed the selection of the main research questions of this paper. FINDINGS Several factors, in addition to culture and cultural differences, are important to for PHC professionals and decision-makers to take into consideration in encounters with older immigrants. The socio-economic position of the older immigrant and close relatives, inter-generational relationships within the immigrant communities, country-specific factors in the host country like health care expenditure, and communication skills in health professionals are all examples of factors playing an important role regarding the health and health-seeking behaviour of older immigrants.
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Affiliation(s)
- Frode F. Jacobsen
- Centre for Care Research, Western Norway, Western Norway University of Applied Services, P.O.Box 7030, N-5020 Bergen, Norway; VID Specialized University, Ulriksdal 10, N-5009, Bergen, Norway
| | - Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, S- 222 41, Lund, Sweden
| | - Limke M. Schopman
- Self-Employed, Pastoor Havinkstraat 37, 7561 AS, Deurningen, the Netherlands
| | - Morten Sodemann
- The Migrant Health Clinic, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark
| | - Maria E.T.C. van den Muijsenbergh
- GP and Professor of Health Disparities and Personcentred Integrated Primary Care, Radboud University Medical Centre, Nijmegen, the Netherlands; Pharos, National Centre of Expertise on Health Disparities, Utrecht, the Netherlands
| | - Gudmund Ågotnes
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway
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Jumaa JA, Bendau A, Ströhle A, Heinz A, Betzler F, Petzold MB. Psychological distress and anxiety in Arab refugees and migrants during the COVID-19 pandemic in Germany. Transcult Psychiatry 2023; 60:62-73. [PMID: 36154342 PMCID: PMC9510964 DOI: 10.1177/13634615221122536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic is associated with various psychological stressors due to health-related, social, economic, and individual consequences, especially for minority groups such as refugees and other migrants who live in unstable conditions and have lost their social support groups. The aim of this study was to explore the impacts of the COVID-19 pandemic on this specific population in Germany.This study used a mixed-method approach. A total of 85 migrants took part in an online survey in Germany from April to July 2020. The questionnaire included demographic information and measures of psychological distress, anxiety and depressive symptoms, as well as risk and protective factors for psychological health during the COVID-19 pandemic. Semi-structured interviews with 10 refugees were conducted between May and June 2020. In our sample, 54.5% expressed fear of being infected with COVID-19. Participants spent several hours per day thinking about COVID-19 (M = 3.13 hours). Psychological and social determinants of mental health showed stronger associations with anxiety regarding COVID-19 than experiences with the disease. Interviews showed that especially for refugees with limited information regarding access to medical treatment, the pandemic increased already-existing psychological symptoms and worries about their families back home and reminded them of their flight from their home country to Europe. The COVID-19 pandemic is associated with psychological distress, anxiety, and depression in refugees and migrants in Germany. Information on where to get medical treatment, if needed, is of utmost importance to this population group, in addition to other strategies such as maintaining a healthy lifestyle and social contacts, and acceptance of strategies to cope with anxiety and negative emotions.
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Affiliation(s)
- Jinan Abi Jumaa
- Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin Campus Charite
Mitte, Germany
| | - Antonia Bendau
- Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin Campus Charite
Mitte, Germany
| | - Andreas Ströhle
- Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin Campus Charite
Mitte, Germany
| | - Andreas Heinz
- Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin Campus Charite
Mitte, Germany
| | - Felix Betzler
- Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin Campus Charite
Mitte, Germany
| | - Moritz Bruno Petzold
- Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin Campus Charite
Mitte, Germany
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25
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Tabas RY, Ahmadian L, Samadbeik M, Arian A, Ameri A. Determining the readiness of patients with renal failure to use health information technology. BMC Med Inform Decis Mak 2022; 22:324. [PMID: 36482469 PMCID: PMC9732994 DOI: 10.1186/s12911-022-02073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Using information technology (IT) for purposes such as patient education and disease prevention and management is effective when patients are ready to use it. The objective of this study was to determine the readiness of patients with renal failure to use health IT. METHODS This study was performed on all dialysis patients in South Khorasan province (n = 263) using a 28-item questionnaire. The questionnaire consisted of (1) demographic information of participants and (2) questions concerning eight main factors including the need for information, desire to receive information, ability to use computers and the Internet, computers and the Internet anxiety, communication with physicians, using mobile phones and concerns about security and confidentiality of information. Descriptive statistics and Mann-Whitney and Kruskal-Wallis statistical tests were used to analyze the data. RESULTS About 15% of the participants stated that they do not want to receive information from the Internet. Anxiety and concern about Internet security and confidentiality were higher in women, married people, people over 60, villagers, and illiterate people (p < 0.05). Married people and people over 60 years had a higher desire to get information (p < 0.05). The rate of computer anxiety and Internet privacy concern was higher than average (p < 0.001). Most patients (34.2%) could only send text messages using mobile phones. CONCLUSION Despite the need of most patients to online health information, they do not use this information due to a lack of skills and experience to use IT. Therefore, the ability of users should be considered when developing IT-based interventions. Due to patients' concerns about Internet privacy, it is required to teach patients how to protect their privacy while using the Internet.
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Affiliation(s)
- Raana Younesi Tabas
- grid.411701.20000 0004 0417 4622Health Information Management Department, Valiasr Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Leila Ahmadian
- grid.412105.30000 0001 2092 9755Health Information Sciences Department, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahnaz Samadbeik
- grid.508728.00000 0004 0612 1516Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Anahita Arian
- grid.411701.20000 0004 0417 4622Department of Internal Medicine, Cardiovascular Diseases Research Center Valiasr Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Arefeh Ameri
- grid.412105.30000 0001 2092 9755Health Information Sciences Department, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
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26
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Vanzella LM, Pakosh M, Oh P, Ghisi G. Health-related information needs and preferences for information of individuals with cardiovascular disease from underserved populations: A systematic review. PATIENT EDUCATION AND COUNSELING 2022; 105:3398-3409. [PMID: 36167758 DOI: 10.1016/j.pec.2022.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This systematic review aimed to identify the information needs and preferences of individuals with CVD from underserved populations. METHODS Five databases were searched from data inception to February 2022. Pilot and case report studies, non-peer-reviewed literature, and studies published in a language other than English, Portuguese, or Spanish were excluded. Structured and thematic analysis of all included studies were performed. The Critical Appraisal Skills Program and the Downs and Black Checklist were used to assess the quality of the qualitative and quantitative studies, respectively. RESULTS Of 35,698 initial records, 19 studies were included, most in observational design and classified as "fair" quality. Underserved populations - women, people living in rural areas, ethnic minority groups, older people, and those with low socioeconomic status - presented unique needs in four main groups, with some similarities across them: information about CVD, primary and secondary prevention of CVD, CVD management, and health care, policies and practices. Across the studies there was a lack of standardization on how individuals' needs were assessed and reported. CONCLUSION Underserved populations with CVD have unique information needs and preferences that should be address during their care. PRACTICAL IMPLICATION Information from this study may assist health care professionals with the development of comprehensive strategies to improve their provision of care for specific CVD patient groups.
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Affiliation(s)
| | - Maureen Pakosh
- Library & Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Paul Oh
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada
| | - Glm Ghisi
- University Health Network, Toronto Rehabilitation Institute, Ontario, Canada.
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27
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Maximos M, Smith K, Harris V, McFarlane T, Blay J, Hahn K, Chang F. A randomized controlled trial to assess the influence of a picture-based antiemetic medication calendar on medication-taking behavior in adults receiving chemotherapy. J Oncol Pharm Pract 2022; 28:1763-1770. [PMID: 34569871 PMCID: PMC9623335 DOI: 10.1177/10781552211041680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A prospective open-label randomized controlled trial to assess the role of a picture-based medication calendar on adherence to antiemetic regimens for adult patients receiving chemotherapy and assess the effect on other medication taking behaviors as well as patient satisfaction with the tool. METHODS Participants were randomly assigned 1:1 to routine care with or without calendar. RESULTS Adherence, stratified by education (university or postgraduate, p = 0.09; grade school, high school or college p = 0.32), was non-significantly different between study arms. At least 70% of intervention arm participants moderately or completely agreed that the calendar helped with medication taking behaviors. There was no statistical difference between study arms for perceived regimen complexity (p = 0.16). Medication Use and Self Efficacy score (adjusted for age) used to assess perceived self-efficacy with medication taking behaviors were not statistically significant between study arms (p = 0.09). CONCLUSION The picture-based medication calendar did not statistically affect adherence to scheduled antiemetics among outpatients receiving chemotherapy for solid organ tumor origins. However, participants indicated that the calendar was effective for keeping track of medications, had an easy-to-understand layout, and provided help around when and how to take medications related to the oncology regimen.
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Affiliation(s)
- Mira Maximos
- London Regional Cancer Centre &
London Health Sciences Centre, London, ON, Canada
- University of Waterloo School of
Pharmacy, Kitchener, ON, Canada
- Woodstock Hospital, Woodstock, ON, Canada
| | - Kelly Smith
- London Regional Cancer Centre &
London Health Sciences Centre, London, ON, Canada
| | - Venita Harris
- London Regional Cancer Centre &
London Health Sciences Centre, London, ON, Canada
- Department of Paediatrics, Western University, London, ON, Canada
| | - Thomas McFarlane
- University of Waterloo School of
Pharmacy, Kitchener, ON, Canada
| | - Jonathan Blay
- University of Waterloo School of
Pharmacy, Kitchener, ON, Canada
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Karin Hahn
- London Regional Cancer Centre &
London Health Sciences Centre, London, ON, Canada
| | - Feng Chang
- University of Waterloo School of
Pharmacy, Kitchener, ON, Canada
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28
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Lee TH, Jarupreechachan W, Tseng YC. Exploring low-income migrant workers' health information-seeking behavior during COVID-19 in Taiwan: A qualitative study. Digit Health 2022; 8:20552076221133764. [PMID: 36312850 PMCID: PMC9608031 DOI: 10.1177/20552076221133764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Background COVID-19 pandemic is reported to exacerbate existing vulnerabilities of marginalized groups, and the lack of self-care can lead to the spread of the virus across society. Therefore, effective responses to the challenges imposed by the health crisis should consider the health information needs of migrant workers. Objective We aimed to explore how migrant low-income workers seek health information and how their health-related information needs were met during a health crisis. We also investigated migrant workers’ preferred information sources and types of content with the theoretical concept of health literacy to understand the development of health competencies among migrant workers. Methods We conducted semi-structured interviews with Thai low-income migrant workers. A total of 13 Thai migrant workers participated in the study, among whom five were undocumented. The interviews were audio-taped, transcribed, and analyzed with the thematic analysis approach. Results Our findings indicated that migrant workers’ health literacy and health information behavior could be improved through technology when facing a health crisis. We found that participants sought health information proactively to reduce their perceived risks. However, there is still space for design to support the ability to process jargon information and apply local policy, such as providing easy-to-understand, accurate, and timely information. The findings of this study provide some insights for the authority and technological design to respond to migrant workers’ health information needs. Conclusions This study acknowledges and understands the needs of vulnerable migrant workers in society. The findings of this study provide insights for the authority and technological design to respond to migrant workers’ health information needs. We also outline the areas worth further investigation, such as the communication between information seekers and providers, and the navigation of the healthcare system for migrants in the host country.
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Affiliation(s)
- Tuan-he Lee
- Institute of Service Science, National Tsing Hua University, Hsinchu, Taiwan,Information Science, Cornell University, Ithaca, NY, USA
| | | | - Yuan-Chi Tseng
- Institute of Service Science, National Tsing Hua University, Hsinchu, Taiwan,Yuan-Chi Tseng, Institute of Service Science, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 300044, Taiwan.
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29
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Longanga Diese E, Baker E, Akpan I, Acharya R, Raines-Milenkov A, Felini M, Hussain A. Health information-seeking behavior among Congolese refugees. PLoS One 2022; 17:e0273650. [PMID: 36084096 PMCID: PMC9462811 DOI: 10.1371/journal.pone.0273650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background The purpose of this cross-sectional study was to determine the extent to which Congolese refugees seek health information, to identify and assess the resources used while exercising Health Information-Seeking Behavior (HISB), and to identify individual determinants that affect their HISB. Methodology Building Bridges program participants who resided in Texas between 2017–2020, reported country of origin as Democratic Republic of Congo, and responded to HISB questions were included in this study. Four HISB questions asked about frequency seeking health information, preferred source and perceived trustworthiness of source, and frequency worrying about their health. Associations between HISB and sociodemographic factors (age, gender, education years, years in US, proficiency speaking English, marital status) were tested using Pearson chi-square or Fisher’s exact tests (α≤0.05). Results Most participants (59%) reported seeking health information sometimes. Less than half (44%) of participants identified doctors as their preferred source of health information, Twenty-five percent relied on family, friends, and community leaders, and 23% used media sources. Doctors were identified as the most trustworthy source (71%), family and friends were the second highest trusted source (25%), whereas media sources were the least trusted (4%). Sociodemographic factors age (p = .02), gender (p < .01), and education years (p < .01) were the only significant predictors of preferred information sources. Conversely, those residing in US <5 years were more likely to seek health information more frequently (p = .01). The majority of participants did not worry about their health, and it was not significantly associated with source or frequency of seeking health information. Conclusions The high trust in doctors represents an opportunity for healthcare professionals to educate and address individual barriers contributing to refugees’ underutilization of preventive care services such as routine immunizations and preventive health screenings.
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Affiliation(s)
- Elvis Longanga Diese
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- * E-mail:
| | - Eva Baker
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Idara Akpan
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Rushil Acharya
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Amy Raines-Milenkov
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Martha Felini
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
| | - Arbaz Hussain
- Department of Pediatrics and Women’s Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America
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Blackburn CC, Jones M, Lee M, Bauer C, Rodriguez A, Garcia R, Fisher-Hoch SP, McCormick JB, Zhang K, Garrett A, Esteves J. Autoethnographic Examination of Data-Driven, Community-Tailored COVID-19 Response in Brownsville, Texas. JOURNAL OF HUMANISTIC PSYCHOLOGY 2022. [DOI: 10.1177/00221678221118708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The City of Brownsville was made vulnerable to the COVID-19 pandemic due to high rates of obesity and diabetes, high rates of poverty, and adverse social determinants of health. To address the unique challenges faced by the community, Brownsville’s COVID-19 response brought together the skills of academia with the local understanding and health expertise of the city’s public health department to craft a pandemic response that addressed the specific needs and unique challenges of the residents. This article explores the response partnerships formed and the data-driven, community-oriented campaigns that were designed by the Brownsville Public Health Department. The collaborative partnership of the COVID-19 working group and the innovative dissemination strategies designed by the health department provided an effective method of disease mitigation among the city’s most vulnerable residents. The article demonstrates the impact of the response campaigns by including a resident’s perspective on the impact of the response, specifically how the health department tailored their efforts to meet the needs of the Brownsville community.
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Affiliation(s)
| | | | - Miryoung Lee
- The University of Texas Health Science Center at Houston, Brownsville, USA
| | - Cici Bauer
- The University of Texas Health Science Center at Houston, Brownsville, USA
| | | | | | | | | | - Kehe Zhang
- The University of Texas Health Science Center at Houston, Brownsville, USA
| | - Ava Garrett
- Sam Houston State University, Huntsville, TX, USA
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Lumpkins CY, Goeckner R, Hale J, Lewis C, Gunville J, Gunville R, Daley CM, Daley SM. In Our Sacred Voice - An Exploration of Tribal and Community Leader Perceptions as Health Communicators of Disease Prevention among American Indians in the Plains. HEALTH COMMUNICATION 2022; 37:1180-1191. [PMID: 34949125 DOI: 10.1080/10410236.2021.2008108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
American Indians (AI) are disproportionately and significantly impacted by disease morbidity, mortalityand poor behavioral health outcomes. Health promotion and health communication programs exist to address these health disparities and health conditions; however, few programs fully integrate holistic approaches when targeting AI populations. The objective of this study was to explore how tribal and community leaders throughout the Central Plains (Kansas, Iowa, Missouri, and South Dakota) viewed themselves as health communicators and health promoters within their communities. Members of the Center for American Indian Community Health (CAICH) conducted 39 in-depth interviews with members of federally recognized tribes living in reservation communities as well as urban tribal communities across the region. Results from the sample show that these individuals do not necessarily see themselves as the "authority" health communicator or health promoter within their tribe or community. They did perceive themselves and others as gatekeepers of pertinent health information. Social and cultural authority within culturally centered messaging and collective delivery of this type of health information from trusted sources within tribes and communities is perceived to bolster health communication programs and positively impact health outcomes among AI populations.
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Affiliation(s)
- Crystal Y Lumpkins
- Department of Family Medicine and Community Health, University of Kansas Medical Center
- William Allen White School of Journalism and Mass Communications, University of Kansas-Lawrence
| | | | - Jason Hale
- Lehigh College of Health, Institute for Indigenous Studies
| | - Charley Lewis
- Lehigh College of Health, Institute for Indigenous Studies
| | | | - River Gunville
- Lehigh College of Health, Institute for Indigenous Studies
| | - Chris M Daley
- Lehigh College of Health, Institute for Indigenous Studies
| | - Sean M Daley
- Lehigh College of Health, Institute for Indigenous Studies
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Lescure DLA, van Oorschot W, Brouwer R, van der Velden J, Tjon-A-Tsien AML, Bonnema IV, Verheij TJM, Richardus JH, Voeten HACM. Providing antibiotics to immigrants: a qualitative study of general practitioners' and pharmacists' experiences. BMC PRIMARY CARE 2022; 23:100. [PMID: 35501699 PMCID: PMC9058745 DOI: 10.1186/s12875-022-01706-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND If healthcare professionals perceive that patients strongly expect to be prescribed antibiotics, inappropriate prescriptions may result. As it is unknown whether this happens more often with certain patient groups, we explored whether general practitioners (GPs) and pharmacists perceived such expectations when they provided antibiotics to immigrant patients. METHODS Ten GPs and five pharmacists from Rotterdam, the Netherlands, were interviewed on the basis of a semi-structured topic guide. Atlas.ti software was then used to conduct a thematic analysis. RESULTS GPs felt that immigrant patients, especially those who had arrived recently, were more likely to expect to receive antibiotics than native Dutch patients. However, these expectations had decreased over the last years and did not always lead immigrants to exert pressure on them. Except for language barriers, the factors reported by GPs to influence their antibiotic prescribing behaviour were unrelated to patients' immigrant background. If there was a language barrier, GPs experienced greater diagnostic uncertainty and needed additional time to obtain and communicate correct information. To overcome language barriers, they often used point-of-care testing to convince patients that antibiotics were unnecessary. Although pharmacists rarely experienced problems dispensing antibiotics to immigrants, they and GPs both struggled to find effective ways of overcoming language barriers, and stressed the need for multi-language support materials. CONCLUSION While pharmacists rarely experience any problems providing antibiotics to immigrants, GPs regularly face language barriers with immigrant patients, which complicate the diagnostic process and communicating information in the limited available time. This sometimes leads antibiotics to be prescribed inappropriately.
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Affiliation(s)
- Dominique L A Lescure
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands
| | | | - Rob Brouwer
- Health Centre Levinas, Pharmacy Ramleh, Noordeinde 97a, 3061 EM, Rotterdam, The Netherlands
| | - Janneke van der Velden
- Pharos (Dutch Centre of Expertise On Health Disparities), Arthur van Schendelstraat 600, 3511 MJ, Utrecht, The Netherlands
| | - Aimée M L Tjon-A-Tsien
- Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands
| | - Iris V Bonnema
- Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands
| | - Theo J M Verheij
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands
| | - Hélène A C M Voeten
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
- Municipal Public Health Service Rotterdam-Rijnmond, Schiedamsedijk 95, 3011 EN, Rotterdam, The Netherlands.
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Kuo SF, Yeh YC, Chang CC, Lin YF, Wang SY. Psychometrics and measurement invariance: Health Literacy Scale for Vietnamese and Indonesian married immigrants. J Adv Nurs 2022; 78:1836-1847. [PMID: 35384029 DOI: 10.1111/jan.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine the psychometrics and measurement invariance of the Short-Form Health Literacy 12-item questionnaire (HL-SF12) among Vietnamese and Indonesian married immigrants. DESIGN A cross-sectional survey design. METHODS In total, 1171 Vietnamese and Indonesian married immigrants were enrolled between September 2019 and December 2019. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the structural validity of the suggested factor structure. The multiple-group CFA (MGCFA) used a series of hierarchical nested-in models as a measurement invariance test which confirmed the adequacy of the model fit at each stage. RESULTS/FINDINGS The Kaiser-Meyer-Olkin coefficient was 0.898, and the Bartlett test of sphericity was statistically significant (χ2 [66] = 1965.97, p < 0.01). According to a scree plot and Kaiser's criterion for eigenvalues of >1, the EFA explained 61.6% of the total variance and confirmed three theoretically supported factors of health care, disease prevention and health promotion. The 12 items showed factor loadings of >0.4 and four items were in each subscale. The CFA showed adequate structural validity, including a relative chi-squared/degrees of freedom (X2 /df) of 2.01, a comparative fit index (CFI) of 0.98 and a root mean square error of approximation (RMSEA) of 0.04 (95% confidence interval [0.03, 0.05]) in married immigrants. For the measurement invariance, a change in the goodness-of-fit measures did not exceed 0.02 for the RMSEA or 0.01 for the CFI. The results indicated Cronbach's α values of 0.87 for the HL-SF12 scale in Vietnamese and Indonesian combined samples (n = 1171). A t-test showed that the HL-SF12 and its three subscales were unable to significantly differentiate between Vietnamese and Indonesian groups (all p > 0.05). CONCLUSIONS The HL-SF12 scale showed acceptable theoretically supported structural validity, equivalent measurement invariance and reliable internal consistency among Vietnamese and Indonesian married immigrants. Measurements of immigrants' HL using the HL-SF12 could be integrated into future immigrant health policies. IMPACT As the first study of the measurement invariance of the HL-SF12 instrument among immigrants. Related factors of immigrants' HL can be further explored to increase immigrants' health and empowerment.
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Affiliation(s)
- Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Chen Yeh
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, and Dean of College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
| | - Yu-Fang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yi Wang
- Loretto Heights School of Nursing, Rueckert-Hartman College for Health Professions, Regis University, Denver, Colorado, USA
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Gonzalez C, Bollinger B, Yip J, Pina L, Roldan W, Nieto Ruiz C. Intergenerational Online Health Information Searching and Brokering: Framing Health Literacy as a Family Asset. HEALTH COMMUNICATION 2022; 37:438-449. [PMID: 33205663 DOI: 10.1080/10410236.2020.1847445] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Latino populations are disproportionately impacted by health disparities and face both connectivity and health literacy challenges. As evidenced by the current global pandemic, access to reliable online health-related information and the ability to apply that information is critical to achieving health equity. Through a qualitative study on how Latino families collaborate to access online health resources, this work frames health literacy as a family-level mechanism. Interviews with parent-child dyads combined with online search tasks reveal how families integrate their individual skillsets to obtain, process, and understand online information about illnesses, symptoms, and even medical diagnoses. As they engage in intergenerational online health information searching and brokering, families creatively navigate information and communication technologies (ICTs) to address a range of health needs. Bilingual children help immigrant parents obtain urgent and non-urgent health information needed to care for other family members. When children are tasked with addressing a health need critical to their parent's wellbeing, they collaborate with their parents to obtain, interpret, and apply online health information. Intergenerational online health information searching and brokering thus reveals family-level strengths that can be leveraged to promote both health and digital literacy among marginalized populations.
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Affiliation(s)
| | | | - Jason Yip
- Information School, University of Washington
| | | | - Wendy Roldan
- Human Centered Design and Engineering, University of Washington
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Stanzel KA, Hammarberg K, Nguyen T, Fisher J. 'They should come forward with the information': menopause-related health literacy and health care experiences among Vietnamese-born women in Melbourne, Australia. ETHNICITY & HEALTH 2022; 27:601-616. [PMID: 32228051 DOI: 10.1080/13557858.2020.1740176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Objectives: Health literacy refers to an individual's capacity to access, understand, evaluate and use health information to make well informed health-related decision to maintain and promote optimal health. Low health literacy is linked with worse health outcomes and is more common in people from socio-economically disadvantaged backgrounds and from culturally and linguistically diverse backgrounds and among people with limited education. Peri-menopausal and postmenopausal health behaviour predicts health in later life. This qualitative study was conducted in Melbourne, Australia. The aim of this study was to explore menopause-related health literacy and experiences with menopause-related health care among Vietnamese-born women who had immigrated to Australia as adults.Design: A qualitative study using semi-structured interviews was conducted with women aged between 45 and 60 years and who were either in the peri or postmenopausal phase. Transcripts were analysed thematically.Results: A total of 12 women were interviewed. Participants viewed menopause as a natural event and obtained most of their menopause-related information from family and friends. Limited English language proficiency affected their capacity to access, understand, evaluate and use menopause-related health information. They identified their Vietnamese speaking General Practitioners (GPs) as a reliable source of health information, but 'shyness' prevented them from asking questions about menopause and they suggested that GPs need to initiate menopause-related health conversations.Conclusion: Low menopause-related health literacy among Vietnamese-born immigrant women may limit their opportunities to access information about and benefit from menopause-related health-promoting behaviours. Access to menopause-related health information in relevant community languages is essential to support immigrant women to make well informed menopause-related health decisions.
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Affiliation(s)
- Karin A Stanzel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Karin Hammarberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Trang Nguyen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Dyrehave C, Nielsen D, Wejse C, Maindal HT, Rodkjaer LO. Development of a Complex Intervention for Health Care Professionals' Care of Patients With African Background and HIV Infection Using the Behavior Change Wheel Method. J Transcult Nurs 2022; 33:259-267. [PMID: 35257609 DOI: 10.1177/10436596221075989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Insufficient cultural competences among health care professionals (HCPs) working with ethnic minorities may result in poorer quality of care. This study aimed to develop a cultural intervention for HCPs. Method. The intervention was designed using the Behavior Change Wheel. The development phase contained empirical studies of patients with HIV and African background, literature review, observations from a migrant health clinic, and transcultural care theory. Results. Systematic development will facilitate an intervention tailored to focus on nurses' sensitivity and awareness, and aims to give them tools to identify narratives about patients' life situation and self-management as well as provide effective, compassionate, and culturally competent care. Discussion. Higher cultural competence among nurses may improve their support of patients to manage their disease.
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Affiliation(s)
- Charlotte Dyrehave
- Aarhus University, Denmark.,Aarhus University Hospital, Denmark.,Odense University Hospital, Denmark
| | - Dorthe Nielsen
- Odense University Hospital, Denmark.,University of Southern Denmark, Odense, Denmark
| | - Christian Wejse
- Aarhus University, Denmark.,Aarhus University Hospital, Denmark
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O'Conor KJ, Golden SH, Hughes MT, Sisson SD, Kachalia A. COVID-19 Vaccination: Health Care Organizations' Responsibility and Opportunity. Am J Public Health 2022; 112:213-215. [PMID: 35080955 PMCID: PMC8802584 DOI: 10.2105/ajph.2021.306633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Katie J O'Conor
- Katie J. O'Conor is with the Department of Emergency Medicine and the Department of Anesthesiology and Critical Care Medicine, Office of Critical Event Preparedness and Response, Johns Hopkins Medicine, Baltimore, MD. Sherita H. Golden is with the Department of Medicine, Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine. Mark T. Hughes is with the Department of Medicine, Berman Institute of Bioethics, Johns Hopkins Medicine. Stephen D. Sisson is with the Department of Medicine, Johns Hopkins Medicine. Allen Kachalia is with the Armstrong Institute for Patient Safety and Quality, Department of Medicine, Johns Hopkins Medicine
| | - Sherita H Golden
- Katie J. O'Conor is with the Department of Emergency Medicine and the Department of Anesthesiology and Critical Care Medicine, Office of Critical Event Preparedness and Response, Johns Hopkins Medicine, Baltimore, MD. Sherita H. Golden is with the Department of Medicine, Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine. Mark T. Hughes is with the Department of Medicine, Berman Institute of Bioethics, Johns Hopkins Medicine. Stephen D. Sisson is with the Department of Medicine, Johns Hopkins Medicine. Allen Kachalia is with the Armstrong Institute for Patient Safety and Quality, Department of Medicine, Johns Hopkins Medicine
| | - Mark T Hughes
- Katie J. O'Conor is with the Department of Emergency Medicine and the Department of Anesthesiology and Critical Care Medicine, Office of Critical Event Preparedness and Response, Johns Hopkins Medicine, Baltimore, MD. Sherita H. Golden is with the Department of Medicine, Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine. Mark T. Hughes is with the Department of Medicine, Berman Institute of Bioethics, Johns Hopkins Medicine. Stephen D. Sisson is with the Department of Medicine, Johns Hopkins Medicine. Allen Kachalia is with the Armstrong Institute for Patient Safety and Quality, Department of Medicine, Johns Hopkins Medicine
| | - Stephen D Sisson
- Katie J. O'Conor is with the Department of Emergency Medicine and the Department of Anesthesiology and Critical Care Medicine, Office of Critical Event Preparedness and Response, Johns Hopkins Medicine, Baltimore, MD. Sherita H. Golden is with the Department of Medicine, Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine. Mark T. Hughes is with the Department of Medicine, Berman Institute of Bioethics, Johns Hopkins Medicine. Stephen D. Sisson is with the Department of Medicine, Johns Hopkins Medicine. Allen Kachalia is with the Armstrong Institute for Patient Safety and Quality, Department of Medicine, Johns Hopkins Medicine
| | - Allen Kachalia
- Katie J. O'Conor is with the Department of Emergency Medicine and the Department of Anesthesiology and Critical Care Medicine, Office of Critical Event Preparedness and Response, Johns Hopkins Medicine, Baltimore, MD. Sherita H. Golden is with the Department of Medicine, Office of Diversity, Inclusion, and Health Equity, Johns Hopkins Medicine. Mark T. Hughes is with the Department of Medicine, Berman Institute of Bioethics, Johns Hopkins Medicine. Stephen D. Sisson is with the Department of Medicine, Johns Hopkins Medicine. Allen Kachalia is with the Armstrong Institute for Patient Safety and Quality, Department of Medicine, Johns Hopkins Medicine
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Harris M, Ekwonye A, Munala L, Buesseler H, Hearst MO. Exploring Knowledge, Prevention Methods, and Prevention Barriers of COVID-19 Among Somali, Karen, and Latinx Community Members in Minneapolis, Minnesota, USA. J Prim Care Community Health 2021; 12:21501327211056595. [PMID: 34854344 PMCID: PMC8646193 DOI: 10.1177/21501327211056595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: As the COVID-19 pandemic has unfolded, understanding the virus and necessary measures to prevent infection have evolved. While effective preventative measures for COVID-19 have been identified, there are also identifiable barriers to implementation. Objective: Explore the access to information, knowledge, and prevention methods and barriers of COVID-19 among Somali, Karen, and Latinx immigrant community members in Minneapolis, Minnesota, USA through analysis of in-depth interviews. Methods: Data were collected through 32 interviews via phone, video conference on a computer, or in-person with Somali, Karen, and Latinx adults to understand the experiences during the COVID-19 pandemic in each group’s native language. All participants were over the age of 18, and identified as Somali, Karen, and Latinx refugee or immigrant. Interview protocol contained 9 main questions including probes. Data were analyzed through use of the qualitative analysis software, Atlas.ti using phenomenology. Results: A total of 32 adults were interviewed (Somali = 12, Karen = 10, and Latinx = 10). One-third were in person and the remainder were remote. The average age recorded was 37 years (range 20-66 years), 43.8% males and 56.3% females. Somali, Karen, and Latinx respondents consistently had accurate knowledge about COVID-19 and were attentive to finding trustworthy information. Information was available in Somali, Karen, and Latinx written language, although Karen elders who are not literate would benefit more from video messaging. Knowledge of preventive measures was consistent; however, barriers included access, working in front-line positions, and living in high density housing. Conclusion: Exploring the impact of COVID-19 on Somali, Karen, and Latinx community members in Minneapolis, MN is advantageous in removing identified barriers and disparities in health. The results of this study highlight the need for increased efforts to address barriers in the prevention of COVID-19, as well as future pandemics for immigrant and refugee populations.
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Perrins G, Ferdous T, Hay D, Harreveld B, Reid-Searl K. Conducting Health Literacy Research With Hard-to-Reach Regional Culturally and Linguistically Diverse Populations: Evaluation Study of Recruitment and Retention Methods Before and During COVID-19. JMIR Form Res 2021; 5:e26136. [PMID: 34581673 PMCID: PMC8565802 DOI: 10.2196/26136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/29/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background In health research, culturally and linguistically diverse (CALD) health care consumers are cited as hidden or hard to reach. This paper evaluates the approach used by researchers to attract and retain hard-to-reach CALD research participants for a study investigating health communication barriers between CALD health care users and health care professionals in regional Australia. As the study was taking place during the COVID-19 pandemic, subsequent restrictions emerged. Thus, recruitment and retention methods were adapted. This evaluation considered the effectiveness of recruitment and retention used throughout the pre-COVID and during-COVID periods. Objective This evaluation sought to determine the effectiveness of recruitment and retention efforts of researchers during a study that targeted regional hard-to-reach CALD participants. Methods Recruitment and retention methods were categorized into the following 5 phases: recruitment, preintervention data collection, intervention, postintervention data collection, and interviews. To compare the methods used by researchers, recruitment and retention rates were divided into pre-COVID and during-COVID periods. Thereafter, in-depth reflections of the methods employed within this study were made. Results This paper provides results relating to participant recruitment and retainment over the course of 5 research phases that occurred before and during COVID. During the pre-COVID recruitment phase, 22 participants were recruited. Of these participants, 15 (68%) transitioned to the next phase and completed the initial data collection phase. By contrast, 18 participants completed the during-COVID recruitment phase, with 13 (72%) continuing to the next phase. The success rate of the intervention phase in the pre-COVID period was 93% (14/15), compared with 84.6% (11/13) in the during-COVID period. Lastly, 93% (13/14) of participants completed the postintervention data collection in the pre-COVID period, compared with 91% (10/11) in the during-COVID period. In total, 40 participants took part in the initial data collection phase, with 23 (58%) completing the 5 research phases. Owing to the small sample size, it was not determined if there was any statistical significance between the groups (pre- and during-COVID periods). Conclusions The success of this program in recruiting and maintaining regional hard-to-reach CALD populations was preserved over the pre- and during-COVID periods. The pandemic required researchers to adjust study methods, thereby inadvertently contributing to the recruitment and retention success of the project. The maintenance of participants during this period was due to flexibility offered by researchers through adaptive methods, such as the use of cultural gatekeepers, increased visibility of CALD researchers, and use of digital platforms. The major findings of this evaluation are 2-fold. First, increased diversity in the research sample required a high level of flexibility from researchers, meaning that such projects may be more resource intensive. Second, community organizations presented a valuable opportunity to connect with potential hard-to-reach research participants.
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Affiliation(s)
- Genevieve Perrins
- Central Queensland Multicultural Association, CQUniversity Rockhampton North, Rockhampton, Australia
| | - Tabassum Ferdous
- Central Queensland Multicultural Association, CQUniversity Rockhampton North, Rockhampton, Australia
| | - Dawn Hay
- Central Queensland Multicultural Association, CQUniversity Rockhampton North, Rockhampton, Australia
| | - Bobby Harreveld
- Centre for Research in Equity, Advancement of Teaching & Education, School of Education and the Arts, Central Queensland University, Rockhampton, Australia
| | - Kerry Reid-Searl
- School of Nursing, Midwifery & Social Science, Central Queensland University, Rockhampton, Australia
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40
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Britt RK, Britt BC, Anderson J, Fahrenwald N, Harming S. "Sharing Hope and Healing": A Culturally Tailored Social Media Campaign to Promote Living Kidney Donation and Transplantation Among Native Americans. Health Promot Pract 2021; 22:786-795. [PMID: 33267677 DOI: 10.1177/1524839920974580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this article, the authors discuss a community-based participatory research (CBPR)-driven and culturally tailored social media campaign to promote living kidney donation and transplantation (LKDT) serving Native American communities, who are disproportionately burdened by kidney failure. The effort represents a collaboration among researchers, tribal leaders and community members, medical centers, and other stakeholders to facilitate health promotion related to LKDT among the broader Native American community. Campaign objectives were collaboratively established by the researchers and stakeholders, and the campaign approach and materials were likewise developed in consultation with the community. The results indicated that the use of success stories about LKDT within campaign materials was a statistically significant predictors of heightened campaign engagement (p = .003, β = .223). Recommendations are offered for partnering with tribal communities and other stakeholders, as well as for building tailored health promotion strategies.
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Lescure D, van der Velden J, Nieboer D, van Oorschot W, Brouwer R, Huijser van Reenen N, Tjon-A-Tsien A, Erdem Ö, Vos M, van der Velden A, Richardus JH, Voeten H. Reducing antibiotic prescribing by enhancing communication of general practitioners with their immigrant patients: protocol for a randomised controlled trial (PARCA study). BMJ Open 2021; 11:e054674. [PMID: 34635534 PMCID: PMC8506856 DOI: 10.1136/bmjopen-2021-054674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Although antibiotic use and antimicrobial resistance in the Netherlands is comparatively low, inappropriate prescription of antibiotics is substantial, mainly for respiratory tract infections (RTIs). General practitioners (GPs) experience pressure from patients with an immigration background to prescribe antibiotics and have difficulty communicating in a culturally sensitive way. Multifaceted interventions including communication skills training for GPs are shown to be most effective in reducing antibiotic prescription. The PARCA study aims to reduce the number of antibiotic prescriptions for RTIs through implementing a culturally sensitive communication intervention for GPs and evaluate it in a randomised controlled trial (RCT). METHODS AND ANALYSIS A non-blinded RCT including 58 GPs (29 for each arm). The intervention consists of: (1) An E-learning with 4 modules of 10-15 min each; (2) A face-to-face training session in (intercultural) communication skills including role plays with a training actor and (3) Availability of informative patient-facing materials that use simple words (A2/B1 level) in multiple languages. The primary outcome measure is the number of dispensed antibiotic courses qualifying for RTIs in primary care, per 1000 registered patients. The secondary outcome measure is the number of all dispensed antibiotic courses, per 1000 registered patients. The intervention arm will receive the training in Autumn 2021, followed by an observation period of 6 winter months for which numbers of antibiotics will be collected for both trial arms. The GPs/practices in the control arm can attend the training after the observation period. ETHICS AND DISSEMINATION The study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, University Medical Center Rotterdam (MEC-2020-0142). The results of the trial will be published in international peer-reviewed scientific journals and will be disseminated through national and international congresses. The project is funded by The Netherlands Organisation for Health Research and Development (ZonMw). TRIAL REGISTRATION NUMBER NL9450.
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Affiliation(s)
- Dominique Lescure
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | | | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Rob Brouwer
- Health Centre Levinas, Pharmacy Ramleh, Rotterdam, The Netherlands
| | | | - Aimée Tjon-A-Tsien
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Özcan Erdem
- Department of Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, The Netherlands
| | - Margreet Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Alike van der Velden
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Hélène Voeten
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
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Bouclaous C, Haddad I, Alrazim A, Kolanjian H, El Safadi A. Health literacy levels and correlates among refugees in Mount Lebanon. Public Health 2021; 199:25-31. [PMID: 34534886 DOI: 10.1016/j.puhe.2021.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The study aimed to assess the levels and correlates of health literacy among refugees. STUDY DESIGN This is a cross-sectional study design. METHODS Health literacy was assessed through face-to-face interviews in eight primary healthcare centers (PHCs) in Mount Lebanon. The questionnaire consisted of the Arabic Functional Health literacy scale, the short version of the European Health Literacy Survey (HLS-EU-Q16), socio-economic questions (sex, age, nationality, marital status, educational level, and ability to pay for medical fees at PHCs), and health-related questions (self-perceived health, long-term illness, recent visit to health care, and freedom to make health decisions). Statistical analyses were performed to evaluate the association between functional health literacy (FHL), comprehensive health literacy (CHL), and potential explanatory variables. RESULTS Of 263 participants (61.6% females), mean age 38.49 ± 12.80 years, 52.1% had inadequate FHL and 35.7% had inadequate CHL. The likelihood of having inadequate CHL was higher in refugees who were ever married (odds ratio [OR] = 2.794; 95% confidence interval [CI]: 1.187-6.576) or had average ability to pay for medical expenses at PHC (OR = 4.562; 95% CI: 1.554-13.393). The odds of having inadequate FHL was lower in refugees with some level of education (OR = 0.211; 95% CI: 0.077-0.580). Furthermore, their perceived lack of freedom to make personal health decisions was associated with inadequate levels of CHL (OR = 5.195; 95% CI: 2.693-10.022) and FHL (OR = 4.676; 95% CI: 2.610-8.376). CONCLUSIONS Health messages and delivery should be tailored to refugee health literacy levels. Initiatives should seek to improve refugee interaction with the health system, promote uptake of available health services and facilitate health-related decision-making in daily life.
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Affiliation(s)
- C Bouclaous
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
| | - I Haddad
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - A Alrazim
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - H Kolanjian
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - A El Safadi
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
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Hashiba C, Imahashi M, Imamura J, Nakahata M, Kogure A, Takahashi H, Yokomaku Y. Factors Associated with Attrition: Analysis of an HIV Clinic in Japan. J Immigr Minor Health 2021; 23:250-256. [PMID: 32072376 PMCID: PMC7914243 DOI: 10.1007/s10903-020-00982-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study evaluated the impact of a public medical interpreter on the follow-up clinic attendance rate of foreign-born people with HIV who live in Japan. Participants were patients who visited Nagoya Medical Center from 2009 to 2016. Lost to follow-up was defined as an absence from follow-up visits for more than six months without any notification. A log-rank test was conducted to compare the lost-to-follow-up rates by patients’ nation of origin and medical interpreter use. Of the 931 participants, 114 were foreign patients, whose overall attendance rate at 5 years was 75.5%, which was significantly lower than that of Japanese patients (94.1%, p < 0.001). There was no significant difference in regular attendance with respect to medical interpreter use (p = 0.09). Social support in addition to a medical interpreter may be needed to improve attendance rates in the study population.
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Affiliation(s)
- Chieko Hashiba
- Department of Nursing, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Mayumi Imahashi
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.
| | - Junji Imamura
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.,Department of Infectious Diseases, Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan
| | - Masashi Nakahata
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Ayumi Kogure
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
| | - Hideto Takahashi
- National Institute of Public Health, 2-3-6 Minami, Wako, 351-0197, Japan
| | - Yoshiyuki Yokomaku
- Department of Infectious Diseases, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan
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Anderson MD, Merkin SS, Everson-Rose SA, Widome R, Seeman T, Magnani JW, Rodriguez CJ, Lutsey PL. Health Literacy Within a Diverse Community-Based Cohort: The Multi-Ethnic Study of Atherosclerosis. J Immigr Minor Health 2021; 23:659-667. [PMID: 33206278 PMCID: PMC8128937 DOI: 10.1007/s10903-020-01123-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Health literacy has yet to be described in a non-clinical, racially diverse, community-based cohort. METHODS Four questions assessing health literacy were asked during annual phone encounters with Multi-Ethnic Study of Atherosclerosis (MESA) participants between 2016 and 2018 (n = 3629). We used prevalence ratios (PRs) with 95% confidence intervals (CIs) to characterize how demographic and acculturation factors related to limited health literacy. Models adjusted for age, sex, and race/ethnicity, and race/ethnicity-stratified models were also examined. RESULTS Limited health literacy was prevalent in 15.4% of the sample. Participants who were older, female, lower-income, or less acculturated were at greater risk for having limited health literacy. Chinese, Hispanic, and Black participants were more likely than White participants to have limited health literacy. Patterns were similar when stratified by race/ethnicity. DISCUSSION Within MESA limited health literacy was common, particularly among Chinese and Hispanic participants, with some of the variance explained by differences in acculturation.
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Affiliation(s)
- Madison D Anderson
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA.
| | - Sharon Stein Merkin
- Division of Geriatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA
| | - Teresa Seeman
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jared W Magnani
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carlos J Rodriguez
- Department of Cardiovascular Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55455, USA
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Koirala B, Turkson-Ocran RA, Baptiste D, Koirala B, Francis L, Davidson P, Himmelfarb CD, Commodore-Mensah Y. Heterogeneity of Cardiovascular Disease Risk Factors Among Asian Immigrants: Insights From the 2010 to 2018 National Health Interview Survey. J Am Heart Assoc 2021; 10:e020408. [PMID: 34182790 PMCID: PMC8403310 DOI: 10.1161/jaha.120.020408] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background The Asian population is the fastest-growing immigrant population in the United States. Prior studies have examined the Asian immigrant population as a homogenous group. We hypothesized that there will be heterogeneity in cardiovascular disease risk factors among Asian immigrant subgroups (Indian subcontinent, Southeast Asia, Asia) compared with the non-Hispanic White population. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey was conducted among 508 941 adults who were born in Asian regions or were non-Hispanic White and born in the United States. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes mellitus, high cholesterol, physical inactivity, and current smoking among Asian immigrants compared with White adults, adjusting for known confounders. We included 33 973 Asian immigrants from Southeast Asia (45%), Asia (29%), the Indian subcontinent (26%), and 474 968 White adults. Compared with non-Hispanic White adults, Indian subcontinent immigrants had the highest prevalence of overweight/obesity (prevalence ratio, 1.22; 95% CI, 1.19-1.25); Southeast Asian immigrants had the highest prevalence of high cholesterol (prevalence ratio, 1.16; 95% CI, 1.10-1.23); Indian subcontinent (prevalence ratio, 1.69; 95% CI, 1.49-1.93) and Southeast Asian (prevalence ratio, 1.38; 95% CI, 1.26-1.52) immigrants had a higher prevalence of diabetes. All Asian immigrant subgroups were more likely to be physically inactive and less likely to smoke than White adults. Conclusions We observed significant heterogeneity in cardiovascular disease risk factors among Asian immigrants and a varied prevalence of risk factors compared with non-Hispanic White adults. Providers caring for Asian immigrants should provide tailored and culturally informed care to improve the cardiovascular health of this diverse group.
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Affiliation(s)
| | | | | | | | | | | | - Cheryl Dennison Himmelfarb
- Johns Hopkins School of Nursing Baltimore MD.,Johns Hopkins School of Medicine Baltimore MD.,Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing Baltimore MD.,Johns Hopkins Bloomberg School of Public Health Baltimore MD
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Feasibility of a community-based cancer awareness initiative: views of those delivering and managing the intervention. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01581-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Abstract
Aim
Many people delay presenting to health services with cancer symptoms due to lack of awareness, particularly in areas of high socio-economic deprivation. A three-year community-based intervention was launched in Northwest England to improve public awareness of cancer symptoms. In this study, we aimed to evaluate this intervention by exploring the views of those involved in its management and delivery.
Methods
Ten semi-structured interviews were conducted with volunteers as well as members of the project management and steering group. Interviews were analysed qualitatively using thematic analysis.
Results
Participants felt they succeeded in raising awareness, influencing behaviour, connecting with local communities and engaging with vulnerable people. Participants perceived some weaknesses in the delivery of the intervention, including limited engagement of stakeholders, particularly general practitioners (GPs), and socially excluded groups.
Conclusions
Future public health interventions should pay particular attention to engagement of socially excluded individuals who do not interact with community events or groups, and to the engagement of stakeholders in early planning stages of the intervention. This should involve a specific GP engagement plan.
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Candeias P, Alarcão V, Stefanovska-Petkovska M, Santos O, Virgolino A, Pintassilgo S, Pascoal PM, Costa AS, Machado FL. Reducing Sexual and Reproductive Health Inequities Between Natives and Migrants: A Delphi Consensus for Sustainable Cross-Cultural Healthcare Pathways. Front Public Health 2021; 9:656454. [PMID: 34055720 PMCID: PMC8155376 DOI: 10.3389/fpubh.2021.656454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/14/2021] [Indexed: 12/30/2022] Open
Abstract
The increasing number of international migrants (ranging from 153 million in 1990 to ~272 million in 2019) brought to attention the wide variation of national contexts concerning the policy measures to protect migrants' rights and ensuring their equal access to basic and essential services, namely in health. Sexual and Reproductive Health (SRH) is a key component to the overall health and quality of life and is impacted by power inequities inherent to society's institutions, environment, economics, and culture. In Portugal, guidelines for intervention in SRH are insufficient, a gap that is more pronounced with migrant populations due to the absence of culturally sensitive indicators to assess and monitor SRH. The aim of this work was 2-fold: to identify good practices in the SRH field, with a particular focus, whenever possible, on migrant populations, and to identify relevant and inclusive indicators to monitor SRH in Portugal. A Delphi panel (via online survey) with 66 experts (researchers, teachers, and health professionals) and 16 stakeholders (non-governmental organizations, civil society, and governmental organizations) was implemented in two rounds. Panelists were asked to state their level of agreement (5-point Likert-type scale) regarding four different SRH areas: Sexual Health, Reproductive Health, Social-Structural Factors, and Good Practices. Items were based on literature review and a World Café with 15 experts and stakeholders. Participation rate was 68% and response rate was 97% on the first round. From the initial list of 142 items, a total of 118 (83%) items were approved by consensus. Findings may provide extended opportunities for the healthcare system to engage in better informed decisions and more inclusive and integrative strategies regarding SRH, contributing to build political measures toward sexual and reproductive justice.
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Affiliation(s)
- Pedro Candeias
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia, ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal
| | | | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Unbreakable Idea Research, Painho, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Sónia Pintassilgo
- Centro de Investigação e Estudos de Sociologia, ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal
| | - Patrícia M. Pascoal
- Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
- Digital Human-Environment Interaction Lab, Universidade Lusófona, Lisboa, Portugal
| | - Andreia Silva Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, Lisboa, Portugal
| | - Fernando Luís Machado
- Centro de Investigação e Estudos de Sociologia, ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Lisboa, Portugal
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Sabbah N, Carles G, Demar M, Nacher M. Diabetes in French Guiana, adapting national standards of therapeutic education and care to the amazonian challenge. World J Diabetes 2021; 12:98-107. [PMID: 33594330 PMCID: PMC7839167 DOI: 10.4239/wjd.v12.i2.98] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
French Guiana is a territory located more than 7000 km from France. It is also the largest French territory, with almost 84000 km2 and 90% of it is covered by forest. Some municipalities are isolated due to the scarcity of transportation and the poor road infrastructure. The population is extremely diverse ethnically and culturally, and includes more than thirty ethnic groups. Immigration is high because it is one of the richest countries in the area bordering northern Brazil, Suriname, Guyana, and as a result of socio-economic crises in some other countries such as Haiti, and it has permeable natural borders. Diabetes and obesity, are emerging issues, with double the prevalence of Mainland France, whereas infectious diseases, such as HIV, take second place. Therapeutic and educational management are challenging because they require the adaptation of tools and treatments to the mul-ticulturalism and precariousness often encountered in these populations. The French and European recommendations are unsuited to the needs of the territory and must take into account the epidemiological, sociological and cultural parameters of these populations in order to provide appropriate and graded management of diabetes in the French Amazon.
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Affiliation(s)
- Nadia Sabbah
- Endocrinology Diabetology Nutrition, Centre Hospitalier Andree Rosemon, Cayenne 97300, French Guiana
| | - Gabriel Carles
- Department of Obstetrics and Gynaecology, Centre Hospitalier Franck Joly, St Laurent Du Maroni 97320, French Guiana
| | - Magalie Demar
- Department of Laboratory, University of French Guiana, Cayenne 97300, French Guiana
| | - Mathieu Nacher
- Department of Medicine, COREVIH Centre Hospitalier Andree Rosemon, Cayenne 97300, French Guiana
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Fried DA, Gupta A, Houchens N. Quality & Safety in the Literature: March 2021. BMJ Qual Saf 2021; 30:260-264. [PMID: 33408248 DOI: 10.1136/bmjqs-2020-012966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 11/04/2022]
Affiliation(s)
- David A Fried
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ashwin Gupta
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Nathan Houchens
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
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Moyce S, Velazquez M, Claudio D, Thompson S, Metcalf M, Aghbashian E, Vanderwood K, Sisson N. Exploring a rural Latino community's perception of the COVID-19 pandemic. ETHNICITY & HEALTH 2021; 26:126-138. [PMID: 33126820 PMCID: PMC7870520 DOI: 10.1080/13557858.2020.1838456] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/13/2020] [Indexed: 05/07/2023]
Abstract
OBJECTIVES The purpose of our study was to understand the perception of the Latino community in a rural state regarding COVID-19. Over one third of national COVID-19 cases are among Latinos, likely due to an increased prevalence of comorbid risk factors and social determinants of health that make following precautions difficult. DESIGN Respondents were recruited using snowball sampling as part of a previous effort to establish an academic-community partnership with Latinos in the area. In April 2020, we conducted 14 semi-structured interviews in Spanish with participants over the phone. Interviews were audio-recorded, transcribed into Spanish, and translated to English. We employed the framework approach in a thematic analysis using NVivo 12. RESULTS Common themes were a wariness of news appearing on social media, generalized worry, and the use of natural medicines to maintain health. Respondents followed recommended guidelines to protect their own health, though expressed concern that members of their community were not. CONCLUSIONS We offer insights into the perception of Latinos of the COVID-19 pandemic in a rural state. Our findings may influence communication techniques of local health departments and offer a way to understand how this often-overlooked community deals with the pandemic.
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Affiliation(s)
- Sally Moyce
- Montana State University, College of Nursing
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