Adaptation of the health literacy universal precautions toolkit for rheumatology and cardiology – Applications for pharmacy professionals to improve self-management and outcomes in patients with chronic disease

Over a decade of research in health literacy has provided evidence of strong links between literacy skills of patients and health outcomes. At the same time, numerous studies have yielded insight into efficacious action that health providers can take to mitigate the negative effects of limited literacy. This small study focuses on the adaptation, review and use of two new health literacy toolkits for health professionals who work with patients with two of the most prevalent chronic conditions, arthritis and cardiovascular disease. Pharmacists have a key role in communicating with patients and caregivers about various aspects of disease self-management, which frequently includes appropriate use of medications. Participating pharmacists and staff offered suggestions that helped shape revisions and reported positive experiences with brown bag events, suggestions for approaches with patients managing chronic diseases, and with concrete examples related to several medicines [such as Warfarin^©] as well as to common problems [such as inability to afford needed medicine]. Although not yet tested in community pharmacy sites, these publically available toolkits can inform professionals and staff and offer insights for communication improvement.     

Literacy,Social Stigma,and HIV Medication Adherence

BACKGROUND  Prior studies have linked limited literacy to poorer HIV medication adherence, although the precise causal pathways of this relationship have only been initially investigated. OBJECTIVE  To examine whether social stigma is a possible mediator to the relationship between literacy and self-reported HIV medication adherence. DESIGN  Structured patient interviews with a literacy assessment, supplemented by medical chart review, were conducted among patients receiving care at infectious disease clinics in Shreveport, Louisiana and Chicago, Illinois. Literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM), while stigma was measured using items taken from the Patient Medication Adherence Questionnaire (PMAQ). PARTICIPANTS  Two hundred and four consecutive patients participated. RESULTS  Approximately one-third of the patients (30.4%) were less than 100% adherent to their regimen, and 31.4% had marginal (7th–8th grade) or low (≤ 6th grade) literacy. In multivariate analyses, patients with low literacy were 3.3 times more likely to be non-adherent to antiretroviral regimens (95% CI 1.3–8.7; p < 0.001). Perceived social stigma was found to mediate the relationship between literacy and medication adherence (AOR 3.1, 95% CI 1.3–7.7). CONCLUSIONS  While low literacy was a significant risk factor for improper adherence to HIV medication regimens in our study, perceived social stigma mediated this relationship. Low literacy HIV intervention strategies may also need to incorporate more comprehensive psychosocial approaches to overcome stigma barriers.     

围生期产妇健康素养量表条目筛选

目的：对围生期产妇健康素养量表条目池进行条目筛选,形成条目更可靠、更准确的围生期产妇健康素 养量表。方法：运用Delphi法,请14名妇幼专家对研究者自行编写的56个条目的需要性和重要性进行两轮函询,保 留50个条目。用该条目池对350名产后1~3 d的产妇进行横断面调查,选取其中10%的调查对象1周后重测。在这些数 据基础上,运用χ2检验法、相关系数法(2种)、因子分析法、Cronbach’s α系数法、重测信度法6种方法进行条目筛 选,保留3种或3种以上方法均不需删除的条目,组成最终量表。结果：重测结果Person相关系数为0.507(P=0.004)。 通过6种筛选方法删除的条目数量分别为：1)χ2检验法删除9条;2)相关系数法1删除25条;3)相关系数法2删除1条;4) Cronbach’s α系数法删除19条;5)因子分析法删除8条;6)重测信度法删除37条。最终由33个条目组成围生期产妇健 康素养量表。结论：运用6种条目筛选方法获得了精简后的量表,但距离推广应用还有很大距离,需要在人群中进行 大样本调查,进行信效度检验。     

大数据背景下卫生人员信息素质培训平台的开发

阐述在大数据背景下卫生人员信息素质提高的重要性,提出开发卫生人员信息素质培训平台是对卫生人员进行信息素质培训的有效途径,介绍平台架构模型、功能模块和应用效果。     

The prevalence and related factors for low health literacy in Xingtai: A cross-sectional survey in prefecture-level city

This study aimed to evaluate the low health literacy prevalence and its socio-demographic related factors in Xingtai.This study was a community-based, cross-sectional survey performed in Xingtai, with a sample size of 960. Participants’ socio-demographic characteristics were collected, and their health literacy status was evaluated by the questionnaire designed by the 2012 Chinese Resident Health Literacy Survey.There were 904 (94.2%) participants who provided valid questionnaires and they were included in the analyses. The mean health literacy score was 63.0 ± 16.6; for its subscales, the mean scores of health literacy of basic knowledge and concepts, lifestyle, and health-related skills were 31.6 ± 8.7, 17.1 ± 4.7, and 14.3 ± 3.9, respectively. Low total health literacy prevalence was 83.1%; as for its subscales, the prevalence of low health literacy of basic knowledge and concepts, lifestyle, and health-related skills was 72.5%, 87.8%, and 87.4%, respectively. Meanwhile, age, male and rural location were positively correlated, but education level and annual household income were negatively correlated with low health literacy risk. Further multivariate analysis revealed that lower education level was the only independent related factor for low total health literacy, and the most important independent related factor for low total health literacy of basic knowledge and concepts, lifestyle and health-related skills.Low health literacy prevalence is 83.1%, and lower education level is the most critical related factor for low health literacy in Xingtai.     

(Mis)informed about what? What it means to be a science-literate citizen in a digital world

Science literacy is often held up as crucial for avoiding science-related misinformation and enabling more informed individual and collective decision-making. But research has not yet examined whether science literacy actually enables this, nor what skills it would need to encompass to do so. In this report, we address three questions to outline what it should mean to be science literate in today’s world: 1) How should we conceptualize science literacy? 2) How can we achieve this science literacy? and 3) What can we expect science literacy’s most important outcomes to be? If science literacy is to truly enable people to become and stay informed (and avoid being misinformed) on complex science issues, it requires skills that span the “lifecycle” of science information. This includes how the scientific community produces science information, how media repackage and share the information, and how individuals encounter and form opinions on this information. Science literacy, then, is best conceptualized as encompassing three dimensions of literacy spanning the lifecycle: Civic science literacy, digital media science literacy, and cognitive science literacy. Achieving such science literacy, particularly for adults, poses many challenges and will likely require a structural perspective. Digital divides, in particular, are a major structural barrier, and community literacy and building science literacy into media and science communication are promising opportunities. We end with a discussion of what some of the beneficial outcomes could be—and, as importantly, will likely not be—of science literacy that furthers informed and critical engagement with science in democratic society.