One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations

Proposes a framework for meeting patients' cultural and linguistic needs: policies and procedures that support cultural competence, data collection, population-tailored services, and internal and external collaborations. Includes a self-assessment tool

Addressing health literacy in patient decision aids

MethodsWe reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews.ResultsAim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies in which health literacy needs were addressed.ConclusionLower health literacy affects key decision-making outcomes, but few existing PtDAs have addressed the needs of lower health literacy users. The specific effects of PtDAs designed to mitigate the influence of low health literacy are unknown. More attention to the needs of patients with lower health literacy is indicated, to ensure that PtDAs are appropriate for lower as well as higher health literacy patients

State of Health Equity Movement, 2011 Update Part C: Compendium of Recommendations DRA Project Report No. 11-03

State of Health Equity Movement, 2011 Update Part C: Compendium of Recommendations DRA Project Report No. 11-0

Optimizing Your Capstone Experience: A Guidebook for Allied Health Professionals

This guidebook is designed for allied health professional students. Each chapter in this guidebook provides students with useful information, tools, and examples that will support them before, during, and after their capstone journey. This is a one of a kind resource that can be used in a variety of professional academic settings. The primary goal of this guidebook is to support students throughout their capstone experience and to help them understand how the capstone process will enrich both their personal and professional advancement.https://touroscholar.touro.edu/opentextbooks/1002/thumbnail.jp

Moving Forward as a Family: Crafting a 2-Generation Strategy for Central Texas, PRP 192

United Way for Greater Austin commissioned this policy research project to guide their focus on helping low socioeconomic families achieve greater financial stability through the development of a Two-Generation (2-Gen) strategy for the Central Texas region. Two-Gen programs emphasize the importance of education as a means for better economic outcomes. High-quality early childhood education programs allow children to make critical neural connections during a period of substantial growth and development, ultimately better preparing them for pre-kindergarten programs and academic success in subsequent years. Adults working low-paying jobs encounter barriers to career advancement due to lacking credentials or relevant education. It is not uncommon for parents working long hours for low wages to have at least one child in need of high-quality early childhood education, yet they are unable to enroll their child in such programs due to issues such as cost, transportation, and time away from work. Two-Gen programs seek to resolve the issues complicating this problem of financial instability by providing high-quality educational and training programs for both parents and children, which are even more effective when intentionally coordinated so that the family develops as a single unit in a positive direction. The research consisted of a literature review; a program scan at the local, state, and federal levels; and site visits within Austin, Dallas, and San Antonio, as well as Boston and Miami. Data collected specific to the Central Texas region include a labor market analysis, a needs assessment, and a mapping of current organizational assets. Obtaining and analyzing this data allowed the team to better understand 2-Gen program development, outcomes, impact measurements, and areas for improvement. The research team developed practical applications for the information collected, ultimately contributing to the proposed anti-poverty strategy through the intentional coordination of 2-Gen services by leveraging existing organizational assets to best address the area’s most salient needs. In addition, the team proposed an evaluation strategy involving cost-benefit equations, program evaluation metrics, and a screening tool to predict the likelihood of a program achieving successful outcomes. The report concludes with policy recommendations at the local, state, and federal levels, as well as a summary of the populations affected by financial instability and future directions for this field.United Way for Greater AustinPublic Affair

Family at the Center

To better understand how family engagement supports school readiness in Los Angeles County, The David and Lucile Packard Foundation and the LA Partnership for Early Childhood Investment convened an advisory group of early childhood leaders and stakeholders to provide advice and explore opportunities to strengthen parent engagement. This report summarizes key insights and recommendations that emerged through these discussions and additional research about parent engagement programs and practices

Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare

Ending Poverty in Our Generation: Save the Children's Vision for a Post-2015 Framework

The Millennium development Goals -- one of the most resonant and unifying agreements in political history -- reach a turning point in 2015, the deadline for their realisation. We must do everything in our power to achieve them. But we also need to find an agreed way forward on work that will remain to be accomplished. This report sets out save the Children's vision for a new development framework -- consisting of ten goals, plus targets and indicators -- that will support the creation of a world where all people everywhere realise their human rights within a generation.Recognising that the global consultation is ongoing, and many voices are still to be heard, we do not present this as a final position. Rather, it as an indicator of our priorities and -- we hope -- a contribution to the process of crystallising the eventual solution

Cultural and Health Literacy Assessment of the Hispanic/Latino Patient Population: Presentation of a Cultural Competence Toolkit for Acute Care Nurses

Background: Barriers to effective communication, such as low health literacy, language, and cultural differences, play a role in the health disparities that affect the Hispanic/Latino population. These barriers have generally been considered in isolation; interventions designed to overcome low health literacy have typically been separate from those focused on decreasing cultural and linguistic barriers. Nurses must understand that culture and language establish the framework for the attainment of health literacy skills, and strive to work within the cultural context of the patient. Methods: Best practices for cultural and health literacy assessment and culturally appropriate nursing interventions were used to develop a Cultural Competence Training Toolkit which was presented to a group of nurses (N = 12). Effectiveness was measured through pre-and post-intervention evaluation of cultural competence using the Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals- Revised. Objectives: 1) Explore the relationship between health literacy, cultural competence, and nursing practice; 2) Describe a cultural competence model that can be used as a framework for nursing practice; 3) Develop and evaluate a Cultural Competence Training Toolkit for acute care nurses. Outcomes: Statistically significant improvements were noted in overall cultural competence (12.25 points) as well as all sub-scale scores (desire: 2.42 points; awareness: 2.75 points; knowledge: 2.08 points; skills: 2.91 points; and encounters: 2.09 points) from baseline to post-test (p \u3c .001). Conclusion: Cultural competence training may lead to improvements in providers’ awareness, knowledge, skills, encounters and desire to learn about the specialized needs of the Hispanic/Latino population

Implementation Of A Medication Adherence Protocol In A Large Urban Safety Net Hospital

Medication nonadherence has a deleterious effect on patients with chronic health conditions, as it contributes to poorer health outcomes and increased healthcare spending. This Doctor of Nursing Practice project sought to improve medication adherence in at-risk patients by enhancing patient-provider communication and improving health literacy in a large, urban, safety net hospital. Utilizing a multi-prong approach, patients were provided with a visual aid – a pill card, in conjunction with the teach-back method, to improve systolic blood pressure (SBP), diastolic blood pressure (DPB) and Hemoglobin A1c (HbA1c) over a 6-month period. Twenty-three patients participated in the project. Participant demographics, attitudes towards the intervention, and clinical indicators were analyzed. The project was well received by all who participated. Key findings included patients finding the pill card easy to use and the teach-back method helpful in learning more about their medications. All target clinical indices decreased: SBP; DBP; A1C, in keeping with current positive findings on the use of triangulated methods conducted with larger samples. This data demonstrates the need for future larger scale projects to evaluate outcomes using these methods. This protocol has the potential to be utilized as a foundational program for other safety net hospitals