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1.
Rev Med Suisse ; 16(713): 2092-2098, 2020 Nov 04.
Artículo en Francés | MEDLINE | ID: mdl-33146957

RESUMEN

Consistent with the principles of evidence-based medicine, communicating clinical risks to patients and their families is an essential part of informed consent and decision-making. Communication of clinical risks can take place during and after consultations, orally or in writing, based on the latest available scientific data, when available. Numerous studies show that there are different degrees of innumeracy in the general population, meaning more or less significant difficulties mastering numbers in everyday situations. It is therefore imperative to communicate risks in a way that is adapted to the patients' variable numeracy and health literacy levels. This article presents a synthesis of international research on risk communication, as well as recommendations for clinical practice.


Asunto(s)
Comunicación , Alfabetización en Salud , Toma de Decisiones , Medicina Basada en la Evidencia , Humanos , Consentimiento Informado , Riesgo
2.
Gesundheitswesen ; 82(11): 836-843, 2020 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-33187003

RESUMEN

BACKGROUND: People with chronic illnesses (Pwci) face a variety of challenges in managing their illness and using health care. Thus, their need for information and health literacy (HL) is high. While the topic has already been addressed in international research, there is a lack of studies on health literacy among Pwci in Germany. OBJECTIVES AND METHODS: The aim was to analyze HL among Pwci in Germany in more detail. For this purpose, cross-sectional data from a total of 499 Pwci of the German Health Literacy Survey (HLS-GER) were used. HL was assessed with the European Health Literacy Survey Questionnaire (HLS-EU-Q 47). Possible differences in the distribution of low HL by socio-demographic characteristics (gender, age, social status, financial resources, educational level and functional HL (assessed with the Newest Vital Sign (NVS)) and disease-related characteristics (number of diseases and disease duration) were tested using chi-square tests. To investigate the influence of these factors on low HL among Pwci, a multiple logistic regression was performed. RESULTS: Low HL was found in 72.7% of Pwci. Low HL differed greatly according the single domains healthcare, prevention and health promotion. Low social status (OR: 4.4 [1.8; 10.7]), low financial resources (OR: 2.0 [1.2; 3.1]), limited literacy skills (OR: 2.7 [1.4; 5.0]), and an intermediate-level of education (OR: 0.5 [0.3; 0.9]) were associated with low HL in multiple logistic regression. Number and duration of chronic illnesses were not significantly associated with low HL. CONCLUSION: The analysis provides initial findings for Germany that need further investigation. However, they already provide important indications for intervention development. It is necessary to develop target group-specific interventions for strengthening personal health literacy of Pwci, specifically addressing people with low social status, low financial resources and limited literacy. To avoid stigmatization, it is also important to address the information demands in the personal environment. Interventions should make it easier to search for, acquire and process information and thus contribute to reducing inequality.


Asunto(s)
Enfermedad Crónica , Alfabetización en Salud , Estudios Transversales , Alemania/epidemiología , Humanos , Encuestas y Cuestionarios
3.
Wei Sheng Yan Jiu ; 49(5): 738-743, 2020 Sep.
Artículo en Chino | MEDLINE | ID: mdl-33070816

RESUMEN

OBJECTIVE: To understand the status of health literacy and its influencing factors among the residents in Haidian District of Beijing, and to provide references for targeted health education intervention. METHODS: A multi-staged probability proportionate to size sampling(PPS) sampling method was used to collect 7034 residents that aged 15-69 years old in Haidian District in 2018. RESULTS: The standardized rate of health literacy among the residents of Haidian District was 28. 56%. The standardized health literacy rate of basic health knowledge and concept literacy, health lifestyle and behavior literacy, basic health skill were 35. 79%, 30. 90% and 36. 39%, respectively. The standardized health literacy rate of 6 health literacy issues from high to low were safety and first aid(66. 39%), scientific health perspectives(51. 24%), infectious diseases prevention and treatment(39. 78%), health information(30. 25%), chronic disease control and prevention(13. 33%), and basic medical care(11. 23%), respectively. The result of multiple logistic regression showed that aged between 30-39 years old, female, high school education and above, the teacher, medical and government staff, staff of other institutions, staff of other enterprises, other employees and the annual income of the family>45000 RMB were protective factors for health literacy. Aged between 50-69 years old was risk factor for health literacy. CONCLUSION: The level of health literacy in Haidian District was low. Various forms of intervention activities should be carried out to improve the residents' health literacy, especially focused on health lifestyle and behavior literacy, chronic disease control and prevention and basic medical care.


Asunto(s)
Alfabetización en Salud , Adulto , Anciano , Beijing , Ciudades , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios
4.
RMD Open ; 6(3)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33011680

RESUMEN

OBJECTIVE: There is emerging evidence that COVID-19 disproportionately affects people from racial/ethnic minority and low socioeconomic status (SES) groups. Many physicians across the globe are changing practice patterns in response to the COVID-19 pandemic. We sought to examine the practice changes among rheumatologists and what they perceive the impact to be on their most vulnerable patients. METHODS: We administered an online survey to a convenience sample of rheumatologists worldwide during the initial height of the pandemic (between 8 April and 4 May 2020) via social media and group emails. We surveyed rheumatologists about their opinions regarding patients from low SES and racial/ethnic minority groups in the context of the COVID-19 pandemic. Mainly, what their specific concerns were, including the challenges of medication access; and about specific social factors (health literacy, poverty, food insecurity, access to telehealth video) that may be complicating the management of rheumatologic conditions during this time. RESULTS: 548 rheumatologists responded from 64 countries and shared concerns of food insecurity, low health literacy, poverty and factors that preclude social distancing such as working and dense housing conditions among their patients. Although 82% of rheumatologists had switched to telehealth video, 17% of respondents estimated that about a quarter of their patients did not have access to telehealth video, especially those from below the poverty line. The majority of respondents believed these vulnerable patients, from racial/ethnic minorities and from low SES groups, would do worse, in terms of morbidity and mortality, during the pandemic. CONCLUSION: In this sample of rheumatologists from 64 countries, there is a clear shift in practice to telehealth video consultations and widespread concern for socially and economically vulnerable patients with rheumatic disease.


Asunto(s)
Enfermedades Autoinmunes/etnología , Betacoronavirus , Grupos de Población Continentales , Infecciones por Coronavirus/epidemiología , Grupos Étnicos , Grupos Minoritarios , Neumonía Viral/epidemiología , Pobreza , Enfermedades Reumáticas/etnología , Enfermedades Autoinmunes/mortalidad , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Abastecimiento de Alimentos/economía , Alfabetización en Salud , Vivienda , Humanos , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/virología , Enfermedades Reumáticas/mortalidad , Reumatólogos , Encuestas y Cuestionarios , Telemedicina
6.
Int J Public Health ; 65(8): 1437-1443, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33063142

RESUMEN

OBJECTIVES: To understand the status of positive affect (PA) and negative affect (NA) on university and college students, and to explore the determinants during the COVID-19 outbreak. METHODS: Our data were from network-based survey, and 17,876 participants completed the questionnaire. t test, one-way ANOVA and multiple linear regression model were performed using PANAS (Positive and Negative Affect Schedule) score as the dependent variable. RESULTS: Of 17,876 participants, the mean score of PA was 25.5 ± 7.3, while NA was 19.1 ± 7.1. Multiple linear regression models showed that there are some common determinants of PA and NA, such as education, health literacy on communicable diseases, satisfaction with measures for epidemic prevention and control, risk of infection, impact of the outbreak on daily life, sleep duration and frequency of hand washing in the past 2 weeks. Besides, whether the student is a medical major and whether outing in the past 2 weeks were specific determinants of PA, and frequency of masks wearing was specific determinant of NA. CONCLUSIONS: The outbreak of COVID-19 is detrimental to university and college students' affect. During the outbreak response, we should strengthen the guidance and regulation for negative affect and pay attention to improving the positive affect of university and college students.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Estudiantes/psicología , Betacoronavirus , Comportamiento del Consumidor , Brotes de Enfermedades , Femenino , Desinfección de las Manos , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Humanos , Masculino , Pandemias , Medición de Riesgo , Sueño , Factores Socioeconómicos , Universidades , Adulto Joven
9.
J Contemp Dent Pract ; 21(7): 787-791, 2020 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-33020364

RESUMEN

AIM: To evaluate the impact of oral health literacy (OHL) on the periodontal health among low-income-group workers of dental institutes. MATERIALS AND METHODS: A cross-sectional study was conducted on 137 class III and IV workers of dental college. Data collection was done by using a customized pro forma including demographics, REALD-30 for calculating OHL, and items on oral hygiene habits like toothpaste use, brushing frequency, and any other oral hygiene aid. Following which periodontal health status was determined, which was categorized into severe, moderate, and mild periodontitis (health). The analysis was done using the SPSS 11.5. Periodontal health status was associated with OHL scores, oral hygiene habits, and demographics using the chi-square test. The statistical significance level was set at 5% level. RESULTS: Among the 137 subjects, 25 participants reported health/mild periodontitis, 53 had moderate periodontitis, and 59 had severe periodontitis. Low OHL was observed in 52.5% and only 13.8% had high OHL. The participants who had low OHL, 56.94% (n = 41), were having severe disease, while the subjects who had better OHL, only 21.05% (n = 4) were found to have severe disease. CONCLUSION: The people with low socioeconomic classes can be reached effectively if the community involvement concept is used through the workers of dental institutions. But first efforts should be made to improve the OHL of these workers. CLINICAL SIGNIFICANCE: Improving OHL can be of great help to the clinicians and the community health workers because it helps them to make patient adherent to the treatment and the medications prescribed to them. Periodontitis affects people with low socioeconomic status and in the present study it was class III and IV workers. Improving OHL of this population will decrease the oral disease burden of India.


Asunto(s)
Alfabetización en Salud , Estudios Transversales , Humanos , India/epidemiología , Salud Bucal , Pobreza
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1031-1034, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115189

RESUMEN

Nutrition literacy is an important part of health literacy, as well as an significant factor to enhance the quality of population, improving the nutritional status of residents and preventing nutrition-related diseases. In 2010, China developed an evaluation tool for health literacy and began to monitor residents' health literacy. So far, eight national surveys on health literacy have been completed, providing an important basis for health promotion intervention strategies and related policies. However, in health literacy evaluation system, there is neither evaluation content of nutrition literacy, nor evaluation tools. In order to achieve the goals of "national nutrition plan (2017-2030)"and evaluate the implementation effect, it is urgent to carry out the assessment and monitoring of nutrition literacy. According to the nutritional characteristics of different populaitons, this research organizes national experts in related fields, following the principles of scientificity, conciseness and generality and through the scientific formulation procedures to construct the nutrition literacy assessment tools for different populations. This assessment tool can enhance the pertinence and scientificity of nutrition education and improve nutrition development strategy. The establishment of the nutrition literacy assessment tool is the premise of gradually establishing the nutrition literacy assessment system of the residents, and also lays a solid foundation for further conducting the national nutrition literacy evaluation work.


Asunto(s)
Alfabetización en Salud , Estado Nutricional , China , Evaluación Nutricional , Encuestas y Cuestionarios
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1146-1151, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115203

RESUMEN

Nutrition literacy is one of essential components of health literacy. A relatively mature health literacy evaluation system has been established in China so far. However, the studies on nutrition literacy evaluation are still limited, especially for specific population, such as children, adolescents, older people, and maternal. The present study introduces the concept of nutrition literacy, and summarizes the evaluation tools of nutrition literacy for both general population and special population (i.e., children, adolescents, older people, and maternal) in China and foreign countries, and their dimension, reliability, validity and applicable scope. This study aim to provide evidence for the development of nutrition literacy evaluation tools for different population according to the current problem of nutrition in China.


Asunto(s)
Alfabetización en Salud , Adolescente , Anciano , Anciano de 80 o más Años , Niño , China , Humanos , Evaluación Nutricional , Estado Nutricional , Reproducibilidad de los Resultados
12.
J Med Internet Res ; 22(10): e19684, 2020 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-33006940

RESUMEN

BACKGROUND: Since its outbreak in January 2020, COVID-19 has quickly spread worldwide and has become a global pandemic. Social media platforms have been recognized as important tools for health-promoting practices in public health, and the use of social media is widespread among the public. However, little is known about the effects of social media use on health promotion during a pandemic such as COVID-19. OBJECTIVE: In this study, we aimed to explore the predictive role of social media use on public preventive behaviors in China during the COVID-19 pandemic and how disease knowledge and eHealth literacy moderated the relationship between social media use and preventive behaviors. METHODS: A national web-based cross-sectional survey was conducted by a proportionate probability sampling among 802 Chinese internet users ("netizens") in February 2020. Descriptive statistics, Pearson correlations, and hierarchical multiple regressions were employed to examine and explore the relationships among all the variables. RESULTS: Almost half the 802 study participants were male (416, 51.9%), and the average age of the participants was 32.65 years. Most of the 802 participants had high education levels (624, 77.7%), had high income >¥5000 (US $736.29) (525, 65.3%), were married (496, 61.8%), and were in good health (486, 60.6%). The average time of social media use was approximately 2 to 3 hours per day (mean 2.34 hours, SD 1.11), and the most frequently used media types were public social media (mean score 4.49/5, SD 0.78) and aggregated social media (mean score 4.07/5, SD 1.07). Social media use frequency (ß=.20, P<.001) rather than time significantly predicted preventive behaviors for COVID-19. Respondents were also equipped with high levels of disease knowledge (mean score 8.15/10, SD 1.43) and eHealth literacy (mean score 3.79/5, SD 0.59). Disease knowledge (ß=.11, P=.001) and eHealth literacy (ß=.27, P<.001) were also significant predictors of preventive behaviors. Furthermore, eHealth literacy (P=.038) and disease knowledge (P=.03) positively moderated the relationship between social media use frequency and preventive behaviors, while eHealth literacy (ß=.07) affected this relationship positively and disease knowledge (ß=-.07) affected it negatively. Different social media types differed in predicting an individual's preventive behaviors for COVID-19. Aggregated social media (ß=.22, P<.001) was the best predictor, followed by public social media (ß=.14, P<.001) and professional social media (ß=.11, P=.002). However, official social media (ß=.02, P=.597) was an insignificant predictor. CONCLUSIONS: Social media is an effective tool to promote behaviors to prevent COVID-19 among the public. Health literacy is essential for promotion of individual health and influences the extent to which the public engages in preventive behaviors during a pandemic. Our results not only enrich the theoretical paradigm of public health management and health communication but also have practical implications in pandemic control for China and other countries.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Neumonía Viral/epidemiología , Medios de Comunicación Sociales , Telemedicina/estadística & datos numéricos , Adulto , Grupo de Ascendencia Continental Asiática/psicología , Betacoronavirus , China/epidemiología , Estudios Transversales , Femenino , Comunicación en Salud , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Muestreo , Adulto Joven
13.
JMIR Mhealth Uhealth ; 8(10): e20099, 2020 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-33064102

RESUMEN

BACKGROUND: Digitalization is a disruptive technology that changes the way we deliver diagnostic procedures and treatments in medicine. Different stakeholders have varying interests in and expectations of the digitalization of modern medicine. Many recent digital advances in the medical field, such as the implementation of electronic health records, telemedical services, and mobile health apps, are increasingly used by medical professionals and patients. During the current pandemic outbreak of a novel coronavirus-caused respiratory disease (COVID-19), many modern information and communication technologies (ICT) have been used to overcome the physical barriers and limitations caused by government-issued curfews and workforce shortages. Therefore, the COVID-19 pandemic has led to a surge in the usage of modern ICT in medicine. At the same time, the eHealth literacy of physicians working with these technologies has probably not improved since our study. OBJECTIVE: This paper describes a representative cohort of German physicians before the COVID-19 pandemic and their eHealth literacy and attitude towards modern ICT. METHODS: A structured, self-developed questionnaire about user behavior and attitudes towards eHealth applications was administered to a representative cohort of 93 German physicians. RESULTS: Of the 93 German physicians who participated in the study, 97% (90/93) use a mobile phone. Medical apps are used by 42% (39/93). Half of the surveyed physicians (47/93, 50%) use their private mobile phones for official purposes on a daily basis. Telemedicine is part of the daily routine for more than one-third (31/93, 33%) of all participants. More than 80% (76/93, 82%) of the trial participants state that their knowledge regarding the legal aspects and data safety of medical apps and cloud computing is insufficient. CONCLUSIONS: Modern ICT is frequently used and mostly welcomed by German physicians. However, there is a tremendous lack of eHealth literacy and knowledge about the safe and secure implementation of these technologies in routine clinical practice.


Asunto(s)
Actitud del Personal de Salud , Alfabetización en Salud , Médicos/psicología , Telemedicina , Adulto , Estudios de Cohortes , Infecciones por Coronavirus/epidemiología , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Médicos/estadística & datos numéricos , Neumonía Viral/epidemiología , Encuestas y Cuestionarios
14.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1069-1074, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115191

RESUMEN

Objective: To establish core items of nutrition literacy for general population in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts' consultation. Content validity test was used to determine the nutrition literacy item. Thirteen experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, and content validity were analyzed to generate the final list of nutrition literacy items. Results: 92.3% of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96.In the content validity evaluation, the correlation I-CVI value of each item was above 0.83 and the κ value was above 0.74. The evaluation result was excellent.After the second round of expert consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), ten subscales (basic nutrition philosophy, food classification and nutrition knowledge, healthy weight, eating behavior and culture, balanced diet, exercise health, food assessment, nutrition information acquisition and decision, nutrition safety, and weight management)with 25 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.


Asunto(s)
Alfabetización en Salud , Estado Nutricional , China , Humanos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
15.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1075-1080, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115192

RESUMEN

Objective: To establish the nutrition literacy core items for older people in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. Content validity test was used to determine the nutrition literacy items. Seven experts in the field of human nutrition, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of expertstowards the items, active coefficient, and content validitywere evaluated and analyzed to generate the final list of nutritionliteracy items. Results: A total of 85.7% (6/7) of questionnaires in two rounds were collected.The active coefficient of experts was satisfied and the authority coefficient was 0.96. In the content validity evaluation, the correlation I-CVI value of each item was above 0.90 and theκvalue was above 0.74. The evaluation result was excellent. After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of three scales (knowledge and concepts, lifestyles and dietary behaviors, and basic skills), twelve subscales (reasonable nutrition, healthy weight, environment of dining, food classification, nutrition and disease, eat regularly, balanced diet, exercise health, information getting, household food measurement, reading nutrition label and calculating, and food safety)with 20 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese older people based on the content validity evaluation. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority, and the content validity evaluation result is satisfied.


Asunto(s)
Alfabetización en Salud , Estado Nutricional , Anciano , Anciano de 80 o más Años , China , Humanos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1081-1086, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115193

RESUMEN

Objective: To establish the nutrition literacy core items for Chinese pregnant women. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items.11 experts in the field of maternal and child nutrition, obstetrics and gynecology, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items. Results: The active coefficients of consultation in two rounds were 81.8% (9/11) and 87.5% (8/9).The authority coefficients were (0.86±0.11) and (0.85±0.06).The average scores of importance were (4.32±0.84) and (4.58±0.57) and the harmony coefficients were 0.387 (χ²=90.472, P<0.001) and 0.290 (χ²=46.752, P=0.002) respectively. After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of 3 scales (basic knowledge and concept, lifestyles and dietary behaviors, and basic skills), 10 sub-scales (basic nutrition concept, food and nutrition knowledge, nutrition and disease knowledge, lifestyles, dietary behaviors, preparation for breastfeeding, gestational weight management, gestational disease management, acquisition, understanding and application of nutrition information, judgement of nutrition information, and nutrition decision making) with 24 items in total. Conclusions: The framework system and core items of nutrition literacy are established for Chinese pregnant women based on E-Delphi method. The experts involved in the consultation process present a performance with good representativeness, enthusiasm and authority. All experts' opinions are coordinated and unified, which could satisfy the demand of developing nutrition literacy core items for target population.


Asunto(s)
Alfabetización en Salud , Alfabetización , Estado Nutricional , Mujeres Embarazadas , Niño , Técnica Delfos , Femenino , Humanos , Estilo de Vida , Embarazo
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1087-1092, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115194

RESUMEN

Objective: To establish the nutrition literacy core items for Chinese lactating women. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items. 11 experts in the field of maternal and child nutrition, obstetrics and gynecology, health education and nutrition and diseases were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items. Results: The active coefficients of consultation in two rounds were 81.8% (9/11) and 87.5% (8/9). The authority coefficients were (0.86±0.11) and (0.85±0.06). The average scores of importance were (4.03±1.24) and (4.64±0.50)and the harmony coefficients were 0.556 (χ²=163.42, P<0.001) and 0.40 (χ²=64.41, P<0.001). After the second round of consultation, all selected items met the inclusion criteria. We identified the final list of nutrition literacy items consisting of 3 scales (basic knowledge and concept, lifestyles and dietary behaviors, and basic skills), 10 subscales (basic nutrition concept, food and nutrition knowledge, feeding knowledge, lifestyles, dietary behaviors, feeding behaviors, weight management, complementary food production, acquisition, understanding and application of nutrition information, judgement of nutrition information, and nutrition decision making) with 24 items in total. Conclusions: The framework system and core items of nutrition literacy were established for Chinese lactating women based on E-Delphi method. The experts involved in the consultation process presented a performance with good representativeness, enthusiasm and authority. All experts' opinions are coordinated and unified, which could satisfy the demand of developing nutrition literacy core items for target population.


Asunto(s)
Alfabetización en Salud , Lactancia , Estado Nutricional , Niño , Técnica Delfos , Femenino , Educación en Salud , Humanos , Estilo de Vida , Encuestas y Cuestionarios
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(10): 1093-1097, 2020 Oct 06.
Artículo en Chino | MEDLINE | ID: mdl-33115195

RESUMEN

Objective: To establish the nutrition literacy core items for preschool children in China. Methods: The framework system and preliminary items of nutrition literacy were established through literature review and experts consultation. E-Delphi method was used to determine the nutrition literacy items. Nine experts in the field of nutrition, child and adolescent health, health education were invited to score the importance of each nutrition literacy item via Email. The judgment basis and familiarity of experts towards the items, active coefficient, authority coefficient and harmony coefficient were evaluated and analyzed to generate the final list of nutrition literacy items. Results: In the first round of E-Delphi consultation, the active coefficient and authority coefficient were 88.9%(8/9) and(0.88±0.07).The harmony coefficient was 0.350 (χ2=36.432, P=0.001). In the second round, the active coefficient and authority coefficient were 100% (9/9) and (0.89±0.11).The harmony coefficient was 0.347 (χ2=34.330, P<0.001). After qualitative and quantitative analyses, we identified the final list of nutrition literacy items consisting of two scales (basic knowledge, lifestyles and dietary behaviors), six subscales (food knowledge, food characteristic, food choice, dietary behavior, dietary safety, and physical activity)with 14 items in total. Conclusion: The framework system and core items of nutrition literacy are established for Chinese preschool children, which could provide a reference basis for the implementation of nutrition education project and the establishment of standardized evaluation tools.


Asunto(s)
Alfabetización en Salud , Estado Nutricional , Adolescente , Preescolar , China , Técnica Delfos , Dieta , Ejercicio Físico , Humanos , Encuestas y Cuestionarios
19.
N Engl J Med ; 383(10): 909-918, 2020 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-32877581

RESUMEN

BACKGROUND: Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking. METHODS: We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months. RESULTS: All 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, -4.99%; 95% confidence interval [CI], -6.02 to -3.96) than in the usual-care group (-0.48%; 95% CI, -1.57 to 0.61), with a mean between-group difference of -4.51 percentage points (95% CI, -5.93 to -3.10) (P<0.001). There were no significant between-group differences in serious adverse events. CONCLUSIONS: A high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.).


Asunto(s)
Disparidades en Atención de Salud , Estilo de Vida Saludable , Obesidad/terapia , Poblaciones Vulnerables , Pérdida de Peso , Adulto , Anciano , Dieta Reductora , Ejercicio Físico , Femenino , Alfabetización en Salud , Humanos , Masculino , Persona de Mediana Edad , Obesidad/etnología , Obesidad/fisiopatología , Educación del Paciente como Asunto , Atención Primaria de Salud , Factores Socioeconómicos , Adulto Joven
20.
PLoS One ; 15(9): e0236861, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32960886

RESUMEN

OBJECTIVE: Telephone based health coaching (TBHC) seems to be a promising approach to foster self-management in patients with chronic conditions. The aim of this study was to evaluate the effectiveness of a TBHC on patient-reported outcomes and health behavior for people living with chronic conditions in Germany. METHODS: Patients insured at a statutory health insurance were randomized to an intervention group (IG; TBHC) and a control group (CG; usual care), using a stratified random allocation before giving informed consent (Zelen's single-consent design). The TBHC was based on motivational interviewing, goal setting, and shared decision-making and carried out by trained nurses. All outcomes were assessed yearly for three years. We used mixed effects models utilizing all available data in a modified intention-to-treat sample for the main analysis. Participants and study centers were included as random effects. All models were adjusted for age, education and campaign affiliation. RESULTS: Of the 10,815 invited patients, 4,283 returned their questionnaires at baseline. The mean age was 67.23 years (SD = 9.3); 55.5% were female. According to the model, TBHC was statistically significant superior to CG regarding 6 of 19 outcomes: physical activity in hours per week (p = .030) and in metabolic rate per week (p = .048), BMI (p = .009) (although mainly at baseline), measuring blood pressure (p< .001), patient activation (p< .001), and health literacy (p< .001). Regarding stages of change (p = .005), the IG group also showed statistically different results than the CG group, however the conclusion remains inconclusive. Within-group contrasts indicating changes from baseline to follow-ups and significant between-group comparisons regarding these changes supported the findings. Standardized effect sizes were small. TBHC did not show any effect on mental QoL, health status, alcohol, smoking, adherence, measuring blood sugar, foot monitoring, anxiety, depression and distress. Campaign-specific subgroup effects were detected for 'foot monitoring by a physician' and 'blood sugar measurement'. CONCLUSION: TBHC interventions might have small effects on some patient reported and behavioral outcomes. PRACTICE IMPLICATIONS: Future research should focus on analyzing which intervention components are effective and who profits most from TBHC interventions. REGISTRATION: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS): DRKS00000584.


Asunto(s)
Enfermedad Crónica/terapia , Asesoramiento a Distancia/métodos , Conductas Relacionadas con la Salud , Medición de Resultados Informados por el Paciente , Telemedicina , Anciano , Ansiedad/psicología , Glucemia/análisis , Ejercicio Físico , Femenino , Alemania , Alfabetización en Salud , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Entrevista Motivacional , Participación del Paciente , Autocuidado
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