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PubMed1990

Pretesting a childbirth handbook.

The development of health education materials for pregnant women involves the work of knowledgeable and experienced health professionals, writers, editors, and artists. Frequently, these materials are also extensively reviewed by various experts and organizations prior to publication. Even with all this expert input and review, however, they can miss the mark if they are not deemed appropriate and acceptable by the audience for whom they were created. In developing a new booklet on childbirth, the New York State Department of Health wanted to ensure that the material would be read and used by pregnant women from various income and educational levels and racial and ethnic groups. Research was conducted by the department to pretest the booklet for its appropriateness for and acceptance by the target audience. Based on the reactions and suggestions from 89 women in eight focus groups, the booklet was revised extensively before being made available to the general public.

Adult↗
PubMed1987

Radon risk information and voluntary protection: evidence from a natural experiment.

This study examines the perceived risks and mitigating behavior of Maine households who received new information on their exposures to significant health risks from indoor radon. The observed responses of these households illustrate conceptual issues related to designing an effective risk information program. Despite the involvement of generally well-motivated homeowners and well-intentioned researchers and government officials, we conclude that the risk information approach used in Maine failed to induce appropriate, cost-effective voluntary protection. The results indicate that, after receiving radon test results, information on associated health risks, and suggestions on how to reduce exposures: perceived risks tended to understate objective risks by orders of magnitude, and there was no statistically significant relationship between mitigating behavior and objective risks. These results suggest that the formation of risk perceptions and subsequent behavioral adjustments involve complex interactions among information, contextual, socioeconomic, and psychological variables. Therefore, government programs that seek to reduce health and safety risks with information programs, instead of using more conventional enforced standards, must be crafted very carefully to accommodate this complex process.

Air Pollutants↗
PubMed1994

Designing risk communications: completing and correcting mental models of hazardous processes, Part I.

Many risk communications are intended to help the lay public make complex decisions about risk. To guide risk communicators with this objective, a mental models approach to the design and characterization of risk communications is proposed. Building on text comprehension and mental models research, this approach offers an integrated set of methods to help the risk communication designer choose and analyze risk communication content, structure, and organization. An applied example shows that two radon brochures designed with this approach present roughly the same expert facts as a radon brochure widely distributed by the U.S. EPA but meet higher standards on other content, structure, and organization criteria.

Communication↗
PubMed1994

Evaluating risk communications: completing and correcting mental models of hazardous processes, Part II.

We propose a decision-analytic framework, called the mental models approach, for evaluating the impact of risk communications. It employs multiple evaluation methods, including think-aloud protocol analysis, problem solving, and a true-false test that allows respondents to express uncertainty about their answers. The approach is illustrated in empirical comparisons of three brochures about indoor radon.

Air Pollution, Indoor↗
PubMed1994

Perception of risks from electromagnetic fields: a psychometric evaluation of a risk-communication approach.

Potential health risks from exposure to power-frequency electromagnetic fields (EMF) have become an issue of significant public concern. This study evaluates a brochure designed to communicate EMF health risks from a scientific perspective. The study utilized a pretest-posttest design in which respondents judged various sources of EMF (and other) health and safety risks, both before reading the brochure and after. Respondents assessed risks on dimensions similar to those utilized in previous studies of risk perception. In addition, detailed ratings were made that probed respondents' beliefs about the possible causal effects of EMF exposure. The findings suggest that naive beliefs about the potential of EMF exposure to cause harm were highly influenced by specific content elements of the brochure. The implications for using risk-communication approaches based on communicating scientific uncertainty are discussed.

Attitude to Health↗
PubMed1990

Readability of commercial and generic contraceptive instructions.

This study describes the readability levels of written instructions for methods of contraception. Materials studied include patient package inserts (PPIs) from commercial manufacturers and generic instructions (GIs) written by staff members in selected health agencies in the community and by health information publishers. Written materials were analyzed using Dale-Chall, Fry, Fog, Flesh, Flesch-Kincaid and SMOG formulas for readability. Readability levels ranged from elementary school (grade 5.5) to college (grade 13.6). Required comprehension levels of the PPIs were higher than those of the GIs for three of the four groups of contraceptives studied (diaphragms, pills, condoms).

Contraceptive Devices↗
PubMedDate not supplied

An exploratory study of antenatal preparation for cesarean birth.

An exploratory study was designed to develop and test an antenatal education program of cesarean birth information. Eighty-one pregnant women and their husbands received the educational program. Eighteen couples experienced cesarean childbirth. Mailed questionnaires containing items dealing with reactions to the educational program and responses to cesarean birth were returned by 15 of these couples. Findings indicated that the educational program met most of the information needs of the study participants. Both mothers and fathers exhibited adaptive and ineffective responses to the cesarean, although the responses were more positive than previous studies have reported.

Adaptation, Physiological↗
PubMedDate not supplied

Antenatal education for cesarean birth: extension of a field test.

An exploratory study was conducted to compare responses of vaginally delivered and cesarean-delivered parents to an antenatal educational program of cesarean birth information and to determine the feasibility of incorporating the educational program into Lamaze childbirth preparation classes. Fifty-eight pregnant women and 57 male partners received the educational program. Mailed questionnaires were returned by 44 women and 42 men, representing 13 of the 15 cesarean deliveries and 31 of the 43 vaginal deliveries experienced by class participants. Findings indicated that the educational program met most of the parents' information needs, regardless of method of delivery. Study results suggest that childbirth educators must continue to seek ways to prepare expectant parents for unanticipated cesarean birth without causing undue distress.

Adult↗
PubMed2006

Patient information on cognitive symptoms in multiple sclerosis - acceptability in relation to disease duration.

OBJECTIVE: Recently, regular cognitive screening assessments have been advised in multiple sclerosis (MS). No studies have been carried out yet on the acceptability of information on cognitive deficits among MS patients. MATERIALS AND METHODS: Translation of an information booklet developed by a working group of European MS Rehabilitation Centers. Distribution of the booklet among 133 MS patients of two rehabilitation units and one outpatient clinic together with a one-page questionnaire. RESULTS: The booklet was highly understandable and rated to give moderate new information. Overall, the brochure was perceived as encouraging but significantly less so (P = 0.014) in recently diagnosed patients. Patients with subjectively perceived deficits considered the brochure to be significantly more relevant (P = 0.002). CONCLUSION: Information on cognitive deficits does not increase fears even in recently diagnosed MS patients. Patients with perceived deficits found the information more relevant than others and also less familiar. Thus, it seems appropriate to offer information about cognitive impairments to MS patients.

Adult↗
PubMed2005

Persistent effects of a pedagogical device targeted at prevention of severe hypoglycaemia: a randomized, controlled study.

AIM: To study the long-term use of self-study material in type 1 diabetes patient education targeted at the prevention of severe hypoglycaemia. METHODS: Randomized 1:1:1 control study in three local hospitals. We studied 332 type 1 diabetes patients from the geographic population, aged 2.6-18.9 y at entry. The intervention group received a videotape and brochure in which interviewed patients, parents and medical experts reviewed in detail practical skills for self-control and treatment, with the aim of preventing severe hypoglycaemia. There were two control groups: one received a videotape and brochure with general diabetes information and the other only traditional treatment. Primary endpoints were severe hypoglycaemia needing assistance by another person and HbA1c. Dissemination, reading/viewing level, patients' attitudes and extra contact with caregivers were also investigated. At 24 mo, 249 subjects provided data. RESULTS: The yearly incidence of severe hypoglycaemia decreased at 24 mo from 42% to 25% (difference 17%, 95% CI 3-31, p = 0.0241) in the intervention group, but not in controls. HbA1c remained unchanged. Video use during months 13-24 was higher in the intervention group than in controls (p = 0.0477), ranging from 1-15 (median 2) times, among 37% of patients (months 1-12, 100%). Higher future use was anticipated for intervention material (p = 0.0003). Extra caregiver contact was related to severe hypoglycaemia (p = 0.0009). The cost of the material was <EUR 10 per patient. CONCLUSION: Mass-distributed pedagogical devices such as high-quality video programmes and brochures may reach high dissemination levels and, when targeted, contribute to the prevention of severe hypoglycaemia over a longer period of time, being a cost-effective complement to traditional care.

Adolescent↗
PubMed2004

Helping the public 'Discover Health' in their local library. Providing health information in public libraries: a partnership approach in Scotland.

A partnership between the Specialist Health Promotion Service of NHS Tayside and Dundee City Council developed a project, 'Discover Health', to bring health information to the public. The two main formats used were traditional leaflets and Internet access via the People's Network, both available in public libraries. The steering group for the project was made up of staff from both organisations. The NHS side secured the funding; the Council side provided the accommodation and information and communication technologies. The partnership worked well, and the project is continuing, with expansion in the pipeline for other areas within Tayside. The various aspects of the functioning of the partnership are discussed. A literature review of similar initiatives is included.

Cooperative Behavior↗
PubMed1997

The development of patient information leaflets. Care of the mouth after radiotherapy.

OBJECTIVES: Describe the methodology used to produce a patient leaflet on care of the mouth after radiotherapy. DESIGN: Prospective study to design a patient information leaflet. SETTING AND SUBJECTS: Patients undergoing radiotherapy for oral cancer. INTERVENTION: After a review of the relevant literature, a patient questionnaire was produced. This was then completed by patients undergoing radiotherapy treatment and gave an indication of the problems being encountered. Healthcare professionals were surveyed for their views. A leaflet was then produced according to published guidelines. It was taken back to another group of patients and a further version produced after input from a health promotion group. RESULTS: A leaflet was produced after wide consultation and survey. CONCLUSIONS: Considerable effort must to be put into the production to patient information leaflet. It must be discussed with patients in the target group if it is to be sensitive, understood and find acceptance among its users.

Cranial Irradiation↗
PubMedDate not supplied

Nonepileptic seizures: reframing the diagnosis.

PROBLEM: Protocols for disclosing the diagnosis of psychological pseudoseizures have been developed. However, outcomes have not been carefully studied. METHOD: Using a retrospective design, the investigators evaluated the outcomes by interviewing patients 2 years after diagnosis who received the diagnosis using a specific protocol. FINDINGS: There was a reduction in symptoms demonstrated by reports of lessened intensity of events or actual reduction in the number of events in 86% of those interviewed. CONCLUSION: This protocol proved helpful in the acceptance of the diagnosis and improved adherence to the treatment recommendations after disclosure of the diagnosis.

Adult↗
PubMed1998

The readability of printed education materials regarding hormone replacement therapy.

In summary, HRT is a preventative medication that has been shown to decrease the incidence of heart disease and osteoporosis. It also has been shown to reduce symptoms of menopause and to increase the quality of life of users. Choosing to begin and maintain HRT is a personal and complicated decision. In evaluating the risks and benefits of HRT for any one woman, that woman and her primary care provider must individualize her past and current medical history, her family history, and her lifestyle. Together they must come to a decision that best represents the health, social needs, and desires of the patient. Individualizing HRT is difficult for a woman to do on her own, and it is time-consuming for a practitioner. Using PEMs to clarify the benefits and risks of HRT can be very beneficial to a woman considering such therapy. PEMs, however, are not a substitute for one-on-one education, and especially are not appropriate for teaching if their level of technical difficulty is beyond the scope of a patient's comprehension. This study suggests that many of the PEM's provided to women on the subject of HRT are failing to reach their target audiences because of their level of reading difficulty. A stated objective identified in the national initiative Healthy People 2000 (U.S. Department of Health and Human Services, 1997) is to "Increase to at least 90% the proportion of perimenopausal women who have been counseled about the benefits and risks of hormone replacement therapy for the prevention of osteoporosis." PEMs are one way to reach this objective, provided they are understandable to the clientele of focus.

Drug Labeling↗