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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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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Finding Health Info on YouTube

29 06 2009

YouTube is a vast library of online videos.  There truly is something there for everyone.

This amount of content makes narrowing a search challenging, but doable.  It is possible to find quality health-related videos on YouTube.

sony-bravia-youtube

Creating An Account
Go to YouTube.com and create an account by clicking the Sign Up link on the top right.

As you’re filling in the blanks on the sign-up page, notice the little box that says, “Let others find my channel on YouTube if they have my email address.”

Channels are people’s accounts. Think of YouTube as a giant TV and everyone signed up, including you, is hosting his/her own channel. Yikes! Very crowded, but there are gems in the crowd.

Once done with the sign-up page, you’ll go to another page where you’ll type in your email and password.  At the end of this process, YouTube sends you an email asking you to confirm your account.  Follow the email instructions and you’ll soon be on your very own YouTube account page.  When you get there, look in the upper right corner of that page.  If your user name is there, you’re signed in and ready to go.

Your Page
Take a look at your personalized home page. The first option you have is Add/Remove Modules.  Click on that to go to Account Settings, where you pick and choose what you want to see on your home page (e.g. add/remove subscriptions, recommendations, friend activity, ect.).

Subscriptions is next (videos from channels to which you’re subscribed), then Recommendations (videos recommended by YouTube that you may like), followed by Friend Activity (videos your friends have uploaded), Featured Videos (videos that are featured on YouTube), and Videos Being Watched Now (which is self-explanatory).

Searching YouTube
Finding health channels to subscribe to is easy―just type a keyword (e.g HIV/AIDS, pertussis, H1N1, etc.) into the search box.

The search brings you results from Channels (other users’ accounts) and Playlists (a user-maintained list of videos).

Browse the channels and playlists and when you find something you like, click the gold Subscribe button on that page.

YouTube-CDC-Streaming-Health

Subscribing allows you to get up-to-date videos from the channels or playlists you select and feeds those videos to your home page.

When looking for a range of information providers to subscribe to, sorting by Playlist can be beneficial, as playlists may be made up of videos created by that particular user, or videos the user likes that are created by others, or a combination.

YouTube - health search

You can also click on the Community tab (see above) and browse videos by categories, shows, movies, channels, contests and events.

Once you’ve identified a health information source and determined its credibility, click subscribe.

The new videos from that user’s channel or playlist will then show up on your YouTube home page under subscription.

It is that easy, so jump in and don’t forget to find some funny vids to get you through the day.

Visit PKIDs and GETVAXED on YouTube, subscribe to our channels and check out our favorites.

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