Good Health Information Research Articles

Health literacy and fruit and vegetable intake in rural Australia.

Adequate fruit and vegetable intake is important in the prevention of chronic disease. Health literacy is associated with health outcomes but its role in dietary behaviour has received little attention. The present study investigated the association between a multidimensional measure of health literacy, sociodemographic characteristics, and fruit and vegetable intake in rural Australia. A cross-sectional survey on intake of fruits and vegetables (servings/d), demographic characteristics and health literacy profile using a nine-scale Health Literacy Questionnaire (HLQ). Associations between health literacy and fruit and vegetable intake were assessed using logistic regression. A large rural area of Victoria. Adults residing in the Grampians region (n 1154; 61 % female, mean age 52 (sd 17) years). The HLQ scale 'Actively managing my health' predicted (OR; 95 % CI) fruit (2·31; 1·87, 2·84) and vegetable (1·81; 1·45, 2·26) intake. The scales 'Appraisal of health information' (fruits: 1·73; 1·41, 2·13; vegetables: 1·49; 1·20, 1·86), 'Social support for health' (fruits: 1·31; 1·06, 1·63; vegetables: 1·40; 1·10, 1·76) and 'Ability to find good health information' (fruits: 1·25; 1·05, 1·48; vegetables: 1·36; CI 1·13, 1·63) also predicted fruit and vegetable intake. These associations remained significant after adjusting for age, gender, educational attainment and having private health insurance. Health literacy, particularly being proactive, appraising information and having social support for health, is associated with greater fruit and vegetable intake. Future interventions should consider the health literacy needs of the community to improve fruit and vegetable intake.

Surfing Behind a Boat: Quality and Reliability of Online Resources on Scaphoid Fractures.

Patients seeking information and advice on treatment of scaphoid fractures unknowingly confront longstanding medical controversies surrounding the management of this condition. However, there are no studies specifically looking into the quality and reliability of online information on scaphoid fractures. We identified 44 unique websites for evaluation using the term "scaphoid fractures". The websites were categorized by type and assessed using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the net (HON) code. The majority of websites were commercial (n = 13) followed by academic (n = 12). Only seven of the websites were HON certified. The mean DISCERN score was 43.8. Only 4 websites scored 63 or above representing excellent quality with minimal shortcomings but 13 websites scored 38 or below representing poor or very poor quality. The mean JAMA benchmark criteria score was 2.2. The Governmental and Non-Profit Organizations category websites had the highest mean JAMA benchmark score. The websites that displayed the HON-code seal had higher mean DISCERN scores and higher mean JAMA benchmark scores compared to websites that did not display the seal. Good quality health information is certainly available on the Internet. However, it is not possible to predict with certainty which sites are of higher quality. We suggest clinicians should have a responsibility to educate their patients regarding the unregulated nature of medical information on the internet and proactively provide patients with educational resources and thus help them make smart and informed decisions.

S07.2 Dr google, porn or friend of a friend? where do young men get their sexual health information?

Background Young people are vulnerable in relation to sexual health. Young men are especially so as they attend the general practitioner less often than females and are less likely to be offered testing for sexually transmitted diseases. Access to good quality health information and education is a cornerstone of primary prevention yet we know very little about how, where and why young people obtain information about sexual health. Methods One-on-one semi-structured interviews were conducted with 35 male students aged 16 -–19 years from at one regional and one metropolitan Victorian educational institution for trade skills until data saturation was reached. Interviews were audio-recorded, transcribed and thematically analysed. Results The young men were generally poorly informed about sexual health. Their existing knowledge mainly came from school based sexual health education, which while valued, was generally poorly recalled and provided only a narrow scope of physiological information. Young men seek sexual health information from various sources including family, the Internet, friends, and pornography, with information from the latter three sources perceived as unreliable. GPs were seen as a source of trustworthy information but were not accessed for this purpose due to embarrassment. Young men preferred the GP to initiate such conversations. A desire for privacy and avoidance of embarrassment heavily influenced young men’s preferences and behaviours in relation to sexual health information seeking. Conclusions The current available sources of sexual health information for young men are failing to meet their needs. Results identify potential improvements to school based sexual education and online resources and describe a need for innovative technology based sources of sexual health education.

Patient information materials in general practices and promotion of health literacy: an observational study of their effectiveness.

Government policy in the UK emphasises providing patients with good health information to encourage participation in their health care. Patient information leaflets (PILs) form part of this policy and have been shown to affect patient health outcomes; however, many are poorly written. To describe the PILs in general practice surgeries in Stoke-on-Trent in terms of readability and variety of content. An observational study of randomly selected GP practices (n = 17) across Stoke-on-Trent. PILs were assessed for readability (Flesch Reading Ease and Flesch-Kincaid Grade Level) and compared with national skills level data and with the recommended level for medical information. The PILs were also categorised for content using the Rudd (2007) health material classification framework. A total of 345 PILs were collected and assessed. Only 24.3% meet recommended reading-level criteria. Compared with national skills levels, over 75% of the PILs collected were too complex for at least 15% of the English population. Of the PILs, 47.8% were classified as 'systems navigation' (information regarding services); 22.9% were disease prevention (screening and immunisations); 14.2% personal and public safety; and less than 10% were for managing illness or health promotion. Current PILs in general practices do not all promote health literacy. Information only accessible to a proportion of higher skilled patients may increase inequalities in health. Less than 10% of PILs promote managing illness or healthy lifestyles. Processes must be put in place to improve the readability and variety of content of PILs in GP practices.

Motivations for contributing to health-related articles on Wikipedia: an interview study.

BackgroundWikipedia is one of the most accessed sources of health information online. The current English-language Wikipedia contains more than 28,000 articles pertaining to health.ObjectiveThe aim was to characterize individuals’ motivations for contributing to health content on the English-language Wikipedia.MethodsA set of health-related articles were randomly selected and recent contributors invited to complete an online questionnaire and follow-up interview (by Skype, by email, or face-to-face). Interviews were transcribed and analyzed using thematic analysis and a realist grounded theory approach.ResultsA total of 32 Wikipedians (31 men) completed the questionnaire and 17 were interviewed. Those completing the questionnaire had a mean age of 39 (range 12-59) years; 16 had a postgraduate qualification, 10 had or were currently studying for an undergraduate qualification, 3 had no more than secondary education, and 3 were still in secondary education. In all, 15 were currently working in a health-related field (primarily clinicians). The median period for which they have been an active editing Wikipedia was 3-5 years. Of this group, 12 were in the United States, 6 were in the United Kingdom, 4 were in Canada, and the remainder from another 8 countries. Two-thirds spoke more than 1 language and 90% (29/32) were also active contributors in domains other than health. Wikipedians in this study were identified as health professionals, professionals with specific health interests, students, and individuals with health problems. Based on the interviews, their motivations for editing health-related content were summarized in 5 strongly interrelated categories: education (learning about subjects by editing articles), help (wanting to improve and maintain Wikipedia), responsibility (responsibility, often a professional responsibility, to provide good quality health information to readers), fulfillment (editing Wikipedia as a fun, relaxing, engaging, and rewarding activity), and positive attitude to Wikipedia (belief in the value of Wikipedia). An additional factor, hostility (from other contributors), was identified that negatively affected Wikipedians’ motivations.ConclusionsContributions to Wikipedia’s health-related content in this study were made by both health specialists and laypeople of varying editorial skills. Their motivations for contributing stem from an inherent drive based on values, standards, and beliefs. It became apparent that the community who most actively monitor and edit health-related articles is very small. Although some contributors correspond to a model of “knowledge philanthropists,” others were focused on maintaining articles (improving spelling and grammar, organization, and handling vandalism). There is a need for more people to be involved in Wikipedia’s health-related content.

The health competence measurement tool (HCMT): Developing a new scale to measure self-rated “health competence”

ObjectivesTo develop and test a tool for measuring health competence. MethodsIn order to measure this attribute, we used a sequential exploratory mixed methods design in rural and urban communities in Cameroon. In the qualitative phase, 67 clients constituted 10 focus groups to elicit themes related to health competence. In the quantitative phase, self-rated items were tested on 300 participants and on a random selection of 25 participants 2 weeks later. ResultsThe internal consistency for the subscales derived varied from 0.61-0.81. Older (F[45, 339.1]=1.2; p=0.031) and more educated (F[3, 22.6]=2.1; p=0.004) people were more likely to score higher on the scale. Interviewers also contributed to the variance (F[5, 37.6]=3.6; p<0.001). Test–retest reliability was 0.66. The final scale with 15 items is made up of three subscales: knowledge of disease, how to stay in good health and health information. ConclusionWe present a new self-rated scale for health competence with good psychometric properties. It circumvents the need to be literate, but requires well trained interviewers. We recommend that it be tested in other settings. Practice implicationsThis tool should be used to appraise individual and community health education needs with minor context specific modifications.

Overcoming the linguistic divide: a barrier to consumer health information

Seeking health information online has become very popular. Despite this popularity, health consumers face many barriers to successfully retrieving good quality health information. This paper reviews the literature on the lin- guistic divide between health consumers and consumer health information. Consumer health vocabularies (CHV) and natural language processing (NLP) show potential for bridging the divide, thereby improving recall and precision from information retrieval systems. Developers of digital libraries can incorporate CHV and (or) NLP as help tools to facili- tate health consumers' search success. Deeper issues, such as health consumers' mental representation of medical do- main, must also be addressed in future research for optimal benefit from such help tools.

The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ).

BackgroundHealth literacy has become an increasingly important concept in public health. We sought to develop a comprehensive measure of health literacy capable of diagnosing health literacy needs across individuals and organisations by utilizing perspectives from the general population, patients, practitioners and policymakers.MethodsUsing a validity-driven approach we undertook grounded consultations (workshops and interviews) to identify broad conceptually distinct domains. Questionnaire items were developed directly from the consultation data following a strict process aiming to capture the full range of experiences of people currently engaged in healthcare through to people in the general population. Psychometric analyses included confirmatory factor analysis (CFA) and item response theory. Cognitive interviews were used to ensure questions were understood as intended. Items were initially tested in a calibration sample from community health, home care and hospital settings (N=634) and then in a replication sample (N=405) comprising recent emergency department attendees.ResultsInitially 91 items were generated across 6 scales with agree/disagree response options and 5 scales with difficulty in undertaking tasks response options. Cognitive testing revealed that most items were well understood and only some minor re-wording was required. Psychometric testing of the calibration sample identified 34 poorly performing or conceptually redundant items and they were removed resulting in 10 scales. These were then tested in a replication sample and refined to yield 9 final scales comprising 44 items. A 9-factor CFA model was fitted to these items with no cross-loadings or correlated residuals allowed. Given the very restricted nature of the model, the fit was quite satisfactory: χ2WLSMV(866 d.f.) = 2927, p<0.000, CFI = 0.936, TLI = 0.930, RMSEA = 0.076, and WRMR = 1.698. Final scales included: Feeling understood and supported by healthcare providers; Having sufficient information to manage my health; Actively managing my health; Social support for health; Appraisal of health information; Ability to actively engage with healthcare providers; Navigating the healthcare system; Ability to find good health information; and Understand health information well enough to know what to do.ConclusionsThe HLQ covers 9 conceptually distinct areas of health literacy to assess the needs and challenges of a wide range of people and organisations. Given the validity-driven approach, the HLQ is likely to be useful in surveys, intervention evaluation, and studies of the needs and capabilities of individuals.

Health Information Literacy and the Elderly: Has the Internet Had an Impact?

The objective of the literature review was to determine whether the existence of the Internet has had a significant impact on health information literacy among the elderly in developed nations. Results were truly mixed, which led to the conclusion that, despite its worldwide acceptance and usage, the Internet has not had an all-encompassing influence on the ability of seniors to make informed health decisions, which is the ultimate product of good health information literacy.

Finding Information by Quality Providers Is an Issue

The International Patient Decision Aid Standards Collaboration (IPDAS) and other networks have shown how to respond to the dearth of good-quality information for patients: by cooperation and qualification. In this spirit, the Gute Praxis Gesundheitsinformation (good practice health information) initiative was founded in Germany (1): under the umbrella of the German Network for Evidence Based Medicine (2), information providers have formulated requirements that health information should meet and have committed to implementing and further developing these. If we want to improve the information landscape, we will have to establish evidence based practice on the one hand and simultaneously create a network of providers that have signed up to implementing this criterion. An important task for this network will be to offer further support to those who are seriously on their way to evidence based activities. At the same time we should ensure that patients can actually find the information provided by quality providers. We can only counteract the enormous amount of information biased by financial or intellectual interests if we stand united. It would be inadvisable to leave information seekers alone until an “optimum” has been reached. We think the better alternative is for the “quality” providers (good, not optimum) need to cooperate and jointly seek further qualification. Doctors are important partners in disseminating quality information as they have direct contact with patients. And the need for evidence based information among doctors is great. The opportunity to familiarize doctors with “good practice” should not be missed by Deutsches Arzteblatt.

Online mental health resources for teenagers: an evaluation of two websites developed for adolescents

Young people are less likely to seek help for mental health difficulties. Good quality mental health information from reliable sources may help overcome barriers to help seeking in young people and improve awareness of the common symptoms related to mental health problems. With an adolescent population in mind, websites for depression and for stress and anxiety were developed for young people and those caring for them by one of the authors. The current evaluation sought to assess the use of, and perceived satisfaction with, each of these mental health websites. Data from the website domains were considered in relation to unique visits, country of origin and source of referral. Qualitative website user feedback was gained from evaluation questionnaires. Findings showed that website visits for both resources have increased year-on-year and feedback from the evaluation revealed that the resource information was perceived to be trustworthy, reliable and informative. The feedback indicated that the resource wa...

Good health information - an asset not a burden!

Good health information is central to informing the delivery of health care. Health has mostly struggled to promote the effective use of information to manage services on a day to day basis. Based on the experience at the Children's Hospital at Westmead, a case is made for seeing information as an asset that requires a structured approach to improving data quality, and making a concerted effort to grow a more robust information culture. Transforming Health through better health information will not happen overnight. It needs a long range plan. It should be supported by appropriate business intelligence tools and a structured approach to process improvement, built around data management.

Health information literacy meets evidence-based practice

Health information literacy meets evidence-based practice

Best of the Web: Just for Kids

There is no shortage of websites for children. In May 2009, approximately 16 million children aged 2 to 11 years (9.5% of all online users) were reported to spend an average of 11 hours online (Nielsen Online, July 6, 2009). These data represent a 63% increase in time spent online in young children since 2004. The purposes of this On the Web article are to provide a brief overview of online safety for children, review quality criteria relevant to children’s sites, and provide examples of high-quality health sites just for kids. And if you have Internet search experience and are between the ages of 55 to 76 years, then you in particular should keep reading! The findings of a recent study suggest that Internet searching can improve brain function, especially the abilities of a middle-aged or older adult to make decisions and

Health and Medical Information on and Off the Internet

A veritable ocean of health and medical information exists on the Internet as well as “off” the Internet in the form of commercially produced aggregations of health information. Some studies have shown that there seems to be a disconnect between many health information seekers and much of this information. Many public libraries have adequate to impressive arrays of health information electronically available through commercial databases or through their provision of links to free Web sites. This paper explores some of the habits of health information seekers, the resources which are available in libraries, and suggests some ways to begin to connect the information seeker to good health information that is readily available. The public library can, and should, be one of the resources health information seekers will explore.

Development of a Health Information Web Site Evaluation Categories with Items for Diabetes Mellitus

OBJECTIVE: The purpose of this study was to develop a health information web site evaluation categories with items for diabetes mellitus in order to offer verified health information, and to propose directions for development of web sites. METHODS: A preliminary evaluation categories with items was developed using domestic and foreign web site evaluation standards for health information and through a review of the literature. The evaluation categories with items was composed of 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. Through expert validity tests and a feasibility test of the preliminary tool, the health information Web site evaluation tool for diabetes mellitus was finalized. RESULTS: This evaluation categories with items included 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. 'Evaluation for web site attributes' included 8 categories with 28 items. The 'evaluation for content information on diabetes mellitus' included 7 categories with 40 items. 'Evaluation component for content' and 'evaluation of category content' included 4 items on 'accuracy', 6 on 'harmfulness' and 3 on 'comprehensibility'. CONCLUSION: From this study guidelines are propose for providing health information for diabetes mellitus, so that health information providers will be able to offer consumers verified good quality health information themselves.

Information and involvement.

This article discusses the beliefs that provision of good quality information is the key to (a) successful and satisfying involvement of patients in their own decision-making and (b) involvement of lay people in the research process, in debate and other involvement in wider health issues. Education of children, health professionals, the public and the media is advocated, enabling critical appraisal skills and good quality health information to lead to improved involvement of citizens in health-care decisions of all kinds, both individual and societal. Examples of individual, group and specific group involvement through research projects, debates about screening, Citizens' Juries, etc. are used to illustrate benefits to patients and to health provision in general.

Health information for the millennium and beyond

Health information for the millennium and beyond