Georgia AHEC Librarians Deliver Consumer Health Information to Rural Areas

ABSTRACT

AHEC librarians are forming traditional and nontraditional partners to deliver consumer health information. Through alliances with public libraries, public health departments, and hospitals/ clinics in 15 rural and four urban counties, training to locate quality consumer health information was provided to patrons, clients, and patients. This article will explain how funding was obtained, secrets to the programs' successes, and the barriers encountered. These successful programs are delivering consumer health information that will provide tools to improve the health status in the AHEC communities.     

The Oral Health Needs of Wisconsin Farmers and the Need for Patient Activation: A Pilot Study

Objectives: This study aimed to determine the level of oral health need of Wisconsin farmers based on sociodemographic variables, perceived oral health, and actual oral health, and to evaluate the effectiveness of a dental hygiene patient activation intervention. Methods: Oral health screenings were administered by calibrated dental hygienists to 60 Wisconsin farmers attending the 2016 Wisconsin Farm Technology Days. Study participants self-administered the Oral Health Inventory Profile-14 survey and participated in an Adult Basic Screening Survey. Validity and reliability of both instruments have been established in previous studies. A follow-up phone call for Wisconsin farmers with a moderate- to high-risk oral health condition determined study participants followed the dental hygiene recommendations signified if study participants followed the dental hygiene recommendations and if patient activation had been achieved. Results: Study participants represented Wisconsin farmers (N = 60; n = 32 men, n = 28 women) with an average age range between 50 and 60 years old. The Oral Health Impact Profile-14 survey results indicated that this group of Wisconsin farmers did not perceive themselves to have an oral health problem. The Adult Basic Screening Survey results also indicated that the majority of study participants did not currently have active oral disease. There were 32% (n = 19) who qualified for follow-up phone call, with 15% (n = 3) seeking oral health care based on the dental hygiene recommendation. Significant associations between sociodemographic variables and actual oral health were not found, and the null hypotheses were not rejected. Conclusions: Findings suggest that this group of Wisconsin farmers is receiving regular oral health care and patient activation despite literature suggesting that farmers and rural individuals might face unique barriers to health and oral health care.     

Making the Most of Web Resources to Enhance Health Disparities Information Programs

Abstract

Libraries have the ability to create significant programs for populations most affected by health disparities. Increasing Web-based health resources is transcending the availability of consumer health information. Reliable information is critical to making informed health care decisions. Library services for targeted populations can provide substantial benefits for health information consumers. To date, several libraries have implemented consumer focused health information programs. Although valuable, such programs do not exist without challenges to both consumers and program providers. This article explores consumer focused program models and primary barriers faced by librarians who carry out health information programs. Finally, the authors recommend ideal information tools and Web-based health resources to enhance consumer focused health disparities information programs.     

Quality of Hospital Communication and Patient Preparation for Home Health Care: Results From a Statewide Survey of Home Health Care Nurses and Staff

Objectives

To evaluate the quality of communication between hospitals and home health care (HHC) clinicians and patient preparedness to receive HHC in a statewide sample of HHC nurses and staff.

Recommended Resources for Cancer Patients: Transitioning from Paper Pathfinders to LibGuides

In 2015, The Learning Center, a consumer health library at MD Anderson Cancer Center, embarked on a project to translate paper pathfinders into online Recommended Resources in Springshare’s LibGuides platform. This project was successfully undertaken by a small staff of librarians and health education specialists with a range of technical skills and allowed online access to resources available both online and in The Learning Center. This article briefly addresses the activities and decisions leading up to the adoption of LibGuides, outlines the process of creating more than 40 online Recommended Resources, and describes the outcomes to date.     

Service and Synergy: Four Professions,One Focus at The Learning Center

Cancer hospital libraries which exist primarily to serve patients and health consumers are few in number. One such library is the University of Texas MD Anderson Cancer Center’s patient education library, The Learning Center. The Learning Center has a unique staffing mix of librarians and health educators plus a team of part-time volunteers. This article will show how Learning Center staff uses the strengths from their different professions to provide service in three locations, plus provide examples of the impact The Learning Center makes within the institution.     

Patient satisfaction: A review of issues and concepts

This review presents issues arising from an analysis of over 100 papers published in the field of patient satisfaction. The published output appearing in the medical and nursing literature which incorporated the term “patient satisfaction” rose to a peak of over 1000 papers annually in 1994, reflecting changes in service management especially in the U.K. and U.S.A. over the past decade. An introductory section discusses the setting and measurement of patient satisfaction within this wider context of changes in service delivery. Various models are examined that have attempted to define and interpret the idea of determining individual perceptions of the quality of health care delivered. Determinants of satisfaction are examined in relation to the literature on expectations, and demographic and psychosocial variables. These are distinguished from the multidimensional components of satisfaction as aspects of the delivery of care, identified by many authors. The review highlights the complexity and breadth of the literature in this field, the existence of which is often not acknowledged by researchers presenting the findings of studies.     

Appraisal Skills,Health Literacy and the Patient-Provider Relationship: Considerations as the Health Care Consumer Turns to the Internet to Inform their Care

Health care consumers increasingly obtain health information from the Internet to inform their health care; the health care consumer, who also has the role of patient, maintains the right to access information from sources of their choosing for this purpose. However, noteworthy considerations exist including information appraisal skills, health literacy and the patient-provider relationship. Awareness and education are warranted to assist the health care consumer in achieving proficiency as they turn to the Internet for health information.     

Education for Consumer Health: A Train the Trainer Collaboration

ABSTRACT

This project featured collaboration between a large public library system and an academic institution to address training needs related to the rise in the demand for quality consumer health information. A train the trainer program featuring hands-on training and Web-based support was designed and implemented. Public reference librarians received customized education and support to facilitate their efforts to train library users of consumer health information. The results of the collaborative effort included an increased awareness of cultural, linguistic, and literacy issues for effective provision of public library consumer health reference service along with a reaffirmation of the need for strategic community collaborations for health education.     

Patient organizations in Finland: increasing numbers and great variation

Objective There is very little research on patient organizations (POs), even though their numbers and influence seem to be increasing. The purpose of this study was to describe the establishment, membership, size, organization, decision making and basic funding of national POs in Finland. Setting and participants National POs (n = 130) were identified from their umbrella organizations and by Internet searches. Data were collected from POs’ web pages (87% of POs had one), Finland’s Slot Machine Association (RAY, an important public financier of POs), a relevant survey done by a local TV‐company, and interviews and written materials of POs. Results and conclusions Some current national POs were established around the turn of the 19^th century. The rate of establishment of new POs increased from the 1970s and particularly in the 1990s when POs were characterized by increasing specialization. POs focused on different patient groups and diseases and were founded by philanthropists, physicians, patients, parents and the drug industry. Members could be patients, patient relatives, health‐care professionals and organizations. POs widely varied in memberships (20–145 000, in 2002) and in number of paid personnel (0–1395, in 2002), organizational structure and decision making. Interest groups and financiers were often represented in decision‐making organs. Activities included mutual support and service production, and, increasingly, informing and lobbying. POs had wide domestic and international co‐operation and networking. Drug industry marketing was visible on PO web pages. Budget sizes varied (4000–15 million euros, in 2001). The main public financier was RAY. The old national POs were large and part of national social and health care, but newer ones were often established for mutual support and lobbying. National POs are not uniform but characterized by great variation. The number of national POs is increasing suggesting tighter competition for financing and visibility in the future.     

Gradual Electronic Health Record Implementation: New Insights on Physician and Patient Adaptation

PURPOSE Although there is significant interest in implementation of electronic health records (EHRs), limited data have been published in the United States about how physicians, staff, and patients adapt to this implementation process. The purpose of this research was to examine the effects of EHR implementation, especially regarding physician-patient communication and behaviors and patients’ responses.METHODS We undertook a 22-month, triangulation design, mixed methods study of gradual EHR implementation in a residency-based family medicine outpatient center. Data collection included participant observation and time measurements of 170 clinical encounters, patient exit interviews, focus groups with nurses, nurse’s aides, and office staff, and unstructured observations and interviews with nursing staff and physicians. Analysis involved iterative immersion-crystallization discussion and searches for alternate hypotheses.RESULTS Patient trust in the physician and security in the physician-patient relationship appeared to override most patients’ concerns about information technology. Overall, staff concerns about potential deleterious consequences of EHR implementation were dispelled, positive anticipated outcomes were realized, and unexpected benefits were found. Physicians appeared to become comfortable with the “third actor” in the room, and nursing and office staff resistance to EHR implementation was ameliorated with improved work efficiencies. Unexpected advantages included just-in-time improvements and decreased physician time out of the examination room.CONCLUSIONS Strong patient trust in the physician-patient relationship was maintained and work flow improved with EHR implementation. Gradual EHR implementation may help support the development of beneficial physician and staff adaptations, while maintaining positive patient-physician relationships and fostering the sharing of medical information.     

Health intervention in social context: understanding social networks and neighbourhood

Recruiting lay people from the neighbourhoods of target communities as Community Health Educators (CHEs) is an increasingly popular strategy for health interventions in the UK. CHEs are assumed to have a distinct advantage in reaching 'difficult to reach' groups by virtue of their network membership. However, results obtained from a recent intervention study [Chiu (2002). Straight talking: Communicating breast screening information in primary care. Leeds: Nuffield Institute for Health, University of Leeds] raised concerns about the much-asserted efficacy of networks and suggested that neighbourhood was a contextual factor that would potentially affect the results of health interventions. In addition, it suggested that the concept of social networks and other related concepts i.e. 'social embeddedness', 'social capital', and 'neighbourhoods' that underpin CHE interventions needed to be better understood. In order to examine these concepts in relation to CHE interventions, we conducted a pilot study involving 53 CHEs (26 White, 27 Black and Minority Ethnic) in seven health organisations across the UK. The CHEs took part in focus group interviews to explore their perceptions of social networks and neighbourhood. Quantitative information on their personal networks was also mapped using three proformas. This paper explores CHEs' networks with a specific focus on the concept of 'social embeddedness' and the effect of neighbourhood. Implications of these findings on the effectiveness of intervention are discussed.     

湖北省城市社区卫生服务机构人力资源现况调查

目的 了解湖北省城市社区卫生服务人力资源现况,分析存在的问题.方法 采用自填式问卷普查的方法,收集湖北省12城市共846家社区卫生服务机构基本资料,采用epidata3.02建立数据库并录入数据,用Excel进行分析.结果 湖北省各城市社区卫生服务的人才队伍已初具规模,但略有不足;地区差异明显,人力结构不合理;人员业务素质偏低;全科医学培训工作开展滞后.结论 应尽快调整社区卫生服务机构人力资源结构,适度扩大人力规模,均衡发展各市人力资源,规范社区卫生服务机构人力资源培训,完善社区卫生服务机构人事配套政策.     

湖北省城市社区卫生服务机构人力资源现况调查

目的了解湖北省城市社区卫生服务人力资源现况,分析存在的问题。方法采用自填式问卷普查的方法,收集湖北省12城市共846家社区卫生服务机构基本资料,采用epidata3.02建立数据库并录入数据,用Excel进行分析。结果湖北省各城市社区卫生服务的人才队伍已初具规模,但略有不足;地区差异明显,人力结构不合理;人员业务素质偏低;全科医学培训工作开展滞后。结论应尽快调整社区卫生服务机构人力资源结构,适度扩大人力规模,均衡发展各市人力资源,规范社区卫生服务机构人力资源培训,完善社区卫生服务机构人事配套政策。     

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

PURPOSE

The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients’ willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample.

METHODS

We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately.

RESULTS

Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68–7.81), general health tips (OR = 2.03; 95% CI, 1.74–2.38), medication reminders (OR = 2.73; 95% CI, 2.35–3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62–1.92), vital signs (OR = 1.63; 95% CI, 1.48–1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24–1.58), and symptoms (OR = 1.62; 95% CI, 1.46–1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information.

CONCLUSIONS

Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication.     

基于“项目成本＋项目绩效＋调控系数”综合的社区公共卫生经费分配方法研究

在既往的社区公共卫生经费分配方法中,多采用“总体考核结论”(如总分、结论等级、排名等)结合“每人口经费标准”进行社区公共卫生经费的分配,此方法存在因公共卫生项目之间的差异和人口结构不同所致的不公平等方面的问题。对通过“项目成本＋项目绩效＋调控系数”把绩效考核与服务数量、服务质量相挂钩,探讨和介绍综合平衡的社区公共卫生经费分配方法。