Project description:BACKGROUND:In order to play an active role in their health care, patients need information and motivation. Current delivery systems limit patients' involvement because they do not routinely provide them with enough details of their own clinical results, conditions and other important clinical data. The purpose of this study was to identify, from the perspective of patients, which topics matter the most, who should be communicating them, and when and how should they be provided. METHODS:We conducted a qualitative, phenomenological study analysing the content of subjective experiences, feelings and behaviours. We organized two focus groups with 13 participants and 15 in-depth interviews. Transcripts of the focus groups and interviews were checked for accuracy and then entered into Atlas ti™ v7.5.13 qualitative software. Two independent researchers performed a qualitative inductive content analysis to classify the data in two levels: themes and categories. RESULTS:The qualitative analysis provided 377 units of meaning synthesized into 22 categories and six themes: hospitalization procedure, Health Literacy relating to the patient's condition, information content, satisfaction, professional-patient relationship, and patient proactivity. Patients described which information they wished for, when they needed it, and who would provide it, usually related to actions such as admission, discharge or diagnostic tests. Oral information was more difficult to comprehend than the written kind, as patients can check written information several times if needed. Nurses were the most available professionals, and patients found easier to relate to them and ask them questions. Moreover, patients identified physicians as those professionals responsible for providing clinical information. CONCLUSIONS:Our results showed that patients suffered from poor Health Literacy regarding their personal condition, as they were unable to describe the symptoms, the type of tests being performed or their results, and some of them also had difficulties in naming the specific disease or comorbidities they had. During the hospitalization process, patients were in good shape to come with doubts and actively asked for more information. Healthcare organizations and professionals were offered the chance to ensure the correct communication and comprehension to their patients.

Project description:BackgroundClear dialogue-based (interactive) communication that ensures comprehension and recall becomes more important in patient-provider interactions, especially in relation to patients with chronic diseases, where self-management education and counseling are cornerstones in managing these diseases. If patients with chronic disease experience challenges in obtaining, understanding, and applying health-related information (necessary to make informed health decisions and sufficiently manage their health), clear communication and ensuring comprehension become even more critical in the patient-provider interactions. Furthermore, patient-provider communication has been proposed as a potential pathway through which health literacy might influence health outcomes, especially in individuals with chronic diseases. Hence, adjusting communication to the individual level of health literacy might have a positive influence on health outcomes. On this basis, the authors have developed a web-based interactive communication model that both seeks to accommodate health literacy by allowing tailored communication and ensure comprehension and recall between nurses and patients.ObjectiveThis study seeks to examine the use of an IT solution that comprises an interactive communication model that seeks to accommodate health literacy in communication and ensure comprehension and recall between nurses and patients.MethodsA quasi-experimental control group study including full economic evaluation with 6-month follow-up. Based on power calculation, a total of 82 participants will be included. Participants are assigned either the interactive communication model (intervention) or usual nursing care. It will be assessed if the model influences the level of health literacy and participants experience a higher health-related quality of life. Further, cost-effectiveness will be evaluated. Overall, the statistical methods will follow an intention-to-treat principle. Results will be presented in accordance with the Transparent Reporting of Evaluations with Non-randomized Designs guidelines for nonrandomized designs as well as the Consolidated Health Economic Evaluation Reporting Standards.ResultsThis paper describes a protocol for a clustered quasi-experimental control study that seeks to evaluate the effectiveness of the interactive communicative model. Most studies in the field of health literacy are epidemiological studies that seek to address the effects of poor health literacy in populations and its potential impact on health inequity. A total of 82 participants, who receive community nursing will be included. The final trial day is May 1, 2022, with the first report of results in the final quarter of 2022.ConclusionsThe results of the trial can create the base for conducting a large-scale study and inspire the conduction of more studies that seeks to create and evaluate interventions aimed at enhancing the level of health literacy and reducing the usage of health resources.Trial registrationClinicalTrials.gov NCT04929314; https://clinicaltrials.gov/ct2/show/NCT04929314.International registered report identifier (irrid)DERR1-10.2196/37673.

Project description:BackgroundMigrants face structural, socio-political barriers in their resettlement processes that negatively affect their health. Migration also adversely impacts resources such as social capital and health literacy that are of importance for health and integration into society. Hence, there is a need for health promotion in the early post-migration phase. In Sweden, newly settled refugee migrants who have received a residence permit are offered an Introduction programme including a civic orientation course. The program is intended to facilitate access to the labour market and promote integration. The aim of the study was to explore participants' perceptions and experiences of a civic orientation course with added health communication.MethodsWe performed six focus group discussions: two in Arabic, two in Farsi and two in Somali. The discussions were facilitated by native speaking moderators. Participants were 32 men and women recruited from civic orientation classes in the county of Stockholm. We used an interview guide with semi-structured questions. The data were analysed using a method for content analysis for focus group discussions.ResultsThree main categories were identified: (1) 'The course gives valuable information but needs adjustments', which includes that the civic and health orientation is needed earlier, during the asylum phase, and that planning and course content need adjustments. (2) 'The health communication inspired participants to focus on their health', which includes that the health communication was useful and inspired uptake of healthier habits. (3) 'Participation in the course promoted independence and self-confidence', which includes that the course gave insights into society and values in Sweden, and promoted independence and new social contacts.ConclusionThis study adds knowledge about the users' perspectives on the potential of civic orientation to promote the health and integration of newly settled migrants, describing ways in which civic orientation with added health communication promoted health and empowerment. However, the content and delivery of the course need adjustment to better fit the migrants' life situations and varying pre-existing knowledge.

Project description:BackgroundHealth inequities arise when the public cannot access and understand health information in an easy, accessible, and understandable way. Evidence supports that health literacy (HL) is a determinant for health outcomes, and when HL is limited this may have a major impact on morbidity as well as mortality. Migrants are known to have limited HL. Therefore, this study aimed to explore comprehensive health literacy (CHL) and electronic health literacy (eHL) among Arabic-speaking migrants in Sweden.MethodsThis was a cross-sectional observational study conducted in Sweden. A total of 703 persons were invited to participate between February and September 2019. Two questionnaires - the Health Literacy Survey European Questionnaire (HLS-EU-Q16) and the eHealth Literacy Scale (eHEALS) - and questions about self-perceived health and Internet use were distributed in Swedish and Arabic. Various statistical analyses were performed to determine the associations for limited CHL and eHL.ResultsA total of 681 respondents were included in the analysis. Of these, 334 (49%) were native Arabic-speaking migrants and 347 (51%) were native Swedish-speaking residents. CHL and eHL differed between the groups. The Arabic speakers had significantly lower mean sum scores in eHL 28.1 (SD 6.1) vs 29.3 (6.2), p = 0.012 and lower proportion of sufficient CHL 125 (38.9%) vs 239 (71.3%), p < 0.001 compared to Swedish speakers. Multiple regression analysis showed on associations between limited CHL and eHL and being Arabic speaking, less Internet use, and not finding the Internet to be important or useful. Furthermore, longer time spent in Sweden was associated with higher levels of CHL among the Arabic speakers, (OR 0.94, 95% CI 0.91-0.98, p < 0.01).ConclusionsCHL and eHL differ between Arabic-speaking migrants and native Swedish speakers, but also between Arabic speakers who have lived different lengths of time in Sweden. Though it seems that the eHealth literacy is less affected by language spoken, the Internet is suggested to be an appropriate channel for disseminating health information to Arabic-speaking migrants.

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Can extended health communication improve newly settled refugees’ health literacy? A quasi-experimental study from Sweden

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