Texas Health Educators’ Health Literacy Competence and Professional Preparation: A Multiple Perspective

Limited health literacy challenges healthcare and perpetuates health disparities. Health Agencies, such as the United States Department of Health and Human Services (USDHHS) and the World Health Organization (WHO), have recommended health literacy training for all health professionals, but little is known about health education specialists’ health literacy preparation and competence. In this dissertation, qualitative and quantitative approaches were used to examine the extent to which health education specialists are prepared to support health literacy capacity building by individuals and communities. The aims of the study were to: 1) assess the data on health literacy education and training for healthcare workers in order to construct an understanding of how health literacy preparation is emerging for health professionals in general and health educators in particular; 2) evaluate the scope (breadth and depth) of health literacy content in the health education/health promotion curricula of selected Texas public universities; 3) assess health education students’ health literacy knowledge and skills; and 4) capture the perceptions of practicing health education specialists regarding health literacy and the role it plays in their practice. A systematic review of the extant literature showed even though there is no formal standard for instruction, health literacy is emerging similarly across disciplines. Instruction, however, focuses on functional level skills and there is a dearth of research on preparation for public health workers. A syllabi analysis also found health literacy is not represented in the intended curricula. Further, health education students and practitioners have limited knowledge about health literacy. There is discrepancy between their self-reported health literacy preparation and competence, their demonstrated knowledge, and the intended content of instruction

The Black Identity, Hair Product Use, and Breast Cancer Scale

Introduction Across the African Diaspora, hair is synonymous with identity. As such, Black women use a variety of hair products, which often contain more endocrine-disrupting chemicals than products used by women of other races. An emerging body of research is linking chemicals in hair products to breast cancer, but there is no validated instrument that measures constructs related to hair, identity, and breast health. The objective of this study was to develop and validate the Black Identity, Hair Product Use, and Breast Cancer Scale (BHBS) in a diverse sample of Black women to measure the social and cultural constructs associated with Black women’s hair product use and perceived breast cancer risk. Methods Participants completed a 27-item scale that queried perceptions of identity, hair products, and breast cancer risk. Principal Component Analyses (PCA) were conducted to establish the underlying component structures, and confirmatory factor analysis (CFA) was used to determine model fit. Results Participants (n = 185) were African American (73%), African, and Caribbean Black women (27%) aged 29 to 64. PCA yielded two components that accounted for 61% of total variance. Five items measuring sociocultural perspectives about hair and identity loaded on subscale 1 and accounted for 32% of total variance (α = 0.82; 95% CI = 0.77–0.86). Six items assessing perceived breast cancer risk related to hair product use loaded on subscale 2 and accounted for 29% of total variance (α = 0.82 (95% CI = 0.74–0.86). CFA confirmed the two-component structure (Root Mean Square Error of Approximation = 0.03; Comparative Fit Index = 0.91; Tucker Lewis Index = 0.88). Conclusions The BHBS is a valid measure of social and cultural constructs associated with Black women’s hair product use and perceived breast cancer risk. This scale is useful for studies that assess cultural norms in the context of breast cancer risk for Black women

Genetic Ancestry, Skin Color and Social Attainment: The Four Cities Study

Introduction The Black population in the US is heterogeneous but is often treated as monolithic in research, with skin pigmentation being the primary indicator of racial classification. Objective: This paper examines the differences among Blacks by comparing genetic ancestry, skin color and social attainment of 259 residents across four US cities—Norman, Oklahoma; Cincinnati, Ohio; Harlem, New York; and Washington, District of Columbia. Methods Participants were recruited between 2004 and 2006 at community-based forums. Cross-sectional data were analyzed using chi-square tests, correlation analyses and logistic regression. Results There were variations in ancestry, melanin index and social attainment across some cities. Overall, men with darker skin color, and women with lighter skin color were significantly more likely to be married. Darker skin individuals with significantly more West African ancestry reported attainment of graduate degrees, and professional occupations than lighter skin individuals. Conclusions Our findings suggest differences in skin pigmentation by geography and support regional variations in ancestry of US Blacks. Biomedical research should consider genetic ancestry and local historical/social context rather than relying solely on skin pigmentation as a proxy for race

Integrating the Principles of Socioecology and Critical Pedagogy for Health Promotion Health Literacy Interventions

While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician–patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level

Health Literacy Competence of Health Education Students in Three Universities

Introduction. Limited health literacy challenges health care and perpetuates health disparities. Health agencies, such as the U.S. Department of Health and Human Services and the World Health Organization, have recommended health literacy training for all health professionals, but little is known about the health literacy competence of health education professionals. The purpose of this study was to assess the health literacy knowledge and experience of advanced health education students. Method. We used a cross-sectional design to collect data from a sample of 250 juniors and seniors enrolled in health education programs who self-reported an intention to take the certified health education specialists examination. Descriptive and bivariate analyses were conducted. Findings. Results showed most students (84%) scored below 70% on the knowledge component of the test, even though majority of them (94%) reported health literacy training was included in their health educator preparation curriculum. A correlation analysis found health literacy knowledge was not associated with students’ reports of health literacy in their health education curriculum. Prior academic degree was negatively correlated with health literacy knowledge (ρ = −.211, p \u3c.05), and there was a negative correlation between health literacy knowledge and health literacy experience (ρ = −.189, p \u3c.05). Discussion. The study identified weaknesses and gaps in the health literacy knowledge and skills of students, most of who were in the final phase of their professional preparation. The findings have implications for research, practice, and credentialing

Rural parents’ beliefs about healthy eating

Objectives: This study explored US rural parents’ perceived facilitators, challenges and motivators to healthy eating. Methods: Qualitative and purposive sampling was used to recruit one hundred (N = 100) parents of children enrolled in the fourth grade to participate in a series of focus group sessions. Eligibility criteria included being the head of the household and having a child enrolled in the fourth grade. Parents were questioned about factors impacting everyday lifestyle practices such as nutrition knowledge and eating habits. Data were analysed using grounded theory and constant comparative method. Results: Twelve focus groups sessions were conducted with parents who self-identified as African American (63%), Hispanic (25%) and Caucasian 2%. The majority (52%) of participants indicated they only had some high school education. Healthy eating among parents was highly dependent on socioeconomic status, time, availability and access to foods. Facilitators to healthy eating were school lunch programmes, nutrition education and family preferences. Findings demonstrate that parents tried to eat meals at home, but many factors (fear of genetically modified foods, money and time) prevented healthy eating and food preparation. Parents who consumed or prepared meals at home did so because of family influence and the fear of being unhealthy. Conclusion and implications: This study provides an in-depth understanding of rural parents’ efforts to promote healthy eating at home regardless of socioeconomic challenges

HPV Vaccination Interventions Among Young Adults: A Systematic Review

https://openworks.mdanderson.org/sumexp21/1061/thumbnail.jp

Use of Community Forums to Increase HPV and Cervical Cancer Knowledge in Diverse Communities

Cervical cancer adversely impacts African American communities. While disparities in incidence remain unclear, communities continue to use forums to increase cervical cancer education. The purpose of this paper is to examine the efficacy of using community forums to increase human papillomavirus vaccine (HPVV) and cervical cancer knowledge in African American communities. This study is a one-group pretest–posttest study design using a 17-item questionnaire to collect data from 412 participants in diverse communities. Our analyses revealed perceived knowledge increased significantly after the forums for African American participants. For African Americans, perceived knowledge prior to the forums was explained by gender, access to care, and trust in clinical trials. After the forum, perceived knowledge was associated with access to care and trust in vaccines. Participants who had health insurance reported higher perceived HPV and cervical cancer knowledge and greater trust in vaccines. This study found community forums that address the cultural and historical context of research mistreatment related to HPVV development and include diverse racial/ethnic representation of stakeholders may be a useful strategy to increase HPVV, and cervical cancer knowledge in African American communities

Genetic ancestry, skin color and social attainment: The four cities study

Introduction: The Black population in the US is heterogeneous but is often treated as monolithic in research, with skin pigmentation being the primary indicator of racial classification. Objective: This paper examines the differences among Blacks by comparing genetic ancestry, skin color and social attainment of 259 residents across four US cities—Norman, Oklahoma; Cincinnati, Ohio; Harlem, New York; and Washington, District of Columbia. Methods: Participants were recruited between 2004 and 2006 at community-based forums. Cross-sectional data were analyzed using chi-square tests, correlation analyses and logistic regression. Results: There were variations in ancestry, melanin index and social attainment across some cities. Overall, men with darker skin color, and women with lighter skin color were significantly more likely to be married. Darker skin individuals with significantly more West African ancestry reported attainment of graduate degrees, and professional occupations than lighter skin individuals. Conclusions: Our findings suggest differences in skin pigmentation by geography and support regional variations in ancestry of US Blacks. Biomedical research should consider genetic ancestry and local historical/social context rather than relying solely on skin pigmentation as a proxy for race.</p

Genetic ancestry, skin color and social attainment: The four cities study.

IntroductionThe Black population in the US is heterogeneous but is often treated as monolithic in research, with skin pigmentation being the primary indicator of racial classification. Objective: This paper examines the differences among Blacks by comparing genetic ancestry, skin color and social attainment of 259 residents across four US cities-Norman, Oklahoma; Cincinnati, Ohio; Harlem, New York; and Washington, District of Columbia.MethodsParticipants were recruited between 2004 and 2006 at community-based forums. Cross-sectional data were analyzed using chi-square tests, correlation analyses and logistic regression.ResultsThere were variations in ancestry, melanin index and social attainment across some cities. Overall, men with darker skin color, and women with lighter skin color were significantly more likely to be married. Darker skin individuals with significantly more West African ancestry reported attainment of graduate degrees, and professional occupations than lighter skin individuals.ConclusionsOur findings suggest differences in skin pigmentation by geography and support regional variations in ancestry of US Blacks. Biomedical research should consider genetic ancestry and local historical/social context rather than relying solely on skin pigmentation as a proxy for race