Asthma and COPD patients’ perceived link between health literacy core domains and self-management of their condition

Poureslami, Iraj; Shum, Jessica; Goldstein, Roger; Gupta, Samir; Aaron, Shawn D.; Lavoie, Kim; Poirier, Claude; Kassay, Saron; Starnes, Kassie; Akhtar, Alizeh; FitzGerald, J. Mark

doi:10.1016/j.pec.2020.02.011

Cited by 9 publications

(22 citation statements)

References 32 publications

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“…(1) A systematic review of 2800 articles was conducted in 2015 to assess the comprehensiveness and disease- relevance of factors included within existing HL tools, and whether they incorporated the five core HL domains in their structure [ 37 ]. (2) 16 patient-oriented focus groups were conducted across Canada with 93 adult male and female asthma and COPD patients from 2015 to 2016 to understand the challenges/barriers pertaining to the five HL domains with respect to self-management practices, as well as to identify the most important disease management topics that patients were interested to receive information on [ 61 ]. (3) 45 key-informant interviews conducted in-person/ telephone/Skype with health care professionals, researchers, and policymakers from Canada, the US, the UK, and Australia in 2016 to obtain their insights on possible solutions to overcome the challenges expressed by focus group patients as well as to help validate the disease self-management topics identified during focus group sessions [ 62 ].…”

Section: Methodsmentioning

confidence: 99%

A conceptual model of functional health literacy to improve chronic airway disease outcomes

et al. 2021

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Background Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework. Methods Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist’s on the ideal functional HL skills for asthma and COPD patients. Results Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT, including application of the obtained information; OUTCOME, covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. Conclusions We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. Trial registration NCT01474928- Date of registration: 11/26/2017.

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Section: Methodsmentioning

confidence: 99%

A conceptual model of functional health literacy to improve chronic airway disease outcomes

et al. 2021

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“…They discussed disease-management topics, including their perceived importance, and provided questions for each topic that they would ask healthcare professionals. The study procedures, including focus-group structure and qualitative analysis, have been described in-depth in previous publications [43,45,47,49,50,62].…”

Section: Phase I: Tool Conceptualizationmentioning

confidence: 99%

“…The goal of the group sessions was to patients and professionals were analyzed using NVivo software (QSR International, version 12) with coding via thematic analysis [63]. We have reported the process and findings of the informant interviews and respiratory experts' input elsewhere [30,43,46,62]. Knowledge generated from the SR and consultations with patients and professionals allowed us to identify and verify important disease-management topics, and understand the internal stimuli (e.g., beliefs, worldviews) and external barriers (e.g., health system and socioeconomic factors) to engage in CAD self-management [48].…”

Section: Phase I: Tool Conceptualizationmentioning

confidence: 99%

An Integrated Framework to Conceptualize and Develop the Vancouver Airways Health Literacy Tool (VAHLT)

Poureslami

Kopeć

Tregobov

et al. 2021

IJERPH

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There is currently no comprehensive tool to assess the functional health literacy (HL) skills of chronic airway disease (CAD) patients. The purpose of this article is to describe the development of a new HL measure, the Vancouver Airways Health Literacy Tool (VAHLT). The tool was developed through the following phases: (1) Tool conceptualization, consisting of: (A) a systematic review (SR), (B) focus group sessions with CAD patients to understand barriers and facilitators to CAD management, (C) a survey with key-informants to obtain strategies to mitigate self-management barriers and validate patient-derived topics, and (D) respiratory physicians’ review of the topics; (2) Scenario and item development; and (3) Tool testing and content validation. The SR identified the lack of a valid HL measurement tool for CAD patients. Patients provided an initial shortlist of disease-related self-care topics. Key-informants helped to finalize topics for inclusion. Respiratory physicians and patients contributed to the development of a scenario-based questionnaire, which was refined during three rounds of testing to develop a 44-item instrument comprising nine self-management passages. We highlight the holistic process of integrating information from the literature with knowledge gained from key stakeholders into our tool framework. Our approach to stakeholder engagement may be of interest to researchers developing similar tools, and could facilitate the development and testing of HL-based interventions to ultimately improve patient outcomes and reduce the burden on the healthcare system.

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“…As HL is a rapidly evolving and expanding concept [49,50], there has been a call-to-action to develop appropriate frameworks to comprehensively measure its core components. Several models have been reported in the literature describing HL as a multidimensional construct that improves an individual's skills related to accessing, understanding and using health information to make informed decisions about one's health [51][52][53]. For instance, McCormack et al [54,55] developed a model that presents HL as an individual-level attribute that is affected by predisposing factors or socio-environmental aspects of the target population (e.g., culture and beliefs).…”

Section: Introductionmentioning

confidence: 99%

“…For instance, McCormack et al [54,55] developed a model that presents HL as an individual-level attribute that is affected by predisposing factors or socio-environmental aspects of the target population (e.g., culture and beliefs). Other models focus merely on mediator elements (factors that in uence a relationship) between HL and health outcomes, and how the model can be used as a screening tool [43,51]. Therefore, there have been signi cant challenges in applying the existing models in clinical practice, as their approaches are primarily theoretical (research-based) and lack clinical signi cance and applicability [56].…”

Section: Introductionmentioning

confidence: 99%

A conceptual model of functional health literacy to improve chronic airway disease outcomes

Poureslami

Tregobov

Shum

et al. 2020

Preprint

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Background: Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework.Methods: Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist’s on the ideal functional HL skills for asthma and COPD patients.Results: Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT, including application of the obtained information; OUTCOME, covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. Conclusions: We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. Trial Registration Number: NCT01474928- Date of registration: 11/26/2017

show abstract

Asthma and COPD patients’ perceived link between health literacy core domains and self-management of their condition

Cited by 9 publications

References 32 publications

A conceptual model of functional health literacy to improve chronic airway disease outcomes

A conceptual model of functional health literacy to improve chronic airway disease outcomes

An Integrated Framework to Conceptualize and Develop the Vancouver Airways Health Literacy Tool (VAHLT)

A conceptual model of functional health literacy to improve chronic airway disease outcomes

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