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Background
When parents want to make health-related decisions for their child, they need to be able to handle health information from a potentially endless range of sources. Early childhood allergy prevention (ECAP) is a good example: recommendations have shifted from allergen avoidance to early introduction of allergenic foods. We investigated how parents of children under 3 years old access, appraise and apply health information about ECAP, and their respective needs and preferences.
Methods
We conducted 23 focus groups and 24 interviews with 114 parents of children with varied risk for allergies. The recruitment strategy and a topic guide were co-designed with the target group and professionals from public health, education, and medicine. Data were mostly collected via video calls, recorded and then transcribed verbatim. Content analysis according to Kuckartz was performed using MAXQDA and findings are presented as a descriptive overview.
Results
Parents most frequently referred to family members, friends, and other parents as sources of ECAP information, as well as healthcare professionals (HCPs), particularly pediatricians. Parents said that they exchanged experiences and practices with their peers, while relying on HCPs for guidance on decision-making. When searching for information online, they infrequently recalled the sources used and were rarely aware of providers of “good” health information. While parents often reported trying to identify the authors of information to appraise its reliability, they said they did not undertake more comprehensive information quality checks. The choice and presentation of ECAP information was frequently criticized by all parent groups; in particular, parents of at-risk children or with a manifested allergy were often dissatisfied with HCP consultations, and hence did not straightforwardly apply advice. Though many trusted their HCPs, parents often reported taking preventive measures based on their own intuition.
Conclusion
One suggestion to react upon the many criticisms expressed by parents regarding who and how provides ECAP information is to integrate central ECAP recommendations into regular child care counseling by HCPs—provided that feasible ways for doing so are identified. This would assist disease prevention, as parents without specific concerns are often unaware of the ECAP dimension of issues such as nutrition.
Organizational health literacy in German hospitals: a cross-sectional survey among hospital managers
(2024)
Abstract
Background
Organizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers.
Methods
Between November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data.
Results
Of 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials.
Conclusions
Given their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.
Zusammenfassung
Hintergrund
Organisationale Gesundheitskompetenz (OGK) beschreibt Bedingungen und Maßnahmen in Einrichtungen der Gesundheitsversorgung, wie z. B. Krankenhäusern, die Patient:innen dabei unterstützen sollen, gute gesundheitsbezogene Entscheidungen zu treffen. In der COVID-19-Pandemie waren auch Krankenhäuser gefordert, ihren Patient:innen den Zugang zu und den Umgang mit Gesundheitsinformationen und -dienstleistungen zu erleichtern.
Ziel
Zielsetzung des Beitrags ist eine Bestandsaufnahme der OGK-Aktivitäten in deutschen Krankenhäusern während der COVID-19-Pandemie. Fokussiert wird dabei der Vergleich der OGK-Aktivitäten in Krankenhäusern während und außerhalb pandemischer Zeiten.
Methodik
Zwischen November und Dezember 2022 wurde eine Online-Befragung von ärztlichen, pflegerischen und kaufmännischen Krankenhausleitungen durchgeführt. Die OGK wurde anhand des HLHO-10-Fragebogens erhoben, wobei dieser für die COVID-19-Pandemie erfolgreich adaptiert wurde (gute interne Konsistenz: α = 0,89). Die Auswertung erfolgte mit SPSS 28 mittels Varianz- und Korrelationsanalysen. Zudem bestand die Möglichkeit einer Freitextangabe zu OGK-Aktivitäten, welche mithilfe von MAXQDA und einer qualitativen Inhaltsanalyse ausgewertet wurden.
Ergebnisse
Von 3301 eingeladenen Krankenhausleitungen nahmen 328 an der Befragung teil (Rücklaufquote 10 %). Die Krankenhausleitungen geben an, dass in ihren Häusern während der Pandemie darauf geachtet wurde, dass sich Patient:innen einfach zurechtfinden. Jedoch ist eine aktive Einbindung von Patient:innen bei der Gestaltung und Evaluierung von Gesundheitsinformationen kaum umgesetzt. Zum Zeitpunkt der COVID-19-Pandemie wurden statistisch signifikant mehr Mitarbeitende zum Thema Gesundheitskompetenz geschult ( p < 0,001). Aus den Freitexten wird deutlich, dass die Befragten Optimierungsbedarf sehen, dem sie aufgrund mangelnder Ressourcen nur schwer nachkommen können.
Schlussfolgerung
Den Krankenhausleitungen ist bewusst, dass nicht alle Teilaspekte der OGK gleichmäßig gut umgesetzt sind. Es ist entscheidend, GK kontinuierlich in das organisatorische Handeln zu integrieren und dem Thema Priorität einzuräumen.
Abstract
Background
When seeking advice on allergy prevention in early childhood (Early Childhood Allergy Prevention, ECAP), parents often turn to health and social care providers, such as paediatricians, midwives, and family centres. However, these actors fulfil various, often care-related, roles, and cannot be considered ‘health information providers’ by default. In addition, although the scientific evidence for ECAP is often known by health professionals, it is not actively communicated. In this study protocol, we describe the planned procedure for the development and implementation of a process to communicate ECAP information to parents, with a focus on reaching out to those from migrant communities. Thereby, we also aim to contribute to the understanding of how to design more robust approaches to deliver health information.
Methods
We have chosen the Implementation Research Logic Model as our framework for a multi-stage process. Firstly, we will map regional and local health and social care providers to find potential providers of ECAP information. We will then approach actors from each mapping category for qualitative interviews to assess facilitators and barriers to implementation. Next, we will define actions to ease the implementation process, develop exemplary ECAP information materials for parents, and deliver these to pre-selected health and social care individuals and organizations. Each step will be adapted to meet the needs and preferences of culturally and linguistically diverse populations. Finally, the process will be evaluated for key implementation outcomes (e.g., acceptability, feasibility, effectiveness) by interviewing information providers and surveying information recipients.
Discussion
From a Public Health perspective, studies seem warranted that investigate how evidence from health research may be effectively communicated to the public, rather than merely focusing on, e.g., intervention development. Also, it has often been highlighted that the dissemination of health information needs to better target those who face the greatest difficulties when seeking advice, i.e. individuals/parents who recently migrated. ECAP is a good use case, as scientific evidence is constantly evolving, and the communication of information is hampered by low awareness of high quality sources.