Intercorrelations of resilience, life satisfaction, self-esteem, depression, and anxiety (N = 5,036).

<p>Intercorrelations of resilience, life satisfaction, self-esteem, depression, and anxiety (N = 5,036).</p

Demographic characteristics of the study sample and associations with RS-11 scores.

<p>Demographic characteristics of the study sample and associations with RS-11 scores.</p

Test for invariance across gender and age using multi-group CFA.

<p>Test for invariance across gender and age using multi-group CFA.</p

Normative data from the general population for the RS-11.

<p>Normative data from the general population for the RS-11.</p

German translation, cultural adaptation, and validation of the Health Literacy Questionnaire (HLQ)

<div><p>The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a ‘validity-driven’ approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach’s Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations.</p><p><b>Trial Registration</b>: German Clinical Trial Registration (DRKS): <a href="https://clinicaltrials.gov/ct2/show/DRKS00000584" target="_blank">DRKS00000584</a>. Registered 23 March 2011.</p></div

Effectiveness of Telephone-Based Health Coaching for Patients with Chronic Conditions: A Randomised Controlled Trial

<div><p>Background</p><p>Chronic diseases, like diabetes mellitus, heart disease and cancer are leading causes of death and disability. These conditions are at least partially preventable or modifiable, e.g. by enhancing patients’ self-management. We aimed to examine the effectiveness of telephone-based health coaching (TBHC) in chronically ill patients.</p><p>Methods and Findings</p><p>This prospective, pragmatic randomized controlled trial compares an intervention group (IG) of participants in TBHC to a control group (CG) without TBHC. Endpoints were assessed two years after enrolment. Three different groups of insurees with 1) multiple conditions (chronic campaign), 2) heart failure (heart failure campaign), or 3) chronic mental illness conditions (mental health campaign) were targeted. The telephone coaching included evidence-based information and was based on the concepts of motivational interviewing, shared decision-making, and collaborative goal setting. Patients received an average of 12.9 calls. Primary outcome was time from enrolment until hospital readmission within a two-year follow-up period. Secondary outcomes comprised the probability of hospital readmission, number of daily defined medication doses (DDD), frequency and duration of inability to work, and mortality within two years. All outcomes were collected from routine data provided by the statutory health insurance. As informed consent was obtained after randomization, propensity score matching (PSM) was used to minimize selection bias introduced by decliners. For the analysis of hospital readmission and mortality, we calculated Kaplan-Meier curves and estimated hazard ratios (HR). Probability of hospital readmission and probability of death were analysed by calculating odds ratios (OR). Quantity of health service use and inability to work were analysed by linear random effects regression models. PSM resulted in patient samples of 5,309 (IG: 2,713; CG: 2,596) in the chronic campaign, of 660 (IG: 338; CG: 322) in the heart failure campaign, and of 239 (IG: 101; KG: 138) in the mental health campaign. In none of the three campaigns, there were significant differences between IG and CG in time until hospital readmission. In the chronic campaign, the probability of hospital readmission was higher in the IG than in the CG (OR = 1.13; p = 0.045); no significant differences could be found for the other two campaigns. In the heart failure campaign, the IG showed a significantly reduced number of hospital admissions (-0.41; p = 0.012), although the corresponding reduction in the number of hospital days was not significant. In the chronic campaign, the IG showed significantly increased number of DDDs. Most striking, there were significant differences in mortality between IG and CG in the chronic campaign (OR = 0.64; p = 0.005) as well as in the heart failure campaign (OR = 0.44; p = 0.001).</p><p>Conclusions</p><p>While TBHC seems to reduce hospitalization only in specific patient groups, it may reduce mortality in patients with chronic somatic conditions. Further research should examine intervention effects in various subgroups of patients, for example for different diagnostic groups within the chronic campaign, or duration of coaching.</p><p>Trial Registration</p><p>German Clinical Trials Register <a href="https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00000584" target="_blank">DRKS00000584</a></p></div

Factor correlations of the nine factors of the HLQ-G.

<p>Factor correlations of the nine factors of the HLQ-G.</p

Sociodemographic characteristics of the sample; total sample and comparison of control group (n = 570) versus those who declined participation (n = 488).

<p>Sociodemographic characteristics of the sample; total sample and comparison of control group (n = 570) versus those who declined participation (n = 488).</p

Factor loadings of the nine-factor model of the Health Literacy Questionnaire in German (HLQ-G); Cronbach’s Alpha (α) by individual HLQ scale.

<p>Factor loadings of the nine-factor model of the Health Literacy Questionnaire in German (HLQ-G); Cronbach’s Alpha (α) by individual HLQ scale.</p

Effects of telephone-based health coaching on healthcare utilization: Results of linear fixed effects difference-in-difference regression models (per protocol).

<p>Effects of telephone-based health coaching on healthcare utilization: Results of linear fixed effects difference-in-difference regression models (per protocol).</p