Health Education Brochures Research Articles

Experience Caring for an Acute Lymphoblastic Leukemia Patient With COVID-19 in the ICU

This article describes the author's experience providing care in the ICU to a patient with acute lymphoblastic leukemia who had contracted COVID-19. The period of care spanned from June 29 to July 12, 2021. Data were collected during direct care, observations, and interviews and using medical record reviews. During the course of care, supportive care, bundle care, and other infection control measures were provided. The patient was monitored and tracked regularly for infection-related indicators, which successfully mitigated the impact of the infection and prevented secondary bacterial infections. Respiratory care measures such as assistance with Q3H awake prone positioning on the bed were provided. Also, the safety and smoothness of the ventilator pipeline and catheter when prone were confirmed and the setting of the ventilator was adjusted based on the blood oxygen concentration and gas analysis. These measures improved the patient's oxygenation, allowing their successful removal from the ventilator. Delayed chemotherapy affects the survival rate of patients with acute lymphoblastic leukemia as well as improves their physical and emotional status. Using patient-centered communication skills, empathizing with the patient's negative feelings, encouraging and assisting their participation in self-care, and helping facilitate prescribed hematologist-oncologist care, the author helped increase the patient's perceived self-control and positive attitudes and effectively alleviated their hopelessness regarding their current situation. Several recommendations arise from this care experience. Social media apps may be used to create virtual support groups for patients comprising significant relatives and friends to better support patients in quarantine. Also, a health education brochure addressing the latest COVID-19 disease, treatment, and care information may be given to patients with COVID-19 upon hospital admission to reduce their uncertainties and improve their self-care awareness to maximize their ability to successfully navigate the long quarantine treatment process.

Effects of self-care programs on the incidence of diabetes among adults with prediabetes: A systematic review and meta-analysis of randomised controlled trials.

To verify the effects of self-care programs among adults with prediabetes, to identify the preferable structure components and to summarise the core content components of self-care programs. A systematic review and meta-analysis of randomised controlled trials. PubMed, Embase, Cochrane, CINAHL, PsycINFO, Wanfang, CNKI, Chinese Biomedical Database and Open Grey were searched for studies published from January 2002 to December, 2021. Meta-analysis was conducted to verify the effects of self-care programs on diabetes incidence. Subgroup analyses based on structure components were performed to contrast the effects. We made a critical analysis to generalise the core elements of content components. The study was reported according to PRISMA statement. Totally, 15 studies were included in systematic review, of which 14 studies were eligible for meta-analysis. The results of meta-analysis showed the incidence of diabetes for prediabetic adults receiving self-care programs was significantly lower than those who received usual care (OR 0.58; 95% CI 0.46 to 0.73). The results of subgroup analyses based on delivery mode, intervention implementer, health education brochures provided, and follow-up duration showed statistically significant reduction in incidence compared with control group (p < .05). However, the differences of these pair-wise comparisons (face-to-face or remote, individual or interdisciplinary team, with or without brochures provided, ≤1year or >1year) were not statistically significant (p > .05). Three core content elements were generalised: cognitive education, behaviour guidance and psychological support. Self-care programs can effectively delay the progression of prediabetes to diabetes. Regardless of the diversified structure components, self-care programs can achieve better effects on the diabetes incidence than usual care, while the optimal structure components still remain unknown. Cognitive education, behaviour guidance and psychological support are core elements for these programs. More clinical trials with rigorous study design are needed to provide further evidence.

The role of health education on cervical cancer screening uptake at selected health centers in Addis Ababa.

Cervical cancer is one of the most common causes of morbidity and mortality among women in developing countries including Ethiopia. Unlike other types of cancers, the grave outcomes of cervical cancer could be prevented if detected at its early stage. However, in Ethiopia, awareness about the disease and the availability of screening and treatment services is limited. This study aims to determine the role of health education on cervical cancer screening uptake in selected health facilities in Addis Ababa. Two-pronged clustered randomized controlled trial was conducted in 2018 at eight public health centers that provide cervical cancer screening services using visual inspection with acetic acid (VIA) in Addis Ababa, Ethiopia. Each of the eight health centers were randomly assigned to serve as either an intervention or a control center. A two-pronged clustered randomized controlled trial was conducted in eight public health care centers. All the selected facilities provided cervical cancer screening services using visual inspection with acetic acid (VIA). Four health centers were randomly assigned to the intervention and control arms. The study participants were women aged 30-49 years who sought care at maternal and child health clinics but who had never been screened for cervical cancer. In the intervention health centers, all eligible women received one-to-one health education and educational brochures about cervical cancer and cervical cancer screening. In the control health centers, participants received standard care. Baseline data were collected at recruitment and follow-up data were collected two months after the baseline. For the follow-up data collection, participants (both in the intervention and control arms) were interviewed over the phone to check whether they were screened for cervical cancer. From the 2,140 women who participated in the study, 215 (10%) screened for cervical cancer, where 152(71%) were from the intervention health centers. Seventy-four percent of these participants reported that they learned about the benefits of screening from the one-to-one health education or the brochure. Women from the intervention health centers had higher odds of getting screened (AOR = 2.43,95%CI;1.58-2.90) than the controls. Women with the educational status of the first degree and those who have a history of sexually transmitted infections (STIs) had higher odds of getting screened (AOR = 2.03,95%CI;(1.15-2.58) and (AOR = 1.55,95%CI;1.01-2.36), respectively. Providing focused health education supported by printed educational materials increased the uptake of cervical cancer screening services. Integrating one-to-one health education and providing a take-home educational material into the existing maternal and child health services can help increase cervical cancer screening uptake.

Information needs in genetic testing: A needs assessment survey among Taiwanese parents of children with autism spectrum disorders.

We conducted the first needs assessment study by examining the information needs in genetic testing for autism spectrum disorders among parents of children with autism spectrum disorders in Taiwan. Parents of children with autism spectrum disorders in 236 public elementary schools with special education services were invited to complete a survey. About two-thirds of participants (65.7%) had never heard about genetic testing for autism spectrum disorders. Yet, the majority (71.4%) expressed an interest in learning about this testing. The top three topics participants identified to assist them in making informed decisions before undergoing genetic testing (for themselves, their affected children, or other family members) were testing accuracy (79.7%), genetic causes of autism spectrum disorders (79.4%), and the link between testing and treatment (79.4%). A health education brochure (47.2%) was the most desired educational approach. Our results can be utilized to develop information and counseling materials for genetic testing for autism spectrum disorders in Taiwan as well as to address the needs of parents of children with autism spectrum disorders, particularly in informed decisions-making. Moreover, to promote better communication between the providers and parents, when discussing genetic testing for autism spectrum disorders with Taiwanese parents of children with autism spectrum disorders, healthcare professionals' priorities should be in line with the preferred topics identified in this study.

Plan for Improving the Initial Ambulation of Acute Stroke Patients

Acute stroke patients should receive a rehabilitation assessment within 24-48 hours of hospitalization. Initial ambulation is known to reduce the occurrence of complications, improve the ability to perform activities of daily living, and reduce the risk of long-term disability. To raise the initial ambulation willingness of acute stroke patients and to increase the willingness of these patients to receive rehabilitation treatment as soon as possible in order to reduce the long-term physical damage of the stroke incident. To develop and implement standard operating procedures for the initiation of ambulation (first time leaving the hospital bed) in acute stroke patients, to use health education brochures with texts and illustrations, and to have nurses physically assist patients to initiate ambulation. The rate of ambulation initiation in acute stroke patients rose from 32.0% pre-intervention to 85.4% post-intervention. Acute stroke patients who initiate ambulation soon after experiencing a stroke may reduce their risk of acute complications, increase their ability to perform activities of daily living, and reduce the risk of long-term disability. Thus, encouraging early ambulation is extremely important to improving the prognosis of this patient population.

An analysis of the readability characteristics of oral health information literature available to the public in Tasmania, Australia.

BackgroundThe effectiveness of print-based health promotion materials is dependent on their readability. This study aimed to assess the characteristics of print-based oral health information literature publically available in Tasmania, Australia.MethodsOral health education brochures were collected from 11 dental clinics across Tasmania and assessed for structure and format, content and readability. Reading level was calculated using three widely-used measures: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease, and Simple Measure of Gobbledygook (SMOG) reading grade level.ResultsThe FKGL of the 67 brochures sampled ranged from grade 3 to 13. The grade level for government health department brochures (n = 14) ranged from grade 4 to 11 (5.6 ± 1.8). Reading levels for materials produced by commercial sources (n = 22) ranged from 3 to 13 (8.3 ± 2.1), those from professional associations (n = 22) ranged from grade 7 to 11 (8.9 ± 0.9) and brochures produced by other sources (n = 9) ranged from 5 to 10 (7.6 ± 1.5). The SMOG test was positively correlated with the FKGL (rs = 0.92, p < 0.001) though consistently rated materials 2-3 grades higher. The reading level required to comprehend brochures published by government sources were, on average, lower than those from commercial, professional and other sources. Government materials were also more likely to contain fewer words and professional jargon terms than brochures from the other sources.ConclusionA range of oral health information brochures were publically available for patients in both public and private dental clinics. However, their readability characteristics differed. Many brochures required a reading skill level higher than that suited to a large proportion of the Tasmanian population. Readability and other characteristics of oral health education materials should be assessed to ensure their suitability for use with patients, especially those suspected of having low literacy skills.

A Mixed-Methods Study of Immigrant Somali Women's Health Literacy and Perinatal Experiences in Maine.

Research on health care provided to clients with limited English proficiency in the United States has revealed poor satisfaction and increased use of the health care system. This mixed-methods study explored health literacy and the perinatal experiences of Somali and Somali Bantu women living in Lewiston, Maine. The study also describes the development and validation of historietas (comic-book style health education brochure) used to increase knowledge and awareness of why emergency cesareans may be required and the symptoms of postpartum depression (PPD). During phase 1, a focus group to discuss the perinatal experiences of Somali women (n = 4) was undertaken and 2 historietas were developed to create greater understanding of emergency cesareans and PPD. In phase 2, Somali and Somali Bantu women (n = 19) completed a health literacy questionnaire and a perinatal experiences questionnaire. A focus group was also conducted during phase 2 to determine the perinatal experiences of the participants. Phase 2 participants validated the historietas developed in phase 1. Responses from focus groups were triangulated with data from the perinatal experiences questionnaire completed during phase 2. Overall, none of the phase 2 participants demonstrated adequate health literacy. Problems with gudnin (Somali word for cutting) related to female genital mutilation/cutting and PPD yielded statistically significant results. Somali women expressed dissatisfaction with certain obstetric interventions, especially emergency cesareans. Phase 2 participants unanimously validated the usefulness of the historietas as a clinical teaching tool. Poor health literacy due to language barriers may place Somali women living in the United States at risk for adverse outcomes during pregnancy and/or birth. Complications related to emergency cesareans and PPD were identified as significant problems for which Somali women require further knowledge. Historietas addressing knowledge gaps related to emergency cesareans and symptoms of PPD were validated by participants as useful teaching tools.

Suitability assessment of health education brochures in Qassim province, Kingdom of Saudi Arabia.

Background:Health education is the cornerstone of primary health care. Health education materials distributed to the community should, therefore, be suitable and effective. The purpose of this study was to evaluate the health education brochures, designed and disseminated by Ministry of Health institutions in the Qassim province.Materials and Methods:The study was a cross-sectional review of health education brochures. We used a structured evaluation form, comprising general information on the brochures and a modified Suitability Assessment of Materials (SAM) score sheet. The SAM consisting of 22 criteria in six groups, includes content, literacy demands, graphics, layout/typography, learning stimulation/motivation, and cultural appropriateness. SAM criteria categorize written material into “superior,” “adequate” and “not suitable.” Two qualified consultant family physicians evaluated the brochures. Data were analyzed using Epi Info version 3.4 statistical package.Results:We evaluated 110 brochures, the majority of which addressed chronic health conditions such as mental health, diabetes mellitus and hypertension. Seventy-four (67.3%) brochures were evaluated as “adequate,” 34 (30.9%) as “not suitable” and 2 (1.8%) as “superior.” “Cultural appropriateness” was the highest scoring factor, with 92 (83.6%) brochures falling into either the “superior” or “adequate” category. With regard to “content,” 88 (80.0%) brochures fell into either the “superior” or “adequate” category. This was the second highest scoring factor. Graphics was the factor that scored the least. Seventy-five (68.2%) brochures were rated in this factor as “not suitable.”Conclusions:Although two-thirds of our brochures were considered “adequate,” the majority needed improvement to their graphics and learning stimulation factors. We recommend that guidelines for designing health education brochures should be formulated to improve the quality of health education brochures.

Effects of a Multifactorial Fall Prevention Program on Fall Incidence and Physical Function in Community-Dwelling Older Adults With Risk of Falls

ObjectiveTo evaluate effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults. DesignMulticenter randomized controlled trial. SettingThree medical centers and adjacent community health centers. ParticipantsCommunity-dwelling older adults (N=616) who have fallen in the previous year or are at risk of falling. InterventionsAfter baseline assessment, eligible subjects were randomly allocated into the intervention group (IG) or the control group (CG), stratified by the Physiological Profile Assessment (PPA) fall risk level. The IG received a 3-month multifactorial intervention program including 8 weeks of exercise training, health education, home hazards evaluation/modification, along with medication review and ophthalmology/other specialty consults. The CG received health education brochures, referrals, and recommendations without direct exercise intervention. Main Outcome MeasuresPrimary outcome was fall incidence within 1 year. Secondary outcomes were PPA battery (overall fall risk index, vision, muscular strength, reaction time, balance, and proprioception), Timed Up & Go (TUG) test, Taiwan version of the International Physical Activity Questionnaire, EuroQol-5D, Geriatric Depression Scale (GDS), and the Falls Efficacy Scale-International at 3 months after randomization. ResultsParticipants were 76±7 years old and included low risk 25.6%, moderate risk 25.6%, and marked risk 48.7%. The cumulative 1-year fall incidence was 25.2% in the IG and 27.6% in the CG (hazard ratio=.90; 95% confidence interval, .66–1.23). The IG improved more favorably than the CG on overall PPA fall risk index, reaction time, postural sway with eyes open, TUG test, and GDS, especially for those with marked fall risk. ConclusionsThe multifactorial fall prevention program with exercise intervention improved functional performance at 3 months for community-dwelling older adults with risk of falls, but did not reduce falls at 1-year follow-up. Fall incidence might have been decreased simultaneously in both groups by heightened awareness engendered during assessments, education, referrals, and recommendations.

Health Literacy Demands of Written Health Information Materials: An Assessment of Cervical Cancer Prevention Materials

Health literacy requires reading and writing skills as well as knowledge of health topics and health systems. Materials written at high reading levels with ambiguous, technical, or dense text, often place great comprehension demands on consumers with lower literacy skills. This study developed and used an instrument to analyze cervical cancer prevention materials for readability, comprehensibility, suitability, and message design. The Suitability Assessment of Materials (SAM) was amended for ease of use, inclusivity, and objectivity with the encouragement of the original developers. Other novel contributions were specifically related to "comprehensibility" (CAM). The resulting SAM + CAM was used to score 69 materials for content, literacy demand, numeric literacy, graphics, layout/typography, and learning stimulation variables. Expert reviewers provided content validation. Inter-rater reliability was "substantial" (kappa = .77). The mean reading level of materials was 11th grade. Most materials (68%) scored as "adequate" for comprehensibility, suitability, and message design; health education brochures scored better than other materials. Only one-fifth were ranked "superior" for ease of use and comprehensibility. Most written materials have a readability level that is too high and require improvement in ease of use and comprehensibility for the majority of readers.

Designing effective health education materials: experimental pre-testing of a theory-based brochure to increase knowledge

The aim of this study is to demonstrate the usefulness of developing health education materials with a theoretical and empirical research basis. With a specific focus on increasing knowledge, the authors utilized well-researched principles in cognitive psychology to increase the message comprehension of an existing health education brochure. The brochure used was produced by a Dutch national campaign office for preventing alcohol abuse among undergraduate students. In two experimental studies, the original version of the brochure was compared with the theory-based modified version on measures of knowledge and psychosocial determinants of alcohol use among undergraduate university students. The results show significant differences in knowledge uptake between the two versions. In both experiments, the modified version elicited higher scores on knowledge uptake than the original version. These findings underscore the importance of theory in the design of health education brochures. Despite these positive findings, no differences in more proximal psychosocial determinants of behavior could be found. As a result, the authors conclude that principles in cognitive psychology should be complemented by determinant-specific theory-driven change methods if behavior change is to occur.

Testing the usability of access structures in a health education brochure

In health education, the design of written materials is seldom subject to experimental tests. Using insights from cognitive-ergonomic literature on usability we tested a brochure against three stepwise improved versions. Effects were assessed of pictorials that flagged references in the brochure text, the use of tabs and colour coding of these pictorials and tabs, on finding information in the brochure. One hundred Dutch adults from the general population were videotaped while looking up search items. Dependent measures relating to search effectiveness, efficiency, satisfaction and learnability were extracted. Results showed a general inferiority of the original brochure. The presence of coloured tabs and pictorials contributed to a more usable brochure design, although errors were still made. It is concluded that this kind of research may provide valuable insights for more effective health education material design and thus contributes to the effectiveness of health education practice.

Chief dentists' perceived strengths and weaknesses of oral health promotion activities in Malaysia

The main aim of this study is to get the Malaysian chief dentists’ perceptions of the oral health promotion activities currently taking place in their respective states in terms of the strengths and weaknesses of these activities. A qualitative method using an open-ended questionnaire was used to obtain this information. The study samples consist of all the chief dentists in Malaysia who represented a majority of population in their states. The results showed that the main current oral health promotion activities is dental health education talks which aims to disseminate oral health information through health education talks, toothbrushing drills, dental exhibition, pamphlets, brochures and publications. Half of the respondents felt that the commitment of the staff, the support of the public sectors and collaboration with other agencies are the main strengths while the lack of staff and fund has been said as the weaknesses. A range of opportunitieshowever exist to strengthen oral health promotion in Malaysia.

The Effect of Graphic Organizers on Subjective and Objective Comprehension of a Health Education Text

This study examined the effect of graphic organizers on the comprehension of a health education brochure text and compared subjective with objective comprehension measures. Graphic organizers are graphical depictions of relations among concepts in a text. Participants read a brochure text about asthma with and without these organizers, and subjective and objective text comprehension was measured. It was found that graphic organizers had effects on four levels of objective comprehension as indicated by open comprehension questions. However, on the subjective comprehension measure using Likert-type scales, the groups with and without graphic organizers did not differ from each other. It is concluded that health education texts could benefit from relatively simple techniques to increase comprehension. Furthermore, in developing health education materials, comprehension should be measured objectively.

Increasing Readers’ Comprehension of Health Education Brochures: A Qualitative Study Into How Professional Writers Make Texts Coherent

The aim of this study was to gain insight into the extent to which health education text writers apply writing principles derived from cognitive psychological theory. Seventeen professional text writers of health education materials participated in a qualitative study, consisting of a rewriting task combined with a think-aloud procedure and a semistructured interview. The verbal data were explored carefully in light of seven text coherence principles that have proven effective in cognitive psychological research to increase text comprehension. Findings indicate text writers vary in their ideas and use of coherence principles to make a text comprehensible. It is argued that the health education profession can benefit greatly from knowledge about cognitive text processing and cognitive coherence principles for realizing effective comprehension of written health education messages.

Disparities between public health educational materials and the scientific evidence that smokeless tobacco use causes cancer.

We reviewed 4 dozen health education brochures on the dangers of smokeless tobacco (ST) use, printed between 1981 and 2001 and available to the public in 2002. Collectively, these brochures state that ST use causes oral leukoplakia, other oral conditions, and cancers of the oral cavity, larynx, pharynx, esophagus, stomach, pancreas, lung, breast, prostate, bladder, and kidney. We then reviewed the scientific literature to determine whether these claims were substantiated. Only for oral leukoplakia and several oral conditions is the evidence persuasive for causation by ST. The evidence that ST causes oral cancer is very suggestive, whereas the evidence for causation of other cancers is either absent or contradictory. Communication of the health risks of using ST must be done accurately and should be data based. Broadening the message to include additional diseases for which the evidence is inadequate could cause the message about true risks, as well as the messenger, to be discounted.

Effectiveness of a perimenopausal health education intervention for mid-life women in northern Taiwan (#MS03-21-LW)

The purpose of this quasi-experimental research was to assess the effectiveness of a perimenopausal health education intervention for mid-life women in northern Taiwan. The health education intervention included a health education brochure, one-on-one teaching. One hundred seventy-nine women were in the intervention group and 174 women were in the control group. Education effectiveness was assessed by participants’ scores on four questionnaires at the beginning of the study and 3 months after initial recruitment. Both groups of women were compared on changes in their scores on health knowledge, level of perceived uncertainty, health behaviors and perceived perimenopausal disturbances. The intervention group had significantly reduced scores on perimenopausal disturbances ( P<0.005) and reported increase practice of healthy behaviors ( P<0.001) compared to the control group. However, a significant decrease of perceived uncertainty was only found in the subgroup of women recruited from the Chinese medicine clinic of the control group ( t=2.22; d.f.=58; P<0.05). Chinese medicine physicians assess patients based on a philosophical approach that treats all symptoms holistically. This may have helped reduce patient uncertainty.

Providing Online Health Information in Many Languages

The need for reliable health information in multiple languages is growing. The Spencer S. Eccles Health Sciences Library, in conjunction with the Utah Department of Health, developed a Web-based project to serve the unique information needs of multilingual health consumers. Features of this project include scanning over 200 health education brochures in 24 languages and making them available online. This article discusses the need for reliable health information in many languages, the project's progress to date, and the technical lessons learned while implementing such a Web-based initiative.

Effects of type of information in health education brochures upon performance on an experimental melanoma detection task

Effects of type of information in health education brochures upon performance on an experimental melanoma detection task

Light Milk Products: Effects of Product Information on Women Participating in the Women's Ten Kilometer Run

418 women participating in the Women's Ten-kilometer Run completed a questionnaire of 51 questions. We hypothesized that a reliable health education brochure on light milk products would help to change consumption habits of milk products and other eating habits. 13% of women reported a positive change in their consumption of milk products. Seven variables explained 41% of the change in eating habits, and three variables (change of eating habits, knowledge about the prevention of osteoporosis, and reading the brochure) 37% of the change in consumption of milk products.