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- Member of: Theses and Dissertations
Description
A core principle in multiple national quality improvement strategies is the engagement of chronically ill patients in the creation and execution of their treatment plans. Numerous initiatives are underway to use health information technology (HIT) to support patient engagement however the use of HIT and other factors such as health literacy may be significant barriers to engagement for older adults. This qualitative descriptive study sought to explore the ways that older adults with multi-morbidities engaged with their plan of care. Forty participants were recruited through multiple case sampling from two ambulatory cardiology practices. Participants were English-speaking, without a dementia-related diagnosis, and between the ages of 65 and 86. The older adults in this study performed many behaviors to engage in the plan of care, including acting in ways to support health, managing health-related information, attending routine visits with their doctors, and participating in treatment planning. A subset of patients engaged in active decision-making because of the point they were at in their chronic disease. At that cross roads, they expressed uncertainly over which road to travel. Two factors influenced the engagement of older adults: a relationship with the provider that met the patient's needs, and the distribution of a Meaningful Use clinical summary at the conclusion of the provider visit. Participants described the ways in which the clinical summary helped and hindered their understanding of the care plan.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
Insights gained as a result of this study include an understanding of the discrepancies between what the healthcare system expects of patients and their actual behavior when it comes to the creation of a care plan and the ways in which they take care of their health. Further research should examine the ability of various factors to enhance patient engagement. For example, it may be useful to focus on ways to improve the clinical summary to enhance engagement with the care plan and meet standards for a health literate document. Recommendations for the improvement of the clinical summary are provided. Finally, this study explored potential reasons for the infrequent use of online health information by older adults including the trusting relationship they enjoyed with their cardiologist.
ContributorsJiggins Colorafi, Karen (Author) / Lamb, Gerri (Thesis advisor) / Marek, Karen (Committee member) / Greenes, Robert (Committee member) / Evans, Bronwynne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Considering the overwhelming prevalence of BPH, how can it best be managed in light of the aging population? The purpose of this investigation is to illustrate that BPH and LUTS are conditions that are highly conducive to health literacy technology interventions. This objective will be met by: a) Providing an overview of the clinically relevant information regarding BPH, including anatomy, physiology, epidemiology, symptoms, and medical treatment for the disease; b) Establishing the necessity for novel health care delivery solutions by identifying past successes and challenges associated with technologic advances in related fields; c) Providing evidence of a lack of a systematic approach to BPH education, especially as it relates to health literacy. The relative successes and failures of previously established clinical decision aids will be discussed, leading to recommendations on how to improve upon these standards. Finally, the procedures and results of a pilot study will be analyzed in an effort to further highlight the necessity of engaging patients in the clinical decision making process.
ContributorsMelikian, Robert Jeffrey (Author) / Santanam, Raghu (Thesis director) / Humphreys, Mitchell (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / School of Historical, Philosophical and Religious Studies (Contributor) / School for the Science of Health Care Delivery (Contributor)
Created2014-12
Description
One of the great difficulties in leading America to become a healthier nation involves overcoming the socioeconomic disparity that exists between income and health literacy. Impoverished communities consistently lack the proper health education to make quality food purchases and healthy lifestyle choices, leading to higher rates of obesity. Through FitPHX Energy Zones, an after-school program designed to encourage Phoenix youths to lead healthier lifestyles through an innovative use of library spaces, I provided health education and opportunities for physical activity for 8 to 14-year-olds in underserved Phoenix communities. However, although this intervention made significant progress with the kids' health literacy development over the course of the program, it is difficult for community-based intervention programs to continue in the long run due to budget or other extraneous circumstances. Once the program ends, there needed to be a way to continue to reach the kids beyond the scope of the program such that they can continue to experience the lessons taught during the program. Following the conclusion of FitPHX, I created an interactive book for the kids I worked with to help them retain the health and nutrition knowledge taught during the program.
ContributorsBejarano, Michael Carlos (Author) / McCoy, Maureen (Thesis director) / Williams, Deborah (Committee member) / Harrington Bioengineering Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
More than 90 million Americans suffer from low health literacy levels that can lead to detrimental health practices. One of the greatest issues stemming from low health literacy is the misuse of medication, which results in 125,000 deaths per year and close to $200 billion dollars in health care funds (Ngoh 2009). With their implementation into neighborhood settings and consequently the everyday lives of individuals, pharmacies show potential in being great assets towards increasing health literacy on an individual and societal level. However, pharmacists must first be made aware of the opportunities and challenges that exist concerning this effort. Through a three step literature review and corresponding comparative analysis, the results of this study show that pharmacists should focus on four main areas: overall assessment of health literacy in a pharmacy setting, individualization and tailoring of health/ medication plans, development of verbal and written communication tools, and the pharmacist-patient relationship. Each area presents a set of opportunities and challenges that must be accounted for in order to design more effective initiatives and tools in the pharmacists' aim to increase health literacy.
ContributorsMergens, Rianna Lynn (Author) / Robert, Jason Scott (Thesis director) / Maienschein, Jane (Committee member) / Kinzig, Ann (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2013-05
Description
The importance and prevalence of health literacy has emerged in part due to continuing changes in the delivery of health care services, creating new responsibilities for patients and their caregivers, which include finding and evaluating information, self-monitoring health status, and understanding financial constraints and obligations. Those with low health literacy are not able to access the same healthcare benefits, nor are they able to maintain a healthier life as they are not as informed about preventative care. Spanish speakers in the U.S. are subject to these outcomes due to their low levels of health literacy, in which they ultimately experience more severe health issues, late-stage diseases, and higher disease burden. This paper is a comprehensive examination of health literacy among Spanish speakers and makes recommendations on policies that could be implemented into the U.S. healthcare system to better accommodate Spanish speakers and help improve their health literacy for the ultimate goal of improving health outcomes and access to healthcare.
ContributorsLopezlira, Ashley (Author) / Gonzalez-Estevez, Dulce (Thesis director) / Gradoville, Michael (Committee member) / Barrett, The Honors College (Contributor) / Harrington Bioengineering Program (Contributor)
Created2023-05
Description
The unprecedented amount and sources of information during the COVID-19 pandemic resulted in an indiscriminate level of misinformation that was confusing and compromised healthcare access and delivery. The World Health Organization (WHO) called this an ‘infodemic’, and conspiracy theories and fake news about COVID-19, plagued public health efforts to contain the COVID-19 pandemic. National and international public health priorities expanded to counter misinformation. As a multi-disciplinary study encompassing expertise from public health, informatics, and communication, this research focused on eliciting strategies to better understand and combat misinformation on COVID-19. The study hypotheses is that 1) factors influencing vaccine-acceptance like socio-demographic factors, COVID-19 knowledge, trust in institutions, and media related factors could be leveraged for public health education and intervention; and 2) individuals with a high level of knowledge regarding COVID-19 prevention and control have unique behaviors and practices, like nuanced media literacy and validation skills that could be promoted to improve vaccine acceptance and preventative health behaviors. In this biphasic study an initial survey of 1,498 individuals sampled from Amazon Mechanical Turk (MTurk) assessed socio-demographic factors, an 18-item test of COVID-19 knowledge, trust in healthcare stakeholders, and measures of media literacy and consumption. Subsequently, using the Positive Deviance Framework, a diverse subset of 25 individuals with high COVID-19 knowledge scores were interviewed to identify these deviants’ information and media practices that helped avoid COVID-19 misinformation. Access to primary care, higher educational attainment and living in urban communities were positive socio-demographic predictors of COVID-19 vaccine acceptance emphasizing the need to invest in education and rural health. High COVID-19 knowledge and trust in government and health providers were also critical factors and associated with a higher level of trust in science and credible information sources like the Centers for Disease Control (CDC) and health experts. Positive deviants practiced media literacy skills that emphasized checking sources for scientific basis as well as hidden bias; cross-checking information across multiple sources and verifying health information with scientific experts. These identified information validation and confirmation practices may be useful in educating the public and designing strategies to better protect communities against harmful health misinformation.
ContributorsSivanandam, Shalini (Author) / Doebbeling, Bradley (Thesis advisor) / Koskan, Alexis (Committee member) / Roschke, Kristy (Committee member) / Chung, Yunro (Committee member) / Arizona State University (Publisher)
Created2023
Description
With the Latinx community anticipated to make up ~30% of the population by 2060, it will be crucial more than ever to mitigate the health disparities preventing them from equitable well-being. From a higher prevalence of obesity to better understanding mental health, there exists a myriad of challenges imposed against the community; however, its largest barrier is American hegemony. This is because their biases have exacerbated the public health system, preventing one from accessing their right to life, liberty, and the pursuit of happiness. As a result, intervention goals, most commonly through educational settings, fail to be met. One of the worst results: poor health literacy rates. Without proper health literacy skills, individuals lack the knowledge required to best manage their health. Unfortunately, the Latinx community is reported to have fewer strengths in terms of this; hence, Sana Sana was created. Through this magazine, the project intends to increase general healthy literacy, improve health trajectories, and promote overall well-being amongst Latino adolescents.
ContributorsZaldivar, Israel O. (Author) / Hinde, Katie (Thesis director) / Murphy, Ana (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
“What the Health is This” is a creative project that aims to provide health education, improve health literacy, encourage young adults to do their own reputable health research, and empower them to make informed health decisions through that research. Centered on topics of interest for young adults, the podcast covers four main concepts: wellness, self-care, health care, and public health. Each episode is approximately 20 minutes.
ContributorsLim, Lance Israel (Author) / Hasse, Kimberly (Co-author) / Chen, Angela (Thesis director) / Hess, Aaron (Committee member) / Barrett, The Honors College (Contributor) / Edson College of Nursing and Health Innovation (Contributor) / Watts College of Public Service & Community Solut (Contributor)
Created2022-05
Description
“What the Health is This” is a creative project that aims to provide health education, improve health literacy, encourage young adults to do their own reputable health research, and empower them to make informed health decisions through that research. Centered on topics of interest for young adults, the podcast covers four main concepts: wellness, self-care, health care, and public health. Each episode is approximately 20 minutes.
ContributorsHasse, Kimberly (Author) / Lim, Lance (Co-author) / Chen, Angela (Thesis director) / Hess, Aaron (Committee member) / Barrett, The Honors College (Contributor) / Edson College of Nursing and Health Innovation (Contributor) / Watts College of Public Service & Community Solut (Contributor)
Created2022-05
Description
The Patient Guidance Project was created by a team of research assistants in the Arizona Cancer Evolution Center as a source of supplemental education and support for recently diagnosed cancer patients. Extensive background research in the form of literature reviews highlighted disparities between the information patients want and are receiving, as well as between average literacy levels of patients and the literacy levels at which cancer information is commonly provided. The Patient Guidance Project has published comprehensive guides for specific types of cancer, which so far include metastatic melanoma, glioblastoma, prostate cancer, oral cancer, kidney cancer, breast cancer, and colorectal cancer. The content of the guides is intended to bridge the gaps in information for patients with an emphasis on treatment options, treatment side effects, and psychological support resources, which surveys have identified as the topics patients want information on most. Written at a sixth-grade literacy level, which over half of adults in the U.S. read at, the guides are meant to be of benefit to as many people as possible. In the future, the team hopes to expand the Patient Guidance Project to include more cancer types, guides in different languages, and multimodal features to increase their effectiveness.
ContributorsWilliams, Erica (Author) / Maley, Carlo (Thesis director) / Baciu, Cristina (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2022-12