The Impact of Cultural Differences on Health Literacy & Chronic Disease Outcomes

文化差异对健康素养的影响

• 批准号: 7914669
• 负责人: SUSAN J SHAW
• 金额: $ 3.86万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-27 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7914669
• 关键词: Accounting; Address; Adherence; Affect; Asthma; Bacteria; Behavior; Belief; Chronic Disease; Communication; Development; Diabetes Mellitus; Diet; Disease Management; Disease Outcome; Epidemiology; Ethnic group; Ethnography; Focus Groups; Health; Health Personnel; Healthcare; Home environment; Hospitalization; Human; Hygiene; Hypertension; Immigrant; Immigration; Indigenous; Informed Consent; Institution; Instruction; Interview; Knowledge; Language; Low income; Massachusetts; Medical; Methods; Outcome; Patient Education; Patients; Pattern; Population; Primary Health Care; Provider; Readability; Recommendation; Recruitment Activity; Research Design; Research Methodology; Role; Sampling; Shapes; Socioeconomic Status; Source; Surveys; Therapeutic; Treatment Protocols; Variant; Work; abstracting; compliance behavior; diaries; ethnic minority population; health literacy; literacy; meetings; prospective; social; socioeconomics

DESCRIPTION (provided by applicant): Health literacy, defined as the ability to understand or act on medical/therapeutic instructions, is increasingly recognized as an important factor in patient compliance and chronic disease outcomes. Health care providers are beginning to assess patient education and other materials from the perspective of readability and patient literacy. Less work has been done, however, to place health literacy in the broader context of socioeconomic and cultural differences among patients and between providers and patients that hinder communication and compliance. The proposed project aims to broaden our understanding of health literacy by identifying and accounting for the cultural factors that shape health literacy in low-income, ethnic minority and immigrant populations. To better understand the cultural influences on low health literacy and the effects of health literacy on health, the proposed project combines qualitative and quantitative methods to meet the following specific aims: 1. To assess variation in health literacy among native and non-native English speakers; 2. To identify factors associated with health literacy, including a) language spoken at home, b) recency of immigration, c) sources of health information, and d) other cultural beliefs and practices; 3. To use a prospective multimethod research design to explore the impact of health literacy on chronic disease outcomes (e.g., asthma, diabetes, and hypertension), including: a. the association between health literacy and patient compliance with therapeutic regimens, and b. the role of health literacy in patient-provider communication; 4. To identify effective ways to combine qualitative and quantitative research methods to further knowledge of health literacy; and 5. To develop recommendations for primary health care providers on chronic disease management for ethnically diverse patients with low health literacy. To achieve these aims, we propose to conduct epidemiological surveys with a targeted sample of 500 patients from 5 ethnic groups (100 per group) recruited from Caring Health Center, a Section 330 health center in western Massachusetts. Chart abstracts will collect chronic disease outcomes at baseline and two 12-month follow-ups. Focus groups, ethnographic interviews, chronic disease diaries and home observations with a subsample of patients will provide greater contextualization and detail, aiding in survey development and the interpretation of survey findings.

描述（由申请人提供）：健康素养，定义为理解或按照医疗/治疗指示采取行动的能力，越来越被认为是患者依从性和慢性病结果的重要因素。医疗保健提供者开始从可读性和患者素养的角度评估患者教育和其他材料。然而，将健康素养置于患者之间以及提供者与患者之间妨碍沟通和依从的社会经济和文化差异的更广泛背景下所做的工作较少。拟议项目旨在通过识别和解释影响低收入、少数民族和移民人群健康素养的文化因素来扩大我们对健康素养的理解。为了更好地了解文化对健康素养低下的影响以及健康素养对健康的影响，拟议项目结合定性和定量方法来实现以下具体目标： 1. 评估以英语为母语和非英语为母语的人健康素养的差异； 2. 确定与健康素养相关的因素，包括 a) 在家使用的语言，b) 移民新近，c) 健康信息来源，以及 d) 其他文化信仰和习俗； 3. 采用前瞻性多方法研究设计探讨健康素养对慢性病的影响 疾病结果（例如哮喘、糖尿病和高血压），包括：健康素养与患者对治疗方案的依从性之间的关系，b．健康素养在医患沟通中的作用； 4. 找出有效的方法，将定性和定量研究方法结合起来，进一步 健康素养知识；和 5. 为初级卫生保健提供者制定关于慢性病管理的建议 健康素养较低的不同种族患者。 为实现这些目标，我们建议开展流行病学调查，目标样本为500人。 来自 5 个种族群体（每组 100 名）的患者从马萨诸塞州西部的 330 医疗中心 Caring Health Center 招募。图表摘要将收集基线和两次 12 个月随访的慢性病结果。焦点小组、民族志访谈、慢性病日记和对患者子样本的家庭观察将提供更多的背景信息和细节，有助于调查的开展和调查结果的解释。

项目成果

Breast self-examination beliefs and practices, ethnicity, and health literacy: Implications for health education to reduce disparities.

• DOI: 10.1177/0017896912471048
• 发表时间: 2014-05
• 期刊: Health education journal
• 影响因子: 1.3
• 作者: Armin J;Torres CH;Vivian J;Vergara C;Shaw SJ
• 通讯作者: Shaw SJ

The pharmaceutical regulation of chronic disease among the U.S. urban poor: an ethnographic study of accountability.

美国城市贫民慢性病的药物监管：责任的人种学研究。

• DOI: 10.1080/09581596.2017.1332338
• 发表时间: 2018
• 期刊: Critical public health
• 影响因子: 2.8
• 作者: Shaw,SusanJ

Consistency in attitudes across cancer screenings in medically underserved minority populations.

• DOI: 10.1007/s13187-011-0285-0
• 发表时间: 2012-03
• 期刊: JOURNAL OF CANCER EDUCATION
• 影响因子: 1.6
• 作者: Shaw, Susan J.;Vivian, James;Orzech, Kathryn M.;Torres, Cristina Huebner;Armin, Julie
• 通讯作者: Armin, Julie