Browsing by Subject "Health literacy"
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Item Associations between health literacy and attention to food packaging, front of pack labels, and claims(2013-05) Ripley, Lindsey Powers; Pasch, Keryn E.; Mackert, MichaelBackground: Poor diet is an important risk factor for chronic disease and obesity in the U.S. and diet related health disparities disproportionately affect race/ethnic minorities and adults with the lowest levels of income, education, and health literacy. Packaged foods contribute to poor diet by adding excess calories, saturated fat, sugars, and sodium. Nutrition labels and claims influence knowledge of the healthfulness and nutrient content of packaged foods, and may ultimately impact purchasing decisions. Objective: The purpose of this study was to investigate how adults with varying levels of health literacy view food packaging components. Sample: 25 University Staff and 25 Adult Education students were recruited for participation in the study. The final sample included 47 adults (24 University Staff and 23 Adult Education Students), with 61% of adults were between 25-44 years old, 77% were female, and 47% non-Hispanic White. Methods: Eye tracking technology was used to measure participant attention to food packaging stimuli. The Newest Vital Sign (NVS) was used to measure health literacy. Using objectively measured attention variables, in linear regression models, this study tested the relationship between health literacy and attention to food packaging, claims, and front of pack labels. Results: Health literacy was found to be positively associated with attention to food packaging (B = 13.52, SE = 6.06, p < .05) and front of pack labels (B = 0.29, SE = 0.12, p < .05). After controlling for education and race/ethnicity, health literacy remained positively associated with attention to food packaging (B = 17.01, SE = 8.45, p = 0.050) but not with front of pack labels. Conclusions: Health literacy may be an important factor influencing initial exposure to nutrition information on food packaging. Understanding attention to food packaging and nutrition labels for vulnerable populations, such as those with limited health literacy, is needed to inform strategies focused on increasing nutrition label use and comprehension.Item Consumer interactions with online genetic testing results : a lesson in health literacy(2011-12) Floyd, Alix Elizabeth; Mackert, Michael; Love, BradThis article reports on consumer interactions with and impressions of self-administered online genetic testing results through a direct-to-consumer (DTC) genetic testing service, 23 and Me. Participants in this study point out a clear need for greater education about genetic testing services, increased considerations of health literacy barriers in results communication, and point to larger marketing, advertising, and public health industry implications as they relate to DTC genetic testing.Item eHealth Effectiveness Model, a focus on the Hispanic minority(2010-08) Soueissi, Lama; Mackert, Michael; Love, BradHealth communications providers strive to increase the health literacy of patients and care takers. Basic health literacy is a measure of a person’s ability to understand and act according to appropriate health information. The rise in the number of people attaining basic health literacy increases the amount of positive health behavior in the aggregate. Therefore, health communication providers can create a direct impact on tangible health results in a given population. The introduction of new technology has led to new ways of distributing health information, specifically through online media. Along with a new method of communication comes a need for a new way of evaluating it. As new media emerge and proliferate in the marketplace, different populations’ levels of health literacy become shaped in previously unpredictable ways. Current research suggests that significant differences in wealth and pervasive cultural features account for why distinct populations respond to these developments differently. Thus, the task of determining health communications’ success overall just got harder. It is now necessary to reassess health communications providers’ efficiency and effectiveness with regard to particular minority populations such as Hispanic/Latino adults. Throughout this paper, I refer to the Hispanic/Latino population’s unique characteristics as a case study for the derivation and application of universal health communication values. Thus, the purpose of this report is, based on current findings, to expose the primary values that describe and prescribe the efficacy of online health communication geared towards minorities such as Hispanic/Latino adults residing in the United States. This report concludes that the effectiveness of health information online is a function of three elements: access, quality, and communication strategy. Access represents the extent to which the intended user can search online for the sought-after health information, employ techniques to locate the intended information, and benefit from the search and comprehend the content. The quality prong of the health related Web content represents the useful indicia of accuracy and completeness of the information provided. The first two factors are a sine qua non for a robust health communication campaign. The communication strategy determines the audience reach and the relevance of the health message; both of which ultimately are the driving force for achieving lasting health behavior modification. Health information providers must periodically assess their services along the model’s benchmarks in order to achieve the highest possible levels of health literacy in their target populations and overall. Providers may engage in self-evaluation in order to gauge their own effectiveness, make improvements wherever necessary, and thereby ensure continued conformity to the aforementioned values. If/when these market players are unable or unwilling to adhere to this rubric, the public sphere may need to enforce it as a last resort. This paper does not investigate the merits of either public or private systems of governance; no matter how compliance is achieved, the modern promotion of optimal health literacy in minority communities (and hence, overall) requires that all three elements comprise a new, uniform model for online health communication initiatives.Item Health literacy in adolescents with Sickle Cell Disease(2015-05) Perry, Elizabeth Leigh; Carter, Patricia A.; Mackert, Michael M; Becker, Heather; Garcia, Alexandra; Johnson, Karen; Buchanan, GeorgeHealth literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (Ratzan & Parker, 2000). Little literature exists on adolescent health literacy; and, none exists on health literacy in patients with Sickle Cell Disease (SCD) (Perry, 2014). The purpose of this study was to a) describe factors influencing facilitators and barriers of health literacy levels in adolescents with SCD and b) gather reliability and validity evidence for the Newest Vital Sign (NVS) for use in adolescents. This cross-sectional, descriptive correlational study included administration of a demographics form and the REALM-Teen and NVS health literacy instruments to 75 Black, non-Hispanic adolescent SCD patients at Children's Medical Center of Dallas. There were 37 male and 38 female participants. The mean age of participants was 14.7 years (SD=2.2). The mean grade level of participants was 8.7 (SD=2.2). The mean REALM-Teen score was 53.7 (SD=12.8). The mean NVS score was 2.37 (SD=1.33). Current grade level and health literacy scores showed the highest significant positive correlation (r =.52, p < .01). Health literacy scores were also significantly positively correlated with age (r =.49, p < .01) and income (r =.37, p < .01). Multiple regression analysis showed that current grade level and annual household income explain a significant amount of the variance in health literacy scores (F (2. 49)= 15.92, p=.000, R² =.394, R² [subscript adjusted]=.369). The model also showed that current grade level significantly contributed to the model (β= 3.09, SE (β)=.698, Standardized β = .521, p=.000); however, income did not contribute further (β= 1.60, SE(β)=.858, Standardized β =.219, p=.069). Thus, with every unit increase in current grade level, a three-point increase in health literacy scores occurs, with all other variables being held constant. Results of criterion validity analysis showed that the correlation between NVS scores and REALM-Teen scores was a significant moderate, positive correlation (r=.383, p<.01). The internal consistency for the NVS in this population was poor (Cronbach's α=.627) due at least in part to low correlations between items requiring numeracy and reading skills. Therefore, this study gave great insight into health literacy levels in adolescents with SCD, laying a solid foundation for future nursing, policy, and research initiatives.Item Health Status and Health Literacy in Older Adults(2014-08-04) Fulton, Daphne SaxonThis study aimed to examine the relationship between health literacy and the health status of older adults. The first section of the study consisted of a comprehensive literature review of prior research regarding cognitive, health, and behavioral factors associated with functional health literacy in older adults. Factors in older adults that influence health literacy include: demographics, including age, race, socioeconomic status, and education; cognitive abilities; health and disease knowledge; health beliefs including mistrust of traditional and nontraditional medicine; reading levels; communication skills; social support; healthcare access; preventive care behaviors; and hospitalizations. The second section of the study involved a comprehensive review of instruments testing health literacy. Most instruments testing health literacy revolve around medical term recognition and are based on clinical experiences and not on the practical application of using health knowledge to maintain and improve one?s health. Instruments examined include the REALM, REALM-R, TOFHLA, S-TOFHLA, MART, NVS, DAHL, SAHLSA, OHLI, and screening questions. The most widely used instrument at this time is the S-TOFHLA and most of the newer instruments use it as the standard when testing their validity. The third section of this study used primary data to examine health literacy, patient activation and health status in older adults. The study participants were older adults (n=533) recruited from senior centers, aging programs, and churches in southeast Texas between 2010 and 2012. Participants completed a survey regarding demographics and health status, functional health literacy and the shortened Patient Activation Measure. Using multivariate linear regression, health literacy was related to mental health (?= ?.191, p<.000) and number of days of limited physical activities (?= ?.123, p=.019); patient activation was related to overall general self-reported health status (?= ?.234, p<.000) and number of days of limited physical activity (?= ?.159, p<.001); and the interaction was related to poor physical health ?= ?.994, p<.000). The only statistically significant relationship with the interaction of the two was with the number of days of limited physical activity. Health literacy is related to the health status of older adults but better instruments are needed to more accurately assess levels of functional health literacy, especially in older adults. Patient activation is also related to the health status of older adults but the only statically significant relationship between the interaction of patient activation and health literacy was with the number of days of limited physical activity.Item Las doñas : health literacy and cervical cancer screening among older Mexican-American women(2012-12) Chapa-Flores, Bertha Eloisa; Acton, Gayle Jane, 1951-; Becker, Heather; Brown, Sharon; Mackert, Michael; Gill, Sara; Arevalo-Flechas, LydaCancer is the leading cause of death for Hispanics, and cervical cancer incidence is higher (64%) for Hispanics than for non-Hispanic whites. In Texas Hispanic women 50 and older are the lowest screened and present with higher incidence of invasive cervical cancer as compared to non-Hispanic white women. They are diagnosed at a peak age of 65-74, which suggests that Hispanic women need to be screened past the recommended screening age. An estimated 90 million people in the U.S. lack basic literacy skills and low literacy may contribute to low screening. Few studies have addressed the relationship between low health literacy and cervical cancer screening among older women of Mexican-American ancestry. This study sought to uncover the cervical cancer screening beliefs, practices, health literacy, knowledge, and experiences of English and/or Spanish-speaking older women of Mexican-American ancestry. Thirty women participated in focus group or individual interviews in English and/or Spanish. Women 50 years of age or older living in the community were recruited from senior centers in South Texas from a purposeful convenience sample. Data collection was conducted through audio-taped semi-structured interviews following a moderator guide developed using Zarcadoolas, Pleasant, and Greer’s (2005) health literacy model. Data were transcribed, analyzed in original language, translated for meaning, aggregated for analysis using qualitative content analysis; matrices were developed and analyzed individually, and then data were aggregated. The Newest Vital Sign, a health literacy tool, was used to partially assess fundamental literacy. Major themes elucidated were (a) Reasons “I don’t go” [fundamental literacy], (b), Prevention of cancer and “everything else” [science literacy], (c) We are different,[cultural literacy], (d) There is always “consejos” (advice, messages) [civic literacy], and media literacy, (e) Telenovelas (soap-operas) teach a lot, and (f) Learning from Internet brochures. The study supports a multidimensional model of health literacy and focus group research, accounting for the group’s cultural norms, language, and educational preferences. It adds information for nurse clinicians about providing holistic care, for nurse educators regarding communication strategies for diverse older populations, and for researchers to continue developing strategies that improve health literacy and health outcomes for minority older women.Item Maternal health literacy among low-income mothers with infants(2016-05) Lee, Ju Young; Kim, Miyong; Walker, Lorraine O; Garcia, Alexandra A; Carter, Patricia A; Jang, YuriLimited health literacy in parents often negatively influences their children’s health. Maternal health literacy in low-income families has been hypothesized as an important predictor of the health of family members, especially infants. This study of low-income families in Travis County, Texas, was conducted with the following objectives: (1) to characterize the level of maternal health literacy and its correlates within the family, (2) to determine relationships between maternal health literacy and health outcomes of families’ infants, and (3) to identify the underlying pathways that might describe the effect of maternal health literacy on theoretically selected mediators and, ultimately, on health outcomes of infants. The study’s conceptual framework was adapted from the Paasche-Orlow Wolf conceptual model. This study used a descriptive, cross-sectional, correlational design. Trained bilingual RAs collected data from low-income mothers of infants at two federally qualified community clinics in Travis County, Texas. The data were collected with the use of two health literacy scales: the Newest Vital Sign (NVS) screening tool for functional health literacy and the Parental Health Literacy Activities Test (PHLAT) for maternal health literacy. Individual health literacy abilities among mothers varied on the NVS and PHLAT. In the study sample, 72% and 63.4% of mothers on the NVS and PHLAT, respectively, were rated as having low health literacy. In the bivariate analysis, functional and maternal health literacy were positively correlated with education, household income, social support, and parenting self-efficacy, and they were negatively correlated with number of children. In the hierarchical multiple linear regression, race/ethnicity, education, and social support were found to significantly predict functional health literacy, and education was a significant predictor of maternal health literacy. Mothers with adequate health literacy tended to use more formal information sources than did mothers with low health literacy. There were significant differences in maternal health literacy and infant growth status. The study’s findings demonstrate that parenting self-efficacy has a mediating effect on health literacy and early parenting practices among mothers with infants. Mothers with low education levels and an ethnic minority status demonstrated low health literacy. Future research is needed to advance knowledge about maternal health literacy in low-income mothers and to inform potential heath literacy interventions for this target population.Item Revising Selected Written Patient Education Materials Through Readability and Concreteness(2011-10-21) Goolsby, Rhonda DeniseThe current state of much research on written patient education materials (WPEM) suggests that they are written in a manner that is too difficult even for educated patients to understand and remember. Much of the research in this area is focused on modification of the readability of WPEM, which has shown to be relatively ineffective. In this study, an attempt was made to determine if a theory-based method in revising WPEM for improved comprehensibility and memorability was effective. The effectiveness of three versions of WPEM regarding breast self-exams (BSEs) was examined; the original version without illustrations obtained from the American Cancer Society website, a version that was written at a lower readability level as measured by the Flesch-Kincaid readability formula, and a version with a lower readability level as measured by the Flesch-Kincaid readability formula and the increased use of concrete language as suggested by Dual Coding Theory. The researcher compared the percentage of recall of idea units recalled by 76 participants at two time periods: immediately after reading the randomly assigned version of WPEM and seven days after the initial reading. The WPEM that contained the lower readability level and concrete language was most recalled by participants both at immediate recall and delayed recall. In fact, the delayed recall of the WPEM that contained the lower readability level and concrete language after the seven-day period was almost equivalent to the immediate recall of the participants in the other two groups. A significant main effect was found for the forms of WPEM, F(2, 73) = 27.69, p = .00, n2 p = .43 with an observed power of 1.00. A significant main effect was found for time, F(1, 73) = 161.94, p <.00, n2 p = .69 with an observed power of 1.00. A significant interaction of WPEM and time was found, F(2, 73) = 5.07, p = .01, n2 p = .12 with an observed power of .80. Reported levels of frequency of performing BSEs and levels of confidence in performing BSEs were also analyzed using the Wilcoxon Signed Ranks Test in relation to the three WPEM versions over time. Reported frequency was significantly greater after seven days, regardless of form of WPEM (WPEM A, p = .32; WPEM B, p = 1.00; WPEM C, p = .74). Levels of confidence were significantly greater after seven days, regardless of form of WPEM (WPEM A, p = ..02; WPEM B, p = .00; WPEM C, p = .00). Overall results indicate that combining reduced readability and increased concrete language is beneficial. The writing of WPEMs in a way that patients can understand should be supported by a theory, and infusing Dual Coding Theory in the writing of selected WPEMs may be beneficial for patients.