Measuring Health Literacy Among U.S. Chinese-Speaking Populations with Limited English Proficiency

It is important to assess health literacy level among individuals with limited English proficiency (LEP) because assessing their health literacy level is the first step to develop a tailored health education program and reduce health disparities. The purpose of my dissertation is to improve the health literacy measurement and theory among populations with LEP. My dissertation investigates the psychometric properties of two functional health literacy measures and evaluates the adequacy of a modified health literacy survey to elicit valid data among 405 U.S. Chinese-speaking individuals with LEP. I found researchers assessed health literacy using the non-English Test of Functional Health Literacy in Adults (TOFHLA) with 15 languages in 13 counties with different translation processes. Also, I determined that only 16 of the 74 eligible studies reported reliability coefficients for their data, with a reporting rate of 21.6%. I also found that the current functional health literacy construct and measurement tools are not applicable among populations with LEP. Most individuals with LEP had adequate functional health literacy when assessed in their native languages. The English TOFHLA was measuring functional health literacy along with language proficiency. The Numeracy items of the Chinese TOFHLA yielded scores with low reliability. My dissertation results show that the participants earned higher health literacy scores when they encounter health information/situations in Chinese rather than in English. I also found that few participants believed they had a voice in influencing reforming U.S. health policy. Further, the theoretical health literacy model had a better fit with the data from the Chinese scenario questions than the data from the English scenario questions. Based on the dissertation study findings, I have three implications for future health literacy research and practice. First, I recommend researchers use the short form for future non-English TOFHLA instruments application. Second, culturally related constructs such as English language proficiency are key components that should be added to the health literacy measurement and theoretical model for populations with LEP. Last, public health professionals should incorporate health interventions and policy approaches to improve critical health literacy among populations with LEP

The effect of elbow position and grip span on isometric grip strength and force distribution of fingers.

Injuries to the hand, lower arm, and shoulder are often attributed to inappropriate use or poor design of hand tools. Isometric grip, performed with the angled handles of pliers was investigated in this study. For this thesis, three factors were studied. They were grip type (traditional and reversed grip), elbow position (0\sp\circ, 30\sp\circ, 60\sp\circ, 90\sp\circ, and 120\sp\circ), and grip span (50, 60, and 70 mm). The resultant forces between the jaws of the pliers and finger forces were measured under each condition. The purpose of this study was to evaluate the effect of elbow position and grip span on grip strength and force distribution across the fingers. The results showed that elbow position, grip span and grip type have significant effects on resultant force and finger force. The forces were statistically higher at the fully extended elbow position than at the 30\sp\circ, 90\sp\circ and 120\sp\circ elbow positions, and the resultant force was higher at the 60\sp\circ, 30\sp\circ, and 90\sp\circ positions than at the 120\sp\circ position. Regardless of elbow positions and grip type the optimal grip span was found to be 50 mm and forces decreased as grip span increased. The resultant force obtained in a traditional grip exceeded the force obtained in a reversed grip. Also, the finger force varied according to elbow position, grip span and grip type. The influences of these factors also varied according to fingers. Interactions between grip span and grip type were found in index and ring fingers. (Abstract shortened by UMI.)Dept. of Industrial and Manufacturing Systems Engineering. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis1997 .C4255. Source: Masters Abstracts International, Volume: 37-01, page: 0334. Thesis (M.A.Sc.)--University of Windsor (Canada), 1997

Is machine language translation a viable tool for health communication?

Chapters in this book aim to fill in a persistent knowledge gap in current multicultural health research, that is, culturally effective and user-oriented healthcare translation.Community Health Sciences, Counseling and Counseling Psycholog

Examining the Influences of COVID-19 Information Avoidance and Uncertainty on Perceived Severity of the Pandemic: Applications from the Health Belief Model and Weick’s Model of Organizing

Public health responses to the COVID-19 pandemic have been insufficient at keeping the virus from spreading rapidly and threatening public health around the globe. Not only has society been challenged by biomedical issues of disease contagion, infection, morbidity, and mortality, but has also confronted complex cognitive challenges to making sense of this health threat, especially related to accurately evaluating and responding appropriately to the severity of the pandemic. Perceived severity is an important cognitive factor associated with public willingness to adopt needed prevention, protection, and treatment behaviors for responding to serious health risks, like COVID-19. Information avoidance and uncertainty are important constructs from powerful public health and communication theories, including the health belief model and Weick’s model of organizing, that guide this study by describing how information influences responses to health threats. We used survey data collected from 561 college students to clarify the relationships among information avoidance, beliefs about unpredictability, and the perceived severity of COVID-19. We found that higher information avoidance was associated with lower perceived severity, and that this association depended on people’s unpredictability beliefs. Specifically, for those who had low assessments about unpredictability, we observed a strong negative association between information avoidance and perceived severity. Among those who had high perceived unpredictability levels, we observed a weak negative association between information avoidance and perceived severity. This study evaluates influences of information avoidance and uncertainty on perceived severity of COVID-19. The findings can help guide strategies for enhancing public response to this pandemic and future health threats

High Level of CXCR4 in Triple-Negative Breast Cancer Specimens Associated with a Poor Clinical Outcome

Despite high sensitivity to chemotherapy, the prognosis for triple-negative breast cancer (TNBC) remains poor because of its high rate of metastasis and low sensitivity to endocrine therapy. CXCR4 expression has been reported in many subtypes of human breast cancers, but it remains unknown whether CXCR4 is expressed in TNBC and whether CXCR4 expression in TNBC could be a prognostic indicator. TNBCs tissues were formalin fixed, paraffin embedded and hematoxylin-eosin (H&E) stained. Immunohistochemical staining was utilized to determine the CXCR4 expression in those specimens. Statistical analyses were performed using SPSS16.0 software to reveal the correlation of CXCR4 expression in TNBC specimens and cancer recurrence and cancer-related death. Our results showed that there was a strong association between CXCR4 overexpression and both menopause and the histological cancer grade of TNBC patients (p values were separately 0.004 and 0.001). The 5-y disease-free survival (DFS) and the 5-y overall survival (OS) were 57.69% and 58.33% for the low-CXCR4 group versus 42.11% and 44.74% for the high-CXCR4 group, respectively (p＝0.031 and 0.048). CXCR4 overexpression plays an important role in triple-negative breast cancers, and may be a predictor of poor prognosis