Improving Health Literacy

21 06 2010

Nearly 9 out of 10 adults have problems understanding and using basic health information.

Insufficient health literacy (a person’s ability to understand health information) is not limited to a select group.  It cuts across all cultures, levels of education and income, and all age groups.

We need to be educated to improve our health literacy, so that we can make optimal health-related choices.

Toward this end, the Department of Health and Human Services, led by Howard K. Koh, M.D., M.P.H., Assistant Secretary for Health, has developed the National Action Plan to Improve Health Literacy.

The plan does a good job of outlining the barriers to health literacy, identifying goals, and providing some steps to reach those goals:

  • Develop and disseminate health and safety information that is accurate, accessible, and actionable
  • Promote changes in the health care system that improve health information, communication, informed decisionmaking, and access to health services
  • Incorporate accurate, standards-based, and developmentally appropriate health and science information and curricula in childcare and education through the university level
  • Support and expand local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community
  • Build partnerships, develop guidance, and change policies
  • Increase basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy
  • Increase the dissemination and use of evidence-based health literacy practices and interventions

The American Medical Association (AMA) Foundation has done a lot of work over the years toward improving health literacy, providing helpful tips and tools to physicians to improve communication and understanding between patients and providers.

In fact, lots of groups are working on health literacy.  If you search the term on the Internet, you’ll get half a million results or more.

If so many people are working on it, why is it still a problem?

It’s a tough nut to crack. Low literacy is a key factor in non-compliance with healthcare recommendations. For example, if the directions for taking medication are complicated, or the instructions for recovery from surgery are hard to understand, chances are patients will be reluctant to ask for help in deciphering the language and therefore they will not be able to follow the directions. In other words, they become non-compliant.

Unfortunately, many healthcare professionals don’t always know why a patient is not responding to treatment.  They may not know that there’s a non-compliance issue and that it’s connected to low health literacy.

Low health literacy plays a significant role in:

For the health of our population, we as educators need to become better at finding ways to improve health literacy. Perhaps Dr. Koh’s plan will blaze some trails.

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Medical Info on the Internet. Reliable?

14 06 2010

When we or our loved ones are diagnosed with a condition, many of us turn to the Internet for information.

Last year, 61 % of Americans used the Internet to research health topics.

The question is, how do we know if the medical information we find online is worth the time spent looking it up?

The National Library of Medicine has a 16 minute tutorial in both English and Spanish that helps users distinguish between reputable sites and those that may not be credible.

When faced with a potentially catastrophic diagnosis, we want to believe the hopeful sites that promise a cure, no matter who the authors may be, but we’re better served in the end by paying attention to details that tell us if a website is trustworthy.

Following are some things to note when determining a site’s credibility:

  • Who sponsors the website and are they easy to identify?
  • Is the sponsor’s contact information easy to find?
  • Who are the sites’ authors?
  • Who reviews the text?
  • Is it easy to determine when something was written?
  • Is there a privacy policy?
  • Does the information sound too good to be true?

The Internet can provide real assistance to us as we work to become team members in our own health care.

One benefit to having access to new technology is we can arrive at our doctor’s office better prepared for the visit. Given that doctor/patient visits last on average only eight to10 minutes, this is good news.

The more we understand walking in the door, the more time we’ll have to get the information that only comes from our healthcare professionals.

Bottom line is, we shouldn’t believe everything we read on the Internet, but if we become discerning in our online research, we’ll be more effective health advocates for ourselves and those we love.

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PubMed: Obtaining Full-Text Journal Articles

23 04 2010

In our previous PubMed articles, we discussed finding free articles online and conducting more effective searches. In this PubMed post, we discuss ways to get full text articles that are not free online.

Visit Your Libraries

Local Library

Check with your local library to see if they have the journal in question, or if they can get it in for you. This may be your only recourse for getting full articles at no cost, even if you have to wait awhile to get the journal.

Nearest Medical Library

If your local library doesn’t have or cannot get the journal or article you want, contact your nearest medical library. Call the National Network of Libraries of Medicine at 800-338-7657 or visit their website to locate your nearest library. (You can’t call this number to get help finding information, but they can help you locate a library.)

Order Online Through PubMed

Loansome Doc

PubMed is primarily for medical students and professionals, which is why it provides a service called Loansome Doc that enables you to 1) find medical libraries in your state serving the general public, and 2) easily and conveniently order journal articles through PubMed.

When viewing an article’s abstract, clicking on the “Send To” link opens a box from which you can select “Order.” Clicking the “Order articles” button will direct you to enter your Loansome Doc login information.

PubMed Loansome Doc

Ordering option for Loansome Doc

Registration for Loansome Doc is free; you only pay when you order an article. To sign up for Loansome Doc, visit the Loansome Doc signup page.  The first step will help you locate a medical library near you. You will need to contact the medical library of your choice to get signed up with them.

If you are not a healthcare provider or student, the medical library will consider you an “unaffiliated user.” Each library will have different criteria regarding unaffiliated users, pricing, and document delivery formats (hardcopy vs. electronic, e.g.).

LinkOut

If you click on an article’s title in your PubMed search results, you can click “LinkOut” at the bottom of the abstract to see online sources providing full text. You do not need a Loansome Doc account for these, but you may have to set up an account on the website of the online source to place an order.

PubMed - LinkOut

Viewing options for ordering under LinkOut

So to sum up:

  • Try your local library or visit a medical library (if you have one close to you).
  • If you are planning to order articles on a relatively frequent basis, sign up for Loansome Doc so you can place all your orders from within PubMed.
  • If you are planning to order articles relatively infrequently, try ordering from a LinkOut service.




PubMed: Refining Searches with MeSH

5 04 2010

Our previous PubMed article described how you could search for journal articles using simple search terms, like you would on the Internet. However, if you want your search to be more targeted and effective, you should use MeSH search terms.

What’s MeSH? Sounds messy.

MeSH (Medical Subject Heading Terms) terms are medically-oriented keywords. Because PubMed is indexing medical journal articles, you will generate better search results if you use medical terms used by PubMed. Previously, our approach was:

  1. Enter keywords into PubMed
  2. Get results

Using MeSH terms, our approach will be:

  1. Enter keywords in MeSH to find MeSH terms
  2. Enter those MeSH terms into PubMed
  3. Get more targeted results

Great! How do I do this?

First, go to the MeSH homepage. Then enter a keyword in the search box, and click the “Go” button. In this example, we’ve entered “hepatitis” and the results are displayed below the term.

Finding MeSH terms

Click to enlarge

Every term or phrase listed here by number is a MeSH search term. Below each term is the definition for that term. Find the terms that most closely match what you have in mind, and check the box next to them. Then click the “Send to” drop-down box and choose “Search Box with AND.” A second search box appears above your search results with the MeSH term inside.

Sending MeSH terms to the new search box

Click to enlarge

Now you can add additional MeSH terms to further refine your search. Try entering “child” in the field at the top, and click “Go” to get MeSH terms related to “child.” Then click the box(es) next to your desired terms, and send them to the search box as you did in the step above.

If you want to exclude a term, choose “Search Box with NOT.”

If you want to search for articles that contain at least one of the terms you’ve sent to the search box, but not necessarily all of them, choose “Search Box with OR.”

Once you’ve sent your desired MeSH terms to the search box, click the “PubMed Search” button directly below it. You will then see a page of results, like the example below:

Getting results from your MeSH terms

Click to enlarge

You can now interact with the search results as we discussed in our previous PubMed article. Watch the blog for future articles on PubMed searching.





Searching Parents…Meet PubMed!

15 03 2010

When you’re a parent searching for information about your child’s medical condition, it doesn’t take long to exhaust the online resources most readily available. MedlinePlus…  Mayo Clinic…  WebMD…  But where do you go when you need more?

If you’re ready to dig deep, you can turn to journal articles for more information and research. One way to search journal articles is to visit NIH’s PubMed website.

You can enter keywords into the search box at the top of the page, and you will get results. But you’ll get a lot of them, and some won’t really be as targeted as you’d like. There are a number of ways to get better results, and we’ll be discussing these in upcoming posts, but today we’re going to show you the most economical: Filter by free text!

First, enter some keywords to search by and click the “Search” button. In our demo shots below, we use “chronic pediatric hepatitis.”

PubMed homepage

The next page will shows you some results. Depending on your personality, you’re either happy to see the 488 results returned by this search, or reeling with shock at the thought of sifting through 488 results! But for today’s purposes, we’re going to narrow our results the thrifty way, by clicking on “Free Full Text” on the right side of the screen.

Search results for "chronic pediatric hepatitis"

Below you can see the 61 free, full text articles available to you. Click on the “Free article” link under the citation.

Search results showing only those with free full text available

PubMed shows you services on the right that provide the article’s text free online. Choose one and start reading!

Links to free full text

Watch the blog for more posts on conducting targeted searches and finding full-text articles both on and offline.

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Kids Bring Home the Darndest Things!

6 01 2010

Nurse Mary Beth explains how to identify and treat pink eye and head lice – oh my!

Listen now!

Right-click here to download podcast (5mb, 10min)


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CDC’s Pre-teen Vaccine Campaign!

13 11 2009

CDC wants folks to know about these educational materials, so we’re doing the viral thing and passing this blurb along.  Hope you do the same:

Pre-teens Need Vaccination Too!

With school in full swing and winter just around the corner, now is a great time for parents of 11 and 12 year olds to get their kids vaccinated against serious diseases such as whooping cough, meningitis, influenza, and, for girls, cervical cancer.

CDC recommends that pre-teens should receive the following:
• Tdap vaccine – combined protection against tetanus, diphtheria and pertussis
• Meningococcal  vaccine  – protection against meningitis and its complications
• Seasonal and H1N1 flu vaccines – protection against seasonal and H1N1 influenza viruses
• For girls, HPV vaccines to protect against the two types of human papillomavirus that cause up to 70% of cervical cancers. Each year, almost 4,000 women in the U.S. die of cervical cancer.

These recommendations are supported by the American Academy of Pediatrics, the American Academy of Family Physicians, and the Society for Adolescent Medicine.

One of two available HPV vaccines also protects against warts in the genital area, and boys and men up through age 26 can get this vaccine.

CDC’s Pre-teen Vaccine Campaign has educational materials tailored for various audiences, including Caucasian, African-American, Hispanic, Asian American, and Native American parents, available in English, Spanish, Korean, and Vietnamese.

Visit the Pre-teen Vaccine Campaign gallery to download or order materials at NO COST.

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