International Journal of Environmental Research and Public Health

Research

20 pages, 398 KiB

Open AccessArticle

Understanding Professional Medical Interpreters’ Perspectives on Advancing Accurate and Culturally Informed Patient–Provider Communication for Filipinos in Hawaiʻi: Qualitative Analysis

by Uliana Kostareva, Carrie A. Soo Hoo, Suzanne M. Zeng, Cheryl L. Albright, Clementina D. Ceria-Ulep and Holly B. Fontenot

Int. J. Environ. Res. Public Health 2023, 20(21), 7012; https://doi.org/10.3390/ijerph20217012 - 2 Nov 2023

Viewed by 2062

Abstract

One in every eight persons in Hawaiʻi, USA, have limited English proficiency (LEP) and are entitled to free language assistance for federally funded services under Title IV of the Civil Rights Act of 1964. They also have the right to culturally and linguistically [...] Read more.

One in every eight persons in Hawaiʻi, USA, have limited English proficiency (LEP) and are entitled to free language assistance for federally funded services under Title IV of the Civil Rights Act of 1964. They also have the right to culturally and linguistically appropriate services (CLAS) provided by professional medical interpreters (PMIs). This study’s goals were to uncover barriers and facilitators of CLAS from the perspective of PMIs. PMIs for Filipino languages (n = 10) participated in an online survey and semi-structured interviews. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using conventional content analysis. Six themes emerged in the qualitative analysis: (1) cultural and social factors that can influence patient–provider communication; (2) barriers to effective patient–provider communication: patient, healthcare provider, and PMI levels; (3) facilitators of effective patient–provider communication: patient, healthcare provider, and PMI levels; (4) COVID-19 and remote interpreting barriers and facilitators; (5) strengths and weaknesses of in-person and stand-by interpreting appointments; and, (6) recommendations: system and provider levels. Proposed interventions could include advertising language services among Filipino communities and educating them about their language rights, providing additional resources for language assistance, employing more PMIs, training staff/providers, and supporting the use of PMIs versus untrained individuals. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

13 pages, 352 KiB

Open AccessArticle

Exploring the Relationship between Medical Research Literacy and Respondents’ Expressed Likelihood to Participate in a Clinical Trial

by Jennifer Dykema, Cameron P. Jones, Dana Garbarski, Mia Farias and Dorothy Farrar Edwards

Int. J. Environ. Res. Public Health 2022, 19(22), 15168; https://doi.org/10.3390/ijerph192215168 - 17 Nov 2022

Cited by 2 | Viewed by 2012

Abstract

Medical research literacy (MRL) is a facet of health literacy that measures a person’s understanding of informed consent and other aspects of participation in medical research. While existing research on MRL is limited, there are reasons to believe MRL may be associated with [...] Read more.

Medical research literacy (MRL) is a facet of health literacy that measures a person’s understanding of informed consent and other aspects of participation in medical research. While existing research on MRL is limited, there are reasons to believe MRL may be associated with a willingness to participate in medical research. We use data from a racially balanced sample of survey respondents (n = 410): (1) to analyze how MRL scores vary by respondents’ socio-demographic characteristics; (2) to examine how MRL relates to respondents’ expressed likelihood to participate in a clinical trial; and (3) to provide considerations on the measurement of MRL. The results indicate no differences in MRL scores by race or gender; younger (p < 0.05) and more educated (p < 0.001) individuals have significantly higher MRL scores. Further, higher MRL scores are associated with significantly lower levels of expressed likelihood to participate in a clinical trial. Additionally, the MRL scale included both true and false statements, and analyses demonstrate significant differences in how these relate to outcomes. Altogether, the results signal that further research is needed to understand MRL and how it relates to socio-demographic characteristics associated with research participation and can be measured effectively. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

17 pages, 528 KiB

Open AccessArticle

Understanding Health Information Behaviors of Migrant Domestic Workers during the COVID-19 Pandemic

by Jeffry Oktavianus, Yanqing Sun and Fangcao Lu

Int. J. Environ. Res. Public Health 2022, 19(19), 12549; https://doi.org/10.3390/ijerph191912549 - 1 Oct 2022

Cited by 8 | Viewed by 2254

Abstract

Migrant domestic workers (MDWs) in Hong Kong remain vulnerable during the COVID-19 pandemic. Obtaining accurate information is essential for MDWs as it helps them understand their predicament and protect themselves. Therefore, this study delves into the MDWs’ health literacy by scrutinizing how they [...] Read more.

Migrant domestic workers (MDWs) in Hong Kong remain vulnerable during the COVID-19 pandemic. Obtaining accurate information is essential for MDWs as it helps them understand their predicament and protect themselves. Therefore, this study delves into the MDWs’ health literacy by scrutinizing how they acquire, verify, and respond to pandemic-related information. Semi-structured interviews were conducted with 32 Indonesian MDWs, recruited through purposive and snowball sampling. The data were examined using a constant comparative approach in grounded theory. The findings reveal that the participants engaged in information seeking and scanning to obtain health crisis information, mainly through their friends, family members, and community organizations. The participants also verified the information using their judgment or by consulting other actors, such as local organizations and media outlets. The messages they obtained informed the means to protect themselves, which motivated them to adopt preventive measures. However, some also engaged in maladaptive coping, such as taking ineffective preventive actions. The participants also disseminated health crisis information throughout their social circle. This study concluded that MDWs performed four health information behaviors during the pandemic, namely information acquisition, authentication, sharing, and adoption of preventive measures. However, their information practices may change at different stages of the pandemic. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

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12 pages, 2085 KiB

Open AccessArticle

Building a Health Literacy Indicator from Angola Demographic and Health Survey in 2015/2016

by Neida Neto Vicente Ramos, Inês Fronteira and Maria Rosário Oliveira Martins

Int. J. Environ. Res. Public Health 2022, 19(5), 2882; https://doi.org/10.3390/ijerph19052882 - 1 Mar 2022

Cited by 3 | Viewed by 2414

Abstract

Health literacy is a determinant factor for population health. It is important both for the prevention of health problems and the better management of those problems and unexpected situations that happen. Low health literacy has been consistently associated with poor health outcomes. This [...] Read more.

Health literacy is a determinant factor for population health. It is important both for the prevention of health problems and the better management of those problems and unexpected situations that happen. Low health literacy has been consistently associated with poor health outcomes. This study aimed to develop a health literacy indicator for Angola and to analyze pertinent demographic characteristics related to it. Data were obtained from the first Angola Demographic and Health Survey conducted in 2015/16; we included 10 questions related to the American National Academy of Medicine definition of health literacy. Using factor analysis, we extracted one i indicator corresponding to four dimensions of health literacy. The indicator was dichotomized, and we used Logistic Regression to estimate factors associated with health literacy level: we obtained data from 19,785 adolescents and adults, aged 15–49 years. The internal consistency of the i indicator was reliable (Cronbach’s α = 0.83). Adjusting for other variables, males with complete secondary education or above and living in urban areas were more likely to have a high level of health literacy. There were substantial differences between the 18 regions. This is the first study evaluating health literacy in Angola using the American National Academy of Medicine definition and a Demographic and Health survey. Our study shows unfavorable results for women, individuals living in rural areas and those less educated. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

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20 pages, 687 KiB

Open AccessArticle

A Systematic Review of Cross-Cultural Adaptation and Psychometric Properties of Oral Health Literacy Tools

by Sobiya Praveen, Jinal Parmar, Navira Chandio and Amit Arora

Int. J. Environ. Res. Public Health 2021, 18(19), 10422; https://doi.org/10.3390/ijerph181910422 - 3 Oct 2021

Cited by 12 | Viewed by 4153

Abstract

The aims of this systematic review were to critically appraise the quality of the cross-cultural adaptation and the psychometric properties of the translated versions of oral health literacy assessment tools. CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), and ProQuest Dissertation and Thesis were searched [...] Read more.

The aims of this systematic review were to critically appraise the quality of the cross-cultural adaptation and the psychometric properties of the translated versions of oral health literacy assessment tools. CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), and ProQuest Dissertation and Thesis were searched systematically. Studies focusing on cross-cultural adaptation and psychometric properties of oral health literacy tools were included. The methodological quality of included studies was assessed according to the COSMIN Risk of Bias checklist. Sixteen oral health literacy instruments in 11 different languages were included in this systematic review. However, only seven instruments met the criteria for an accurate cross-cultural adaptation process, while the remaining tools failed to meet at least one criterion for suitable quality of cross-cultural adaptation process. None of the studies evaluated all the aspects of psychometric properties. Most of the studies reported internal consistency, reliability, structural validity, and construct validity. Despite adequate ratings for some reported psychometric properties, the methodological quality of studies on translated versions of oral health literacy tools was mostly doubtful to inadequate. Researchers and clinicians should follow standard guidelines for cross-cultural adaptation and assess all aspects of psychometric properties for using oral health literacy tools in cross-cultural settings. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

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16 pages, 718 KiB

Open AccessArticle

Implementation, Mechanisms and Context of the MAMAACT Intervention to Reduce Ethnic and Social Disparity in Stillbirth and Infant Health

by Trine Damsted Rasmussen, Helle Johnsen, Signe Smith Jervelund, Ulla Christensen, Anne-Marie Nybo Andersen and Sarah Fredsted Villadsen

Int. J. Environ. Res. Public Health 2021, 18(16), 8583; https://doi.org/10.3390/ijerph18168583 - 14 Aug 2021

Cited by 7 | Viewed by 3674

Abstract

The MAMAACT intervention aimed to address ethnic and social disparity in stillbirth and infant health by improving management of pregnancy complications. This process evaluation of the intervention was guided by the British Medical Research Council’s framework. We examined implementation through dose, reach, and [...] Read more.

The MAMAACT intervention aimed to address ethnic and social disparity in stillbirth and infant health by improving management of pregnancy complications. This process evaluation of the intervention was guided by the British Medical Research Council’s framework. We examined implementation through dose, reach, and fidelity, important mechanisms and the influence of contextual factors. The intervention included a six-hour training session for antenatal care (ANC) midwives in intercultural communication and cultural competence, two follow-up dialogue meetings, and health education materials (leaflet and app) on warning signs of severe pregnancy complications and how to respond for pregnant women. A mixed-methods approach was applied. Cross-sectional survey data and administrative data were used to assess intervention reach and dose. Qualitative data (records from dialogue meetings with midwives, participant observations and field notes from ANC visits, focus group interviews with midwives, and individual interviews with non-Western immigrant women) evaluated intervention fidelity, mechanisms, and contextual barriers. More than 80% of women received the MAMAACT leaflet and many found the content useful. The app was used more selectively. Midwives described being more aware and reflective in their communication with women from various cultural backgrounds. Organizational factors in ANC (time pressure, lack of flexibility in visits, poor interpreter services), barriers in women’s everyday life (lack of social network, previous negative experiences/lack of trust and domestic responsibilities), and habitual interaction patterns among midwives served as contextual barriers. The reach of the intervention was high and it was evaluated positively by both pregnant women and midwives. Organizational factors hindered changes towards more needs-based communication in ANC potentially hindering the intended mechanisms of the intervention. When interpreting the intervention effects, attention should be drawn to both organizational and interpersonal factors in the clinic as well as the pregnant women’s life situations. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

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23 pages, 12382 KiB

Open AccessArticle

Estimating the Economic Burden of Low Health Literacy in the Blacktown Community in Sydney, Australia: A Population-Based Study

by Wadad Kathy Tannous, Moin Uddin Ahmed, James Rufus John, Graham Reece and Golo Ahlenstiel

Int. J. Environ. Res. Public Health 2021, 18(5), 2303; https://doi.org/10.3390/ijerph18052303 - 26 Feb 2021

Cited by 5 | Viewed by 5036

Abstract

Evidence shows that inadequate or low health literacy (LHL) levels are significantly associated with economic ramifications at the individual, employer, and health care system levels. Therefore, this study aims to estimate the economic burden of LHL among a culturally and linguistically diverse (CALD) [...] Read more.

Evidence shows that inadequate or low health literacy (LHL) levels are significantly associated with economic ramifications at the individual, employer, and health care system levels. Therefore, this study aims to estimate the economic burden of LHL among a culturally and linguistically diverse (CALD) community in Blacktown: a local government area (LGA) in Sydney, Australia. This study is a secondary analysis of cross-sectional data from publicly available datasets, including 2011 and 2016 census data and National Health Survey (NHS) data (2017–2018) from the Australian Bureau of Statistics (ABS), and figures on Disease Expenditure in Australia for 2015–2016 provided by the Australian Institute of Health and Welfare (AIHW). This study found that 20% of Blacktown residents reported low levels of active engagement with health care providers (Domain 6 of the Health Literacy Questionnaire (HLQ)), with 14% reporting a limited understanding of the health information required to take action towards improving health or making health care decisions (Domain 9 of the HLQ). The overall extra/delta cost (direct and indirect health care costs) associated with LHL in the Blacktown LGA was estimated to be between $11,785,528 and $15,432,239 in 2020. This is projected to increase to between $18,922,844 and $24,191,911 in 2030. Additionally, the extra disability-adjusted life year (DALY) value in 2020, for all chronic diseases and age-groups—comprising the extra costs incurred due to years of life lost (YLL) and years lived with disability (YLD)—was estimated at $414,231,335. The findings of our study may enable policymakers to have a deeper understanding of the economic burden of LHL in terms of its impact on the health care system and the production economy. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

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14 pages, 314 KiB

Open AccessArticle

Exploring Knowledge and Experience of Health Literacy for Chinese-Speaking Nurses in Taiwan: A Cross-Sectional Study

by Ya-Wen Chang, Tsai-Chung Li, Yen-Chin Chen, Jo-Hua Lee, Mei-Chuan Chang and Li-Chi Huang

Int. J. Environ. Res. Public Health 2020, 17(20), 7609; https://doi.org/10.3390/ijerph17207609 - 19 Oct 2020

Cited by 10 | Viewed by 2824

Abstract

Background: Health literacy has become the best predictor of healthcare status. However, two-thirds of health providers are unaware of patients’ health literacy. Thus, the aim of the study is to investigate factors related to Chinese-speaking nurses’ knowledge and experience of health literacy. [...] Read more.

Background: Health literacy has become the best predictor of healthcare status. However, two-thirds of health providers are unaware of patients’ health literacy. Thus, the aim of the study is to investigate factors related to Chinese-speaking nurses’ knowledge and experience of health literacy. Methods: This cross-sectional study used a web-based survey. A total of 430 nurses were recruited by stratified sampling from different levels of hospitals and community health centers in Taiwan. Primary outcome measure by Health Literacy Knowledge and Experience. Results: The participants’ overall health literacy knowledge was limited; the correct responses were 51%. The education level of the participants, job category, working years, and having attended in-service patient education programs were the predictors of knowledge of health literacy (p < 0.05); Institute, job category, and having attended in-service patient education programs were the predictors of experience of health literacy (p < 0.01). Conclusions: Participants’ education levels and In-service patient education programs are beneficial factors to improve nurses’ knowledge of health literacy. Furthermore, nursing education should emphasize on how to identify individuals’ health literacy and using readable healthcare materials to improve health education. Full article

(This article belongs to the Special Issue Health Literacy and Health Equity)

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