Health Information Brochure Research Articles

Educational Intervention regarding Osteoporosis Knowledge among Nurses: A Comparative Cross-Sectional Survey

Background: Osteoporosis, a significant public health concern, necessitates informative health interventions due to its largely modifiable risk factors. Non-pharmacological approaches play a vital role in managing this condition. This survey aimed to assess the impact of an educational intervention on osteoporosis knowledge among nursing professionals. Objective: The primary objective was to evaluate the effectiveness of a health information brochure as an educational tool in enhancing osteoporosis awareness among nurses. Methods: Employing a comparative cross-sectional design, the study systematically sampled 278 nurses using the Roasoft calculator. Data were collected through a pre- and post-intervention osteoporosis quiz, with a health information brochure utilized for the intervention. Results: The study achieved a 100% response rate. Pre-intervention, 70.9% of nurses correctly identified that osteoporosis affects both genders, which increased to 82.4% post-intervention. Statistical analysis revealed a weak correlation in bone health knowledge (r=0.35, p<0.001), a strong association in understanding risk factors (r=0.70, p<0.001), and treatment and prevention (r=0.89, p<0.001). Significant differences in knowledge improvement were confirmed through paired t-test statistics. Conclusions: The survey demonstrated a statistically significant improvement in osteoporosis knowledge following the educational intervention. The results advocate for the integration of enhanced osteoporosis-related education in nursing curricula and continuing education programs, addressing the identified gap in responsiveness and knowledge as a barrier to optimal patient care.

O3-6 The Healthy School Start Plus Study - A parental support programme to promote healthy behaviours and prevent childhood obesity in disadvantaged areas

BackgroundThe rise in childhood overweight and obesity worldwide demands effective health promotion and obesity prevention programmes, especially targeting socially disadvantaged areas. The aim of this study is to examine the effectiveness of a revised parental support programme, promoting physical activity and a healthy diet, and on preventing overweight and obesity among children in disadvantaged areas.MethodsThe effectiveness of this programme will be compared to standard school routines in a parallel group cluster randomised controlled trial. The 6-month programme included: 1) A health information brochure; 2) School nurses conducting motivational interviewing with parents; 3) Classroom activities and home assignments for children; 4) A self-test for type-2 diabetes risk for parents. Seventeen schools were enrolled including 352 six-year-old children (155 intervention/197 control). Physical activity and sedentary time were measured by accelerometry. Dietary intake was assessed by a newly developed mobile phone-based photo method. Weight and height were measured by trained researchers. All outcomes were measured at baseline and at 6 and 18 months post baseline. Parental level of education was self-reported, and the highest level achieved by either parent was used as an indicator of socioeconomic position (SEP). A mixed-effect regression analysis will be performed to evaluate the effectiveness of the programme.ResultsAfter the intervention, when adjusting for sex and parental education, the intervention group showed 6.4 mins more moderate to vigorous physical activity (MVPA) during weekdays than the control group (p = 0.03). No significant effect on MVPA was detected during weekends (p = 0.47). Further, no significant effect was detected on time spent sedentary during weekdays (p = 0.12) nor during weekends (p = 0.78).According to IOTF classifications, 9.6% of the children had obesity, 16.4% overweight, 4.4% underweight and 69.6% normal weight. Results on changes in BMI, and dietary intake at 6 months will be presented.ConclusionsThe results from the evaluation of this parental support programme will add to the knowledge and advance intervention and implementation research in the Swedish/Nordic context relating to prevention of overweight and obesity in childhood.

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.

Design of an oral health information brochure for at-risk individuals

Objective: Our aim was to develop written resource material for use in the Oral Health Information through Community Pharmacists project. Poor oral health is associated with cardiovascular disease and diabetes. Many people do not access dental services on a regular basis; however, they may access community pharmacies for help and advice about oral health problems. Community pharmacists may be a valuable point of oral health information for people with heart disease or diabetes. Design: This paper reports the development of the written resource material for the project groups. Methods: Brochure development was guided by Fishbein and Yzer’s integrative model, and pre-tested with seven focus groups representing the potential target groups. Feedback from the focus groups was analysed concurrently and modified versions of the brochures were presented to subsequent groups. Results: The use of both written and visual messages enhanced the readability of the brochures for the focus groups with attendant Flesch Reading Ease scores of 77.4 and 79.4, while the ‘Make a plan’ section prompted future action planning amongst the participants. Conclusion: Well-designed patient education materials with good content, aesthetics and readability are important to deliver health messages within the context of a planned intervention. The three final brochures will be used in the intervention trial of the project.

A healthy school start - Parental support to promote healthy dietary habits and physical activity in children: Design and evaluation of a cluster-randomised intervention

BackgroundChildhood obesity is multi-factorial and determined to a large extent by dietary habits, physical activity and sedentary behaviours. Previous research has shown that school-based programmes are effective but that their effectiveness can be improved by including a parental component. At present, there is a lack of effective parental support programmes for improvement of diet and physical activity and prevention of obesity in children.Methods/DesignThis paper describes the rationale and design of a parental support programme to promote healthy dietary habits and physical activity in six-year-old children starting school. The study is performed in close collaboration with the school health care and is designed as a cluster-randomised controlled trial with a mixed methods approach. In total, 14 pre-school classes are included from a municipality in Stockholm county where there is large variation in socio-economic status between the families. The school classes are randomised to intervention (n = 7) and control (n = 7) groups including a total of 242 children. The intervention is based on social cognitive theory and consists of three main components: 1) a health information brochure; 2) two motivational interviewing sessions with the parents; and 3) teacher-led classroom activities with the children. The primary outcomes are physical activity in the children measured objectively by accelerometry, children's dietary and physical activity habits measured with a parent-proxy questionnaire and parents' self-efficacy measured by a questionnaire. Secondary outcomes are height, weight and waist circumference in the children. The duration of the intervention is six months and includes baseline, post intervention and six months follow-up measurements. Linear and logistic regression models will be used to analyse differences between intervention and control groups in the outcome variables. Mediator and moderator analysis will be performed. Participants will be interviewed.DiscussionThe results from this study will show if it is possible to promote a healthy lifestyle and a normal weight development among children from low-income districts with relatively limited efforts involving parents. Hopefully the study will provide new insights to the further development of effective programmes to prevent overweight and obesity in children.Trial registrationISRCTN: ISRCTN32750699

The Influence of Personality and Health Beliefs on Maintaining Proper Hydration

The present study was designed to examine factors that could facilitate or impede adherence to proper hydration. Forty volunteers (20 male, 20 female) were randomly assigned to one of two groups: Informed Group (n = 20) and Uninformed Group (n = 20). Bioelectrical impedance was used to measure intracellular (ICW) and extracellular (ECW) body water at Time 1 and 2. Personality, health beliefs, and health behaviors inventories were administered at Time 1. A health information brochure on proper hydration and consequences of poor hydration was given to the Informed Group. All participants were given six 1-liter bottles of water and drank two bottles per day. Both ICW, F(1,38) = 4.79, p < .05, and ECW, F(1,38) = 10.12, p < .005, significantly increased for both groups, and females had significantly greater changes than males in ECW, F(1,38) = 4.43, p < .05, and ICW, F(1,38) = 4.48, p < .05. Health information had no significant effect on female adherence but was a significant predictor of male adherence, β = .266, p < .05. Agreeableness, r = .36, p < .05, and social desirability, r = .33, p < .05, were the only personality factors related to change in ECW for the group as a whole. Health beliefs were unrelated to adherence, but general health concern, β = –.053, p < .05, was a significant predictor of change in ECW for males, although it was an inverse relationship.

Effective communication of risks to young adults: Using message framing and visual aids to increase condom use and STD screening.

Sexually Transmitted Diseases (STDs)-including HIV/AIDS-are among the most common infectious diseases in young adults. How can we effectively promote prevention and detection of STDs in this high risk population? In a two-phase longitudinal experiment we examined the effects of a brief risk awareness intervention (i.e., a sexual health information brochure) in a large sample of sexually active young adults (n = 744). We assessed the influence of gain- and loss-framed messages, and visual aids, on affective reactions, risk perceptions, attitudes, behavioral intentions, and reported behaviors relating to the prevention and detection of STDs. Results indicate that gain-framed messages induced greater adherence for prevention behaviors (e.g., condom use), whereas loss-framed messages were more effective in promoting illness-detecting behaviors (e.g., making an appointment with a doctor to discuss about STD screening). The influence of the framed messages on prevention and detection of STDs was mediated by changes in participants' attitudes toward the health behaviors along with changes in their behavioral intentions. Moreover, when visual aids were added to the health information, both the gain- and loss-framed messages became equally and highly effective in promoting health behaviors. These results converge with other data indicating that well-constructed visual aids are often among the most highly effective, transparent, fast, memorable, and ethically desirable means of risk communication. Theoretical, economic, and public policy implications of these results are discussed.

Verbal versus numerical probabilities: Does format presentation of probabilistic information regarding breast cancer screening affect women’s comprehension?

Objective: To test whether the format in which women receive probabilistic information about breast cancer and mammography affects their comprehension. Methods: A convenience sample of 180 women received pre-assembled randomized packages containing a breast health information brochure, with probabilities presented in either verbal or numeric format, and four questionnaires. Enclosed questionnaires assessed women’s knowledge of breast health, socio-demographic/ clinical characteristics, comprehension of breast health information brochure and format preference. Results: Nearly two-thirds of the study participants reported a preference for the numeric format. However, the study results showed that comprehension was significantly higher among women who received probabilistic information in verbal format than those who received the information in numeric format. This higher degree of comprehension was sustained even if the verbal format was inconsistent with the respondents’ format preference, and even if the respondents’ educational background were relatively limited. Women’s comprehension was strongly associated with the interaction between received format and their format preferences as well as their education level and their perceived benefit of early detection of breast cancer. Conclusion: The study demonstrates that comprehension of information depends on: (1) women’s readiness to receive information; and (2) their education and numeracy skills in processing and interpreting probabilistic information, particularly, when presented in quantitative format. Attention must be paid to these factors when designing or communicating breast health information in order to ensure full comprehension of information, and to avoid any potential discrimination which people may face relating to their poor education or numeracy skills. Systematic investigation into the relationships among readiness, numeracy problems, and format preferences could help build effective guidelines for providing women with appropriate and comprehensible information.

Can a Health Clinic-Based Intervention Increase Safety in Abused Women? Results from a Pilot Study

Intimate partner violence (IPV) has been related to a number of adverse physical and mental health consequences. Research has identified relatively high IPV victimization rates among women seeking care in primary healthcare and emergency department settings. Studies have shown the potential usefulness of screening and intervention in these settings. This article reports results from a pilot study designed to assess the effect of a clinic-based intervention on women's engagement in safety-promoting behaviors. This study was conducted in a primary healthcare clinic for the uninsured in Baltimore, Maryland. Women who screened positive for recent IPV were randomly assigned to an intervention or control group. The intervention consisted of an on-site counseling session and six telephone counseling sessions over a 3-month period. Women in the control group received health information brochures, a list of community resources, and a monthly telephone call to confirm contact information. A total of 41 women participated in the study. Results demonstrated that women who received the clinic-based intervention engaged in significantly more safety-promoting behaviors than did women in the control group. The results of this study and others indicate the potential usefulness of screening and intervention in a medical setting.

Health campaign for atherosclerosis prevention

The goal of the campaign "plus leben", a project designed to run for at least 5 years, is to heighten the awareness of patients at risk of heart disease and to provide them with an appropriate prevention program. During the first two years of the campaign 20,000 visitors were registered on the homepage, 400,000 tests for risk of heart disease were distributed, and more than 3,000 health information brochures were requested. Thus, a survey of patients was designed to provide information on the extent to which preventive measures are effective. The survey, which was carried out by mail, had a response rate of 28%, or 230 participants. In the random sample, consisting of about 60% men and 40% women, only 16% are younger than 50 years of age. Thus the survey provides a representative picture of the affected target group. The test for risk of cardiac disease provided by "plus leben" led to an increase in awareness of preventive measures in more than two thirds of the respondents, and 60% also completed the test. Although only a fourth of the patients are regularly informed by their physician about preventive measures, the campaign has led about 90% of the respondents to make fundamental or at least partial changes in their lifestyle. In connection with the study it was shown that the media play an important role in providing information on preventive measures. Communication in the doctor's office as an important building block in raising consciousness about atherosclerosis prevention could be further improved.

Prescribing Wellness: A Case Study Exploring the Use of Health Information Brochures

Objective A case study was undertaken to ascertain the potential usefulness of brochures as a strategy for encouraging short-term and longer-term acquisition of healthy behaviors at the consumer-health care system interface. Method Purposive sampling of chiropractic clinics and convenience sampling of patients attending these primary contact practitioners were undertaken. Patients were asked to complete a questionnaire. Interested patients were given a health information brochure on topics of their choice. Patients who had requested health information brochures were phoned at 3 weeks, 3 months, and 1 year after completing the initial questionnaire and asked if they had implemented any of the suggestions for health promotion or risk prevention. A minimum of 4 attempts were made to contact each participant by telephone. Data were analyzed using descriptive statistics. Results Twenty-one chiropractic clinics and 781 patients participated. Although every third patient requested one or more health information brochures, fewer than 1 in 4 of those receiving brochures implemented some health-promoting behavior. Although some patients persisted with their newly initiated health-promoting behaviors, compliance diminished over time. Exercise and dietary change were the behaviors most likely to be modified. Conclusion Implementation of even one healthy behavior can have a ubiquitous health benefit. Despite dwindling compliance, it is therefore suggested that suitably formulated health information brochures that inform and encourage adoption of healthy behaviors by motivated patients deserve consideration by all health professionals working at the consumer-health care system interface.

Health information and promotion in chiropractic clinics

Objective: To explore the current health education behaviors of chiropractors, ascertain their willingness to provide patient counseling, and compare this with topics of interest to chiropractic patients. Methods: This study involved a postal survey of 400 randomly selected members of the Chiropractic Association of Australia (35% response rate) and a semistructured interview of 316 patients attending one of 20 purposively selected chiropractic practices. Data were collated, and the current health information practices of chiropractic respondents and their willingness to undertake counseling on various topics was identified and compared with the information interests of participating patients. Particular emphasis was placed on injury prevention both with respect to patient counseling and chiropractic practice risk. Results: Respondents expressed varying degrees of willingness to provide health information on diverse topics, but no clear health education chiropractic practice pattern emerged. Although expressing willingness to undertake counseling, respondents were more likely to provide health information brochures than develop a tailored health promotion contract. Health education topics ranged from exercise (91%) to osteoporosis prevention (23%). Seventy-eight percent of chiropractors were prepared to offer counseling on injury prevention, yet 45% of respondents themselves reported having some work-related injury. Maintenance care failed to emerge as a global term for describing a common core of topics or chiropractic health education practices. Conclusion: This study demonstrated an interest by chiropractors in providing and by chiropractic patients in obtaining health information that extends beyond spinal health. The range of relevant topics covered and modes used for health information transmission in chiropractic practice requires clarification. The prevalence of work-related injury among chiropractors suggests a need to develop safe chiropractic clinical practice protocols. (J Manipulative Physiol Ther 2002;25:240-245)

The Health Information Brochure: A Useful Tool for Chiropractic Practice?

Background: It has been suggested that clinicians should be looking at new ways to enhance their patients' self-care. Patient education is one strategy that primary providers may use. Objective: This study investigates the format in which patients would like to pursue their health education within the chiropractic clinic. Methods: An exploratory study of chiropractic patients was undertaken to investigate patients' preferred health education formats, their commitment to pursuing health objectives, and their literacy level. Purposive sampling of 9 Australian chiropractic clinics was undertaken. Convenience sampling of patients attending these clinics resulted in 102 patients participating. Participants completed a questionnaire. A research assistant was available to clarify any questions. Data were collected and collated. A Likert scale was used to capture responses to questions ascertaining patient opinions. Results: Patients considered health the most important of the life objectives listed; however, they preferred spending time with family to undertaking health- and fitness-promoting activity. More chiropractic patients opted for health information brochures than health promotion classes, personally supervised self-care programs, or practitioner-supervised self-care contracts. Patient literacy levels varied within and between clinics. Conclusions: Brochures may provide a definitive health information tool for chiropractors who limit their clinical role to primary contact and a helpful adjunct to patient education for chiropractors committed to a primary care role. However, care should be taken to select brochures consistent with the patients' literacy level. Tips for selecting and preparing suitable brochures are provided. The discrepancy between how greatly patients value health and how they prefer spending their time may have implications for successful behavior change. Brochures may not alone constitute adequate practitioner involvement. (J Manipulative Physiol Ther 2001;24:331-4)