Youth, the World Bank argues, need to become a constituency for reform in developing countries. This case study responds to this challenge by investigating adolescent students' understanding of the relationship between health literacy, HIV/AIDS, and gender in the context of Uganda. The four questions investigated are: (i) What kind of health literacy, HIV/AIDS, and gender-related information is accessible to Ugandan adolescent secondary school students? (ii) In the students' view, what are the factors contributing to health and HIV/AIDS related challenges faced by young people in Uganda today? (iii) According to these students, what is the impact of the debate on gender equality in the fight against health epidemics including HIV/AIDS? and (iv) What do these students consider to be the way forward for Uganda to achieve better health and improve life chances for all? The theoretical framework includes critical pedagogy and indigenous knowledge systems, as well as integrative gender frameworks. Each contributes a different but complementary understanding of adolescent students' perspectives on the issues under investigation. Data were collected in a qualitative study from January 2005 — May, 2007. The data corpus includes: student journals, reflective reports, artifacts/documents, life history interviews, questionnaires, informal ethnographic conversations, focus group discussions and critical inquiry discussions. In response to each of the research questions, the major findings were as follows: i) The students' understanding of the relationship between health literacy, HIV/AIDS, and gender were in part influenced by the media, and in part their own experiences. ii) Poverty and peer pressure impact young people's health practices. iii) Young people want gender equality debates to have a focus on marginalized males as well as females. iv) Youth suggest that education, fair trade, and better health care services are important in the attainment of the "better health for all" goal in Uganda. The study concludes that marginalized groups, especially youth, need opportunities to develop a united voice and be active participants in reform processes. Further, new analysis frameworks are needed to understand the gender/power relations in Uganda.

Children’s health outcomes are affected by multiple variables, including biological, environmental, psychological and social factors. Many determinants are decided after birth depending on the surrounding physical, psychological and social environment that the child enters. Elements such as socioeconomic status, marital status, race, education level and access to healthcare greatly affect a mother’s health literacy, and, thus, her ability to adequately care for her child(ren). This project examines the impact of maternal health literacy training on the knowledge of mothers, who have been homeless. Ninety-one women completed a six-hour maternal health literacy training. A pre-posttest design was used to measure maternal knowledge change as the result of the training. The same measure was used at both time points, and the measure was designed in a multiple-choice format. Outcomes indicate that the maternal health literacy training positively impacted reported maternal child health knowledge. Additionally, a follow-up survey was given to 11% of the total sample, to examine the sustainability of the knowledge gains 2-4 months post-training. Findings indicate that the women who took the follow-up survey retained a considerable amount of health literacy knowledge. This is a first step into research examining how maternal health literacy training improves short and long term knowledge in a high risk sample of mothers. The positive outcomes suggest that this program could be beneficial to agencies across the country serving maternal needs in similar circumstances. Recommendations for further research are discussed.

En av de viktigaste sakerna vi har i livet är vår hälsa och genom denna studie undersöktes sex kvinnors uppfattningar om begreppet hälsolitteracitet genom kvalitativa intervjuer. Syftet var att undersöka kvinnornas sätt att förvärva, förstå och använda sig av den hälsoinformation som cirkulerar i samhället. Resultat visar att respondenterna innehar en förhållandevis god hälsolitteracitet trots detta uppger respondenterna att de ibland har svårt att göra goda hälsoval. Det var inte svårt för respondenterna att förvärva information, då mycket fanns att tillgå via internet. För att kunna tolka och skapa förståelse kring hälsoinformation, tog de hjälp av bland annat personlig tränare. I den tolkande och kunskapsskapande process var det egna kritiska tänkandet viktigt, även om utsorteringen mellan bra och felaktig hälsoinformation tog mycket tid. Vad avser möjliga hälsofrämjande åtgärder, föreslog respondenterna att ämnet idrott och hälsa skulle få ett delvis annorlunda innehåll, där fokus skulle läggas på helhetshälsan, samt skatteregleringar (Sockerskatt). Sammanfattningsvis visar denna studie att ytterligare forskning behövs inom området hälsolitteracitet med fokus på hur hälsoinformation påverkar individer i olika sociala omgivningar.

Youth, the World Bank argues, need to become a constituency for reform in developing countries. This case study responds to this challenge by investigating adolescent students' understanding of the relationship between health literacy, HIV/AIDS, and gender in the context of Uganda. The four questions investigated are: (i) What kind of health literacy, HIV/AIDS, and gender-related information is accessible to Ugandan adolescent secondary school students? (ii) In the students' view, what are the factors contributing to health and HIV/AIDS related challenges faced by young people in Uganda today? (iii) According to these students, what is the impact of the debate on gender equality in the fight against health epidemics including HIV/AIDS? and (iv) What do these students consider to be the way forward for Uganda to achieve better health and improve life chances for all? The theoretical framework includes critical pedagogy and indigenous knowledge systems, as well as integrative gender frameworks. Each contributes a different but complementary understanding of adolescent students' perspectives on the issues under investigation. Data were collected in a qualitative study from January 2005 — May, 2007. The data corpus includes: student journals, reflective reports, artifacts/documents, life history interviews, questionnaires, informal ethnographic conversations, focus group discussions and critical inquiry discussions. In response to each of the research questions, the major findings were as follows: i) The students' understanding of the relationship between health literacy, HIV/AIDS, and gender were in part influenced by the media, and in part their own experiences. ii) Poverty and peer pressure impact young people's health practices. iii) Young people want gender equality debates to have a focus on marginalized males as well as females. iv) Youth suggest that education, fair trade, and better health care services are important in the attainment of the "better health for all" goal in Uganda. The study concludes that marginalized groups, especially youth, need opportunities to develop a united voice and be active participants in reform processes. Further, new analysis frameworks are needed to understand the gender/power relations in Uganda.

The primary purpose of this case study was to determine if the university under study had adequate health-related programs, services, and supports in place to develop health-literate young adults. A secondary purpose was to identify strengths and gaps in these university health-related programs, services, and supports, which, if addressed, could increase the likelihood that college graduates would be health-literate. This research study served to answer three broad research questions: 1) What are the health-related needs and concerns among selected university undergraduates? 2) What is the level of awareness and utilization of health-related programs, services, and supports by university undergraduate students? 3) What are the strengths and gaps among health-related programs, services, and supports? As more and more young adults come to colleges and universities seeking an education, they bring with them high-risk health behaviors that can impede their academic success. Post-secondary institutions have programs, services, and supports in place specifically designed to ease the transition into college, provide academic assistance services, promote a safe learning and living environment as well as facilities and departments dedicated to raising awareness of and maintaining physical and mental health. The effectiveness with which these health-related programs, services, and supports are meeting their goals and reaching their target audience can be assessed by collecting student feedback regarding their attitudes, perceptions and usage. The first part of the study involved personal interviews with preselected representatives of Student Affairs, the President of the university, the Provost, Captain of Public Safety, and the Senior Athletic Director. Interview questions were designed to determine how, if any, of the programs, services, or supports under study supported the six dimensions of health and wellness, or the IOM skill set for health literacy. After all interviews were conducted, transcripts were reviewed and coding was conducted to determine the connection between the selected programs, services, and supports, and the IOM health literacy skill set and the six dimensions of health and wellness. Additionally, transcript review allowed for the identification of strengths and weakness among each of the programs, services, and supports. The second part of the study engaged students who volunteered to participate in focus groups in an open discussion about what they perceived health to be (as a concept) and to determine what, if any, personal health-related issues or concerns they felt at the present time, how health-related issues or concerns created barriers to their academic success, and their level of awareness about the programs, services, and supports available. In addition to conducting personal interviews and focus groups, I analyzed documents and material (i.e. web-pages, brochures, student handbook, under graduate bulletin) related to each department under study. This document analysis was also coded for connections to the six dimensions of health and wellness or the IOM's health literacy skill set. Web-pages were further analyzed for strengths and gaps related to each program, service, or support. An embedded analysis was conducted and themes were interpreted. Discussion and recommendations were stated at the conclusion of the case study; increasing health-literacy among college students and raising awareness of and attempting to reduce high-risk, health-related behaviors are consistent with goals and characteristics of a graduate from the university under study. Not surprisingly, when asked, most students only identified the physical aspect of "health" and sometimes, as a mental aspect with regards to stress. Feedback from focus group discussions indicated that students could make a connection between all six dimensions of health and how they might impede academic performance. Unfortunately, however, they did not seem to possess the skills or the knowledge on to how correct negative health behaviors themselves, or how to seek out various health-related programs, services, and supports that are available. By in large, students seemed very interested in learning more about many of these programs, services, and supports and indicated that they wished they had been made aware of such opportunities at the beginning of their college careers. Students also communicated lack of knowledge and awareness about the available health-related programs, services, and supports. Focus group discussions indicated that students felt as though the campus under study had not really taken the time to discover which methods of communication were successful; further indicating that current delivery methods were outdated and ineffective.

Class of 2012 Abstract / Specific Aims: The objective of this study is to first assess whether student pharmacist interns feel they can gauge patient health literacy levels with confidence, second to assess which methods are used most commonly in practice by student pharmacists to assess patient health literacy, and third to determine what techniques student pharmacist interns most often employ to communicate more effectively to patients with low health literacy. Methods: The questionnaire consisted of questions about demographics, and knowledge/experiential based questions. Key questions were: How well do you feel you are able to assess patient health literacy? How often do you use the following techniques to assess patient health literacy? (Observe contextual clues, Observe patient word pronunciation, Observe patient willingness to talk, Assess by demographics) When counseling low health literacy patients, how often do you use the following communication techniques? (Speak slowly, Give extra written material, Repeat information, Ask patient to repeat information, Ask if patient understands English, Avoid complicated medical terms). The answers to these questions are measured on a likert scale. Data from the questionnaire was analyzed using one sample t tests and paired t tests. Main Results: Regarding the first primary objective, on a scale of 1 to 5, with confidence measured 3 or greater and no confidence measured 2 or less, student intern pharmacists are statistically significantly confident in their ability to gauge patient health literacy (p< 0.001). There is no statistically significant difference in confidence in ability to gauge patient health literacy between males and females. The method student pharmacist interns used for assessing patient health literacy with the highest average use was observing patient willingness to talk (3.65 +/- 1.01) followed by observing patient word pronunciation (3.57 +/- 0.97), assessing patient demographics (race, age, ability to pay, culture, gender) (3.23 +/- 1.16) and observing contextual clues (patients identify pills by color, asks to be read to, etc) (3.04 +/- 1.04). There was no statistically significant difference between observing patient willingness to talk versus observing patient word pronunciation (p=0.55). There is a statistically significant difference between observing patient willingness to talk versus assessing patient demographics (p=0.011). The technique for improving communication with patients with low health literacy with the highest average use was avoiding complicated medical terms (3.97 +/- 0.95) followed by speaking slowly (3.91 +/- 0.89), repeating information (3.85 +/- 0.73), giving extra written material (3.02 +/- 1.36), asking patients if they understand English (2.85 +/- 1.21) and asking patients to repeat information. (2.39 +/- 1.02). There is a statistically significant difference between avoiding complicated medical terms and giving out extra written material (p<0.001) and speaking slowly and giving out extra written material (p<0.001). Conclusions: We conclude that students pharmacists working as interns are quite confident in their ability to assess patient health literacy, that observing patient willingness to talk is be the most commonly used method to assess patient health literacy, and that avoiding complicated medical terms is be the most commonly used technique student pharmacist interns use to communicate more effectively with patients who have low health literacy.

Low health literacy affects overall health and is associated with poor chronic disease self-management and medically underserved populations. The purpose of this project was to promote health literacy by utilizing the teach back method to deliver culturally sensitive information to enhance knowledge about the risks, management, and prevention of hypertension among Native Hawaiians and Pacific Islanders in a rural primary care clinic in Northern Oahu. Pender’s Health Promotion Model was used to guide the creation of this intervention and the Institute for Healthcare Improvement Model was used to guide implementation. Item responses on the High Blood Pressure Questionnaire were used to investigate the efficacy of the teach back method in improving hypertension knowledge pre-and post intervention. Responses were analyzed using an Excel spreadsheet for descriptive data. Eight participants identifying as either Native Hawaiian or Pacific Islander aged 35 and over were included in the DNP project. Each answered a questionnaire prior to the intervention, received a one-on-one teach back session, then participated in a telephone interview one week later to complete the post-questionnaire. The results indicated that there was improvement in at least four of the responses from pre to post-intervention. There was no change in four of the item responses as participants had correct knowledge before and after the intervention. Overall, providers should be encouraged to utilize the teach back method when delivering culturally sensitive information to improve their patients’ outcomes.

ObjectivesUnderstanding the difficulties faced by different migrant groups is vital to address disparities and inform targeted health-care service delivery. Migrant oncology patients experience increased morbidity, mortality and psychological distress, with this tentatively linked to language and communication difficulties. The objective of this exploratory study was to investigate the communication barriers and challenges experienced by Arabic, Greek and Chinese (Mandarin and Cantonese) speaking oncology patients in Australia. MethodsThis study employed a cross-sectional design using patient-reported outcome survey data from migrant and English-speaking Australian-born patients with cancer. Patients were recruited through oncology clinics and Australian state cancer registries. Data were collected regarding patient clinical and demographic characteristics and health-care and communication experiences. Data from the clinics and registries were combined for analysis. ResultsSignificant differences were found between migrant groups in demographic characteristics, communication and health-care experiences, and information and care preferences. Chinese patients cited problems with understanding medical information, the Australian health-care system, and communicating with their health-care team. Conversely, Arabic- and Greek-speaking patients reported higher understanding of the health-care system, and less communication difficulties. ConclusionsOur study findings suggest that migrant groups differ from each other in their health communication expectations and requirements. Lower education and health literacy of some groups may play a role in poorer health outcomes. Public health interventions and assistance provided to migrants should be tailored to the specific needs and characteristics of that language or cultural group. Future research directions are discussed.

Class of 2017 Abstract / Objectives: To compare the impacts of regularly scheduled education and health clinic sessions on individual’s health outcomes and self-care. Subjects: Tucson community members who are participants of Project Taking Charge and have attended more than three clinic sessions during the six-month study period. Methods: A retrospective review of a central database was used to collect baseline characteristics, blood glucose, A1c, blood cholesterol, blood pressure, BMI and weight. These clinical values were then used to assess participant clinical health outcomes. The questionnaire surveys distributed at the last clinic session were collected and used to analyze the improvement in participant understanding of self-care. Results: For weight, a 1.5% decrease from 186.1 (±50.7) to 183.3 (±50.4) pounds (p=0.012) was observed to be statistically significant. In response to the importance and the frequency of different self-care questions, participants had an improved perspective on the importance of exercise by 0.9 scale (p=0.008), a better understanding of having a balanced nutritious meals by 1.34 (p=0.0002), proper hand-washing technique by 0.54 (p=0.027), and eating at home more often by 0.31 (p=0.039) compared to baseline. Conclusions: Participant responses reflect positive changed perceptions of exercise and healthy lifestyle choices. Although post-clinical values for BMI, fasting blood glucose, A1c, systolic blood pressure, and blood cholesterol levels, did not meet p<0.05 statistical significance, the trend towards improved cholesterol levels, blood sugar levels and blood pressure levels indicate there may be some benefits attributed from participation in the clinic project.

Youth, the World Bank argues, need to become a constituency for reform in developing countries. This case study responds to this challenge by investigating adolescent students' understanding of the relationship between health literacy, HIV/AIDS, and gender in the context of Uganda. The four questions investigated are: (i) What kind of health literacy, HIV/AIDS, and gender-related information is accessible to Ugandan adolescent secondary school students? (ii) In the students' view, what are the factors contributing to health and HIV/AIDS related challenges faced by young people in Uganda today? (iii) According to these students, what is the impact of the debate on gender equality in the fight against health epidemics including HIV/AIDS? and (iv) What do these students consider to be the way forward for Uganda to achieve better health and improve life chances for all? The theoretical framework includes critical pedagogy and indigenous knowledge systems, as well as integrative gender frameworks. Each contributes a different but complementary understanding of adolescent students' perspectives on the issues under investigation. Data were collected in a qualitative study from January 2005 — May, 2007. The data corpus includes: student journals, reflective reports, artifacts/documents, life history interviews, questionnaires, informal ethnographic conversations, focus group discussions and critical inquiry discussions. In response to each of the research questions, the major findings were as follows: i) The students' understanding of the relationship between health literacy, HIV/AIDS, and gender were in part influenced by the media, and in part their own experiences. ii) Poverty and peer pressure impact young people's health practices. iii) Young people want gender equality debates to have a focus on marginalized males as well as females. iv) Youth suggest that education, fair trade, and better health care services are important in the attainment of the "better health for all" goal in Uganda. The study concludes that marginalized groups, especially youth, need opportunities to develop a united voice and be active participants in reform processes. Further, new analysis frameworks are needed to understand the gender/power relations in Uganda. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate