Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial

Sany, Seyedeh Belin Tavakoly; Behzhad, Fatemeh; Ferns, Gordon A.; Peyman, Nooshin

doi:10.1186/s12913-020-4901-8

Cited by 143 publications

(83 citation statements)

References 26 publications

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“…The HCWs' consultations cannot be altered by social media networks [37,38]. Continuous training and education have been recognized as effective approaches to improving HCWs' HL, further improving health care delivery [39,40], communication [39,41,42], shared decision making [43], and patient health outcomes [40]. Furthermore, raising awareness of behavioral pitfalls could support appropriate behavioral changes and containment of the crisis [44].…”

Section: Introductionmentioning

confidence: 99%

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

Binh¹,

Tran²,

Phan³

et al. 2020

J Med Internet Res

103

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Background The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic. Objective The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown. Methods We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations. Results The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively. Conclusions The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.

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Section: Introductionmentioning

confidence: 99%

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

Binh¹,

Tran²,

Phan³

et al. 2020

J Med Internet Res

103

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“…Low health literacy usually leads to a series of negative health outcomes [15] . The existing literature has also demonstrated that HBP-HL is an independent predictor of blood pressure control [16][17][18] , and emphasized that health care providers should evaluate HBP-HL level when they meet the patients with hypertension for the rst time in order to provide tailored interventions [19][20] . However, HBP-HL has not been introduced into the study of the HRQoL of patients with hypertension, especially among Kazakh hypertension patients in rural China.…”

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confidence: 99%

The Effect of Health Literacy, Self-management Behavior, Self-efficacy and Social Support on the Health-related Quality of Life of Kazakh Hypertension Patients in a Low-income Rural Area of China: a structural Equation Model

Zhang

Huang

Zhang

et al. 2020

Preprint

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Background Considering the High Blood Pressure-Health Literacy (HBP-HL) has not been included in the study of Health-Related Quality of Life (HRQoL). The synergistic effects and the potential mechanism HBP-HL, self-management behavior, medication adherence, self-efficacy, social support on HRQoL remain unclear. This study aimed to introduce the conception of HBP-HL, and develop a structural equation model to identify the factors influencing of the HRQoL among Kazakh hypertensive patients. Methods A cross-sectional investigation study was conducted to collect data. Patients with hypertension were recruited through random cluster sampling in Kazakh settlements in Urumqi County, Xinjiang. The one-on-one household interviews were conducted by Kazakh investigators. The questionnaires regarding HBP-HL, HRQoL, self-management behavior, medication adherence, self-efficacy, and social support were collected. In addition, the results of physical examination were also included. A structural equation model was used to assess the association between the measured factors and HRQoL. Results 516 Kazakh patients were recruited, and 94.4% of them had a relatively low HBP-HL score. The mean standardized scores of HRQoL, self-management, medication adherence were poor; they were 63.5, 66.2, and 64.4, respectively. But 96.1% and 98.3% of the participants had high levels of self-efficacy and social support. The structural equation model of the HRQoL had a good overall fit (χ2/df = 2.078, AGFI = 0.944, GFI = 0.968, CFI = 0.947, IFI = 0.949, RMSEA = 0.046). The model indicated that the HBP-HL has the highest correlation with HRQoL, following with self-management behavior, social support, and self-efficacy. Conclusions Evidence from this study demonstrates that low HBP-HL is a major influenced factor of HRQoL among Kazakh hypertensive patients. Future programs should consider HBP-HL as the breakthrough point when designing targeting intervention strategies for Kazakh hypertension patients. Firstly, researchers should give a priority to evaluate patient’s HBP-HL before intervention. Next, tailored interventions are implemented for patients, and and ultimately it will contribute to control blood pressure and improve patients’ HRQoL.

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“…Similar studies globally have identified the importance of communication skills to improve the patient-provider relationship and enhance service delivery. Moreover, such trainings have been found to improve patient outcomes [ 31 ]. There is a highlighted need for building the life skills of community health workers besides improving health literacy and technical information [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a training program for life skills education and financial literacy to community health workers in India: a quasi-experimental study

Sharma

Arora

Chandrashekhar

et al. 2021

BMC Health Serv Res

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Background Accredited Social Health Activists (ASHA) are community health workers responsible for improving the health status of people by facilitating their access to healthcare services. The life skills of ASHA are known to be effective in negotiating behaviour change in the community; however, there has been a meagre focus towards improving them. Considering this gap, we adopted a comprehensive training program, known as Personal Advancement and Career Enhancement (P.A.C.E.), to empower ASHAs on life skills and financial literacy. The present study intends to assess the training program in two districts of Uttar Pradesh, India, by examining changes in knowledge, perceptions, and practices of ASHAs about life skills and financial literacy. Methods We conducted a quasi-experimental, non-randomized, controlled study with pre-and post-test assessments. Data were collected on socio-demographic characteristics, knowledge, and practices related to life skills (communication skills, self-confidence, problem–solving and decision-making skills, time and stress management skills) and financial literacy. Additionally, change perceptions on gender-, life skills-, and savings-related practices at the personal, community, and workplace levels were assessed in the intervention group. Factor analysis was performed to obtain the change patterns by assessing the degree to which the four life skills, financial literacy, and change perceptions on practices were correlated. A general linear regression model was performed to assess associations among change pattern scores and socio-demographic variables. Results We analyzed the data of 171 ASHAs (intervention group:86 and control group:85). There was a significant improvement in the average post-test scores of all the life skills and financial literacy in the intervention group (p < 0.001). Three distinct change patterns were found post-training in the intervention group. Factor 1 (high loadings for change perceptions on practices) was positively associated with ASHAs aged 38 and above and with experience of ≤12 years. On the contrary, the change in financial literacy and self-confidence scores was common among ASHAs with more than 12 years of experience. Conclusions The P.A.C.E training program was found effective in improving the life skills and financial literacy of ASHAs in India.

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Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial

Cited by 143 publications

References 26 publications

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

The Effect of Health Literacy, Self-management Behavior, Self-efficacy and Social Support on the Health-related Quality of Life of Kazakh Hypertension Patients in a Low-income Rural Area of China: a structural Equation Model

Evaluation of a training program for life skills education and financial literacy to community health workers in India: a quasi-experimental study

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