Computer science education for medical informaticians

The core curriculum in the education of medical informaticians remains a topic of concern and discussion. This paper reports on a survey of medical informaticians with Master's level credentials that asked about computer science (CS) topics or skills that they need in their employment. All subjects were graduates or "near-graduates" of a single medical informatics Master's program that they entered with widely varying educational backgrounds. The survey instrument was validated for face and content validity prior to use. All survey items were rated as having some degree of importance in the work of these professionals, with retrieval and analysis of data from databases, database design and web technologies deemed most important. Least important were networking skills and object-oriented design and concepts. These results are consistent with other work done in the field and suggest that strong emphasis on technical skills, particularly databases, data analysis, web technologies, computer programming and general computer science are part of the core curriculum for medical informatics.     

2018年四川省贫困县区居民健康素养监测结果分析

目的掌握四川省贫困地区居民的健康素养现况及其影响因素,为贫困地区居民健康素养的提升及健康扶贫工作的落实提供科学依据。方法采用分层多阶段、PPS、方便抽样相结合的方法,2018年在四川省88个贫困县区抽取18个县,对非集体居住的15~69岁常住人口进行健康素养问卷调查。采用SPSS 20.0软件进行t检验和单因素ANOVA分析,校验水准α=0.05。结果共调查四川省贫困地区5 797名居民,经过加权调整后,2018年四川省贫困地区居民具备健康素养的比例是1.5%;健康素养得分为(21.76±9.66)分,不同性别(t=4.221,P<0.001)、民族(t=18.900,P<0.001)、年龄组(F=2.952,P=0.012)、文化程度(F=10.941,P<0.001)、职业(F=3.152,P=0.001)、家庭常住人口数(F=3.232,P=0.040)、家庭人均年收入(F=4.581,P=0.003)的居民健康素养得分的差异具有统计学意义;具备基本知识和理念、健康生活方式与行为、健康技能3个维度健康素养的比例分别是9.2%、13.7%和5.8%。结论 2018年四川省贫困地区居民健康素养水平较低,健康素养水平在不同人群特征的居民中表现出差异,应结合健康扶贫相关政策,加大健康教育工作力度,进一步提高贫困地区居民健康知识知晓率,健康技能掌握率和健康行为形成率,并针对健康知识、健康技能的掌握环节进行重点干预。     

Functional Health Literacy: Psychometric Properties of the Newest Vital Sign for Portuguese Adolescents (NVS-PTeen)

Self-management of health requires skills to obtain, process, understand, and use health-related information. Assessment of adolescents’ functional health literacy requires valid, reliable, and low-burden tools. The main objective of this study was to adapt and study the psychometric properties of the Newest Vital Sign for the Portuguese adolescents’ population (NVS-PTeen). Classic psychometric indicators of reliability and validity were combined with item response theory (IRT) analyses in a cross-sectional survey, complemented with a 3-month test-retest assessment. The NVS-PTeen was self-administered to students enrolled in grades 8 to 12 (12 to 17 years old) in a school setting. Overall, 386 students (191 girls) from 16 classes of the same school participated in the study (mean age = 14.5; SD = 1.5). Internal reliability of the NVS-PTeen was α = 0.60. The NVS-PTeen total score was positively and significantly correlated with Portuguese (r = 0.28) and mathematics scores (r = 0.31), school years (r = 0.31), and age (r = 0.19). Similar to the original scale (for the U.S.), the NVS-PTeen is composed of two dimensions, reading-related literacy and numeracy. Temporal reliability is adequate, though with a learning effect. IRT analyses revealed differences in difficulty and discriminative capacity among items, all with adequate outfit and infit values. Results showed that the NVS-PTeen is valid and reliable, sensible to inter-individual educational differences, and adequate for regular screening of functional health literacy in adolescents.     

How different health literacy dimensions influences health and well‐being among men and women: The mediating role of health behaviours

BackgroundHealth literacy, the ability to access, understand, evaluate and apply health information, was found to contribute to positive health outcomes, possibly via promoting healthy behaviours. However, the specific pathways linking different health literacy skills to health and well‐being have remained unclear.MethodsA cross‐sectional survey with structural questionnaires was administered among 2236 adults in Hong Kong (mean age = 46.10 ± 19.05). Health literacy was measured by HLS‐Asian‐47. Participants'' physical conditions and subjective well‐being were predicted by health literacy and health behaviours with structural modelling path analysis.ResultsHealth literacy in finding and understanding information showed a direct effect on enhancing physical health, while applying information capacity had an indirect positive effect via promoting health behaviours, which was moderated by sex. Only among women, this indirect effect predicting fewer physical symptoms and better well‐being was significant.ConclusionsDifferent health literacy dimensions showed distinct direct and indirect pathways in influencing health for men and women. Based on the findings, skill trainings should be developed to enhance both gender''s abilities of finding and understanding health information, while the ability of applying health information should also be improved for modifying lifestyle and promoting health, particularly for women.Patient or Public ContributionTwo thousand and two hundred thirty‐six adults from different districts of Hong Kong participated in the study, and responded to questions on health literacy, behaviours and health status.     

泰州市居民慢性病防治健康素养水平及其影响因素

目的分析泰州市居民慢性病防治健康素养水平及其影响因素。方法在2018年6月—2019年5月间经多阶段分层整群随机抽样选取泰州市2022名常住居民开展慢性病防治健康素养相关问卷调查,分析调查结果。结果2022份问卷回收有效问卷2010份;以“儿童青少年也可能发生抑郁症”正确率89.0%、“超重或肥胖者易患的病”正确率80.3%占据前两名;慢性病防治健康素养水平相关因素包括地区,年龄,文化等,差异有统计学意义(P<0.05),性别方面差异无统计学意义(P>0.05);经Logistic回归分析显示,影响慢性病防治健康素养影响因素主要包括地区、年龄、学历、职业及家庭收入,差异有统计学意义(P<0.05)。结论泰州市居民慢性病防治健康素养在蔬菜水果、儿童抑郁症及肥胖者易患病等方面水平较高,而在骨质疏松相关知识了解程度则较低,影响因素包括地区、年龄、学历、职业及家庭收入。     

脑卒中患者口腔健康素养现状及其影响因素分析

目的 调查脑卒中患者口腔健康素养现状并分析其影响因素,为制订个体化干预方案提供参考.方法 采用人口学资料及相关影响因素调查表、脑卒中患者口腔健康素养量表、口腔生活质量影响程度量表、汉密尔顿抑郁量表对199例脑卒中患者进行调查.结果 脑卒中患者口腔健康素养总分为(82.24±5.90)分;脑卒中患者口腔健康素养与口腔生活质量影响程度及抑郁呈负相关(均P＜0.01).文化程度、居住地、领悟社会支持、营养状态、婚姻状态、医疗支付方式、经济来源、吞咽功能、患慢性病种数、自觉经济压力、神经系统功能、自我感受负担、主要陪护者是脑卒中患者口腔健康素养的影响因素(P＜0.05,P＜0.01).结论 脑卒中患者口腔健康素养有待提高,其影响因素较多.医护人员应采取针对性措施提高患者的口腔健康素养.     

中国公众公共卫生安全素养量表的开发研究

目的开发公共卫生安全素养量表, 为我国公众的公共卫生安全素养测评提供适宜工具。方法通过理论构想、指标池构建、现场验证、题项缩减等步骤编制中国公共卫生安全素养初始量表, 转为"问卷星"电子问卷, 随机抽取4个省份共2 809名居民进行现场测试。利用经典测试理论(CTT)和项目反应理论(IRT)进行题项缩减。使用SPSS 23.0软件进行探索性因子分析(EFA)和单维性检验。使用R 4.1.1软件ltm和mirt包进行题项的心理测量学指标分析, 并绘制项目特征曲线(ICC)和信息函数曲线(IIC和TIF)。结果选用专家一致性系数最优的初始量表3, 共30个题项(B1～B30), 测试对象完成1个题项平均需9.8 s。根据CTT分析, 删除校正题项-总相关系数(CITC)<0.3及题项-维度相关系数(IDCC)<0.4的B2题项;删除CITC<0.3、IDCC<0.4及难度指数<0.2的B23题项;删除CITC<0.3及难度指数<0.2的B30题项。删除后量表总内部一致性信度(Cronbach’’sα)值为0.923。EFA提示删除14个因子载荷较小...     

Employing computational linguistics techniques to identify limited patient health literacy: Findings from the ECLIPPSE study

ObjectiveTo develop novel, scalable, and valid literacy profiles for identifying limited health literacy patients by harnessing natural language processing.Data SourceWith respect to the linguistic content, we analyzed 283 216 secure messages sent by 6941 diabetes patients to physicians within an integrated system''s electronic portal. Sociodemographic, clinical, and utilization data were obtained via questionnaire and electronic health records.Study DesignRetrospective study used natural language processing and machine learning to generate five unique “Literacy Profiles” by employing various sets of linguistic indices: Flesch‐Kincaid (LP_FK); basic indices of writing complexity, including lexical diversity (LP_LD) and writing quality (LP_WQ); and advanced indices related to syntactic complexity, lexical sophistication, and diversity, modeled from self‐reported (LP_SR), and expert‐rated (LP_Exp) health literacy. We first determined the performance of each literacy profile relative to self‐reported and expert‐rated health literacy to discriminate between high and low health literacy and then assessed Literacy Profiles’ relationships with known correlates of health literacy, such as patient sociodemographics and a range of health‐related outcomes, including ratings of physician communication, medication adherence, diabetes control, comorbidities, and utilization.Principal FindingsLP_SR and LP_Exp performed best in discriminating between high and low self‐reported (C‐statistics: 0.86 and 0.58, respectively) and expert‐rated health literacy (C‐statistics: 0.71 and 0.87, respectively) and were significantly associated with educational attainment, race/ethnicity, Consumer Assessment of Provider and Systems (CAHPS) scores, adherence, glycemia, comorbidities, and emergency department visits.ConclusionsSince health literacy is a potentially remediable explanatory factor in health care disparities, the development of automated health literacy indicators represents a significant accomplishment with broad clinical and population health applications. Health systems could apply literacy profiles to efficiently determine whether quality of care and outcomes vary by patient health literacy; identify at‐risk populations for targeting tailored health communications and self‐management support interventions; and inform clinicians to promote improvements in individual‐level care.     

Determinants of information diffusion in online communication on vaccination: The benefits of visual displays

ObjectiveSocial media are an increasingly important source of information on the benefits and risks of vaccinations, but the high prevalence of misinformation provides challenges for informed vaccination decisions. It is therefore important to understand which messages are likely to diffuse online and why, and how relevant aspects—such as scientific facts on vaccination effectiveness—can be made more comprehensible and more likely to be shared. In two studies, we (i) explore which characteristics of messages on flu vaccination facilitate their diffusion in online communication, and (ii) whether visual displays (i.e., icon arrays) facilitate the comprehension and diffusion of scientific effectiveness information.MethodsIn Study 1, 208 participants each rated a random sample of 15 out of 63 messages on comprehensibility, trustworthiness, persuasiveness, familiarity, informativeness, valence, and arousal, and then reported which information they would share with subsequent study participants. In Study 2 (N = 758), we employed the same rating procedure for a selected set of 9 messages and experimentally manipulated how scientific effectiveness information was displayed.ResultsStudy 1 illustrated that scientific effectiveness information was difficult to understand and thus did not diffuse well. Study 2 demonstrated that visual displays improved the understanding of this information, which could, in turn, increase its social impact.ConclusionsThe comprehensibility of scientific information is an important prerequisite for its diffusion. Visual displays can facilitate informed vaccination decisions by rendering important information on vaccination effectiveness more transparent and increasing the willingness to share this information.