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Women's guide to health : run walk run, eat right, and feel better
\"After more than 50 years of developing, practicing, evaluating, and teaching his Run Walk Run(R) method, Jeff Galloway is now partnering with two primary care physicians, Ruth M. Parker and Carmen Patrick Mohan, with over 50 years of clinical practice experience. Both physicians use Galloway's Run Walk Run(R) method to achieve their own health goals and regularly prescribe it to patients with common chronic health conditions. The Women's Guide to Health is an action guide that combines Galloway's Run Walk Run(R) programs with the best available medical knowledge for using Run Walk Run(R) and the Mediterranean Diet as key treatment modalities for chronic medical conditions related to excess body weight. It provides sequential action steps for overweight women who would like to begin a graduated exercise program combined with quality meal planning for weight loss. We summarize the evidence that supports our recommendations to achieve health goals. Run Walk Run(R) is then prescribed like a medication with the core components of daily dosage, frequency, indication, and method for building up to the cumulative dosage of 150 minutes of Run Walk Run(R) per week. Diet and nutrition advice is offered in the form of food prescriptions. Throughout the text, the authors integrate best evidence for forming new lifelong habits, encourage journaling as a core weight loss strategy, and use self-reported health numbers to catalyze meaningful conversations with health care providers.\"--Amazon.com.
Book
Use of Text Messaging for Maternal and Infant Health: A Systematic Review of the Literature
Text messaging is an increasingly popular communication tool in health interventions, but has been little studied in maternal and infant health. This literature review evaluates studies of text messaging that may be applied to the promotion of maternal and infant health. Articles from peer-reviewed journals published before June 2012 were included if they were experimental or quasi-experimental studies of behaviors endorsed either by the American College of Obstetrics and Gynecology, the American Pediatrics Association, or the United States Preventive Services Task Force; included reproductive age women (12–50 years) or infants up to 2 years of age; and were available in English. Qualitative studies of text messaging specific to pregnant women were also included. Studies were compared and contrasted by key variables, including: design, time-period, study population, and results. Forty-eight articles were included, 30 of which were randomized controlled trials. Interventions vary greatly in effectiveness and soundness of methodology, but collectively indicate that there is a wide range of preventative behaviors that text message interventions can effectively promote, including smoking cessation, diabetes control, appointment reminders, medication adherence, weight loss, and vaccine uptake. Common methodological issues include not accounting for attention affect and not aligning text message content to measured outcomes. Those interventions that are based on an established theory of behavior change and use motivational as opposed to informational language are more likely to be successful. Building on the growing body of evidence for text message interventions reviewed here, as well as the growing popularity of text messaging as a medium, researchers should be able to use this technology to engage difficult to reach populations.
Journal Article
Super human encyclopedia : discover the amazing things your body can do
This illustrated guide to the human body reveals the truly amazing processes that go on in our bodies on a daily basis.
Book
Climate action requires new accounting guidance and governance frameworks to manage carbon in shelf seas
Accounting guidelines exist for the recording of carbon flows in terrestrial and coastal ecosystems. Shelf sea sediments, while considered an important carbon store, have yet to receive comparable scrutiny. Here, we explore whether effective management of carbon stocks accumulating in shelf seas could contribute towards a nation’s greenhouse gas emissions reduction targets. We review the complexities of carbon transport and fate in shelf seas, and the geopolitical challenges of carbon accounting in climate governance because of the transboundary nature of carbon flows in the marine environment. New international accounting guidance and governance frameworks are needed to prompt climate action.
Accounting guidelines exist for carbon flows in terrestrial and coastal ecosystems, but not shelf sea sediments. In this Review, the authors explore whether effective management of carbon stocks accumulating in shelf seas could contribute to a nation’s greenhouse gas emissions reduction targets.
Journal Article
Supporting US healthcare providers for successful vaccine communication
Background
While many healthcare providers (HCPs) have navigated patients’ vaccine concerns and questions prior to the rollout of the COVID-19 vaccines, sentiments surrounding the COVID-19 vaccines have presented new and distinct challenges.
Objective
To understand the provider experience of counseling patients about COVID-19 vaccinations, aspects of the pandemic environment that impacted vaccine trust, and communication strategies providers found supportive of patient vaccine education.
Methods
7 focus groups of healthcare providers were conducted and recorded during December 2021 and January 2022, at the height of the Omicron wave in the United States. Recordings were transcribed, and iterative coding and analysis was applied.
Results
44 focus group participants representing 24 US states with the majority (80%) fully vaccinated at the time of data collection. Most participants were doctors (34%) or physician’s assistants and nurse practitioners (34%). The negative impact of COVID-19 misinformation on patient-provider communication at both intrapersonal and interpersonal levels as well as barriers and facilitators to patient vaccine uptake are reported. People or sources that play a role in health communication (“messengers”) and persuasive messages that impact behavior or attitudes towards vaccination (“messages”) are described. Providers expressed frustration in the need to continuously address vaccine misinformation in clinical appointments among patients who remained unvaccinated. Many providers found value in resources that provided up-to-date and evidence-based information as COVID-19 guidelines continued to change. Additionally, providers indicated that patient-facing materials designed to support vaccination education were not frequently available, but they were the most valuable to providers in a changing information environment.
Conclusions
While vaccine decision-making is complex and hinges on diverse factors such as health care access (i.e., convenience, expense) and individual knowledge, providers can play a major role in navigating these factors with their patients. But to strengthen provider vaccine communication and promote vaccine uptake, a comprehensive communication infrastructure must be sustained to support the patient-provider dyad. The findings provide recommendations to maintain an environment that facilitates effective provider-patient communication at the community, organizational and policy levels. There is a need for a unified multisectoral response to reinforce the recommendations in patient settings.
Journal Article
Development and Usability Testing of a Web-based COVID-19 Self-triage Platform
The development and deployment of a web-based, self-triage tool for severe respiratory syndrome coronavirus 2 (COVID-19 disease) aimed at preventing surges in healthcare utilization could provide easily understandable health guidance with the goal of mitigating unnecessary emergency department (ED) and healthcare visits. We describe the iterative development and usability testing of such a tool. We hypothesized that adult users could understand and recall the recommendations provided by a COVID-19 web-based, self-triage tool.
We convened a multidisciplinary panel of medical experts at two academic medical schools in an iterative redesign process of a previously validated web-based, epidemic screening tool for the current COVID-19 pandemic. We then conducted a cross-sectional usability study over a 24-hour period among faculty, staff, and students at the two participating universities. Participants were randomly assigned a pre-written health script to enter into the self-triage website for testing. The primary outcome was immediate recall of website recommendations. Secondary outcomes included usability measures. We stratified outcomes by demographic characteristics.
A final sample of 877 participants (mean age, 32 years [range, 19-84 years]; 65.3% female) was used in the analysis. We found that 79.4% of the participants accurately recalled the recommendations provided by the website. Almost all participants (96.9%) found the website easy to use and navigate.
Adult users of a COVID-19 self-triage website, recruited from an academic setting, were able to successfully recall self-care instructions from the website and found it user-friendly. This website appears to be a feasible way to provide evidence-based health guidance to adult patients during a pandemic. Website guidance could be used to reduce unnecessary ED and healthcare visits.
Journal Article
A Patient-Centered Prescription Drug Label to Promote Appropriate Medication Use and Adherence
BackgroundPatient misunderstanding of prescription drug label instructions is a common cause of unintentional misuse of medication and adverse health outcomes. Those with limited literacy and English proficiency are at greater risk.ObjectiveTo test the effectiveness of a patient-centered drug label strategy, including a Universal Medication Schedule (UMS), to improve proper regimen use and adherence compared to a current standard.DesignTwo-arm, multi-site patient-randomized pragmatic trial.ParticipantsEnglish- and Spanish-speaking patients from eight community health centers in northern Virginia who received prescriptions from a central-fill pharmacy and who were 1) ≥30 years of age, 2) diagnosed with type 2 diabetes and/or hypertension, and 3) taking ≥2 oral medications.InterventionA patient-centered label (PCL) strategy that incorporated evidence-based practices for format and content, including prioritized information, larger font size, and increased white space. Most notably, instructions were conveyed with the UMS, which uses standard intervals for expressing when to take medicine (morning, noon, evening, bedtime).Main MeasuresDemonstrated proper use of a multi-drug regimen; medication adherence measured by self-report and pill count at 3 and 9 months.Key ResultsA total of 845 patients participated in the study (85.6 % cooperation rate). Patients receiving the PCL demonstrated slightly better proper use of their drug regimens at first exposure (76.9 % vs. 70.1 %, p = 0.06) and at 9 months (85.9 % vs. 77.4 %, p = 0.03). The effect of the PCL was significant for English-speaking patients (OR 2.21, 95 % CI 1.13–4.31) but not for Spanish speakers (OR 1.19, 95 % CI 0.63–2.24). Overall, the intervention did not improve medication adherence. However, significant benefits from the PCL were found among patients with limited literacy (OR 5.08, 95 % CI 1.15–22.37) and for those with medications to be taken ≥2 times a day (OR 2.77, 95 % CI 1.17–6.53).ConclusionsA simple modification to pharmacy-generated labeling, with minimal investment required, can offer modest improvements to regimen use and adherence, mostly among patients with limited literacy and more complex regimens.Trial Registration (ClinicalTrials.gov): NCT00973180, NCT01200849
Journal Article
The Prevalence of Limited Health Literacy
Objective: To systematically review U.S. studies examining the prevalence of limited health literacy and to synthesize these findings by evaluating demographic associations in pooled analyses. Design: We searched the literature for the period 1963 through January 2004 and identified 2,132 references related to a set of specified search terms. Of the 134 articles and published s retrieved, 85 met inclusion criteria, which were 1) conducted in the United States with≥25 adults, 2) addressed a hypothesis related to health care, 3) identified a measurement instrument, and 4) presented primary data. The authors extracted data to compare studies by population, methods, and results. Main Results: The 85 studies reviewed include data on 31,129 subjects, and report a prevalence of low health literacy between 0% and 68%. Pooled analyses of these data reveal that the weighted prevalence of low health literacy was 26% (95% confidence interval [CI], 22% to 29%) and of marginal health literacy was 20% (95% CI, 16% to 23%). Most studies used either the Rapid Estimate of Adult Literacy in Medicine (REALM) or versions of the Test of Functional Health Literacy in Adults (TOFHLA). The prevalence of low health literacy was not associated with gender (P=.38) or measurement instrument (P=.23) but was associated with level of education (P=.02), ethnicity (P=.0003), and age (P=.004). Conclusions: A pooled analysis of published reports on health literacy cannot provide a nationally representative prevalence estimate. This systematic review exhibits that limited health literacy, as depicted in the medical literature, is prevalent and is consistently associated with education, ethnicity, and age. It is essential to simplify health services and improve health education. Such changes have the potential to improve the health of Americans and address the health disparities that exist today.
Journal Article
Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes
Background The purpose of this study is to determine the prevalence of diabetes distress and its relationship with health behaviours and clinical outcomes in low-income patients. Methods Secondary analyses were conducted using baseline data from a clinical trial evaluating a diabetes self-management intervention. Interviews were conducted with 666 participants receiving care at nine safety net clinics in Missouri. Distress was measured using the Diabetes Distress Scale, and outcomes included medication adherence, physical activity, nutrition and clinical biomarkers (haemoglobin A1C (HbA1C), blood pressure, low-density lipoprotein (LDL) cholesterol). Results In a sample of 666 participants, 14.1% and 27.3% of patients were identified as highly and moderately distressed, respectively, with higher rates among younger, female and lower income patients. When compared with moderately and no distress groups, highly distressed patients were less adherent to medications (20.7% vs 29.9% vs 39.4%, p<0.001) and had higher HbA1C values (9.3% (SD=2.0) vs 8.2% (SD=1.8) vs 7.8% (SD=1.7), p<0.001), diastolic blood pressure (81.8 (SD=9.4) vs 80.2 (9.7) vs 78.9 (SD=8.8), p=0.02) and LDL cholesterol (104.6 (SD=42.4) vs 97.2 (34.3) vs 95.5 (37.9)) In multivariable analyses, high and moderate distress were associated with lower medication adherence (OR=0.44; 0.27 to 0.23, p=0.001) and (OR=0.58; 0.42 to 0.79; p=0.001), respectively, and higher HbA1C in only the highly distressed group (B=1.3; 0.81 to 1.85; p<0.001) compared with the no distress group. Conclusions Diabetes distress is prevalent and linked to poorer adherence to health behaviours and glycemic control in a sample of patients receiving care from low-income clinics.
Journal Article
Functional Health Literacy and the Risk of Hospital Admission Among Medicare Managed Care Enrollees
Objectives. This study analyzed whether inadequate functional health literacy is an independent risk factor for hospital admission. Methods. We studied a prospective cohort of 3260 Medicare managed care enrollees. Results. Of the participants, 29.5% were hospitalized. The crude relative risk (RR) of hospitalization was higher for individuals with inadequate literacy (n = 800; RR = 1.43; 95% confidence interval [CI] = 1.24, 1.65) and marginal literacy (n = 366; RR = 1.33; 95% CI = 1.09, 1.61) than for those with adequate literacy (n = 2094). In multivariate analysis, the adjusted relative risk of hospital admission was 1.29 (95% CI = 1.07, 1.55) for individuals with inadequate literacy and 1.21 (95% CI = 0.97, 1.50) for those with marginal literacy. Conclusions. Inadequate literacy was an independent risk factor for hospital admission among elderly managed care enrollees. (Am J Public Health. 2002;92:1278–1283)
Journal Article