The Role of the School in Consumer Health Education

Ethical consumer health education is education that is noncoercive and facilitates an individual's voluntary adoption of health improving behaviors. Patients and consumers attempting to utilize the medical marketplace for cure or prevention may be ill-prepared to do so because of the complexity of the marketplace, the strong marketing influences of the marketplace, and their own lack of fundamental preparation in the rudiments of decision-making, valuing, assertiveness, data collection, and other skills necessary to be a good consumer. For this reason, school-based consumer health education is necessary to prepare current and future consumers to safely and efficiently use the medical marketplace.     

Primary sources of health information: comparisons in the domain of health attitudes, health cognitions, and health behaviors

The recent growth in consumer autonomy in health care accompanied by the surge in the use of new media for health information gathering has led to an increasing scholarly interest in understanding the consumer health information search construct. This article explores consumer health information seeking in the realm of the primary sources of health information used by consumers. Based on an analysis of the 1999 HealthStyles data, the paper demonstrates that active communication channels such as interpersonal communication, print readership, and Internet communication serve as primary health information sources for health-conscious, health-information oriented individuals with strong health beliefs, and commitment to healthy activities. On the other hand, passive consumption channels such as television and radio serve as primary health information resources for individuals who are not health-oriented. Media planning implications are drawn from the results, suggesting that broadcast outlets with an entertainment orientation are better suited for prevention campaigns. Such channels provide suitable sites for entertainment-education. On the other hand, print media, interpersonal networks, and the Internet are better suited for communicating about health issues to the health-active consumer segment.     

Counting the cost of calories

Obesity is a significant public health issue. Marion Nestle spoke with Ben Jones about calories and why anti-obesity measures must prevail.     

Numeracy skill and the communication, comprehension, and use of risk-benefit information

Current health care policy emphasizes improving health outcomes and the efficacy of health care delivery by supporting informed consumer choices. At the same time, health information often involves uncertainty, and many people may lack the skills and knowledge to process this information, manage their health and health care, and make informed choices. Innumeracy, an element of poor health literacy, is associated with the comprehension and use of important health information. We review this literature and examine what can be done to help less numerate people act more effectively and take charge of their health.     

Consumer Health Information Literacy Promotion Program in Public and Community Libraries in Africa: Experience from Kenya,Nigeria, Uganda,and Zimbabwe

The aim of this project was to enhance the capacity of public and community librarians in four African countries (Kenya, Nigeria, Uganda, and Zimbabwe) in meeting the consumer health information (CHI) needs of their patrons. A total of 65 librarians from 34 public and community libraries were trained on how to access and use consumer health information resources by health sciences librarians in the selected countries. A needs assessment preceded the training that focused on health literacy, health information literacy, sources of health information, online information searching tools and search techniques, and how to search CHI resources, including Kidshealth.org, Womenshealth.gov, MedlinePlus, and CancerNet, among others. Each team of participating libraries received a seed grant to design and implement a consumer health activity. The trained public and community librarians in both Nigeria and Uganda conducted training on use of CHI resources to different categories of patrons. In Nigeria, high school students were trained on how to use their mobile phone to access CHI resources. Adolescents and other categories of library patrons were trained on information and communication technology (ICT) skills and accessing CHI resources in Uganda. In Kenya, the public librarian created a Consumer Health Information Corner and purchased CHI books for patrons to consult, while in Zimbabwe, the public library partnered with other non-governmental organizations to provide consumer health information materials to the library for patron use. It is possible for academic health sciences librarians to partner with public and community librarians in Africa to carry out a successful CHI project.     

A consumer-designed model of continuing education for administrators

Conclusions Mental health administrators can design for them-selves a training experience which is both interesting and educational. Futhermore, such a consumer designed curriculum and format can be generalized to a broader representation of mental health administrators, evidenced by the satisfaction ratings given to the second conference. Conference participants were drawn from thirty agencies and several disciplines. Ratings were not related to years of experience nor to judged similarity in ideological orientation between the respondent and other conference participants. It is interesting to note that in terms of training needs, the planning participants identified more strongly with their administrative roles than with mental health per se. Only two of the eight topics chosen related directly to mental health. Thus the training model and program content may have broader application to administrators in other health related fields. In conclusion the consumer designed model for continuing education for administrators is a concept worthy of further pursuit. Administrators are willing to design and attend such programs. They rate these experiences as satisfying, relevant, and contributing to their knowledge of the field. Administrators are also willing to support the model through registration fees, by recruiting trainees, and as consultants to future training efforts. As a further step in generalizing the consumer designed model, the Continuing Education Program is now evaluating its use in improving service systems. Mental health centers have become the consumers who design training programs tailored to their individual needs. Training intervention is then employed in order to make their specified changes in service delivery.     

Health care consumer reports: an evaluation of consumer perspectives

There has been a proliferation of health care consumer reports, also known as "consumer guides," "report cards," and "performance reports," which are designed to assist consumers in making more informed health care decisions. While there is evidence that providers use such reports to identify and make changes in practice, thus improving the quality of care, there is little empirical evidence on how consumer guides/report cards are used by consumers. This study fills that gap by surveying 925 patients as they wait for ambulatory care in several clinics in a midwestern city. Findings indicate that consumers are selective in their use of these reports and quickly identify those sections of the report of most interest to them. Report developers should take precautions to ensure such reports are viewed as credible sources of health care information.     

Assessing the Utility of Consumer Surveys for Improving the Quality of Behavioral Health Care Services

The development and implementation of provider performance and consumer outcome measures for behavioral health care have been growing over the last decade, presumably because they are useful tools for improving service quality. However, the extent to which providers have successfully used performance measurement results has not been adequately determined. To this end, two methods were used to better understand the use of data obtained from an annual survey of behavioral health care consumers: a cross-sectional survey of executive directors, clinical program directors, and quality improvement directors and follow-up interviews with a subsample of survey respondents. Results revealed information about the use of consumer survey data, factors that facilitate and hinder the use of results, as well as respondents?? opinions about consumer survey administration procedures. These findings provide valuable information for the application of performance measures and, ultimately, improving consumer outcomes.     

Consumer drop-in centers: operations,services, and consumer involvement

Interest in involvement of consumers in mental health and psychiatric rehabilitation services delivery has expanded in recent years, encompassing self-help approaches, consumers employed as providers in formal agencies, and consumers operating their own services. This study reports results from in-depth phone surveys conducted with 32 consumer drop-in centers in Michigan. Results indicate that centers operate in many ways like other human services businesses, albeit with much smaller budgets. Funding levels, salaries, and services showed great heterogeneity among the centers and in comparison with reports in the literature. Centers autonomously run by consumers and centers with consumer involvement (operated by a non-consumer agency) were found to differ significantly on several variables, including consumer control, funding and service levels, and challenges. Implications for the growth and increased use of consumer drop-in centers are discussed.     

深圳市医疗保险管理的探讨与实践

该回顾总结了深圳市实施职工基本医疗保险制度的实践经验,主要内容包括：建立医疗保险社会化服务网络;不断探索和改进医疗费用结算办法;建立对医患双方的制约机制;加强对特殊人群医疗费用的管理工作;加强各有关部门的协调配合;建立健全医疗保险管理专业队伍。     

脂肪税、肥胖问题与政府管制

由于现代生活节奏的加快,久坐不动的生活方式和能量密集的高脂饮食导致了肥胖的流行,它不仅对消费者自身的健康造成了损害,还存在强烈的外部性,因此政府对肥胖问题的管制成为应有之义,但由于肥胖问题本身的复杂性和普遍性,使得对肥胖流行的管制陷入干预消费者选择自由与提高消费者福利的两难。本文通过对肥胖流行问题的梳理,考虑到肥胖流行所导致的长期健康风险,讨论了政府实施脂肪税管制的可行性,并就脂肪税收政策在食品市场预期可能产生的效果进行了分析。     

Clinical practice guidelines: a tool to improve care

The American patient and consumer groups are increasing pressure on physicians and health care organizations to improve and document the quality of care that they deliver. A leading cause of inadequate care is the significant variations in medical practice that cannot be explained by patient differences, which persist through out the country. Managed care and the rise of consumer groups has forced health care providers and organization to begin analyzing how and why they deliver care to patients. The incorporation of quality improvement tools such as evidence-based practice guidelines have been shown to reduce practice variability, improving the process and outcomes of care. The correct development and implementation of these guidelines can be an effective tool to assist the practicing physician in improving the care delivered to his/her patient.     

Reimagining consumer involvement: Resilient system indicators in the COVID‐19 pandemic response in New South Wales,Australia

BackgroundReflections on the response to the COVID‐19 pandemic often evoke the concept of ‘resilience’ to describe the way health systems adjusted and adapted their functions to withstand the disturbance of a crisis, and in some cases, improve and transform in its wake. Drawing from this, this study focuses on the role of consumer representatives in healthcare services in initiating changes to the way they participated in the pandemic response in the state of New South Wales in Australia.MethodsIn‐depth interviews were conducted with two cohorts of consumer representatives. Cohort A included experienced and self‐identified consumer leaders, who worked together in a COVID‐19 Consumer Leaders Taskforce; Cohort B included participants outside of this group, and purposively included consumer representatives from rural and regional areas, and culturally and linguistically diverse communities.ResultsThe pause in consumer engagement to support health service decision‐making in responding to the pandemic forced consumer representatives to consider alternative approaches to participate. Some initiated networking with each other, forming new collaborations to produce consumer‐led research and guidelines on pandemic‐related patient care. Others mobilized support from community and politicians to lobby for specific healthcare issues in their local areas.ConclusionThe response to the COVID‐19 pandemic made visible the brittle nature of previous engagement processes of involving consumers in organizational design and governance. However, the momentum for proactive self‐organization in an unexpected crisis created space for consumer representatives to reset and reimagine their role as active partners in health services. Their ability to adapt and adjust ways of working are key assets for a resilient health system.Patient or Public ContributionThis project is a collaborative study between academic researchers and health consumer (patient and public) representatives. It followed the principles of codesign and coresearch, whereby both consumer representatives and academic researchers contributed equally to all stages of the project. The study was cofunded by both academic institutions and consumer representative organizations.     

Shared Principles of Ethics for Infant and Young Child Nutrition in the Developing World

Background  

The defining event in the area of infant feeding is the aggressive marketing of infant formula in the developing world by transnational companies in the 1970s. This practice shattered the trust of the global health community in the private sector, culminated in a global boycott of Nestle products and has extended to distrust of all commercial efforts to improve infant and young child nutrition. The lack of trust is a key barrier along the critical path to optimal infant and young child nutrition in the developing world.     

基于社会学习的中医药服务认可度SEM改进分析

作为我国传统医学,中医药服务具有＂简、便、廉、验＂等优势,是医疗卫生服务的重要组成部分。在西医的冲击下,中医药服务质量如何完善、凸显其优势以获得广大居民认可成为亟需解决的重要问题。本文以行为与社会科学为视角,基于社会学习理论系统考察影响居民对中医药服务认可度的相关因素,构建居民中医药服务认可度的结构方程模型,并通过AMOS17.0和SPSS软件对实证数据进行深入分析,得出以下结论：居民的中医药服务接触质量、自身情感情况和受影响程度对认可度产生直接影响;居民的个体认知和信任度对认可度没有影响;居民对中医药技术的认可是中医药服务认可度的最主要来源。最后,基于上述结论对区域进行中医药服务质量改进和服务推广提供理论支持和政策建议。     

Health Claims: History, Current Regulatory Status, and Consumer Research

During the past 13 years regulatory and consumer communications policies on health claims have been hotly debated and have evolved from a nonregulatory action policy by which health claims were written by manufacturers to one in which claims are carefully proscribed and legally allowed by regulatory agencies. Unfortunately, health claims are not used to full public health potential. This review examines the scientific literature to determine the most effective way to communicate health claims to consumers. The results of health claims studies suggest an evolution in consumer preferences: from complete non–product-specific information in the middle to late 1980s to shorter product-specific claims in 1995 and 1996. Comprehension research suggests that shorter health claims communicate most effectively. Related label research shows that effective messages suggest action, contain text and graphics, and are placed on the front panel. In conclusion, effective health claims:▪ Are concise▪ Relate to a consumer need or task to be solved▪ Appear on the front panel▪ Combine text and graphics using color▪ Provide an additional benefit beyond the label (eg, increase the production and availability of more nutritious products and increase consumers’ knowledge of nutrition and health). J Am Diet Assoc. 1998;98:1312-1322.     

Consumer evaluation of food with nutritional benefits: a systematic review and narrative synthesis

As a consequence of the growing interest in, and development of, various types of food with nutritional benefits, the modern consumer views their kitchen cabinet more and more as a medicine cabinet. Given that consumer evaluation of food is considered key to the successful production, marketing and finally consumption of food, a procedure commonly used in medical fields was employed to systematically review and summarize evidence of consumer evaluation studies on nutritious foods. The focus is primarily on consumer understanding of nutritious food and the underlying determinants of consumer evaluation. Our results highlight four groups of key determinants: (1) nutrition knowledge and information; (2) attitudes, beliefs, perceptions and behavioural determinants; (3) price, process and product characteristics; and (4) socio-demographics. The findings also point to the importance of understanding consumer acceptance as one many concepts in the consumer evaluation process, and provide support for developing appropriate strategies for improving health and well-being of consumers.     

Governing the ethical consumer: identity, choice and the primary care medical encounter

Government policy promoting consumerism in healthcare can be seen as offering up certain preferred identities to which its citizens are encouraged to aspire. Whilst many commentators reject the notion that health services users should be conceived of as consumers, this paper outlines the relevance of the concept to our understanding of the ways in which individuals manage their health and service use. The paper examines the identity work undertaken by individuals in relation to decisions about healthcare preferences and assesses the extent to which this is compatible with the identities promoted in Government policy. We suggest that in circumstances where individuals feel both a sense of personal entitlement and a desire to be supportive of the needs of other members of the community, 'doing' ethical consumer can be fraught with discomfort and anxiety. These anxieties are exacerbated in a context where citizenship is increasingly being defined in terms of consumer identities, and making good (health) choices might be seen as distinguishing the civilised from the marginalised.     

A consumer involvement model for health technology assessment in Canada

Similar to other health policy initiatives, there is a growing movement to involve consumers in decisions affecting their treatment options. Access to treatments can be impacted by decisions made during a health technology assessment (HTA), i.e., the rigorous assessment of medical interventions such as drugs, vaccines, devices, materials, medical and surgical procedures and systems. The purpose of this paper was to empirically assess the interest and potential mechanisms for consumer involvement in HTA by identifying what health consumer organizations consider meaningful involvement, examining current practices internationally and developing a model for involvement based on identified priorities and needs. Canadian health consumer groups representing the largest disease or illness conditions reported a desire for involvement in HTA and provided feedback on mechanisms for facilitating their involvement.     

供方需方第三方

分析了体制因素对共需双方的影响。指出，供需双方都呼唤第三方从体制改革入手，为供方和需方共同提供适宜的环境。第三方找基本职责调供需关系，其中构建起把供需利用统一起来的体制尤为重要。卫生行政部门应该承担第三方的职责，而医疗保险制度的构建与运行是第三方必须牢牢抓住的龙头。