Health literacy and online educational resources: an opportunity to educate patients.

OBJECTIVE: Given the increasing accessibility of material on the Internet and the use of these materials by patients as a source of health care information, the purpose of this study was to quantitatively evaluate the level of readability of resources made available on the European Society of Radiology website to determine whether these materials meet the health literacy needs of the general public as set forth by guidelines of the U.S. National Institutes of Health (NIH) and the American Medical Association (AMA). MATERIALS AND METHODS: All 41 patient education articles created by the European Society of Radiology (ESR) were downloaded and analyzed with the following 10 quantitative readability scales: the Coleman-Liau Index, Flesch-Kincaid Grade Level, Flesch Reading Ease, FORCAST Formula, Fry Graph, Gunning Fog Index, New Dale-Chall, New Fog Count, Raygor Reading Estimate, and the Simple Measure of Gobbledygook. RESULTS: The 41 articles were written collectively at a mean grade level of 13.0 ± 1.6 with a range from 10.8 to 17.2. For full understanding of the material, 73.2% of the articles required the reading comprehension level of, at minimum, a high school graduate (12th grade). CONCLUSION: The patient education resources on the ESR website are written at a comprehension level well above that of the average Internet viewer. The resources fail to meet the NIH and AMA guidelines that patient education material be written between the third and seventh grade levels. Recasting these resources in a simpler format would probably lead to greater comprehension by ESR website viewers.

[Health literacy: An introduction to the concept and its measurement]. / Gesundheitskompetenz/Health Literacy : Das Konzept und seine Operationalisierung.

Over the last 20 years, health literacy (German: Gesundheitskompetenz/health competency) has become a popular concept in research and health policy. Initially defined as an individual's ability to understand medical information, the definition has quickly expanded to describe individual-based resources for actions or conduct relevant to health, in different socio-cultural or clinical contexts. Today, researchers and practice experts can draw on a wide variety of definitions and measurements. This article provides an overview of the definitions, briefly introduces the "structure and agency" approach as an example of theorizing health literacy, and shows different types of operationalization. The article presents the strengths and shortcomings of the available concepts and measures and provides starting points for future research in public health and health promotion.

[Are German information materials on colorectal cancer screening understandable or do they fail? Rating of health information by users with different educational backgrounds]. / Sind Informationsmaterialien zur Darmkrebsfrüherkennung in Deutschland verständlich oder verfehlen sie ihre Wirkung? : Bewertung von Gesundheitsinformationen durch Nutzerinnen und Nutzer mit unterschiedlichem Bildungshintergrund.

Evidence-based patient information is an essential part of decision making in health issues. A qualitative study was conducted to examine whether consumers consider the health information on colorectal cancer screening in Germany helpful in supporting their decision making. In this study, eight texts from different German authors about colorectal cancer screening were evaluated with a criteria-based selection. The texts were tested for understandability, structure, design, and effect on readers. Thirteen semi-structured focus groups were formed including 59 higher-educated and 15 lower-educated testers, 46 % of them being male with a mean age of 62.9 years. The transcripts were analyzed by content-analytic assessment. The testers provided detailed comments on the content and design of the texts. They revealed inaccuracies and suggested improvements of the texts. The testers differed from each other in terms of the intensity of their participation in the discussions and comprehension of the material. The reception of the flyers and brochures varied according to the educational level of the testers. Lower-educated testers often skipped passages of texts about risks as well as passages containing numbers and graphics. The texts had different effects on the testers, regardless of the level of education. If adverse effects were presented, some testers became scared while others were reassured because they felt informed. Most of the testers appreciated a call for participation as a central message of the text. Sometimes, if there was no clear appeal to attend the screening, the testers even asked for it. The recently introduced political strategy of promoting an informed choice is applied to an unprepared population who was used to getting a clear yes-or-no recommendation. Thus, at first, the population has to learn how to make an informed choice. This topic must be addressed and taken into account in the process of developing health information. Since this is not always the case, we conclude that current materials are limited in their contribution toward the decision of attending CRC screening.

Education about HIV/AIDS--theoretical underpinnings for a practical response.

Human immunodeficiency virus (HIV)- and acquired immunodeficiency syndrome (AIDS)-related education is seen by many as central to increasing young people's awareness of, as well as decreasing their vulnerability to, HIV. There is less agreement, however, on the central goals of HIV- and AIDS-related education and the form it might best take. This paper offers a conceptual framework for understanding some of the main approaches to HIV- and AIDS-related education being implemented today, drawing a distinction between approaches which are 'scientifically' informed; those that draw upon notions of 'rights' and those which are overtly 'moralistic' in the sense that they promote conservative moral positions concerning sexuality and sexual acts. In outlining these three approaches, we examine different ways in which the terms 'science', 'rights' and 'moral values' are conceptualized and some of the key assumptions underpinning different forms of HIV- and AIDS-related education. Findings will be useful for those desiring to develop a typology of approaches to HIV- and AIDS-related education and their potential effects.

The Impact of Cultural Factors, The Level of Health Education Received by the Caregivers, and Stigma on Asthma Treatment among Children in Southern Jordan

Abstract For asthma treatment in children, caregivers need good knowledge and attitudes regarding the disease and its treatment. This study aimed to determine the impact of cultural factors, the level of health education provided to patients and their families, as well as the impact of stigmatization on the treatment awareness of children with asthma in southern Jordan. A validated questionnaire was used to collect data from a sample of ninety-seven caregivers selected from three hospitals in southern Jordan. Open ended questions were answered after demonstrating the inhaler technique in and evaluated according to the instructions of the National Asthma Education and Prevention Program (NAEPP, 2013). The result revealed moderate knowledge of asthma with a mean score of (22.36/32), as well as moderate knowledge of asthma treatment (24.26/40). A high mean was found for the impact of cultural and environmental factors (22.93/28), whereas low impact was found for stigma with a mean value of (4.73/12). Therefore, to improve future asthma management, additional efforts are required to educate caregivers and improve their asthma awareness and rectify any falsehoods regarding asthma medications by health care providers.

Health education can save the environment from medicine residues

Abstract The incorrect disposal of medicines and their environmental impact has been related to the health medicalization and the improper use of medication by society. In this sense, it is very important to know the profile of drug disposal for foster health policies. The aim was to identify the profile of disposal of medicines by the population, including the cost perspective. This is an inquiry descriptive study that began in September 2019. Medicine disposal health education program was carried out over six months in two University pharmacies. A questionnaire for sociodemographic and discarded medicines data collection was applied. Logistic regression analysis for variables association of correct disposal and the chi-square and t-student analysis for comparison between disposal programs were performed for a level of 5% and test power of 80%. Medicines weighed 23.3 kg and 28.5 kg, with the cost variation from US$ 13.5 to US$ 16.1 until the final treatment. The correct disposal was strongly associated with the disposal reason (p=0.013), source of information (p=0.006), prescription (p=0.03), form of use (p=0.01), acquisition source (p=0.001), cost with medication (p=0.0001), education (p=0.028) and age (p=0.05). The correct medicine disposal was associated with important features of the community related to education health.

[Reflections about actual understanding of health education as a conceptional category in pedagogical science]. / Refleksje wokól aktualnego rozumieniawychowania zdrowotnego jako kategorii pojeciowej w naukach pedagogicznych.

Health education is area of social reality, in which all less or more purposeful interactions on consciousness, behaviour and conduct of human met. They are meant to be understand as holistic, dynamic and long- term process. Bases of this process are two elemental values: life and health of the human being, which are the source of pedagogical and obligatory norms. In the area of health education we should highline processes of health education and health promotion. From the health pedagogic point of view, which is fulfilling explicational, generalising, communicative, applicational and heuristic function, they become also needed to describing, explaining and estimating the health education process. Example of attaching bigger weight to health educational processes is obligatory entering to the teacher's educational programs terms connected with it's aims, contents, forms, methods and measures.

Work content of Norwegian occupational physicians.

There is little empirical knowledge of the work done in occupational health services. In a study of the work of 50 Norwegian occupational physicians, their work on 249 workdays was recorded and classified into nine different categories according to the work content. Most (40%) of the work concerned work environment matters, 26% went to nonwork-related activities, 18% was for administration, 4% was for personal proficiency, and 12% went to various other activities. A total of 36% of the work concerned preventive activities, and 30% involved curative activities, of which two-thirds (22%) was for nonwork-related illnesses. This latter figure seems large in comparison with the preventive aims of occupational health services given by the Norwegian labor inspectorate. The physicians spent little time on educating employees about work environment matters and on new projects to ensure good work environment standards. The amount of activity involving occupational rehabilitation was fair.

The role of feedback in the process of health behavior change.

OBJECTIVE: To offer a taxonomy of types of feedback and describe potential mechanisms of action particularly in the area of addictive behaviors. METHOD: Reviewed the literature to examine support for types-Generic, Targeted, and Personalized-and for mechanisms of feedback. RESULTS: Although it is not clear how it works, feedback is thought to offer important information, to create a sense of caring and helping relationship, to reach more directly decisional considerations, to increase engagement in the materials, to increase motivation, or to provide social comparison and norms. CONCLUSIONS: Avenues for future research in search of the most effective manner of using feedback to promote health behavior change are discussed.

Patient Internet services: creating the value-added paradigm.

An analysis of consumer and organizational perspectives on web design suggests emerging webside functionality, growing patient needs for self-management skills, and mounting corporate accountability will transform web strategies and consumer expectations from the current general health information approach to a value-added paradigm, which is described with a list of eight guiding principles.

The educational value of consumer-targeted prescription drug print advertising.

BACKGROUND: The case for direct-to-consumer (DTC) prescription drug advertising has often been based on the argument that such promotions can educate the public about medical conditions and associated treatments. Our content analysis of DTC advertising assessed the extent to which such educational efforts have been attempted. METHODS: We collected advertisements appearing in 18 popular magazines from 1989 through 1998. Two coders independently evaluated 320 advertisements encompassing 101 drug brands to determine if information appeared about specific aspects of the medical conditions for which the drug was promoted and about the treatment (mean kappa reliability=0.91). We employed basic descriptive statistics using the advertisement as the unit of analysis and cross-tabulations using the brand as the unit of analysis. RESULTS: Virtually all the advertisements gave the name of the condition treated by the promoted drug, and a majority provided information about the symptoms of that condition. However, few reported details about the condition's precursors or its prevalence; attempts to clarify misconceptions about the condition were also rare. The advertisements seldom provided information about the drug's mechanism of action, its success rate, treatment duration, alternative treatments, and behavioral changes that could enhance the health of affected patients. CONCLUSIONS: Informative advertisements were identified, but most of the promotions provided only a minimal amount of information. Strategies for improving the educational value of DTC advertisements are considered.

[Evaluating quality and effectiveness in the promotion of health: approaches and methods of public health and social sciences]. / Evaluer la qualité et l'efficacité de la promotion de la santé: approches et méthodes de santé publique et de science humaines.

Health promotion and health education have often been limited to evaluation of the effectiveness of actions and programmes. However, since 1996 with the Third European Conference on Health Promotion and Education Effectiveness, many researchers have become interested in "quality assessment" and new ways of thinking have emerged. Quality assurance is a concept and activity developed in industry with the objective of increasing production efficiency. There are two distinct approaches: External Standard Inspection (ESI) and Continuous Quality Improvement (CQI). ESI involves establishing criteria of quality, evaluating them and improving whatever needs improvement. CQI views the activity or service as a process and includes the quality assessment as part of the process. This article attempts to answer the questions of whether these methods are sufficient and suitable for operationalising the concepts of evaluation, effectiveness and quality in health promotion and education, whether it is necessary to complement them with other methods, and whether the ESI approach is appropriate. The first section of the article explains that health promotion is based on various paradigms from epidemiology to psychology and anthropology. Many authors warn against the exclusive use of public health disciplines for understanding, implementing and evaluating health promotion. The author argues that in practice, health promotion: -integrates preventive actions with those aiming to maintain and improve health, a characteristic which widens the actions of health promotion from those of classic public health which include essentially an epidemiological or "risk" focus; -aims to replace vertical approaches to prevention with a global approach based on educational sciences; -involves a community approach which includes the individual in a "central position of power" as much in the definition of needs as in the evaluation of services; -includes the participation and socio-political actions which necessitate the use of varied and specific instruments for action and evaluation. With the choice of health promotion ideology, there exist corresponding theories, concepts of quality, and therefore methods and techniques that differ from those used until now. The educational sciences have led to a widening of the definition of process to include both "throughput and input", which has meant that the methods of needs analysis, objective and priority setting and project development in health promotion have become objects of quality assessment. Also, the modes of action and interaction among actors are included, which has led to evaluation of ethical and ideological aspects of projects. The second section of the article discusses quality assessment versus evaluation of effectiveness. Different paradigms of evaluation such as the public health approach based on the measurement of (epidemiological) effectiveness, social marketing and communication, and the anthropological approach are briefly discussed, pointing out that there are many approaches which can both complement and contradict one another. The author explains the difference between impact (the intermediate effects, direct or indirect, planned or not planned, changes in practical or theoretical knowledge, perceptions, and attitudes) and results (final effects of mid to long term changes such as changes in morbidity, mortality, or access to services or cost of health care). He argues that by being too concerned with results of programmes, we have often ignored the issue of impact. Also, by limiting ourselves to evaluating effectiveness (i.e. that the expected effects were obtained), we ignore other possible unexpected, unplanned and positive and negative secondary effects. There are therefore many reasons to: -evaluate all possible effects rather than only those lined to objectives; -evaluate the entire process rather than only the resources, procedures and costs; -evaluate the impact rather than results; -evalu

Estudio experimental de intervención educativa en conocimientos, actitudes y prácticas para ictus / Experimental study of educational intervention in knowledge, attitudes and practices for ictus

El ictus es una de las patologías neurológicas de mayor prevalencia en el país.Objetivo: determinar la eficacia de la intervención educativa en el cambio de conocimientos, actitudes y prácticas frente a los factores de riesgo del ictus.Método: estudio experimental con muestra al azar de intervención en 68 sujetos, quienes recibieron programa educativo y al mismo tiempo actua-ron como control. Se aplicó un cuestionario sobre conocimientos, actitudes y prácticas validado pre y post intervención. Además, se realizó toma de su presión arterial, determinación del índice de masa corporal, perfil lipídico, hemoglobina glicosilada. La efectividad de la intervención educativa se representa como cambio en porcentaje pre y post intervención en un lapso de tres meses.Resultados: la media de edad fue de 61.07 años, 64.7% fueron mujeres, el porcentaje de conocimientos, actitudes y prácticas adecuadas mejoró de 61.36% a 73.7%; de 64.94% a 83.94%; 87.92% y 76.52% respectivamente. La efectividad total fue un incremento del 22%. Las variables cuantitativas como índice de masa corporal, tensión arterial, niveles de perfil lipídico, así como hemoglobina glicosilada no alcanzaron diferencia significativa.Conclusiones: existe una relación directa y eficacia mayor del 20% cuan-do los pacientes son intervenidos educativamente para modificar positiva-mente los conocimientos, actitudes y prácticas sobre los factores de riesgo de ictus.(AU).

Objective: to determine the effectiveness of the educational intervention in the change of knowledge, attitudes and practices regarding ictus.Method: It is a quasi-experimental study with a random sample of intervention in 68 subjects, who received an educational program and at the same time acted as control. A questionnaire on knowledge, attitudes and practices validated before and after intervention was applied.In addition, blood pressure, determination of body mass index, lipid profile and glycosylated hemoglobin were taken. The effectiveness of the educational intervention is represented as a change in pre and post intervention percentage in a period of three months.Results: the average age was 61.07 years, 64.7% were women, the percentage of knowledge, attitudes and appropriate practices improved from 61.36% to 73.7%; from 64.94% to 83.94%; 87.92% and 76.52% respectively. The total effectiveness was an increase of 22%. The quantitative variables such as body mass index, blood pressure, lipid profile levels, as well as glycosylated hemoglobin did not reach a significant difference.Conclusions: there is a direct and efficacy relationship greater than 20% when patients are educated to positively modify knowledge, attitudes and practices on risk factors regarding ictus. (AU).

The role of taxonomies in social media and the semantic web for health education. A study of SNOMED CT terms in YouTube health video tags.

BACKGROUND: An increasing amount of health education resources for patients and professionals are distributed via social media channels. For example, thousands of health education videos are disseminated via YouTube. Often, tags are assigned by the disseminator. However, the lack of use of standardized terminologies in those tags and the presence of misleading videos make it particularly hard to retrieve relevant videos. OBJECTIVES: i) Identify the use of standardized medical thesauri (SNOMED CT) in YouTube Health videos tags from preselected YouTube Channels and demonstrate an information technology (IT) architecture for treating the tags of these health (video) resources. ii) Investigate the relative percentage of the tags used that relate to SNOMED CT terms. As such resources may play a key role in educating professionals and patients, the use of standardized vocabularies may facilitate the sharing of such resources. iii) Demonstrate how such resources may be properly exploited within the new generation of semantically enriched content or learning management systems that allow for knowledge expansion through the use of linked medical data and numerous literature resources also described through the same vocabularies. METHODS: We implemented a video portal integrating videos from 500 US Hospital channels. The portal integrated 4,307 YouTube videos regarding surgery as described by 64,367 tags. BioPortal REST services were used within our portal to match SNOMED CT terms with YouTube tags by both exact match and non-exact match. The whole architecture was complemented with a mechanism to enrich the retrieved video resources with other educational material residing in other repositories by following contemporary semantic web advances, in the form of Linked Open Data (LOD) principles. RESULTS: The average percentage of YouTube tags that were expressed using SNOMED CT terms was about 22.5%, while one third of YouTube tags per video contained a SNOMED CT term in a loose search; this analogy became one tenth in the case of exact match. Retrieved videos were then linked further to other resources by using LOD compliant systems. Such results were exemplified in the case of systems and technologies used in the mEducator EC funded project. CONCLUSION: YouTube Health videos can be searched for and retrieved using SNOMED CT terms with a high possibility of identifying health videos that users want based on their search criteria. Despite the fact that tagging of this information with SNOMED CT terms may vary, its availability and linked data capacity opens the door to new studies for personalized retrieval of content and linking with other knowledge through linked medical data and semantic advances in (learning) content management systems.

Dynamic generation of a table of contents with consumer-friendly labels.

Consumers increasingly look to the Internet for health information, but available resources are too difficult for the majority to understand. Interactive tables of contents (TOC) can help consumers access health information by providing an easy to understand structure. Using natural language processing and the Unified Medical Language System (UMLS), we have automatically generated TOCs for consumer health information. The TOC are categorized according to consumer-friendly labels for the UMLS semantic types and semantic groups. Categorizing phrases by semantic types is significantly more correct and relevant. Greater correctness and relevance was achieved with documents that are difficult to read than those at an easier reading level. Pruning TOCs to use categories that consumers favor further increases relevancy and correctness while reducing structural complexity.

WHO Health Promotion Glossary: new terms.

The WHO Health Promotion Glossary was written to facilitate understanding, communication and cooperation among those engaged in health promotion at the local, regional, national and global levels. Two editions of the Glossary have been released, the first in 1986 and the second in 1998, and continued revision of the document is necessary to promote consensus regarding meanings and to take account of developments in thinking and practice. In this update 10 new terms that are to be included in the Glossary are presented. Criteria for the inclusion of terms in the Glossary are that they differentiate health promotion from other health concepts, or have a specific application or meaning when used in relation to health promotion. The terms defined here are: burden of disease; capacity building; evidence-based health promotion; global health; health impact assessment; needs assessment; self-efficacy; social marketing; sustainable health promotion strategies, and; wellness. WHO will continue to periodically update the Health Promotion Glossary to ensure its relevance to the international health promotion community.

A etnografia na saúde: tecendo perspectivas interdisciplinares / Ethnography in helthcare: interdisciplinary prospects

O presente trabalho traz uma reflexão sobre as possibilidades de etnografia como metodologia de pesquisa, aliada à noção de interdisciplinaridade, de contribuir para aprimorar as práticas em saúde oferecidas à população pelos profissionais que escolhem trabalhar nesse campo tão desafiador que é o de lidar com as dificuldades humanas e buscar uma superação de dores e doenças.

Participacao da enfermagem na prevencao de incapacidades fisicas na hanseniase / ?

O estudo tem como objetivo analisar a participacao da enfermagem na prevencao de incapacidades fisicas em pacientes portadores de hanseniase, pelo registro da assistencia prestada pela equipe de enfermagem ao longo de tres anos subsequentes ao diagnostico inicial da doenca. A analise foi procedida a partir dos registros de enfermagem contidos em 299 prontuarios de portadores de hanseniase em tratamento em 28 Centros de Saude da Secretaria de Estado de Saude no Municipio de Sao Paulo no periodo de 1986 a 1988. Verificou-se uma baixa cobertura dos pacientes pelas acoes de prevencao de incapacidades. O numero de Centros de Saude que desenvolvem o subprograma e pequeno e o numero de centros de prevencao de incapacidades e insuficiente para atender a demanda