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Social media is widely used globally by patients, families of patients, health professionals, scientists, and other stakeholders who seek and share information related to cancer. Despite many benefits of social media for cancer care and research, there is also a substantial risk of exposure to misinformation, or inaccurate information about cancer. Types of misinformation vary from inaccurate information about cancer risk factors or unproven treatment options to conspiracy theories and public relations articles or advertisements appearing as reliable medical content. Many characteristics of social media networks-such as their extensive use and the relative ease it allows to share information quickly-facilitate the spread of misinformation. Research shows that inaccurate and misleading health-related posts on social media often get more views and engagement (e.g., likes, shares) from users compared with accurate information. Exposure to misinformation can have downstream implications for health-related attitudes and behaviors. However, combatting misinformation is a complex process that requires engagement from media platforms, scientific and health experts, governmental organizations, and the general public. Cancer experts, for example, should actively combat misinformation in real time and should disseminate evidence-based content on social media. Health professionals should give information prescriptions to patients and families and support health literacy. Patients and families should vet the quality of cancer information before acting upon it (e.g., by using publicly available checklists) and seek recommended resources from health care providers and trusted organizations. Future multidisciplinary research is needed to identify optimal ways of building resilience and combating misinformation across social media.
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The coronavirus disease 2019 (COVID-19) pandemic has highlighted the importance of health literacy and trust in pandemic management. Collaborating with the community to prepare for pandemics is incredibly effective in fostering understanding and building trust in public health and scientific research.
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COVID-19 , Letramento em Saúde , Saúde Pública , Confiança , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controleRESUMO
The US Department of Health and Human Services has defined health literacy (HL) as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Structural and social determinants of health lead to low HL in approximately 36% of adults in the United States, where this condition is most prevalent in racial and ethnic minorities, economically disadvantaged communities, and immigrants with limited English proficiency. In turn, low HL can worsen asthma outcomes through direct effects (eg, nonadherence to or incorrect use of medications) and indirect effects (eg, an unhealthy diet leading to obesity, a risk factor for asthma morbidity). The purpose of this update is to examine evidence from studies on low HL and health and asthma outcomes published in the last 12 years, identify approaches to improve HL and reduce health disparities in asthma, and discuss future directions for research in this area under the conceptual framework of a socioecological model that illustrates the multifactorial and interconnected complexity of this public health issue at different levels.
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Asma , Letramento em Saúde , Humanos , Asma/epidemiologia , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: Understand if cancer fatalism among adult social media users in the United States is linked to social media informational awareness and if the relationship varies by education level. METHODS: Cross-sectional data from the 2022 Health Information National Trends Survey (n = 3,948) were analyzed using multivariable linear probability models. The study population was defined as social media users active within the past year. The outcome variable was cancer fatalism and the predictor variables were social media informational awareness and education level. RESULTS: Participants with low social media informational awareness were 9% (95% CI = 3, 15), 6% (95% CI = 1, 11), and 21% (95% CI = 14, 27) percentage points more likely to agree that it seems like everything causes cancer, you cannot lower your chances of getting cancer, and there are too many cancer prevention recommendations to follow, respectively. Participants with a college degree or higher level of education and who reported high social media informational awareness were the least likely to agree that everything causes cancer (60%; 95% CI = 54, 66), you cannot lower your chances of getting cancer (14%; 95% CI = 10, 19), and there are too many cancer prevention recommendations to follow (52%; 95% CI = 46, 59). CONCLUSION: Social media informational awareness was associated with lower levels of cancer fatalism among adult social media users. College graduates with high social media informational awareness were the least likely to report cancer fatalism.
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Despite increased risk of severe acute respiratory syndrome coronavirus 2 infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.
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Árabes , Vacinas contra COVID-19 , COVID-19 , Letramento em Saúde , Povos Indígenas , Racismo , Humanos , Feminino , Masculino , Adulto , COVID-19/prevenção & controle , COVID-19/etnologia , Canadá/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Pessoa de Meia-Idade , Povos Indígenas/estatística & dados numéricos , Confiança , Adulto Jovem , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Idoso , Povo Asiático , População Negra/estatística & dados numéricos , População Negra/psicologia , SARS-CoV-2/imunologia , Vacinação/psicologia , Vacinação/estatística & dados numéricos , Adolescente , EtnicidadeRESUMO
Factors influencing vaccine uptake in Black individuals remain insufficiently documented. Understanding the role of COVID-19 related stress, conspiracy theories, health literacy, racial discrimination experiences, and confidence in health authorities can inform programs to increase vaccination coverage. We sought to analyze these factors and vaccine uptake among Black individuals in Canada. A representative sample of 2002 Black individuals from Ontario, Quebec, Alberta, Nova Scotia, New Brunswick, British Columbia, and Manitoba, aged 14 years or older completed questionnaires assessing vaccine uptake, health literacy, conspiracy theories, racial discrimination experiences, COVID-19-related stress, and confidence in health authorities. Mediation analyses were conducted to assess (1) the effect of health literacy on COVID-19 vaccination uptake through confidence and need, COVID-19 related traumatic stress, and racial discrimination, and (2) the effect of conspiracy beliefs on COVID-19 vaccination uptake through the same factors. Overall, 69.57% (95% confidence interval, 67.55%-71.59%) of the participants were vaccinated and 83.48% of them received two or more doses. Those aged 55 years and older were less likely to be vaccinated, as well as those residing in British Columbia and Manitoba. Mediation models showed that the association between health literacy and COVID-19 vaccine uptake was mediated by confidence in health authorities (B = 0.02, p < 0.001), COVID-19-related stress (B = -0.02, p < 0.001), and racial discrimination (B = -0.01, p = 0.032), but both direct and total effects were nonsignificant. Lastly, conspiracy beliefs were found to have a partial mediation effect through the same mediators (B = 0.02, p < 0.001, B = -0.02, p < 0.001, B = -0.01, p = 0.011, respectively). These findings highlight the need for targeted interventions to address vaccine hesitancy and inform approaches to improve access to vaccinations among Black communities.
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COVID-19 , Letramento em Saúde , Racismo , Humanos , Vacinas contra COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Canadá , VacinaçãoRESUMO
OBJECTIVE: Structured transition of adolescents and young adults with a chronic endocrine disease from paediatric to adult care is important. Until now, no data on time and resources required for the necessary components of the transition process and the associated costs are available. DESIGN, PATIENTS AND MEASUREMENTS: In a prospective cohort study of 147 patients with chronic endocrinopathies, for the key elements of a structured transition pathway including (i) assessment of patients' disease-related knowledge and needs, (ii) required education and counselling sessions, (iii) compiling an epicrisis and a transfer appointment of the patient together with the current paediatric and the future adult endocrinologist resource consumption and costs were determined. RESULTS: One hundred and forty-three of 147 enroled patients (97.3%) completed the transition pathway and were transferred to adult care. The mean time from the decision to start the transition process to the final transfer consultation was 399 ± 159 days. Transfer consultations were performed in 143 patients, including 128 patients jointly with the future adult endocrinologist. Most consultations were performed by a multidisciplinary team consisting of a paediatric and adult endocrinologist, psychologist, nurse, and a social worker acting also as a case manager with a median of three team members and lasted 87.6 ± 23.7 min. The mean cumulative costs per patient of all key elements were 519 ± 206 Euros. In addition, costs for case management through the transition process were 104.8 ± 28.0 Euros. CONCLUSIONS: Using chronic endocrine diseases as an example, it shows how to calculate the time and cost of a structured transition pathway from paediatric to adult care, which can serve as a starting point for sustainable funding for other chronic rare diseases.
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Doenças do Sistema Endócrino , Transição para Assistência do Adulto , Humanos , Adolescente , Doenças do Sistema Endócrino/terapia , Doenças do Sistema Endócrino/economia , Transição para Assistência do Adulto/economia , Masculino , Feminino , Adulto Jovem , Adulto , Estudos Prospectivos , Doença Crônica/economia , Criança , Custos de Cuidados de SaúdeRESUMO
BACKGROUND: Cervical cancer (CxCa), although preventable, is still among the most prevalent cancers in women. Mortality from this cancer is high, especially in low-income countries where preventive strategies are often lacking. We studied the knowledge, attitudes, and practices regarding CxCa among Yemeni women. METHODS: This cross-sectional study was conducted in 2019 among 399 women in five major hospitals in Sanaa, the capital city of Yemen. Data were collected through face-to-face interviews using structured questionnaires. We used logistic regression models to analyze the likelihood of hearing about CxCa, believing that CxCa is treatable and preventable, awareness of the Pap smear test, and ever having this test, in relation to participant's age, education level, working outside the household, and family history of CxCa. RESULTS: Only 66.7% of the women had heard of CxCa. Women with higher education, working outside the household, and with a family history of CxCa were more likely to be aware of CxCa. Working outside the household was the only variable related to a higher likelihood of knowing that CxCa is a treatable and preventable. Furthermore, women with a family history of CxCa were more likely to have knowledge about Pap smear test and were more likely to have Pap smear test in the past. CONCLUSION: This study identified a low awareness of CxCa and its prevention among Yemeni women. In order to reduce the burden of CxCa in Yemen and save women's lives, it is necessary to raise women's awareness of this disease, especially among those with lower education and those not involved in work outside their homes.
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Conhecimentos, Atitudes e Prática em Saúde , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/psicologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/epidemiologia , Iêmen/epidemiologia , Estudos Transversais , Adulto , Pessoa de Meia-Idade , Teste de Papanicolaou , Adulto Jovem , Inquéritos e Questionários , Esfregaço Vaginal/psicologia , IdosoRESUMO
BACKGROUND: Tumor genomic profiling (TGP) identifies targets for precision cancer treatments, but also secondary hereditary risks. Oncologists are poorly trained to communicate the results of TGP, especially among patients with lower health literacy, poorer genetics knowledge, and higher mistrust. African American (AA) patients are especially vulnerable to poor understanding due to significant cancer disparities and lower uptake of TGP. The goal of this research is to inform the development of an internet-based brief educational support for oncologists to prepare them to provide better decisional support related to TGP for their AA cancer patients. METHODS: This mixed-methods study used semi-structured interviews of oncologists to inform development of an online survey with a convenience sample of US-based oncologists (n = 50) to assess perceptions of the challenges of TGP and communicating results to AA patients. RESULTS: Most interviewed oncologists felt it was important to consider racial/cultural differences when communicating about hereditary risks. Cost, family dynamics, discrimination concerns, and medical mistrust were identified as particularly salient. Survey respondents' views related to AAs and perceptions of TGP were strongly associated with years since completing training, with recent graduates expressing stronger agreement with statements identifying barriers/disadvantages to TGP for AA patients. CONCLUSIONS: Oncologists who had more recently completed training expressed more negative perceptions of TGP and more perceived challenges in communicating about TGP with their AA patients. Focused training for oncologists that addresses barriers specific to AAs may be helpful in supporting improved communication about TGP and improved decisional support for AA patients with cancer considering TGP to evaluate their tumors.
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Neoplasias , Humanos , Negro ou Afro-Americano/genética , Genômica , Neoplasias/genética , Oncologistas , Confiança , Fatores de Risco , Comunicação , Relações Médico-PacienteRESUMO
OBJECTIVE: Little is known about health literacy in childhood-onset systemic lupus erythematosus (cSLE) and how health literacy relates to medication adherence and psychosocial outcomes in this high-risk population. The objective of this study was to evaluate health literacy in adolescents and young adults with cSLE and its association with medication adherence and quality of life. METHODS: Youth 10-24 years with cSLE (n = 48) completed the Brief Healthy Literacy Screen (BHLS) and the Newest Vital Sign (NVS) to assess health literacy. Participants also completed validated measures of medication adherence and quality of life. Descriptive analyses were used to determine levels of health literacy. Bivariate correlations were used to evaluate associations between measures of health literacy with adherence and quality of life. A multivariable regression analyses was used to determine if health literacy was a significant predictor of adherence or quality of life, after adjusting for age, sex, race, and household income. RESULTS: Inadequate health literacy was common in this population, with 67% of youth categorized as having inadequate health literacy by the BHLS and 42% by the NVS. Higher medication adherence was associated with a higher BHLS score (r=.36, p = .017). BHLS was also significantly associated with better quality of life (r = 0.31, p = .034). CONCLUSION: Inadequate health literacy is prevalent among youth with cSLE. Higher health literacy is associated with higher medication adherence and better quality of life, suggesting that attention to health literacy could improve outcomes for this vulnerable population.
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BACKGROUND: Although sexual life and its knowledge are still taboo in many cultures, especially for women, it can negatively affect women's sexual health. AIM: The aim of this study was to examine the relationship between the frequency and duration of masturbation and the sexual health literacy among young Muslim women of reproductive age between 18 and 25 years living in western Turkey. METHODS: The cross-sectional descriptive study was conducted with 921 young women in western Turkey between March and December 2023. Participants were included in the study per the snowball method. The data consisted of attitudes, beliefs, and behaviors regarding masturbation, sexual life, and sexual health literacy. Data were obtained on an online platform and analyzed with SPSS (version 24; IBM). Difference, correlation, and regression analyses were performed. The significance level for statistical analyses was accepted as P < .05. OUTCOMES: The outcomes of the study are the attitudes, beliefs, and behaviors regarding masturbation, orgasm, sexual health literacy, and sexual function in women. RESULTS: The participants were young Muslim women aged 21.00 ± 1.89 years (mean ± SD). The frequency of masturbation was 5.06 ± 2.03 times per month, and the duration was 3.47 ± 1.77 minutes per day. Masturbation frequency and duration were significantly associated with sexual health literacy and sexual function (P < .001). According to regression analysis, sexual function increased and sexual health literacy increased as masturbation frequency and duration increased (P < .001). CLINICAL IMPLICATIONS: This study presents results on the current situation regarding the sexual health literacy and sexual lives in women from different geographies and cultures, and it serves as a source for future studies on areas that need to be improved. STRENGTHS AND LIMITATIONS: The limitation of the study is that it was conducted only with Muslim and Turkish women who use smartphones and are sexually active, so it cannot be generalized to all women. The strengths of the study are that it was conducted with a sample of 921 women, it was based on self-report and addressed many dimensions related to masturbation and female sexuality, and the results were reached through exploratory analysis. CONCLUSION: The study found that the higher the duration and frequency of masturbation in young women, the better their sexual function and higher their sexual literacy.
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Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde , Islamismo , Masturbação , Saúde Sexual , Humanos , Feminino , Turquia , Estudos Transversais , Letramento em Saúde/estatística & dados numéricos , Masturbação/psicologia , Adulto Jovem , Adulto , Adolescente , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Orgasmo , Fatores de TempoRESUMO
INTRODUCTION: Cancer Health literacy (CHL) is the health literacy related to cancer knowledge, prevention, treatment, screening, and access to services. It is an important indicator of people's adherence to screening and preventive measures, which helps to reduce the incidence and prevalence of cancer. The study assessed the CHL level and its association with relevant socio-demographic characteristics and sources of information among primary health care patients and visitors in the United Arab Emirates (UAE). METHODS: A cross-sectional study recruited survey participants who consented to respond to an interviewer-administered questionnaire. The assessment of CHL was done by using 15 questions. CHL level was measured as a median score and also categorized as poor/inadequate, moderate, good/excellent. Nominal logistic regression was used to analyze the relationship between CHL categories and participants' sociodemographic characteristics and CHL sources of information. RESULTS: Of the total 492 participants, 45.5% were young adults (30-39 years old), 32.9% were males, and 70.8% were UAE nationals. The overall median CHL score was 8.0 (IQR = 5.0-10). 33.7% of the participants had a poor/inadequate level of CHL, 49.6% had a moderate level and 16.7% had a good to excellent level of CHL. 76.9% of the participants knew the importance of early cancer screening tests, 72.7% acknowledged the metastatic capacity of cancer, and the protective factors of cancer, especially, in colon cancer (71.7%). A high proportion of participants received health information about cancer via the internet (50.7%), television (45.3%), social media (40.2%), and doctors (43.6%). Nationality other than UAE (aOR = 1.62, 95% CI = 1.03-2.56, P = .038), having university education (aOR = 2.20, 95% CI = 1.21-3.99, P = .010) compared to those with lower than high school, and having a family history of cancer (aOR = 2.42, 95% CI = 1.33-4.41, P = .004) were positively associated with CHL. Older age (aOR = .36, 95% CI = .17-.75, P = .007 for 50-59 years, and aOR = .29, 95% CI = .11-.82, P = .019) for 60-69 years, higher-income (aOR = .57, 95% CI = .33-.99, P = .047 for 10,000-19,999 AED; aOR = .53, 95% CI = .33-.88, P = .013 for ≥20,000) compared with those earning <10,000 AED were negatively associated with CHL. CONCLUSIONS: CHL among the resident UAE population was moderately adequate, therefore implementation of awareness campaigns seems to be warranted. Moreover, evaluation research targeting the CHL impact on cancer prevention practices and screening is also advocated.
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Letramento em Saúde , Neoplasias , Humanos , Emirados Árabes Unidos/epidemiologia , Letramento em Saúde/estatística & dados numéricos , Feminino , Masculino , Estudos Transversais , Adulto , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Pessoa de Meia-Idade , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Detecção Precoce de Câncer/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: High consumption of sugar-sweetened beverages (SSB) is a global health concern. Additionally, sugar-sweetened beverage (SSB) consumption is disproportionately high among adolescents and adults in rural Appalachia. The primary study objective is to determine the intervention effects of Kids SIPsmartER on students' SSB consumption. Secondary objectives focus on caregivers' SSB consumption and secondary student and caregiver outcomes [e.g, body mass index (BMI), quality of life (QOL)]. METHODS: This Type 1 hybrid, cluster randomized controlled trial includes 12 Appalachian middle schools (6 randomized to Kids SIPsmartER and 6 to control). Kids SIPsmartER is a 6-month, 12 lesson, multi-level, school-based, behavior and health literacy program aimed at reducing SSB among 7th grade middle school students. The program also incorporates a two-way text message strategy for caregivers. In this primary prevention intervention, all 7th grade students and their caregivers from participating schools were eligible to participate, regardless of baseline SSB consumption. Validated instruments were used to assess SSB behaviors and QOL. Height and weight were objectively measured in students and self-reported by caregivers. Analyses included modified two-part models with time fixed effects that controlled for relevant demographics and included school cluster robust standard errors. RESULTS: Of the 526 students and 220 caregivers, mean (SD) ages were 12.7 (0.5) and 40.6 (6.7) years, respectively. Students were 55% female. Caregivers were mostly female (95%) and White (93%); 25% had a high school education or less and 33% had an annual household income less than $50,000. Regardless of SSB intake at baseline and relative to control participants, SSB significantly decreased among students [-7.2 ounces/day (95% CI = -10.7, -3.7); p < 0.001, effect size (ES) = 0.35] and caregivers [-6.3 ounces/day (95% CI = -11.3, -1.3); p = 0.014, ES = 0.33]. Among students (42%) and caregivers (28%) who consumed > 24 SSB ounces/day at baseline (i.e., high consumers), the ES increased to 0.45 and 0.95, respectively. There were no significant effects for student or caregiver QOL indicators or objectively measured student BMI; however, caregiver self-reported BMI significantly decreased in the intervention versus control schools (p = 0.001). CONCLUSIONS: Kids SIPsmartER was effective at reducing SSB consumption among students and their caregivers in the rural, medically underserved Appalachian region. Importantly, SSB effects were even stronger among students and caregivers who were high consumers at baseline. TRIAL REGISTRATION: Clincialtrials.gov: NCT03740113. Registered 14 November 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03740113 .
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Índice de Massa Corporal , Cuidadores , Qualidade de Vida , Estudantes , Bebidas Adoçadas com Açúcar , Humanos , Feminino , Masculino , Região dos Apalaches , Adolescente , Estudantes/psicologia , Instituições Acadêmicas , Criança , Adulto , População Rural , Promoção da Saúde/métodosRESUMO
INTRODUCTION: As our growing population demonstrates a significant increase in the incidence of thyroid cancer, so does patient access to their medical records. Poor health literacy and understanding of disease severity, underscores the importance of effective and accessible patient-doctor communication. No previous studies on patient understanding of thyroid pathology reports exist; therefore, we sought to characterize health literacy in this population. METHODS: Using a modified Delphi technique, a 12-question multiple-choice survey regarding common pathology terms with possible definitions for each term was synthesized and administered to patients in a high-volume endocrine surgery clinic. Survey results, patient demographics, history of prior thyroid procedure (biopsy or surgery), and self-reported health literacy were collected. Data analysis included t tests, chi-squared, and multivariable linear regression using R. RESULTS: The survey was completed by 54 patients (response rate: 69.8%). On univariate analysis, White race, previous thyroid procedure, and at least a high school level education were all more likely to score higher on the survey than their counterparts (P < 0.05). On multivariable logistic regression for predicting a higher survey score, only race (est: 2.48 [95% confidence interval: 1.01-3.96]) and higher educational attainment (est: 3.98 [95% confidence interval: 2.32-5.64]) remained predictive (P < 0.05). The remaining demographic groups (age, health literacy confidence, and previous thyroid procedure) did not show a statistically significant difference. CONCLUSIONS: Overall, terms on a thyroid pathology report are poorly understood by patients. This is exacerbated by non-White race and low educational attainment. There is a need for patient-facing pathology education.
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Letramento em Saúde , Humanos , Letramento em Saúde/estatística & dados numéricos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Técnica Delphi , Inquéritos e Questionários/estatística & dados numéricos , Relações Médico-Paciente , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Doenças da Glândula Tireoide/patologia , Doenças da Glândula Tireoide/cirurgiaRESUMO
INTRODUCTION: Health literacy (HL) is a patient's capacity to understand health information. Low HL is associated with worse cancer outcomes and adherence to treatment regimens. This study aimed to test physicians' ability to predict their patients' HL after an initial consultation to determine if routine HL screening is valuable. METHODS: From February 2023 through June 2023, patients seen at an academic breast clinic completed a validated, self-reported HL assessment. Surgical and medical oncologists estimated their patients' HL by answering the same HL questionnaire based on their perception of the patient visit. Patient and physician scores were compared using an intraclass correlation coefficient. Linear regression was used to evaluate associations between physicians' ability to predict HL and other variables. RESULTS: The cohort included 210 patient HL scores with corresponding physician scores for each. Most patients (75.7%) had adequate HL. There was moderate agreement between the patient and physician HL scores (intraclass correlation coefficient = 0.677, P < 0.01), meaning physicians could somewhat predict their patient's HL. Physicians were worse at predicting HL when patients had low HL. There was no difference in physicians' ability to predict HL based on patient age (P = 0.09) or race (P = 0.29). Additionally, we found no difference in the ability to predict HL based on the physician's specialty (P = 0.25). CONCLUSIONS: After an initial consultation, physicians cannot accurately predict patient HL, particularly in patients with lower HL. Given the impact of low HL on a patient's ability to make treatment decisions and adhere to treatment plans, using a validated tool to measure HL is necessary.
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INTRODUCTION: Parental health literacy and neighborhood socioeconomic disadvantage are associated with adverse health outcomes and increased health-care resource utilization in children. We sought to evaluate the association between community-level health literacy and neighborhood socioeconomic disadvantage and their relationships with outcomes of pediatric patients undergoing gastrostomy tube (GT) placement. METHODS: Pediatric patients who underwent GT placement from 2000 to 2019 were identified using the IBM MarketScan Research database. Claims data were merged with the health literacy index (HLI) and area deprivation index (ADI), measures of community-level health literacy and neighborhood socioeconomic disadvantage, respectively. We used multivariate logistic regression to estimate factors associated with postoperative 30- and 90-day ED visits (EVs) and 30-day readmissions. RESULTS: A total of 4374 pediatric patients underwent GT placement. In this cohort, 6.1% and 11.4% had 30-day and 90-day EV; and 30-day readmissions in 19.75%. HLI was lower in those with 30-(244.6 ± 6.1 versus 245.4 ± 6.1; P = 0.0482) and 90-(244.5 ± 5.8 versus 245.5 ± 6.1; P = 0.001) day EV, and 30-day readmission (244.5 ± 5.56 versus 245.4 ± 6.1; P = 0.001) related to GT. ADI was lower in those with 90-day EV (55.1 ± 13.1 versus 55.9 ± 14.6; P = 0.0244). HLI was associated with decreased odds of 30- (adjusted odds ratio: 0.968; 95% confidence interval: 0.941-0.997) and 90-day (adjusted odds ratio: 0.975; 95% confidence interval: 0.954-0.998) EV following GT placement. ADI was also significantly associated with 30 and 90-day EV following GT placement. CONCLUSIONS: In pediatric patients undergoing GT placement, higher ecologically-measured health literacy and neighborhood socioeconomic disadvantage are associated with decreased health-care resource utilization, as evidenced by decreased ED visits. Future studies should focus on the role of individual parental health literacy in outcomes of pediatric surgical patients.
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Gastrostomia , Letramento em Saúde , Criança , Humanos , Gastrostomia/efeitos adversos , Estudos Retrospectivos , Aceitação pelo Paciente de Cuidados de Saúde , Modelos LogísticosRESUMO
INTRODUCTION: On most online platforms, just about anyone can disseminate plastic surgery (PS) content regardless of their educational or professional background. This study examines the general public's perceptions of the accuracy of online PS content and the factors that contribute to the discernment of credible information. METHODS: The Amazon Mechanical Turk crowdsourcing platform was used to survey adults in the United States. The survey assessed respondent demographics, health literacy (HL), and perceptions of online PS content accuracy. T-tests, Chi-square tests, and post hoc analyses with Bonferroni corrections assessed differences between HL groups. Multivariate linear regressions assessed associations between sociodemographic variables and perceptions of online content. RESULTS: In total, 428 (92.0%) of 465 complete responses were analyzed. The median age of respondents was 32 y (interquartile range: 29-40). Online sources were predominantly perceived to have a high degree of accuracy, with mean scores of various platforms ranging from 3.8 to 4.5 (1 = not accurate at all; 5 = extremely accurate). The low HL group perceived social media sites and review sites to be more accurate than the high HL respondents, particularly for Reddit (P = 0.004), Pinterest (P = 0.040), and Snapchat (P = 0.002). CONCLUSIONS: There is a concerning relationship between low HL and the perceptions of the accuracy of online PS sources. This study underscores the need for education campaigns, the development of trustworthy online resources, and initiatives to improve HL. By fostering a more informed public, individuals seeking PS can make better informed decisions.
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Letramento em Saúde , Cirurgia Plástica , Confiança , Humanos , Letramento em Saúde/estatística & dados numéricos , Adulto , Feminino , Masculino , Cirurgia Plástica/educação , Cirurgia Plástica/estatística & dados numéricos , Cirurgia Plástica/psicologia , Estados Unidos , Pessoa de Meia-Idade , Mídias Sociais/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Crowdsourcing , Internet , Adulto JovemRESUMO
INTRODUCTION: Caregiver health literacy is affected by both personal knowledge and education provided by clinicians. Literature on implementation of educational materials into pediatric surgical clinical practice is scarce. We developed plain-language picture-based educational material and implemented it in a pediatric surgery clinic. We assessed both caregiver and clinician satisfaction before and after implementation. METHODS: Picture-based educational material was developed for epigastric/umbilical/inguinal hernias/hydroceles, gastrostomy/gastrojejunostomy tube creation, and soft tissue masses and implemented in an academic pediatric surgery clinic. Pediatric surgeons (n = 12), clinic nurses (n = 4), and physician extenders (n = 2) were surveyed before and after a 4-week pilot implementation period. In parallel, parents of children (0-18 y) completed a 19-item postpre electronic survey capturing demographics, self-professed level of prior knowledge, and opinions regarding the material. Descriptive statistics were performed. RESULTS: Clinician response rate was 88% (pre) and 72% (post). Preimplementation, clinicians overwhelmingly reported repetitive parental counseling, need to redraw diagrams, and anticipation of improvement in workflow with standardized materials. Postimplementation, most clinicians felt the material was easy to use (76%), beneficial (77%), and perceived satisfaction in parents they were counseling (77%). Caregiver response rate was 100%. The majority reported their understanding improved after reviewing the material, found the material easy to understand and helpful, were more comfortable managing their child's condition, and recommended continued use of the material during visits. CONCLUSIONS: Results indicate clinician satisfaction and willingness to use standardized educational material during outpatient visits, as well as caregiver satisfaction and self-reported improved understanding. These findings support further development and use of standardized educational material for pediatric surgical conditions and procedures.
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Especialidades Cirúrgicas , Cirurgiões , Masculino , Humanos , Criança , Projetos Piloto , Pacientes Ambulatoriais , Procedimentos Cirúrgicos AmbulatóriosRESUMO
OBJECTIVE: This scoping review summarises health literacy and disease knowledge in patients with abdominal aortic aneurysm (AAA) or peripheral arterial disease (PAD) and the influencing factors. DATA SOURCES: A systematic search was conducted in PubMed, Embase, PsychINFO, and CINAHL covering the period January 2012 to October 2022. REVIEW METHODS: This scoping review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Inclusion criteria encompassed studies addressing health literacy, knowledge, perception, or awareness in patients with AAA or PAD. Two authors independently reviewed abstracts and full texts, resolving any discrepancies through discussion or by consulting a third author for consensus. All article types were included except letters, editorials, study protocols, reviews, and guidelines. No language restrictions were applied. Primary outcomes were health literacy and disease knowledge. Secondary outcomes were factors that could influence this. Quality assessment was done using the Mixed Methods Appraisal Tool (MMAT). RESULTS: The review included 32 articles involving a total of 5 268 patients. Four articles reported health literacy and the rest disease knowledge. Ten studies (31%) met all quality criteria. Twenty studies were quantitative, eight were qualitative, and four were mixed methods studies. The review revealed inadequate health literacy in the majority of patients, and disease knowledge was relatively low among patients with AAA and PAD, with disparities in measures and assessment tools across studies. Factors influencing health literacy and disease knowledge included socioeconomic status, education, income, and employment. CONCLUSION: This scoping review revealed low health literacy and low disease knowledge in patients with AAA and PAD. Standardised health literacy assessment may contribute to improve communication strategies and decision aids to enhance patients' understanding and engagement in healthcare decisions, however further research is needed to prove its merits.
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Aneurisma da Aorta Abdominal , Conhecimentos, Atitudes e Prática em Saúde , Letramento em Saúde , Doença Arterial Periférica , Humanos , Aneurisma da Aorta Abdominal/cirurgia , Doença Arterial Periférica/diagnóstico , Educação de Pacientes como AssuntoRESUMO
BACKGROUND: Planned behaviors and self-care against the coronavirus are two important factor in controlling its spread and self-care behaviors depend on the level of health literacy. This research was conducted to determine the mediating role of health literacy in the relationship between elements of planned behavior and self-care in dealing with the Covid-19. METHODS: In this descriptive-analytical quantitative study, the sample size was calculated using Cochrane's formula and considering a p-value of 0.51, α = 0.05, and d = 0.05, and 313 students were selected based on stratified and random method. To gather data and assess various aspects of variables, a questionnaires were utilized, focusing on health literacy, self-car and planned behavior. The relationship between the variables was examined by SPSS version 26 and via descriptive statistics, including the mean and standard deviation, and inferential statistics such as Pearson's correlation coefficient (P = 0.05), path analysis, and determining the standard coefficients between self-care and planned behavior, mediated by the indicators of the health literacy. RESULTS: A significant difference was found between the level of health literacy of women and men. The comparison of the mean health literacy and self-care behavior in terms of other variables did not show any significant difference. Meanwhile, the comparison of health status control behaviors, hand washing, and mask use did not show any significant difference between the two groups. A positive and significant correlation was found between self-care behaviors, attitude, subjective norms, perceived behavioral control, and behavioral intention. The relationship of health literacy and psychological variables of attitude, subjective norms, and perceived behavioral control with self-care against COVID-19 was significant. CONCLUSION: The direct and significant impact of health literacy on individuals' self-care behaviors against the coronavirus was not observed. However, health literacy did have a significant effect on subjective norms. This finding is important because subjective norms significantly influenced individuals' behavioral intention, which in turn had a significant effect on self-care behaviors against the coronavirus. Thus, health literacy played a mediating role in this relationship. Furthermore, attitude emerged as the strongest predictor of behavioral intention, exerting a direct effect. Conversely, perceived behavioral control did not directly and significantly affect students' self-care behaviors.