Developing predictive models of health literacy.

IntroductionLow health literacy (LHL) remains a formidable barrier to improving health care quality and outcomes. Given the lack of precision of single demographic characteristics to predict health literacy, and the administrative burden and inability of existing health literacy measures to estimate health literacy at a population level, LHL is largely unaddressed in public health and clinical practice. To help overcome these limitations, we developed two models to estimate health literacy.MethodsWe analyzed data from the 2003 National Assessment of Adult Literacy (NAAL), using linear regression to predict mean health literacy scores and probit regression to predict the probability of an individual having 'above basic' proficiency. Predictors included gender, age, race/ethnicity, educational attainment, poverty status, marital status, language spoken in the home, metropolitan statistical area (MSA) and length of time in U.S.ResultsAll variables except MSA were statistically significant, with lower educational attainment being the strongest predictor. Our linear regression model and the probit model accounted for about 30% and 21% of the variance in health literacy scores, respectively, nearly twice as much as the variance accounted for by either education or poverty alone.ConclusionsMultivariable models permit a more accurate estimation of health literacy than single predictors. Further, such models can be applied to readily available administrative or census data to produce estimates of average health literacy and identify communities that would benefit most from appropriate, targeted interventions in the clinical setting to address poor quality care and outcomes related to LHL

Data Collection for the Study on Climate Change and Migration in the MENA Region

A large part of this study is based on data collected in 2011 in five focus countries of the MENA region. In addition, other existing data sources were used as well, as documented in the various chapters that follow, but this need not be discussed in this chapter. This chapter documents the process followed and some of the choices made for new data collection, both quantitative and qualitative, for the study on climate change and migration in the MENA region. After a brief introduction, we explain the nature of the household survey questionnaire, what it enables us to document, as well as some of its limits. Next, we explain how the household survey sites were selected and how the samples were constructed in each of the five focus countries. We also provide a few comments on the challenges encountered during survey implementation. The chapter finally explains the process used for the focus group discussions and in-depth interview, as well as for the interviews with key informants conducted in each country

Data Collection for the Study on Climate Change and Migration in the MENA Region

A large part of this study is based on data collected in 2011 in five focus countries of the MENA region. In addition, other existing data sources were used as well, as documented in the various chapters that follow, but this need not be discussed in this chapter. This chapter documents the process followed and some of the choices made for new data collection, both quantitative and qualitative, for the study on climate change and migration in the MENA region. After a brief introduction, we explain the nature of the household survey questionnaire, what it enables us to document, as well as some of its limits. Next, we explain how the household survey sites were selected and how the samples were constructed in each of the five focus countries. We also provide a few comments on the challenges encountered during survey implementation. The chapter finally explains the process used for the focus group discussions and in-depth interview, as well as for the interviews with key informants conducted in each country

Cellulitis-Associated Hospitalizations in Baltimore City

Examines increases in hospitalizations associated with cellulitis, a skin infection often linked to methicillin-resistant staphylococcus aureus, by age, area, and insurance status, and compared with the rest of Maryland and the District of Columbia

Ambulatory Care Sensitive Hospitalizations and Emergency Department Visits in Baltimore City

Examines rates of hospitalizations and emergency room visits in Baltimore that could be preventable with high-quality primary care. Analyzes data by age, area, and insurance status, and compared with the rest of Maryland and the District of Columbia

Views from the Homefront: The Experiences of Youth and Spouses from Military Families

As the United States continues deployments of service members to support operations in Iraq and Afghanistan, it is increasingly important to understand the effects of this military involvement, not only on service members but also on the health and well-being of their children and spouses. The purpose of this report is to examine the functioning of a sample of youth in military families who applied to a free camp for children of military personnel and to specifically assess how these youth are coping with parental deployment. The report addresses the general well-being of military youth during and after parental deployment, with attention to their emotional, social, and academic functioning. It also examines the challenges that their nondeployed caregivers face. The study includes quantitative and qualitative components: three waves of phone surveys with youth and nondeployed caregivers, and in-depth interviews with a subsample of caregivers. The researchers found that children and caregivers who had applied to attend the camp confronted challenges to their emotional well-being and functioning. Four factors in particular (1) poorer caregiver emotional well-being, (2) more cumulative months of deployment, (3) National Guard or Reserve status, and (4) poor quality of family communication were strongly associated with greater youth or caregiver difficulties

PartyIntents

PartyIntents examines whether portal survey methods could be used to anonymously survey gay and bisexual men about HIV-risk behaviors before and after a weekend party–oriented vacation. The study recruited 97% of eligible men and of these 489 participants 47% completed the follow-up assessment. Approximately one half of the men intended to use illegal drugs over the weekend, and almost 20% thought that they might have anal intercourse and not use a condom. The methodology can be applied and provides useful information about HIV risk at these events, though refinements may be needed to increase the follow-up rates.HIV; surveys; gay and bisexual; substance use