"Keep it simple": older African Americans' preferences for a health literacy intervention in HIV management.
"Keep it simple": older African Americans' preferences for a health literacy intervention in HIV management.
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DOI：
10.2147/ppa.s69763
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发表时间：
2015
影响因子：
2.2
通讯作者：
Raper JL
中科院分区：
文献类型：
--
作者：
Gakumo CA;Enah CC;Vance DE;Sahinoglu E;Raper JL
在少数民族和老年人中，健康素养较低，并与人类免疫缺陷病毒(HIV)携带者不坚持药物、治疗和护理有关。同样，携带艾滋病毒的非裔美国人更有可能不遵守他们的艾滋病毒药物，不太可能遵守与艾滋病毒治疗和护理有关的诊所预约，并且比他们的种族同龄人更有可能在住院期间死亡。本研究探讨了感染艾滋病毒的老年非裔美国人对促进艾滋病毒管理的健康素养干预的偏好。在这项定性研究中，20名携带艾滋病毒的老年非裔美国人从美国东南部地区的一家艾滋病毒/获得性免疫缺陷综合征门诊招募。采用以患者为中心的参与式设计方法，进行半结构化个人访谈，以确定患者对干预开发和设计的偏好。健康素养也使用修订的成人医学素养快速评估(REALM-R)来衡量。与干预措施的开发和设计相关的四个主要主题出现了：保持健康信息简单；使用基于团队的方法进行健康教育；根据患者的个人需求量身定做教学策略；以及考虑到患者对技术缺乏经验但兴趣浓厚。根据修订后的成人医学素养快速评估，45%的研究人群的健康素养较低。今后针对感染艾滋病毒的少数群体和老年人的干预措施应考虑到患者的学习需求、特定性别和心理健康需求以及分娩方法，以增加吸入率并改善疾病管理和健康结果。
Health literacy is lower in minorities and older adults, and has been associated with nonadherence to medications, treatment, and care in people living with human immunodeficiency virus (HIV). Likewise, African Americans with HIV are more likely to be nonadherent to their HIV medications, less likely to keep their clinic appointments related to HIV treatment and care, and more likely to die during hospitalizations than their ethnic counterparts. The present study explored the preferences of older African Americans with HIV for a health literacy intervention to promote HIV management. In this qualitative study, 20 older adult African Americans living with HIV were recruited from an HIV/acquired immunodeficiency syndrome outpatient clinic in the southeastern region of the US. Using patient-centered participatory design methods, semi-structured individual interviews were conducted to determine patient preferences for intervention development and design. Health literacy was also measured using the Rapid Estimate of Adult Literacy in Medicine – Revised (REALM-R). Four major themes emerged related to intervention development and design: keep health information simple; use a team-based approach for health education; tailor teaching strategies to patients’ individual needs; and account for patients’ low experience, but high interest, in technology. Forty-five percent of the study population had low health literacy based on the revised Rapid Estimate of Adult Literacy in Medicine. Future interventions that target minorities and older adults living with HIV should consider patients’ learning needs, sex-specific and mental health needs, and delivery approaches, in order to increase uptake and improve disease management and health outcomes.