Need For Educational Materials Research Articles

Development of the intelligent knee osteoarthritis lifestyle app: a person-based approach

BackgroundKnee osteoarthritis is one of the most prevalent long term health conditions globally. Exercise and physical activity are now widely recognised to significantly reduce joint pain, improve physical function and quality of life in patients with knee osteoarthritis. However, prescribed exercise without regular contact with a healthcare professional often results in lower adherence and poorer health outcomes. Digital mobile health (mHealth) technologies offer great potential to support people with long-term conditions such as knee osteoarthritis more efficiently and effectively and with relatively lower cost than existing interventions. However, there are currently very few mHealth interventions for the self-management of knee osteoarthritis. The aim of the present study was to describe the development process of a mHealth app to extend the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through self-management, personalised physical activity, education, and social support.MethodsThe development of the intelligent knee osteoarthritis lifestyle application intervention involved an iterative and interconnected process comprising intervention ‘planning’ and ‘optimisation’ informed by the person-based approach framework for the development of digital health interventions. The planning phase involved a literature review and collection of qualitative data obtained from focus groups with individuals with knee osteoarthritis (n = 26) and interviews with relevant physiotherapists (n = 5) to generate ‘guiding principles’ for the intervention. The optimisation phase involved usability testing (n = 7) and qualitative ‘think aloud’ sessions (n = 6) with potential beneficiaries to refine the development of the intervention.ResultsKey themes that emerged from the qualitative data included the need for educational material, modifying activities to suit individual abilities and preferences as well as the inclusion of key features such as rehabilitation exercises. Following a user-trial further changes were made to improve the usability of the application.ConclusionsUsing a systematic person-based, development approach, we have developed the intelligent knee osteoarthritis lifestyle application to help people maintain physical activity behaviour. The app extends the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through personalised physical activity guidance, education, and social support.

The Effects of Animations and Multimedia Messages on Public Engagement in Precision Medicine: Assessment of Moderation and Mediation

Public participation in precision medicine (PM) research is essential to achieving effective health care but has been impeded by a lack of awareness and basic knowledge. There is a critical need for educational materials that can clearly explain PM to foster involvement. This randomized controlled trial with a posttest-only control group design aims to assess the effects of educational messages delivered through animations relative to live-action videos and leaflets on intentions of involvement in PM research. Knowledge as the moderator and four mediators (engagement, vividness, trustworthiness, and cognitive value) of the intended effects were also evaluated. A total of 326 U.S. adults were sampled from Amazon Mechanical Turk. Among participants with less knowledge about PM, animations produced stronger information-seeking intentions and willingness to participate than leaflets. The effects of three message modalities were not significantly different among average and highly knowledgeable participants. Engagement and vividness mediated the effects of animations relative to two other message modalities. Trustworthiness and cognitive value mediated the effects of animations relative to live-action videos. Overall, animations can be an effective communication strategy to motivate involvement in PM but its effectiveness could decline as knowledge increases. The explanations and implications of the findings were discussed.

Strength Training Guide for Personal Training Practitioners

Resistance exercise is the performance of physical exercises designed to improve strength, muscular, endurance, hypertrophy, and neuromuscular efficiency with the use of weights (Braith & Stewart, 2006)[1]. Resistance exercise has long been utilized for its beneficial health qualities and propensity to elicit certain desired physiological changes (Fry, 2004)[2]. There has been a recent, and significant, increase in resistance exercise activity in American adults (NCHS, 2018)[3] attributable to factors such as autonomous compulsion and self fulfilment to extrinsic factors like health and physical appearance (Fisher et al., 2017; Heinrich et al., 2014; Ingledew & Markland, 2008)[4,5,6]. As such, there is an ever-increasing need for educational material regarding resistance exercise, its benefits, purpose, and manner in which it should be conducted. Purpose- to (a) provide resistance exercise-based educational material regarding the background and rationale behind resistance training; (b) to provide a specific resistance-based exercise program to elicit strength gain; (c) to provide individuals with the knowledge to safely and effectively engage in said program; and (d) to provide the participant with expected physiological adaptations to completing the program. Methods- Two 6-week, 5-day per week resistance exercise programs – with a brief nutritional guide accompaniment – are outlined for a hypothetical participant, age 25-40, of moderate experience with fitness training, and with the goal of strength gain and moderate fat loss as a secondary goal. Results- Anticipated benefits of the program include: increased maximal strength caused by training above 85% 1RM for 2-6 sets of 1-6 reps; increased synergistic muscle groups strength which will contribute to improved prime mover strength; hypertrophy of skeletal muscles throughout the body, induced by lifts of 67-85% 1 rep max (RM) for 3-6 sets of 6-12 reps and increased resting energy expenditure (basal metabolic rate) accompanied by improved body composition. Conclusion- Continued progression though this protocol with modifications to resistance include potential improved running speed, explosive power potential, and other anaerobic sport performance factors, as well as enhanced neuromuscular efficiency associated with increased prime mover force production capabilities.

Health Disparities in Uterine Cancer: Report From the Uterine Cancer Evidence Review Conference.

The Centers for Disease Control and Prevention recognized the need for educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. The American College of Obstetricians and Gynecologists convened a panel of experts in evidence review from the Society for Academic Specialists in General Obstetrics and Gynecology and content experts from the Society of Gynecologic Oncology to review relevant literature, best practices, and existing practice guidelines for the development of evidence-based educational materials for women's health care clinicians about uterine cancer. This article is the evidence summary of the literature review of health disparities and inequities related to uterine cancer. Substantive knowledge gaps are noted and summarized to provide guidance for future research.

Executive Summary of the Uterine Cancer Evidence Review Conference.

The Centers for Disease Control and Prevention recognized the need for educational materials for clinicians on the prevention and early diagnosis of gynecologic cancers. The American College of Obstetricians and Gynecologists convened a panel of experts in evidence review from the Society for Academic Specialists in General Obstetrics and Gynecology and content experts from the Society of Gynecologic Oncology to review relevant literature, best practices, and existing practice guidelines as a first step toward developing evidence-based educational materials for women's health care clinicians about uterine cancer. Panel members conducted structured literature reviews, which were then reviewed by other panel members and discussed at a virtual meeting of stakeholder professional and patient advocacy organizations in January 2021. This article is the evidence summary of the relevant literature and existing recommendations to guide clinicians in the prevention, early diagnosis, and special considerations of uterine cancer. Substantive knowledge gaps are noted and summarized to provide guidance for future research.

59 Rapid Training During A Pandemic: An Evaluation of a Covid-19 Video E-Learning Package

As COVID-19 hospital admissions rose in 2020, there was a requirement to prepare wards and staff to care for COVID-19 patients, especially given the rapidly emerging and frequently evolving guidance, and high levels of re-deployment (GMC, 2020). In one London Trust, this need for educational material geared towards ward staff resulted in a multi-disciplinary simulation education team being commissioned to produce an e-learning resource. We measured the effectiveness of the resource for ward staff as well as any improvement in learners’ COVID-19 knowledge.The aim of the study was to quantify the effectiveness of an e-learning package in improving learners’ COVID-19 knowledge.In November 2020, an e-learning package was created, comprising a video series documenting the journey of a patient with COVID-19 covering admission to discharge (filmed from the patient perspective). This was integrated with content highlighting key aspects of COVID-19 care, ending with a mandatory assessment with an 80% pass mark. The e-learning was disseminated to hospital staff (doctors, nurses and allied healthcare professionals) with data collection via SurveyMonkey® from November 2020 for 3 months. Pre- and post-surveys were included to investigate the average improvement of learners and the impact of the resource on learner self-efficacy through self-rating on six learning outcomes. Free-text options in the post-survey allowed qualitative feedback, aiding continual resource development.In total, 108 learners, about half of whom were doctors, completed both surveys, with a significant difference (p < 0.01) between the pre- and post-learning results and an overall improvement in learners’ knowledge after completion of the e-learning (Average pre- and post-learning scores of learners’ self-reported knowledge and percentage improvement*Treatment escalation plans.E-learning can rapidly disseminate learning, at a time when most feel the pandemic has had a mixed or negative impact on learning opportunities (Dean E, 2020; GMC, 2020). The e-learning is continually updated with new evidence, with plans to expand access across London. An iterative process was undertaken with updates in response to learner feedback due to the speed at which the resource needed to be developed, for example, turning resources into PDFs for home access. The e-learning remains live given rising COVID-19 cases. Further work is required to investigate the effectiveness of this resource across London and how beneficial it has been for clinical work.

Availability and Need for Education Materials on Oklahoman Aquaponics

Availability and Need for Education Materials on Oklahoman Aquaponics

Oral Health in Rheumatoid Arthritis: Listening to Patients.

Rates of periodontal disease and tooth loss are increased in individuals with rheumatoid arthritis (RA). Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and arthritis outcomes. To determine the perceptions held by people with RA relating to their oral health, to identify patient-centered priorities for oral health research, and to inform optimal strategies for delivering oral health knowledge. Semistructured interviews were conducted with patients with RA. Recorded interview transcripts were iteratively reviewed to reveal surface and latent meaning and to code for themes. Constructs were considered saturated when no new themes were identified in subsequent interviews. We report themes with representative quotes. Interviews were conducted with 11 individuals with RA (10 women [91%]; mean age, 68 y), all of whom were taking RA medication. Interviews averaged 19 min (range, 8 to 31 min) and were mostly conducted face-to-face. Three overall themes were identified: 1) knowledge about arthritis and oral health links; 2) oral health care in RA is complicated, both in personal hygiene practices and in professional oral care; and 3) poor oral health is a source of shame. Participants preferred to receive oral health education from their rheumatologists or dentists. People with RA have unique oral health perceptions and experience significant challenges with oral health care due to their arthritis. Adapting oral hygiene recommendations and professional oral care delivery to the needs of those with arthritis are patient priorities and are required to improve satisfaction regarding their oral health. Patients living with long-standing rheumatoid arthritis described poor oral health-related quality of life and multiple challenges with maintaining optimal oral health. Study findings indicate a need for educational materials addressing oral health maintenance for patients with rheumatic diseases and their providers.

Food allergy knowledge, attitude, and practices of chefs in resort hotels in Turkey

The purpose of this study is to evaluate the food allergy knowledge, attitudes, and practices of chefs in resort hotels. The chefs in various positions were surveyed and 514 valid questionnaires were analyzed. The findings of this study indicated that chefs had moderate food allergy knowledge, but they had positive attitudes and practices for food allergy. The mean score for the participants’ knowledge was 73.66, attitude was 79.19 and practice was 81.43 (out of 100). The majority of the participants could identify merely three (peanuts, eggs, and milk) of the eight most common allergen foods. The participants indicated a high level of willingness to learn more about food allergies by participating in trainings and assisting customers with food allergies. The participants demonstrated misunderstandings about food allergen handling practices, particularly over frying with allergens and the risks of cross-contamination. The study suggests that there is a need for educational materials for food handlers and regulations for training. It further discusses the implications for the industry, authorities, and staff.

Alternative approaches for clinical clerkship during the COVID-19 pandemic: online simulated clinical practice for inpatients and outpatients\u2014A mixed method

BackgroundThe COVID-19 pandemic has created a need for educational materials and methods that can replace clinical clerkships (CCs) for online simulated clinical practice (online-sCP). This study evaluates the impact of using simulated electronic health records (sEHR) for inpatients, and electronic problem-based learning (e-PBL) and online virtual medical interviews (online-VMI) for outpatients, for an online-sCP using a learning management system (LMS) and online meeting system facilitated by a supervising physician.MethodsThe sEHR was reviewed by medical students and subsequently discussed with a supervising physician using an online meeting system. In the e-PBL, medical students reviewed the simulated patients and discussed on the LMS. For the online-VMI, a faculty member acted as an outpatient and a student acted as the doctor. Small groups of students discussed the clinical reasoning process using the online meeting system. A mixed-method design was implemented. Medical students self-assessed their clinical competence before and after the online-sCP. They answered questionnaires and participated in semi-structured focus group interviews (FGIs) regarding the advantages and disadvantages of the practice.ResultsForty-three students completed the online-sCP during May and June 2020. All students indicated significant improvement in all aspects of self-evaluation of clinical performance after the online-sCP. Students using sEHR reported significant improvement in writing daily medical records and medical summaries. Students using e-PBL and online-VMI reported significant improvement in medical interviews and counseling. Students also indicated CCs as more useful for learning associated with medical interviews, physical examinations, and humanistic qualities like professionalism than the online-sCP. Eight FGIs were conducted (n = 42). The advantages of online-sCP were segregated into five categories (learning environment, efficiency, accessibility, self-paced learning, and interactivity); meanwhile, the disadvantages of online-sCP were classified into seven categories (clinical practice experience, learning environment, interactivity, motivation, memory retention, accessibility, and extraneous cognitive load).ConclusionsOnline-sCP with sEHR, e-PBL, and online-VMI could be useful in learning some of the clinical skills acquired through CC. These methods can be implemented with limited preparation and resources.

Demographic Characteristics and Husbandry and Biosecurity Practices of Small Poultry Flocks in Ontario, Canada.

As part of a 2 yr disease surveillance project of small poultry flocks, owners of birds submitted for postmortem examination to the Animal Health Laboratory were asked to complete a questionnaire designed to gather information on the characteristics of the flock and its environment, how the flock was managed, and biosecurity measures used. A total of 153 unique questionnaires were received. Personal consumption of meat or eggs was the most common reason for owning a small flock (69.3%). Almost all owners (97.4%) reported having chickens on their property, while 21.6% had waterfowl, 15.7% had turkeys, and 15.7% had game birds. Nearly 70% (69.9%) of the flocks had some degree of outdoor access. For those with indoor access, the most common bedding material provided was soft wood shavings (70.2%). Kitchen waste or leftovers were offered to 65.3% of flocks, and well water was the most common source of drinking water (80.6%). For flocks with indoor access, dedicated shoes and clothes were used when entering or cleaning the coop by fewer than half of owners, and shoes were rarely disinfected before or after contact with the flock. Most owners (93.8%) reported washing their hands after contact with their birds, although only 48.3% reported washing their hands before contact. Among owners who sourced birds from a hatchery, only 36.8% indicated that the birds had been vaccinated, and 21.1% were unsure if vaccines had been administered. Among owners using medication (60.5%), the use of antibiotics was common (60.9%). Overall, questionnaire responses describe a wide range of husbandry and biosecurity practices, often suboptimal, and point out the need for educational material for Ontario small flock owners.

Tumor Genomic Profiling Practices and Perceptions: A Survey of Physicians Participating in the NCI-MATCH Trial.

To identify factors that may influence physician participation in tumor profiling studies and to assess the routine use of tumor profiling in clinical practice. Physicians in the National Cancer Institute-Molecular Analysis for Therapy Choice (NCI-MATCH) were invited to participate in an electronic survey consisting of 73 questions related to participation in genomic profiling studies, tumor profiling practices and education during usual patient care, and physician background and practice characteristics. The survey response rate was 8.9% (171 surveys returned of 1,931 sent). A majority of respondents practiced in academic medical centers (AMCs). Participation in NCI-MATCH increased workload and cost but resulted in increased professional satisfaction, confidence in treatment recommendation, and subsequent use of tumor profiling. Barriers to patient participation included length of wait time for results and lack of a therapeutic option from the testing. Physicians who worked in AMCs reported a higher use of tumor profiling than did those who worked in non-AMC settings (43% v 18%; P = .0009). Access to a molecular tumor board was perceived as valuable by 56%. The study identified a need for educational materials to guide both physicians and patients in the field of genomic profiling. Physicians who participate in NCI-MATCH perceive value to patient treatment that outweighs the additional effort required; survey results help identify barriers that may limit participation. The current findings have implications for the design of future genomic and other profiling studies.

Dietary Application for the Management of Patients with Hemodialysis: A Formative Development Study.

ObjectivesTo describe the step-by-step person-centered, theory-based development of the KELA.AE app for Arabic speaking hemodialysis patients.MethodsA step-by-step person-driven theory-based approach was conducted to develop a self-monitoring and educational dietary app for hemodialysis patients. The development follows the Integration, Design, Assessment, and Sharing (IDEAS) framework. Qualitative, semi-structured interviews with 6 hemodialysis patients and 6 healthcare practitioners (dietitians and nephrologists) were performed to assess the need for an app, the willingness to use an app, and features desired in an app.ResultsThe KELA.AE app, which includes a self-monitoring feature, CKD-friendly recipes, and a theory-based, evidence-based educational feature was developed. Qualitative analysis of interviews revealed two predominant themes from patient interviews ‘Experience with the diet’, ‘App evaluation’, and one theme from interviews with healthcare practitioners ‘App evaluation’. Patients expressed frustration with current accessibility of dietary information along with the need for educational materials in the app. The review of the KELA.AE prototype was positive overall, and patients reported a willingness to use the app. Healthcare practitioners considered the app accurate, simple, and culturally sensitive but expressed concerns about app misuse and the replacement of healthcare practitioners.ConclusionsThe KELA.AE app was found to be satisfactory and supportive of the participants' needs. Changes were made to the app as suggested during the interviews.

Women with spinal cord injury and sexual health: The role of the recreational therapist

Sexual health takes on an entirely new meaning for women after sustaining a spinal cord injury (SCI). The majority of sexual health information provided during the rehabilitation process is often geared toward men with limited to no resources available to women. Furthermore, this information is typically not provided by recreational therapists in structured sexual health groups. This study employed semistructured interviews with eight SCI women living independently in the community to examine sexuality and intimacy while living with a SCI and how sexual health is currently being addressed during the rehabilitation process, including the recreational therapy process. A phenomenological data analysis was employed with reduction of data into themes. Findings indicate that sexual health education information was sometimes provided in rehabilitation hospitals, however, such materials were perceived to be focused on male patients, untimely, and attention to sexuality issues was usually absent from post-rehabilitation care. There was no mention of recreational therapists providing any form of sexual health education. Additionally, participants identified a need for educational materials for partners of individuals with SCI, as well as themselves regarding sexuality and relationship with particular attention on (a) intrapersonal constraints to intimacy/sexuality, (b) interpersonal partner communication, and (c) physiological constraints to intimacy/sexuality. The results demonstrate the impact living with a SCI has on intimacy and sexuality for women and the need for better sexual health education within the context of recreational therapy.

Global Design Strategy for Cancer Patient Education Materials: Haiti Pilot Case Study

Cancer care providers at Queen Elizabeth Central Hospital in Malawi identified a need for educational materials for their low‐literacy patients. Global Oncology, a nonprofit focused on improving cancer care, research, and education in resource‐limited settings, partnered with THE MEME to develop cancer patient educational materials (PEMs). The goal of the project was to create clinically relevant and culturally appropriate low‐literacy PEMs to improve clinical care, support services, and patient adherence in resource‐limited settings. The team also aimed to develop a product strategy and business model for long‐term sustainability. The article introduces the challenge from a global health perspective and the ways design can have a significant impact. It presents the collaborative process of developing the “Cancer and You” booklet for multiple cultural contexts and focuses on the results of a pilot study in Haiti evaluating the efficacy of the design in simplifying complex medical information, facilitating patient education, and improving communication.

Swings and roundabouts: The impact of legal drafting on the language and understanding of copyright law and the need for educational materials

Legislators face the challenging task of drafting copyright law, which takes into account the views of various stakeholders, intended policy and technological developments, whilst ensuring that the wording and language that is used is accurate and precise. Meeting these objectives means that the law in its legislative form can be hard-to-understand, complex and not easily accessible to the layperson. This article explores steps, which have been put in place by various organisations and online resources, to assist in the understanding of copyright for the public and schools, with particular focus on education and teaching materials – as presented on Copyrightuser.org.

A sculpture masterpiece for the teaching of anatomy.

Background and aimThe study of anatomy remains the backbone of medical education in the first years. There is a constant need for educational materials that enable the assimilation of knowledge by students. The casts after human bodies have not lost the value, even in the era of virtual education. We present in this paper a museal item destined to improve the anatomy teaching.MethodsGiven the existence in the department of anatomy from Cluj –Napoca of an item of exceptional artistic and scientific value, we intensively searched Pubmed and Scopus, as well as by manual search of printed only documents, for all papers related to the muscle man by Brancusi created for educational purposes of anatomy students.ResultsThis paper presents summary data from the biography of the creators of this item, the world famous sculptor Constantin Brancusi and the professor of anatomy and surgery from Bucharest Dimitrie Gerota. We also describe this item and the conditions which generated itConclusionTeaching anatomy relies on the quality of the didactic support. The muscle man by Brancusi is a very realistic reproduction of a man, very useful for anatomical training and teaching.

Evaluation of a community health worker intervention to improve adherence to therapy for non-communicable disease in Chiapas, Mexico

: 02NCD019 Creating and implementing low literacy cancer education materials: bridging the gap in sub-Saharan Africa M. Olsen, V.E. Manzo, C. Cardenas, A. Bhatt, A. Fajardo, F. Huang, M. Jacobs, S. Kennell-Heiling, L.S. May, H. Mehrtash, K. Taylor, M. Xu; Partners In Health, Cambridge, MA/US, Stanford University, Stanford, CA/US, THE MEME Design, Cambridge, MA/US, Dana-Farber Cancer Institute / Harvard Medical School / Global Oncology, Inc., Boston, MA/US, Brigham and Women’s Hospital, Boston, MA/US, Harvard Medical School, Boston Children’s Hospital, Partners In Health, Boston, MA/US, Boston University School of Public Health, Boston, MA/US, Harvard Medical School, Boston, MA/US, Harvard Medical School, Cambridge, MA/US Program/Project Purpose: Global Oncology (GO) is a non-profit community of professionals and student volunteers helping global partners alleviate suffering through providing the highest quality cancer care. In January 2013, GO established a partnership with Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. In June 2013, GO initiated the development of cancer educational materials for QECH’s low-literate patient population, in collaboration with THE MEME Design in Cambridge, MA. The materials were completed in May 2014 and piloted in Malawi and Rwanda in JuneSeptember 2014. Through this project, GO aims to improve psychosocial support services and patient adherence in resource-limited settings. Structure/Method/Design: Cancer care providers at QECH identified a need for educational materials for their low-literate patient population. In order to develop a clinically relevant and culturally appropriate product, GO is working with MEME, QECH, Partners In Health (PIH) in Rwanda, and has consulted with experts throughout Boston and sub-Saharan Africa. In addition to developing the materials, GO and its partners are investigating ways to integrate the booklets into clinical protocols as a platform to better engage patients and families in the treatment process.

Groundwater for the 21st Century: A Primer for Citizens of Planet Earth

Although the daily water needs of 2.5 billion people worldwide are met with groundwater (UNESCO 2012), only a small percentage of the world’s population has any formal education in hydrogeology. Thus, there is a profound need for educational materials that introduce hydrogeology in a manner that is accessible to a wide audience, including nonscientists. Conners (2013) recognizes and addresses this need with his book, Groundwater for the 21st Century: A Primer for Citizens of Planet Earth . In the preface, Conners describes his book as “a broad flexible resource” that “does not have pages filled with differential equations” and is also not a “‘popular science’ book, filled with human interest stories” but that does “provide a basic understanding of groundwater science . . . in a manner that is accessible to all.” (viii). To make the book both widely accessible and applicable, Conners includes chapters on basic scientific and geologic principles, global water resources issues, and applied hydrogeology, in addition to covering the fundamentals of hydrogeology. As a consequence of being broad, the book is rather long. With 614 pages, 14 chapters, and 3 appendices, I suspect some readers, particularly those without a scientific background, might be overwhelmed by the book’s size. In my opinion the book is unnecessarily broad and long. Although the basic science and geology chapters provide background for later chapters, they also cover several topics (e.g., subatomic chemistry, plate tectonics, modes of crustal deformation, and periglacial geology) that are well beyond the background necessary for a general, nontechnical understanding of hydrogeology and groundwater resources. The readability of the text and Conners’s professional yet unintimidating writing style are notable. Several case studies are presented in boxes throughout the book and these very effectively elucidate the applicability of the

Predictors of Health Information Needs among U.S. Mainland and Puerto Rican Caregivers

Stroke caregivers often do not have the information necessary to adequately manage the stroke recovery process at home. We explore how the educational needs of stroke caregivers vary by race, ethnicity, and place, and their association with caregiver characteristics. We surveyed 276 stroke caregivers living on the U.S. Mainland and in Puerto Rico to assess their educational needs related to stroke recovery. Caregivers report a high overall need for educational materials with Puerto Rican stroke caregivers having greater needs compared to whites and African Americans on the Mainland. Increased caregiver educational needs are associated with greater desire to institutionalize, less positive appraisals of caregiving, greater use of coping strategies, and greater burden. All caregivers can benefit from educational materials, but special attention to island-dwelling Puerto Rican caregivers may provide additional benefit. Future research and interventions should focus on tailoring educational materials for race, culture, and other caregiver characteristics.