14. Complexity of Health Behaviors.pdf

Health Literacy • “the degree to which individuals have the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions” • Which subgroups of the populations are most impacted by low health literacy? – Racial and ethnic m...

Health Literacy • “the degree to which individuals have the capacity to obtain, communicate, process, and understand basic health information and services needed to make appropriate health decisions” • Which subgroups of the populations are most impacted by low health literacy? – Racial and ethnic minorities; older adults, children (in some cases) Health Literacy • Most adults read at an 8th grade level • 20% of the population reads at or below a 5th grade level • Most health care materials are written at a 10th grade level Health Literacy Measurement Tools • Short Assessment of Health Literacy- Spanish and English • Rapid Estimate of Adult Literacy in MedicineShort Form • Short Assessment of Health Literacy for Spanish Adults The Result of Low Health Literacy • • • • Reduced use of preventive healthcare services Greater chance of being hospitalized More suffering from worse health outcomes Difficulty: – accessing health care – Following physician instruction – Taking medicines appropriately mHealth and Health Literacy • Can be an innovative way to overcome health literacy barriers because of its reach: mobile phone ownership is ubiquitous across race, ethnicity, education, and income levels • Conveniently delivers relevant health information that could improve patientphysician communication mHealth • Mobile Health: the use of mobile phone and other wireless technology in medical care to educate consumers about preventive health care services. • “Opening new lines of communication between patients and their physicians” • An innovative strategy to engage traditionally hard-to-reach populations such as racial and ethnic minority communities How to effectively achieve health behavior change in patients… • Use evidence-based theories, models, or frameworks to effectively propose or initiate necessary behavior changes Theory, Model, Framework • Theory- a set of principles or statements that structure our observation, understanding, and explanation of the world – Provides clear explanation of specific relationships or events • Model- a deliberate simplification of a phenomenon or a specific aspect of a phenomenon – Not always completely accurate; more descriptive than explanatory • Framework- outline, system or plan for the relationship between descriptive variables and how they may lead to a phenomenon Concepts, Constructs, and Variables • Concepts: paints a vivid picture on something that helps to understand the diversity of a related phenomenon – (e.g., body build relative to weight) • When concepts are adopted for use in a particular theory, they are called constructs – A focused abstract idea on something inferred from an observable phenomenon For Example: Theory of Planned Behavior Concepts, Constructs, and Variables • Concepts: paints a vivid picture on something that helps to understand the diversity of a related phenomenon • When concepts are adopted for use in a particular theory, they are called constructs – A focused abstract idea on something inferred from an observable phenomenon • Variable: the factor or aspect of an issue that can be measured – Based on values – Varies from study to study – (e.g., demographics, geographic, etc.) How does the use of theory effectively change health behaviors? • It depends… • Different theories are best suited to different units of practice, such as individuals, groups, and organizations. Commonly used Theories for Behavior Change • Social Cognitive Theory • Transtheoretical Model • Health Belief Model Social Cognitive Theory Five Stages of Behavior Change (Transtheoretical Model) Decisional Balance: weighing the pros and cons Self-efficacy: degree of confidence in ones ability to make and maintain a change Processes of Change: cognitive and affective experiential processes and behavioral processes Example: Transtheoretical Model • Often used by health care providers to initiate a conversation about health behaviors – E.g., Smoking cessation, Substance abuse, Addictive behaviors, Physical activity, Weight management, Stress management Example: Health Belief Model Example: Health Belief Model • Overcoming personal barriers; beliefs about susceptibility and severity of a health concern and beliefs about the utility of possible preventive action predict the likelihood of action – E.g., obtaining a mammogram – Immunizations – Taking medication Example: Health Belief Model