Health Communication Training Research Articles

Patient‐Centered Communication: Exploring the Dentist's Role in the Era of e‐Patients and Health 2.0

In today's digital era, people are increasingly relying on the Internet-including social media-to access health information and inform their health decisions. This article describes an exploratory initiative to better understand and define the role of dentists in patient education in the context of e-patients and Health 2.0. This initiative consisted of four phases. In Phase I, an interdisciplinary expert advisory committee was assembled for a roundtable discussion about patients' health information-seeking behaviors online. In Phase II, a pilot case study was conducted, with methods and analysis informed by Phase I recommendations. Phase III consisted of a debriefing conference to outline future areas of research on modernizing health communication strategies. In Phase IV, the findings and working theories were presented to 75 dental students, who then took a survey regarding their perspectives with the objective of guiding potential curriculum design for predoctoral courses. The results of the survey showed that the validity of online content was often secondary to the strength of the network sharing it and that advocacy online could be more effective if it allowed for emotional connections with peers rather than preserving accuracy of the information. Students expressed high interest in learning how to harness modern health communications in their clinical care since the role of the dentist is evolving from giving information to giving personalized guidance against the backdrop of an often contradictory modern information environment. The authors recommend that the dental profession develop patient-centered health communication training for predoctoral students and professional development and continuing education for practicing professionals.

Facilitating psychosexual adjustment for women undergoing pelvic radiotherapy: pilot of a novel patient psycho-educational resource.

PurposeThis pilot study aimed to obtain feedback on the feasibility, safety and acceptability of a psychosexual rehabilitation booklet developed for women undergoing pelvic radiation therapy (PRT) and to explore women's sexual, informational and supportive care needs post‐PRT rehabilitation.MethodsTwenty women treated with PRT for gynaecological or anorectal cancer within the last 5 years, who had received vaginal dilators, provided feedback on the format, content and utility of the booklet and discussed their post‐treatment information needs, via a semi‐structured phone interview. Women completed standardized (HADS, IES‐R) and study‐specific scales to characterize psychological status of the sample and to assess participants' booklet knowledge and feedback, respectively.ResultsThe booklet was perceived as very helpful, informative and not distressing, providing additional information to that discussed with clinicians. After reading the booklet, women had good understanding of strategies to reduce the sexual impact of PRT. Many women reported that discussion of sexuality was often avoided during consultations, despite them experiencing distressing sexual experiences and difficulties post‐PRT.ConclusionsThis novel resource which addresses an important component of post‐pelvic radiation care appears acceptable and highly valued. Findings have highlighted a need for sexual health communication training for clinicians who treat this population so that they can initiate conversations about vaginal health and sexual health in an informed and comfortable manner. The impact of the revised booklet on psychosexual and clinical outcomes is being evaluated in a multicentre RCT.

How midwives tailor health information used in antenatal care

Objectiveto examine the informal approaches taken by midwives and other antenatal staff to adapt health communication to the needs of their patients, as well as their perception of the barriers faced when trying to provide tailored health promotion. Designqualitative research methods (participant observation, individual and group interviews) were utilised to gain an understanding of how media and communication resources were used in practice within the study hospital. Settinga major metropolitan teaching hospital located in the Northern suburbs of Adelaide, South Australia. Participantsindividual semi-structured interviews with antenatal staff (n=8) were combined with group interviews (n=2; total number of staff=13), and observational research. Findingsmidwives and other antenatal staff use a range of strategies to meet the perceived health literacy level of their patients. However, their attempts to tailor health information to individual needs are frequently based on incomplete information about patients׳ health literacy, may be inconsistent in delivery and content and are seldom assessed to determine whether communication has been understood or led to patient behaviour change. Key conclusionsmidwives fully recognise the need to adapt standard printed materials to meet the diverse health literacy needs of patients but lack the resources required to evaluate whether these adaptations have positive effect. Implications for practicemidwives׳ commitment to improving health communication provides a latent resource that institutions can build on to improve health outcomes for patients with low health literacy. This requires improvements in health communication training, willingness to use a range of validated instruments for measuring health literacy, and commitment to use of innovative approaches to health promotion where these have been shown to have a positive impact on health behaviours.

Obesity communication among patients by health professionals: Findings from the Weight Care Project

Obesity is on the increase worldwide and is a major global public health problem. In an increasingly obesogenic environment, it’s important that health professionals are equipped to identify and address obesity issues within their clinical practice. As part of the Weight Care Project, the aim of this study was to explore the obesity-related communication issues for primary care and community-based health professionals. The study design was a quantitative survey, which was completed by 382 primary care and community-based health professionals across Northern Ireland and Republic of Ireland working with adults and children. Key findings included that the majority of the health professionals (86%) recognized having a role in giving obesity advice, acknowledged that in clinical practice communication of obesity messages is both complex and challenging (81%), and reported difficulty in sensitively addressing obesity issues (27%). The health professionals surveyed stated that they communicate obesity messages to their patients using a range of different methods, mainly verbally to individuals, leaflets and factsheets. Numerous benefits of communicating obesity messages were reported; the main one was interacting with patients to build trust. Identified barriers to commu nication were: limited time in patient consultations, restricted access to appropriate information, and not sure where to access appropriate resources. Communication needed be reported by the health professionals included provision of greater resources, more information on obesity management and prevention, followed by health communication training, and clear and consistent messages. Significant differences were observed, including significantly much younger health professionals considered their role to provide obesity advice (P = 0.025). It is clear from this study that health professionals view as important the need to be given information on “what” and “how” to communicate with their patients on obesity. This study highlights that health professionals need continued support to enable them to effectively address weight-related issues in a sensitive manner that is acceptable to the patient.

Effect of a Pharmacy-Based Health Literacy Intervention and Patient Characteristics on Medication Refill Adherence in an Urban Health System

Limited health literacy is associated with poor understanding of medication instructions and may be related to medication adherence. To evaluate a 3-part intervention (automated telephone reminder calls to refill prescriptions, picture prescription card, and clear health communication training for pharmacists) intended to increase refill adherence through attention to health literacy. Three pharmacies that serve a primarily indigent, minority population served as the intervention sites, and one pharmacy served as the control site. To evaluate the impact of the 6-month intervention on medication adherence, pharmacy refill data were used to calculate the cumulative medication gap (CMG), in which values close to zero indicate better adherence. The primary measure of treatment effect was a comparison of the change in refill adherence within each group, from baseline to follow-up. A total of 173 patients were enrolled in the intervention group and 102 patients in the control group. Medication adherence was significantly different between intervention (CMG = 0.25) and control (CMG = 0.18) groups at baseline (p = 0.004). Refill adherence in the intervention group improved slightly during follow-up (CMG = 0.23), while it worsened slightly in the control group (CMG = 0.21), but the change in adherence between intervention and control groups was not significantly different (p = 0.4). Between 80% and 90% of intervention participants indicated that receiving the picture prescription and phone call interventions helped them remember when and how to take their medications and refill their prescriptions. No patient characteristics, including health literacy, were consistently associated with adherence. Implementation of a 3-part intervention--automated telephone reminders, picture prescription card, and pharmacist communication skills training--did not significantly improve refill adherence among inner-city patients. Further study should explore whether other aspects of medication management, such as dosing or adverse events, can be improved through these types of interventions, implemented either alone or in combination.

Addressing Literacy and Numeracy to Improve Diabetes Care

OBJECTIVEDiabetic patients with lower literacy or numeracy skills are at greater risk for poor diabetes outcomes. This study evaluated the impact of providing literacy- and numeracy-sensitive diabetes care within an enhanced diabetes care program on A1C and other diabetes outcomes.RESEARCH DESIGN AND METHODSIn two randomized controlled trials, we enrolled 198 adult diabetic patients with most recent A1C ≥7.0%, referred for participation in an enhanced diabetes care program. For 3 months, control patients received care from existing enhanced diabetes care programs, whereas intervention patients received enhanced programs that also addressed literacy and numeracy at each institution. Intervention providers received health communication training and used the interactive Diabetes Literacy and Numeracy Education Toolkit with patients. A1C was measured at 3 and 6 months follow-up. Secondary outcomes included self-efficacy, self-management behaviors, and treatment satisfaction.RESULTSAt 3 months, both intervention and control patients had significant improvements in A1C from baseline (intervention −1.50 [95% CI −1.80 to −1.02]; control −0.80 [−1.10 to −0.30]). In adjusted analysis, there was greater improvement in A1C in the intervention group than in the control group (P = 0.03). At 6 months, there were no differences in A1C between intervention and control groups. Self-efficacy improved from baseline for both groups. No significant differences were found for self-management behaviors or satisfaction.CONCLUSIONSA literacy- and numeracy-focused diabetes care program modestly improved self-efficacy and glycemic control compared with standard enhanced diabetes care, but the difference attenuated after conclusion of the intervention.

The potential of schoolchildren as health change agents in rural western Kenya

A prospective, quasi-experimental study was carried out in Bondo district in western Kenya to determine the potential of schoolchildren as health change agents in a rural community. A group of 40 schoolchildren were given health education using action-oriented and participatory approaches and their knowledge and practices as well as the influence on recipient groups consisting of peers at school and parents/guardians at home, were studied. The study, which used questionnaire surveys, involved a pre-test of knowledge about malaria, diarrhea and hygiene among the recipient groups. After the baseline surveys they underwent health communication training conducted by the 40 schoolchildren. An identical post-test questionnaire was administered to all participants at 4 and 14 months. Health-related practices were studied regularly through observation in schools and homes over 14 months. Significant improvement in knowledge was detected in all recipient groups. Behavioral changes were more evident among the children than among the adults. The impact of the project was reflected in concrete changes in the school environment as well as the home environments. The implications of the findings for health education projects and public health programs are outlined.