Michael Mackert

Health literacy awareness training for healthcare workers: Improving knowledge and intentions to use clear communication techniques

OBJECTIVE Health literacy is a growing concern as its relationship with health outcomes becomes clearer. Efforts to enhance awareness of patient health literacy in health professional education have focused on physicians, and the objective of this research was to provide an initial assessment of a training session designed for healthcare workers of all kinds. METHODS Pre- and post-surveys were completed by 166 participants (N=166) in training sessions designed to improve knowledge of health literacy and instruction in clear communication techniques. Participants provided baseline and post-training assessments of perceived knowledge of health literacy and use of strategies to improve communication with low health literate audiences. RESULTS Participants, initially overestimating their own knowledge of health literacy, improved on outcome measures regarding perceived health literacy knowledge. Participants also indicated strong intentions to use clear communication techniques covered in the training. CONCLUSION Results suggest there is an opportunity and need to improve health literacy training for healthcare workers of all kinds. Widespread adoption of health literacy training programs would improve the delivery of healthcare to low health literate patients. PRACTICE IMPLICATIONS Participants initially overestimated their knowledge of health literacy, suggesting a need to improve initial training and continuing medical education regarding health literacy.

Perspectives from the Veterans Health Administration about opportunities and barriers in telemedicine.

We used qualitative interviews to examine the perceptions of direct providers of telemedicine services, primary care providers (PCPs) and hospital administrators about opportunities and barriers to the implementation of telemedicine services in a network of Veterans Health Administration hospitals. A total of 37 interviews were conducted (response rate of 28%) with 17 direct telemedicine providers, nine PCPs and 11 administrators. The overall inter-coder reliability across all themes was high (Scotts π = 0.94). Direct telemedicine providers generally agreed that telemedicine improved rapport with patients, and respondents in all three groups generally agreed that telemedicine improves access, productivity, and the quality and coordination of care. Respondents mentioned several benefits to home telemedicine, including the ability to better manage chronic diseases, provide frequent clinician contact, facilitate quick responses to patient needs and provide care in patients homes. Most respondents anticipated future growth in telemedicine services. Barriers to telemedicine implementation included technical challenges, the need for more education and training for patients and staff, preferences for in-person care, the need for programme improvement and the need for additional staff time to provide telemedicine services.

Identifying the public's concerns and the Centers for Disease Control and Prevention's reactions during a health crisis: An analysis of a Zika live Twitter chat.

The arrival of the Zika virus in the United States caused much concern among the public because of its ease of transmission and serious consequences for pregnant women and their newborns. We conducted a text analysis to examine original tweets from the public and responses from the Centers for Disease Control and Prevention (CDC) during a live Twitter chat hosted by the CDC. Both the public and the CDC expressed concern about the spread of Zika virus, but the public showed more concern about the consequences it had for women and babies, whereas the CDC focused more on symptoms and education.

A Systematic Review of Literature About the Genetic Testing of Adolescents

PURPOSE Mapping of the human genome raises interest in and concern about the genetic testing of adolescents. Our purpose was to determine the attitudes and knowledge adolescents and their parents have about genetic testing. DESIGN AND METHOD This paper is a report of a systematic review of the research literature (n = 56) about the attitudes and knowledge adolescents and their parents have about genetic testing. RESULTS The majority of studies, which were descriptive in design, focused on a specific heritable disorder, were conducted in the United States, and over-sampled well-educated White females. PRACTICE IMPLICATIONS Results suggest that adolescents and their families have relatively positive attitudes about genetic testing and may experience both harms and benefits from testing. Nurses may be in positions to assist adolescents and their families in making decisions about genetic testing, remaining sensitive to family dynamics and issues of privacy and autonomy.

Sharing Health Information and Influencing Behavioral Intentions: The Role of Health Literacy, Information Overload, and the Internet in the Diffusion of Healthy Heart Information

Low health literacy remains an extremely common and problematic issue, given that individuals with lower health literacy are more likely to experience health challenges and negative health outcomes. In this study, we use the first three stages of the innovation-decision process found in the theory of diffusion of innovations (Rogers, 2003). We incorporate health literacy into a model explaining how perceived health knowledge, information sharing, attitudes, and behavior are related. Results show that health information sharing explains 33% of the variance in behavioral intentions, indicating that the communicative practice of sharing information can positively impact health outcomes. Further, individuals with high health literacy tend to share less information about heart health than those with lower health literacy. Findings also reveal that perceived heart-health knowledge operates differently than health literacy to predict health outcomes.

Understanding Health Literacy Measurement Through Eye Tracking

This study used eye-tracking technology to explore how individuals with different levels of health literacy visualize health-related information. The authors recruited 25 university administrative staff (more likely to have adequate health literacy skills) and 25 adults enrolled in an adult literacy program (more likely to have limited health literacy skills). The authors administered the Newest Vital Sign (NVS) health literacy assessment to each participant. The assessment involves having individuals answer questions about a nutrition label while viewing the label. The authors used computerized eye-tracking technology to measure the amount of time each participant spent fixing their view at nutrition label information that was relevant to the questions being asked and the amount of time they spent viewing nonrelevant information. Results showed that lower NVS scores were significantly associated with more time spent on information not relevant for answering the NVS items. This finding suggests that efforts to improve health literacy measurement should include the ability to differentiate not just between individuals who have difficulty interpreting and using health information, but also between those who have difficulty finding relevant information. In addition, this finding suggests that health education material should minimize the inclusion of nonrelevant information.

Cool, but Is It Credible? Adolescents’ and Parents’ Approaches to Genetic Testing:

Advances in genomic science create both opportunities and challenges for future generations. Both adolescents and adults may benefit or be harmed by decisions they make in response to this new science. Using a qualitative descriptive design, the authors interviewed 22 adolescents (11 who were aged 14-17 years and 11 who were 18-21 years) and 11 parents to determine levels of knowledge and approaches to decision making. It was found that younger adolescents and their parents have very limited knowledge about genetics and genetic testing. Older adolescents have more complete information and consider a broader range of points in making decisions about hypothetical situations involving genetic testing. Adolescents and parents need much more information to enhance their ability to make decisions about using genetic services. These findings have implications for developing interventions and public health policy highlighted by the need for improved education about the benefits and harms of genetic testing.

Systematic Review of Psychosocial Benefits and Harms of Genetic Testing

Genetic testing can help individuals and families by giving them a sense of control over their futures; however, results of some types of testing cause individuals and their families great distress and anxiety. The purpose of this paper is to report findings from a systematic review of literature about perceived benefits and harms associated with genetic testing. A second purpose was to determine if perceived benefits and harms varied by age and gender. We reviewed a sample of 30 articles published between 1997 and 2009. Most of the articles were other literature reviews. We summarized the benefits and harms associated with each type of genetic testing and made recommendations for future study. As technologies increase, genetic testing will expand and psychiatric mental health nurses must be prepared to meet the challenges of psychosocial disorders that may develop in response to genetic testing.

E-Cigarette Social Media Messages: A Text Mining Analysis of Marketing and Consumer Conversations on Twitter

Background As the use of electronic cigarettes (e-cigarettes) rises, social media likely influences public awareness and perception of this emerging tobacco product. Objective This study examined the public conversation on Twitter to determine overarching themes and insights for trending topics from commercial and consumer users. Methods Text mining uncovered key patterns and important topics for e-cigarettes on Twitter. SAS Text Miner 12.1 software (SAS Institute Inc) was used for descriptive text mining to reveal the primary topics from tweets collected from March 24, 2015, to July 3, 2015, using a Python script in conjunction with Twitter’s streaming application programming interface. A total of 18 keywords related to e-cigarettes were used and resulted in a total of 872,544 tweets that were sorted into overarching themes through a text topic node for tweets (126,127) and retweets (114,451) that represented more than 1% of the conversation. Results While some of the final themes were marketing-focused, many topics represented diverse proponent and user conversations that included discussion of policies, personal experiences, and the differentiation of e-cigarettes from traditional tobacco, often by pointing to the lack of evidence for the harm or risks of e-cigarettes or taking the position that e-cigarettes should be promoted as smoking cessation devices. Conclusions These findings reveal that unique, large-scale public conversations are occurring on Twitter alongside e-cigarette advertising and promotion. Proponents and users are turning to social media to share knowledge, experience, and questions about e-cigarette use. Future research should focus on these unique conversations to understand how they influence attitudes towards and use of e-cigarettes.

Memory Performance, Health Literacy, and Instrumental Activities of Daily Living of Community Residing Older Adults

Background:Health literacy is associated with cognitive function across multiple domains inolder adults, and these older adults may face special memory and cognitive challenges that can limit their health literacy and, in turn, their ability to live independently. Objectives:The aim of this study was to evaluate if an association existed among health literacy, memory performance, and performance-based functional ability in community-residing older adults. Methods:Forty-five adults participated in this study. Designed to reflect everyday memory, the Rivermead Behavioral Memory Test (RBMT) bridges laboratory-based measures of memory and assessments obtained by self-report and observation. The RBMT classifies individuals into four categories of memory performance: normal, poor, mildly impaired, and severely impaired. The participants were recruited in the two categories of normal (≥22) or impaired (⩽16) category on the RBMT. The sample consisted of 14 who were in the impaired category and 31 in the normal group. Their average age was 77.11 years, and their average number of years of education was 15.33 years. Health literacy scores measured with the Rapid Estimate of Adult Literacy in Medicine. Results:Health literacy scores were high (M = 65.09, SD = 2.80). Thirty-four participants or 76% of the sample scored a 66 out of a possible score of 80. Pearson correlations were calculated for the study variables. Health literacy scores with education and cognition (.30), memory performance groups (normal vs. poor; .25), and performance-based instrumental activities (.50) were associated significantly. Discussion:The development of a broader assortment of health literacy instruments would improve the ability of researchers to both compare studies and build on the knowledge and results of others.