A health literacy analysis of the consumer-oriented COVID-19 information produced by ten state health departments

Video Clips of the Dietary Approaches to Stop Hypertension Diet on YouTube: A Social Media Content Analysis

BACKGROUND

YouTube is among the most highly used internet video sharing platforms worldwide.

OBJECTIVE

The aim in this study was to conduct a social media content analysis of Dietary Approaches to Stop Hypertension (DASH) diet videos on YouTube.

METHODS

Specific search parameters were input into YouTube, and 101 videos were evaluated for quality and viewer exposure/engagement metrics independently by 3 content experts using the DISCERN instrument, a 16-item instrument designed to assess quality, reliability, and dependability of an online source. Scores were aggregated for analysis.

RESULTS

The majority (n = 69, 68.3%) of the videos were categorized as educational and came from a nonprofit source (n = 35, 34.7%). Although multiple speakers were the most frequent speaker type (n = 30, 29.7%), influencers/actors, dietitians, and healthcare providers were relatively equally distributed across the category (25.7%, 22.8%, and 21.8% respectively). Correlation analysis evaluating video's views, comments, and likes indicates that these video metrics are not correlated with video quality. However, the length of video was moderately and positively associated (P = .01) with the 4 DISCERN parameters of quality.

CONCLUSION

Study findings suggest that videos on DASH diet offered via YouTube could potentially be an inexpensive venue to promote healthful dietary practices and educate clients. Existing YouTube content on DASH diet demonstrates significant variability in quality ratings based on DISCERN. Providers should direct individuals to engage with high-quality educational DASH diet videos on YouTube that are created with qualified health professionals and are shared by reputable institutions.

Assessing the Understandability and Actionability of Education Materials for Agricultural Workers' Health

OBJECTIVES

Agricultural health and safety educators, including community health workers and Extension agents, represent an important community of practice, connecting agricultural workers (i.e. migrant and seasonal farmworkers) to health information and care. We sought to identify and evaluate existing education resources available to educators for use in health education and outreach with farmworkers.

METHODS

This study used a systemized search process to identify health education materials in English and Spanish used in the United States. Two independent coders coded each material for its understandability and actionability using the Patient Educational Material Assessment Tool (PEMAT). We report descriptive statistics by type of material, topic, and publication date of the material.

RESULTS

We identified farmworker health education materials (n = 602) from across the United States. The average understandability score was 86%, and the average actionability score was 76%. Materials were most commonly print material in the format of handouts, brochures, and posters. Some topic areas (e.g. musculoskeletal injuries) had considerably more resources than others (e.g. green tobacco).

CONCLUSION

This research represents the first, to our knowledge, comprehensive assessment of health education materials for education and outreach to agricultural workers. While the average scores for understandability and actionability were high among materials, there is room to build a stronger set of resources in some topic areas and to modernize materials for electronic delivery. Using PEMAT tools can help the Extension and community health worker communities of practice improve the quality of materials they share with agricultural workers.

Randomized experimental test of a reduced-exposure message for an e-cigarette: comprehension and related misperceptions

Completely switching from cigarette smoking to electronic nicotine delivery systems (ENDS) reduces exposure to toxic substances. Yet, many smokers believe that ENDS are at least as harmful as smoking, making them less likely to switch from cigarettes to ENDS. Effectively communicating reduced-exposure information is critical, but such messages must be properly understood. This online study evaluated comprehension of a factual message, indicating that smokers who switch completely away from smoking to JUUL-brand ENDS can reduce their exposure to harmful chemicals in cigarette smoke. Participants were 12 557 adults 18+ years (smokers, dual users and former and never users of tobacco) randomized to see the reduced-exposure message or to a Control condition. After exposure to the message, the majority of smokers (89%) understood the need to switch completely from cigarettes to JUUL to achieve reduced exposure. Most smokers and nonusers (>75%) did not misperceive JUUL as completely eliminating exposure to harmful chemicals, and >85% understood that using JUUL has risk. Exposure to the message improved understanding of the intended audience for JUUL. Individuals with limited health literacy showed modestly lower comprehension, regardless of condition. Ensuring adequate comprehension of messages about reduced exposure from ENDS is important to ensuring that such messaging can benefit public health.

Video Abstracts in Research

Video abstracts can be useful in health research. A video abstract provides key messages about a research article and can increase public engagement, spark conversations, and may increase academic attention. A growing number of open source software programs make it easier to develop a video abstract. This viewpoint provides practical tips for creating a video abstract for health research.

Evaluating understandability and actionability of online education materials for home-care patients with COVID-19 in Japan

OBJECTIVE

In Japan, educational materials on the home care of coronavirus disease 2019 (COVID-19) were developed owing to limited access to medical care during the pandemic. This study quantitatively evaluated the understandability, actionability, natural flow, and readability of 87 materials published by local governments in Japan for patients with COVID-19. Their understandability and actionability were rated using the Japanese version of the Patient Education Material Evaluation Tool for Printed Materials (PEMAT-P). Natural flow and readability were rated using Global Quality Score (GQS) and jReadability, respectively.

RESULTS

Of the 87 materials, 55 (62.1%) were understandable and 33 (37.9%) were actionable according to the PEMAT-P. Regarding understandability, the materials used medical terms without providing definitions and lacked summaries. Regarding actionability, the materials did not demonstrate explicit steps or utilize visual aids to help the readers take action. The mean (SD) of GQS was 3.44 (0.98), indicating a moderate level of naturalness and comprehensiveness of the materials. The mean (SD) score for readability was 2.4 (0.6), indicating a "lower advanced" level. However, challenges regarding the materials' plain language remained, such as defining medical terms, summarizing the content for understandability, and using charts and tables that encourage patients to act.

Disparities in the level of COVID-19 health literacy and the associated factors among employees in long-term care facilities in Taiwan

BACKGROUND

Coronavirus disease 2019 (COVID-19) poses a significant threat to the safety of residents in long-term care facilities, and the staff of long-term care facilities are essential in the care and prevention of major infectious diseases and therefore require good health literacy to ensure the health of residents. The main objective of this study was to examine the health literacy of staff in long-term care facilities and analyze the factors associated with their COVID-19 health literacy in Taiwan to provide a basis for the response mechanism to emerging infectious diseases.

METHODS

A cross-sectional survey with a structured questionnaire by a convenience sample method and to assess the COVID-19 health literacy of caregivers working in long-term care facilities in this study. The COVID-19 health literacy scale was a self-administered scale designed to combine the concept of "health literacy" with the 3 levels and 5 stages of preventive medicine. A total of 385 workers from 10 long-term care facilities were surveyed as the study sample, and the validated questionnaires were statistically analyzed using SPSS version 22.0 statistical software. A multivariate logistic regression model was used to establish the associated factors of the COVID-19 health literacy level.

RESULTS

Overall, the mean COVID-19 health literacy score was 88.7 ± 10.4 (range: 58-105). Using a quartile scale, 92 (23.9%) of the study participants had low health literacy (health literacy score < 82), 190 (49.3%) had average health literacy (health literacy score 82-98), and the remaining 103 (26.8%) had good health literacy (health literacy score 99-105). Statistical analysis revealed significant differences (p < 0.05) in the COVID-19 health literacy score by demographic variables (education, job category, number of daily service users, and training related to infectious disease prevention and control) of the study population. The logistic regression analysis of the COVID-19 health literacy level (> 82 vs. ≤82) showed a significant difference in the study sample by gender (male vs. female, OR = 2.46, 95% CI = 1.15-5.26), job category (nurse practitioner vs. caregiver, OR = 7.25, 95% CI = 2.46-21.44), monthly service hours (> 160 h vs. 40-79 h, OR = 0.044, 95% CI = 0.07-0.97), experience caring for confirmed COVID-19 patients (yes vs. no, OR = 0.13, 95% CI = 0.02-0.98), and training related to infectious disease prevention and control (yes vs. no, OR = 2.8, 95% CI = 1.52-5.15).

CONCLUSIONS

This study recommends that facilities provide immediate updated COVID-19 information to staff, especially frontline caregivers, and specifically enhance COVID-19 infection control education training for all facility staff to eliminate health literacy disparities.

Strategic Combination of Theory, Plain Language, and Trusted Messengers Contribute to COVID-19 Vaccine Uptake: Lessons Learned from Development and Dissemination of a Community Toolkit

Widely accepted practices for the development of health education materials include the use of theoretically driven content, the execution of plain language writing and design strategies, the solicitation of community input, and a plan for dissemination via trusted messengers. Here, we describe the development of a COVID-19 vaccine education toolkit and share preliminary outcomes from dissemination via community health workers. The toolkit was developed to equip community messengers to educate community members about the COVID-19 vaccine. It includes an easy-to-read workbook for community learners, a Leader Guide with scripting, and additional resources for community health workers and other local messengers. The Health Belief Model was used to select content for the workbook, which was refined with input from community members. A team of trained plain language writers worked with clinicians and subject matter experts to draft content that was deemed readable, understandable, and actionable by formal measures and drafts were further refined with additional community feedback. Survey results from community health workers who used the toolkit to provide local education about COVID-19 vaccines indicate that the toolkit facilitated confidence in their ability to deliver scientific content to their community members. More than two-thirds report that use of the toolkit facilitated community members' decisions to receive COVID-19 vaccines.

Patient education information material assessment criteria: A scoping review

BACKGROUND

Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources.

OBJECTIVE

This paper aims to identify these criteria and recognize the tools or methods used to evaluate them.

METHODS

National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included.

RESULTS

Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability.

CONCLUSION

This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.

Health literacy characteristics of over-the-counter rapid antigen COVID-19 test materials

Background

The United States Food & Drug Administration's emergency authorized use, in December 2020, of over-the-counter (OTC) rapid antigen COVID-19 tests was a pandemic control milestone.

Objective

To assess health literacy-related characteristics of OTC rapid antigen COVID-19 test materials.

Methods

Between September–December 2021, we identified eleven (n = 11) OTC rapid antigen COVID-19 tests available for purchase in the US. We assessed readability (Flesch Reading Ease and Fernández-Huerta), formatting and layout features of English- and Spanish-language step-by-step OTC rapid antigen COVID-19 test package insert instructions. Video-based step-by-step OTC rapid antigen COVID-19 test instructions were evaluated for understandability and actionability (Patient Education Materials Assessment Tool for Audiovisual Materials [PEMAT-A/V]), overall quality (Global Quality Scale [GQS]) and cultural diversity and inclusiveness. Descriptive analyses were performed using IBM® Statistical Package for the Social Sciences.

Results

Nine (81.8%) OTC rapid antigen COVID-19 tests included English-language (≈8th-9th reading grade level) step-by-step instructions, while 4 included Spanish-language (≈10th-12th reading grade level) instructions. On average, instructions were printed on a tabloid sized piece of paper, with text size ranging from 4 to 12 point and including nearly 20 illustrations. English-language step-by-step OTC rapid antigen COVID-19 test video-based instructions (n = 6) ranged from 1:04 to 5:41 min with PEMAT-A/V scores ranging from 80% to 100%. As indicated by GQS scores, English-language videos were of high quality (5 videos scored 5/5; 1 video scored 4/5). One COVID-19 test product manufacturing website included Spanish-language video-based instructions (time = 4:59 min; PEMAT-A/V = 100%; GQS = 5).

Conclusions

OTC COVID-19 test step-by-step instructions—both package inserts and video-based—included features shown to foster patient understanding and facilitate proper use. Moving forward, greater attention needs to be placed on expanding both Spanish-language and video-based OTC COVID-19 test material availability to improve accessibility across diverse populations.