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PubMed1995

Risk factors of nutritional blindness and determinants of a successful vitamin A prophylaxis programme.

Data on 7668 children (0-72 months) and their 4621 mothers and 81 Anganwadi Workers (AWWs) collected for the USAID Assisted ICDS Evaluation Surveys were analysed. The results indicated that the major risk factors of nutritional blindness were lack of nutrition and health knowledge among mothers; presence of iron deficiency anemia in the children; and history of the child having had measles in the past one year. Mother's health and nutrition, knowledge and maternal literacy status were the determinants of the success of a vitamin A prophylaxis programme. Factors that determined AWW's performance in vitamin A supplementation were her nutrition and health knowledge, her literacy status and the amount of supervisory assistance she received from Auxillary Nurse Midwife (ANM).

Adult↗
PubMed2005

Malaria prevention practices in Mopti region, Mali.

OBJECTIVES: To assess insecticide-treated nets (ITNs) use, other malaria prevention measures, knowledge of malaria and diffusion of information about ITNs by the National Malaria Control Programme (NMCP) in Mali. DESIGN: A descriptive cross-sectional study. SETTING: Four villages in Mopti region, Mali that had participated in the Mopti Regional Malaria Control Program (MRMCP) ITN Education Programme five years prior. PARTICIPANTS: Three hundred thirty nine randomly-selected households. Within each household, mothers of children one to nine years of age were interviewed regarding knowledge of malaria and prevention practices. RESULTS: Overall, 11% of households used ITNs, with 97% of these in two villages. Ninety eight percent of households used bednets, 22% used insecticide sprays and 39% used mosquito coils. Significant predictors of ITNs use were: head of household literacy, larger family size, Bambara ethnicity, hearing about the NMCP and hearing about ITNs from health agents. Reasons why ITNs were not used included not knowing anything about ITNs, cost and not having net impregnation services readily available in the village. Levels of knowledge concerning malaria disease, transmission and prevention varied amongst the four villages. ITN households had significantly higher levels of knowledge about malaria and its prevention. CONCLUSION: Five years after the implementation of the MRMCP, ITNs use was low and diffusion of malaria prevention information was unequal among villages. Future efforts in improving the programme must recognise these differences in knowledge and ITNs utilisation and make village-specific changes that are acceptable for each village.

Adolescent↗
PubMed2006

Why American business demands twenty-first century learning: A company perspective.

Microsoft is an innovative corporation demonstrating the kind and caliber of job skills needed in the twenty-first century. It demonstrates its commitment to twenty-first century skills by holding its employees accountable to a set of core competencies, enabling the company to run effectively. The author explores how Microsoft's core competencies parallel the Partnership for 21st Century Skills learning frameworks. Both require advanced problem-solving skills and a passion for technology, both expect individuals to be able to work in teams, both look for a love of learning, and both call for the self-confidence to honestly self-evaluate. Microsoft also works to cultivate twenty-first century skills among future workers, investing in education to help prepare young people for competitive futures. As the need for digital literacy has become imperative, technology companies have taken the lead in facilitating technology training by partnering with schools and communities. Microsoft is playing a direct role in preparing students for what lies ahead in their careers. To further twenty-first century skills, or core competencies, among the nation's youth, Microsoft has established Partners in Learning, a program that helps education organizations build partnerships that leverage technology to improve teaching and learning. One Partners in Learning grantee is Global Kids, a nonprofit organization that trains students to design online games focused on global social issues resonating with civic and global competencies. As Microsoft believes the challenges of competing in today's economy and teaching today's students are substantial but not insurmountable, such partnerships and investments demonstrate Microsoft's belief in and commitment to twenty-first century skills.

Adolescent↗
PubMed2004

Flexible learning for postgraduate nurses: a basis for planning.

This paper describes a survey undertaken with postgraduate nursing students in a New Zealand University based School of Nursing in 2002 to establish their access to and use of computers and information technology for study. Whilst there is minimal flexibility and use of technology to support student learning for postgraduate nurses in the University's School of Nursing presently, the University proposes increasing flexibility across all courses. This is in part a response to the increased internationalisation of education and developments in technology affecting programme design, delivery and support that can benefit teachers and students. The findings of this survey form a basis for planning the introduction of flexible learning. Results indicate that not all students have convenient access to technology for study purposes, nor are they at the same level in terms of using technology. The implications of the survey for planning flexible learning, including the need to be explicit about requirements for access to technology and upskilling opportunities are discussed.

Attitude of Health Personnel↗
PubMed1999

Factors affecting contraceptive use and behavior in Kocaeli, Turkey.

This study aimed to investigate contraceptive use and its determinants in Kocaeli, Turkey. A questionnaire was applied to 922 randomly selected sexually active women of reproductive age, in order to extract information concerning contraceptive use and sociodemographic factors affecting behavior and contraceptive use. Knowledge of at least one method was nearly universal. Intrauterine devices and withdrawal were the most commonly used methods. Illiterate women and housewives had less knowledge about some modern methods. The number of children (p < 0.001), nuclear type family (p < 0.05), and approval of family planning (p < 0.001) were the factors most predictive of contraceptive use. Husbands were involved in family planning via discussing family size (79.4%) and method (85.5%) 38.2% of males participated actively by using withdrawal or condom. Increasing the literacy of both male and female partners significantly increased both contraceptive use and the participation of husbands in family planning descision making. In conclusion, increasing the education level of couples and the status of women would result in increased contraceptive use in the future. Since the contraceptive behavior of women is influenced by their husbands' attitudes, family planning programs should be focused on the needs of both partners.

Adolescent↗
PubMed2000

Teaching information literacy skills: an evaluation.

This paper describes an evaluation of a curriculum-integrated information literacy programme in an undergraduate nursing course. The aim of the programme was to provide students with an awareness of the discipline's literature and the skills to locate and retrieve the literature. A multidimensional process for determining nursing students' development was utilised in the evaluation of the programme. Pre- and post-programme questionnaires were distributed to a cohort of students who undertook the programme. A cohort of more senior students who had not undertaken the information literacy programme was utilised as a comparison group. Questionnaire results were analysed using a range of inferential statistics. This paper will focus on two main findings related to objective measures of information literacy skills. These include pre-programme/post-programme change in student performance and differences in student performance between those who undertook the programme and those who did not. The programme demonstrated its effectiveness in developing information literacy skills, however the challenge remains for both academics and students to ensure that these skills are consolidated and extended for effective life-long learning.

Catalogs, Library↗
PubMed2006

Health promotion for women with human immunodeficiency virus or acquired immunodeficiency syndrome.

PURPOSE: The purpose of this pilot study was twofold: first, to modify Stuifbergen's health promotion intervention initially developed for women with multiple sclerosis for use among women with human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS) and to evaluate the feasibility of the newly modified health promotion intervention named "Put Health Into Living" (PHIL). The pilot study was completed in two phases. DATA SOURCES: In phase I, data were derived from a literature review, a focus group of women with HIV/AIDS (n= 7), a panel of experts who reviewed the intervention for content, and three female community workers who evaluated the intervention for the context of living with HIV/AIDS, cultural relevancy, and literacy. During phase II, a pretest/posttest one-group design was used to determine the feasibility of the study methods, content, and format of the health promotion intervention among 10 women with HIV/AIDS. CONCLUSIONS: The pilot study demonstrated the importance of a health promotion intervention for a vulnerable population. Participants verbalized the benefits of attending a health promotion program to gain knowledge and skills to promote their health. One woman said, "I have been positive for 20 years now and no one has talked to me just about my overall health." Participants indicated the PHIL intervention offered a supportive group environment, an overall health focus, and an acceptable format. IMPLICATIONS FOR PRACTICE: Health promotion is a desirable goal for persons living with a chronic disease, and the PHIL intervention has the potential to benefit persons living with HIV/AIDS if subsequent evidence is found in further testing of the intervention.

Adult↗
PubMed1997

Gordin Kaplan Award Lecture. Building a relationship: science and the community.

An appreciation for the intrinsic relationship that exists among science, scientists, and the public must be established. Both practitioners of science and the public should be made more aware that science is part of everyday life and that the definition of a scientist should be more encompassing. It is generally accepted that the public supports but often does not understand the goals of the scientific community. This is often due to lack of effective communication. The scientific community has accepted accountability to the public and attempts have been made to improve our image. Programs by groups and individuals to interact with the public, particularly school children, have grown. However, there is still a need to expand this area. It is our responsibility to find our niche in science awareness programs as speakers, mentors, or facilitators. Participation in these programs is an essential part of a professional scientist's career and should be encouraged by administration. Interaction with the public improves our ability to explain science in lay terms and the relevance of our work to the community. End points should be established to measure success: not just numbers of students entering "scientific" careers but also science literacy. Developing this strategy will not only improve the image of the scientific community with the public but also build a lasting relationship where needs and aspirations will be mutually appreciated.

Community-Institutional Relations↗
PubMed2003

A cognitive framework for understanding barriers to the productive use of a diabetes home telemedicine system.

Telemedicine has the potential to transcend geographic and socio-cultural barriers to the delivery of high quality health care to the medically underserved populations. However, there are significant cognitive and usability barriers. This paper presents a multifaceted cognitive evaluation of the IDEATel diabetes education and telemedicine program. The evaluation included a cognitive walkthrough analysis to characterize task complexity and identify potential problems as well as field usability testing in patients' homes. The study revealed dimensions of the interface that impeded optimal access to system resources. In addition, we found significant obstacles corresponding to perceptual-motoric skills, mental models of the system, and health literacy. The objective of this work is to contribute to a design framework so that participants with a wide range of skills can better manage their chronic illnesses.

Aged↗
PubMed2004

Asthma: in plain language.

The Community Asthma Program was designed to increase awareness of asthma among urban residents and to bring more people into available care. Educational sessions with patients indicated that many adults struggle with the complicated demands of managing a chronic disease. At the same time, however, a good deal of the written materials meant to provide information and assistance instead make inappropriate demands on the average adult reader. The project team members developed a glossary of asthma terms to improve communication between patients and providers and to help patients understand the materials commonly used in neighborhood health centers. We report on the development of the glossary and describe formative research activities, initial dissemination efforts, and an interim evaluation. Health literacy, included in the goals and objectives for Healthy People 2010, can be improved when health materials are written in plain language and designed for the existing skills of the average U.S. adult reader.

Adolescent↗
PubMed1997

The development of an approach to evaluate NHS manager's competence in medical informatics.

This paper describes the research and development of Checkpoint, a self-assessment instrument. It outlines how the instrument has helped managers in the NHS identify their strengths and weaknesses with respect to their management and use of informatics. The paper presents trends and feedback from the use of Checkpoint and the implications for future education and training of managers in the NHS.

Administrative Personnel↗
PubMed2004

A multimedia interactive education system for prostate cancer patients: development and preliminary evaluation.

BACKGROUND: A cancer diagnosis is highly distressing. Yet, to make informed treatment choices patients have to learn complicated disease and treatment information that is often fraught with medical and statistical terminology. Thus, patients need accurate and easy-to-understand information. OBJECTIVE: To introduce the development and preliminary evaluation through focus groups of a novel highly-interactive multimedia-education software program for patients diagnosed with localized prostate cancer. METHODS: The prostate interactive education system uses the metaphor of rooms in a virtual health center (ie, reception area, a library, physician offices, group meeting room) to organize information. Text information contained in the library is tailored to a person's information-seeking preference (ie, high versus low information seeker). We conducted a preliminary evaluation through 5 separate focus groups with prostate cancer survivors (N = 18) and their spouses (N = 15). RESULTS: Focus group results point to the timeliness and high acceptability of the software among the target audience. Results also underscore the importance of a guide or tutor who assists in navigating the program and who responds to queries to facilitate information retrieval. CONCLUSIONS: Focus groups have established the validity of our approach and point to new directions to further enhance the user interface.

Adult↗
PubMed1993

Assessment of the current computer literacy and future computer needs of emergency medicine residents and faculty.

The purpose of this study was to assess the current computer literacy and future computer needs of emergency medicine residents and faculty to aid in developing a computer literacy curriculum. All emergency medicine residents and full-time faculty from a random sample of emergency medicine residencies were mailed questionnaires assessing current computer familiarity and future computer needs. Twenty-one residencies were surveyed; 15 resident and 17 faculty questionnaires were returned. Thirty-seven percent (116 of 314) faculty and 29% (135 of 470) resident questionnaires were completed and returned. Eighty percent (12 of 15) of residencies had a designated computer for resident use; 93% (14 of 15) had a computer for use in the emergency department. Forty-seven percent of residents owned their own computer; 68% of faculty had a computer in their home, and 52% had computers in their office. Less than 30% of residents and faculty had formal computer training. Residents and faculty rated the current familiarity and future needs for various software applications on a five-point scale. Data were analyzed using the Wilcoxon-Rank Sum Test. Residents and faculty had the most anticipated need for word processing, graphics, literature searching, data base, and patient management programs. Future computer need was rated significantly higher than current computer familiarity in all computer application areas (P < or = .0002). It seems that emergency medicine residents and faculty have adequate access to computers, but minimal computer training. Residents and faculty have a high anticipated need for various basic computer applications.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Literacy↗
PubMed2005

Patients' perception of preoperative information by interactive computer program-exemplified by cholecystectomy.

Patients' perception of preoperative information by interactive computer program informing about cholecystectomy was assessed. Patients were asked to qualify the computer program after hospital discharge by an anonymous questionnaire. Two hundred and fifty-seven of 278 consecutive patients completed the questionnaire resulting in a response rate of 92%. Sixty-three percent were very satisfied and 37% were satisfied, whereas none were dissatisfied or undecided. Patients' satisfaction was not associated with sex, age, surgeon or prior knowledge of computers. Most of the patients considered the clarity of text and illustrations and the volume of information as good or excellent and found the information well adapted to their prior knowledge. Ninety-eight percent stated that they would like to be informed again by an interactive computer program in case of another surgical intervention. Thus, interactive computer programs seem to be a valuable adjunct to written and oral information in the preoperative informed consent procedure.

Adult↗
PubMed2001

Effectiveness of a community leaders' programme to promote healthy lifestyles in Tokyo, Japan.

The aim of this study was to evaluate a community-based health promotion programme in terms of changing: (i) attitudes with respect to a healthy lifestyle; (ii) behaviour with respect to access to health-related information; and (iii) attitudes and health literacy regardless of socio-economic status. In this programme, 20 people are selected every 2 years in each municipality from the lay people of the community, and they are designated as members of a 'community leaders' committee' by the Mayor. They, as a group, have opportunities to gain knowledge about and skills in healthy lifestyles, and undertake voluntary activities to serve the community. A programme intervention sample (INT group) was selected from programme participants from 13 municipalities in the greater Tokyo area. A questionnaire survey was carried out with the INT group and a general population group (REF group). The data obtained for female respondents, aged 30-59 years, in the two sample populations (n = 662 and 1361, respectively) were analysed using the chi(2) test, the Kruskal-Wallis test and multivariate log-linear methods. Another questionnaire was given to female programme participants (n = 200) to identify any changes since the start of their participation. The results showed that the people in the INT group were pursuing healthier lifestyles than those in the REF group; current non-smokers who performed physical exercise and who ate meals regularly paid more attention to a healthy lifestyle and were more interested in the relationship between food and health. From the INT and REF groups, 22 and 4% of people, respectively, frequently obtained information from health professionals, and 29.8 and 10.8%, respectively, were satisfied with their access to health-related information. Results of multivariate log-linear analysis showed that significantly more people in the INT group were doing exercise, eating meals regularly, paying attention to nutritional balance and to food additives, were interested in health, and were satisfied with access to health information, after excluding the effects of age and socio-economic factors (p < 0.05). The results also showed positive changes after the implementation of the programme. These findings indicated that the people in the INT group were significantly more likely to pursue a healthier lifestyle and to have greater health literacy than those in the REF group, regardless of socio-economic status. In conclusion, this community participation approach, employing a committee style, was effective in improving health-related behaviour and in promoting health literacy while overcoming socio-economic variation.

Adult↗
PubMedDate not supplied

Acceptability of computer assessments among ethnically diverse, low-income smokers.

PURPOSE: To examine the acceptability of computer-based assessments among an ethnically diverse, low-income population of primary care patients. Although computers have been used to provide assessments and interventions in health care settings, members of ethnic minority and low-income households have less access to computers than other groups, and therefore the acceptability of computers as a health care assessment and delivery tool needs to be examined. DESIGN: We examined the acceptability of computers for providing assessments of smoking history, nicotine dependence, and other related variables among an ethnically diverse, low-income primary care population. No intervention was used in this study. SETTING: Three inner-city primary care clinics located in hospitals were used as sites for this study. These hospitals were located in areas of the city where low-income and ethnic minority households are overrepresented relative to the total population. SUBJECTS: Adult male and female smokers (n = 522) were recruited while awaiting appointments in each primary care clinic. MEASURES: A questionnaire assessing smoking rate, patterns, history, motivation to quit smoking, and other smoking-related variables was administered using either a paper-and-pencil format or a laptop computer. RESULTS: Frequency counts, analysis of variance, and chi 2 tests were used where appropriate. Most subjects (78.5%) used the computer to complete the baseline survey. Almost all subjects (92%) rated the computer "very easy" or "easy" to use. Subjects who were Spanish-speaking, were born outside the United States, or were Hispanic tended to rate the program as slightly less easy to use than other subjects. CONCLUSIONS: Computer-based assessments appear highly acceptable to individuals in low-income populations.

Adult↗
PubMed2000

A multivariate analysis of factors associated with depression: evaluating the role of health literacy as a potential contributor.

BACKGROUND: High rates of low health literacy among elderly populations along with a high prevalence of chronic conditions may lead to increased levels of depression symptomatology. We sought to determine whether older adults with inadequate health literacy were more likely to report depressive symptoms and whether health literacy was an independent predictor of depression symptomatology. METHODS: A total of 3260 new Medicare enrollees 65 years or older were interviewed in person between June and December 1997 from 4 managed care plans (853 in Cleveland, Ohio, 498 in Houston, Tex, 975 in South Florida, and 934 in Tampa, Fla). Depression symptoms were measured by the Geriatric Depression Scale. RESULTS: Overall, 13% of respondents were classified as depressed. Individuals with inadequate health literacy had 2.7 times the odds (95% confidence interval, 2.2-3.4) of being depressed compared with individuals with adequate health literacy skills. However, after controlling for health status with multiple logistic regression, individuals with inadequate health literacy were not more likely to be depressed (adjusted odds ratio, 1.2; 95% confidence interval, 0.9-1.7). Individuals who had less social support, exercised less than twice a week, drank alcohol heavily, or had poor health status (at least 3 health conditions, physical limitations, or fair or poor self-rated health) had significantly higher odds of depression symptomatology. CONCLUSIONS: Although individuals with inadequate health literacy were more than twice as likely to report depressive symptoms, this was mostly explained by their worse health status. The strong relation between depression symptoms and poor health status suggests the need to research interventions to improve mental and physical health concurrently. The influence of particular interventions on depression, such as referral to community support contacts and recommendations for an exercise program, needs to be further evaluated. Arch Intern Med. 2000;160:3307-3314.

Activities of Daily Living↗
PubMed1990

Computerization of plateletpheresis quality control records with a commercially available spreadsheet program.

Many apheresis units lack the resources to acquire customized computer software for record keeping. We have adapted a commercially available "spreadsheet" program (Lotus 1-2-3) to aid in quality control activities for plateletpheresis. Data are entered in a grid pattern wherein each donation occupies one row and successive columns contain numerical data derived from the donation. The last two columns contain formulas that calculate yield and collection efficiency from values entered in preceding columns. The program runs on an IBM PC or equivalent with 512 K RAM; the combined cost of a computer and software is currently under $2,000.00. Data entry requires fewer keystrokes per record than computation of yield and efficiency with a calculator, and creates an inclusive permanent record for future analysis. Data sorting and statistical functions allow rapid identification of incomplete records, and derivation of average platelet yield and/or collection efficiency for any time period of interest. The program also facilitates determining the proportion of donations that fall below any chosen cutoff. Performance characteristics of a particular instrument or operator can be assessed easily by isolating the pertinent records and analyzing them separately. The system will thus accomplish a variety of quality control activities, including those mandated by licensing agencies. It can be implemented by apheresis personnel with limited "computer literacy" and is superior to manual tabulation of quality control data in both ease of data entry and facility of analysis.

Data Interpretation, Statistical↗