Influence of high versus low readability level of written health information on self-efficacy: A randomized controlled study of the processing fluency effect.
ABSTRACT: We investigated the relationship of processing fluency of written information about exercise to participants' perceived interest, safety, self-efficacy, outcome expectation, and behavioral intention regarding the exercise. We randomly assigned 400 men and women aged 40-69?years to control or intervention conditions. Perceived self-efficacy of performing the exercise in the intervention group (i.e. easy to read) was significantly higher than that in the control group (i.e. difficult to read) (p?=?0.04). Easy-to-read written health information may be important not only for making written health information comprehensible but also for increasing readers' self-efficacy for adopting health-related behaviors.
Project description:BACKGROUND:Falls are a major contributor to the burden of disease in older adults. Home-based exercise programs are effective in reducing the rate and risk of falls in older adults. However, adherence to home-based exercise programs is low, limiting the efficacy of interventions. The implementation of technology-based exercise programs for older adults to use at home may increase exercise adherence and, thus, the effectiveness of fall prevention interventions. More information about older adults' experiences when using technologies at home is needed to enable the design of programs that are tailored to older adults' needs. OBJECTIVE:This study aimed to (1) explore older adults' experiences using SureStep, an interactive cognitive-motor step training program to reduce fall risk unsupervised at home; (2) explore program features that older adults found encouraged program uptake and adherence; (3) identify usability issues encountered by older adults when using the program; and (4) provide guidance for the design of a future technology-based exercise program tailored to older adults to use at home as a fall prevention strategy. METHODS:This study was part of a larger randomized controlled trial. The qualitative portion of the study and the focus of this paper used a qualitative descriptive design. Data collectors conducted structured, open-ended in-person interviews with study participants who were randomly allocated to use SureStep at home for 4 months. All interviews were audiotaped and ranged from 45 to 60 min. Thematic analysis was used to analyze collected data. This study was guided by Pender's Health Promotion Model. RESULTS:Overall, 24 older adults aged 70 to 97 years were interviewed. Findings suggest older adults are open to use technology-based exercise programs at home, and in the context of optimizing adherence to home-based exercise programs for the prevention of falls, findings suggest that program developers should develop exercise programs in ways that provide older adults with a fun and enjoyable experience (thus increasing intrinsic motivation to exercise), focus on improving outcomes that are significant to older adults (thus increasing self-determined extrinsic motivation), offer challenging yet attainable exercises (thus increasing perceived self-competence), provide positive feedback on performance (thus increasing self-efficacy), and are easy to use (thus reducing perceived barriers to technology use). CONCLUSIONS:This study provides important considerations when designing technology-based programs so they are tailored to the needs of older adults, increasing both usability and acceptability of programs and potentially enhancing exercise participation and long-term adherence to fall prevention interventions. Program uptake and adherence seem to be influenced by (1) older adults' perceived benefits of undertaking the program, (2) whether the program is stimulating, and (3) the perceived barriers to exercise and technology use. Older adults shared important recommendations for future development of technologies for older adults to use at home.
Project description:Recurrent respiratory papillomatosis (RRP) is a rare disease for which a limited number of information sources for patients exist. The role of the Internet in the patient-physician relationship is increasing. More and more patients search for online health information, which should be of good quality and easy readable. The study aim was to investigate the quality and readability of English online health information about RRP.Quality and readability assessment of online information.Relevant information was collected using three different search engines and seven different search terms. Quality was assessed with the DISCERN instrument. The Flesch Reading Ease Score (FRES) and average grade level (AGL) were determined to measure readability of the English websites.Fifty-one English websites were included. The mean DISCERN score of the websites is 28.1 ± 9.7 (poor quality); the mean FRES is 41.3 ± 14.9 (difficult to read); and the mean AGL is 12.6 ± 2.3.The quality and readability of English websites about RRP is alarmingly poor.NA. Laryngoscope, 127:2293-2297, 2017.
Project description:OBJECTIVE:To qualitatively explore perceived physical and psychosocial effects and overall patient experience associated with a 12-week tai chi (TC) intervention and an education group in a clinical trial of patients with chronic heart failure (HF). SUBJECTS AND METHODS:We randomized 100 patients with chronic systolic HF (NYHA Class 1-3, ejection fraction?40%) to a 12-week group TC program or an education control. At 12-weeks, semi-structured interviews were conducted on a random subset (n = 32; n = 17 in TC, n = 15 in control), audiorecorded and transcribed verbatim. Two independent reviewers extracted information using grounded-theory methods for emergent themes. We explored similarities and differences in themes/sub-themes between the groups, and examined qualitative association with changes from baseline to post-intervention in previously reported quantitative measures (e.g., Minnesota Living with HF, Cardiac Exercise Self Efficacy and Profile of Mood States). RESULTS:The mean age (±SD) of participants was 68±9 years, baseline ejection fraction 29±7%, and median New York Heart Association class 2 HF. We idenitifed themes related to the patient's experience of illness, perceptions of self, and relationship to others. Specific psychosocial and physical benefits were described. Common themes emerged from both groups including: social support and self-efficacy related to activity/exercise and diet. The tai chi group, however, also exhibited a more global empowerment and perceived control. Additional themes in TC included mindfulness/self-awareness, decreased stress reactivity, and renewed social role. These themes mirrored improvements in previously reported quantitative measures (quality-of-life, self-efficacy, and mood) in TC compared to control. Patients in TC also reported physical benefits (e.g., decreased pain, improved energy, endurance, flexibility). CONCLUSION:Positive themes emerged from both groups, although there were qualitative differences in concepts of self-efficacy and perceived control between groups. Those in tai chi reported not only self efficacy and social support, but overall empowerment with additional gains such as internal locus of control, self-awareness and stress management. Future studies of mind-body exercise might further examine perceived control, self-efficacy, and locus-of-control as potential mediators of effect.
Project description:<h4>Background</h4>Exercise and adequate self-management capacity may be important strategies in the management of venous leg ulcers. However, it remains unclear if exercise improves the healing rates of venous leg ulcers and if a self-management exercise program based on self-efficacy theory is well adhered to.<h4>Method/design</h4>This is a randomised controlled in adults with venous leg ulcers to determine the effectiveness of a self-efficacy based exercise intervention. Participants with venous leg ulcers are recruited from 3 clinical sites in Australia. After collection of baseline data, participants are randomised to either an intervention group or control group. The control group receive usual care, as recommended by evidence based guidelines. The intervention group receive an individualised program of calf muscle exercises and walking. The twelve week exercise program integrates multiple elements, including up to six telephone delivered behavioural coaching and goal setting sessions, supported by written materials, a pedometer and two follow-up booster calls if required. Participants are encouraged to seek social support among their friends, self-monitor their weekly steps and lower limb exercises. The control group are supported by a generic information sheet that the intervention group also receive encouraging lower limb exercises, a pedometer for self-management and phone calls at the same time points as the intervention group. The primary outcome is the healing rates of venous leg ulcers which are assessed at fortnightly clinic appointments. Secondary outcomes, assessed at baseline and 12 weeks: functional ability (range of ankle motion and Tinetti gait and balance score), quality of life and self-management scores.<h4>Discussion</h4>This study seeks to address a significant gap in current wound management practice by providing evidence for the effectiveness of a home-based exercise program for adults with venous leg ulcers. Theory-driven, evidence-based strategies that can improve an individual's exercise self-efficacy and self-management capacity could have a significant impact in improving the management of people with venous leg ulcers. Information gained from this study will provide much needed information on management of this chronic disease to promote health and independence in this population.<h4>Trial registration</h4>Australian New Zealand Clinical Trials Registry ACTRN12612000475842.
Project description:Biased transmission of health knowledge has far-reaching effects on information reproduction and health-related cognitions. We examined whether transmissions of different types of disorder and etiological information influence recollections of health knowledge and evaluations of patients, by simulating the digital transmission of information. Transmission chains of four non-interacting persons (i.e., four generations) were formed. The first generation read three vignettes describing fictitious patients with one of three disorders (physiological, psychological, culture-bound) uniquely paired with one of three etiologies (genetic, environmental, unknown etiology). Next, they evaluated patients' well-being, rated desired social distance, and recalled the vignettes. These written recollections replaced the original vignettes for a second-generation of participants, whose recollections were used for the third generation and so on. The framing of disorders affected recollections of etiology, in which culture-bound framings resulted in the poorest recall of etiologies. Participants also perceived the culture-bound disorder as the least serious but desired the most social distance from patients diagnosed with it, when compared to other disorders. The study showed that health information is selectively attended to and reproduced, possibly affected by perceived self-relevance. Faulty recollections and framing of disorders affect health cognitions, potentially instigating biased transmission of disorder- and patient-related narratives.
Project description:BACKGROUND:Overweight and obesity have become a significant public health concern in both developing and developed countries. Due to the health implications of weight-reduction behaviors, it is important to explore the factors that predict their occurrence. Therefore, the present study was performed to examine factors affecting the behavioral intention of weight management as well as assess the predictive power of the Health Belief Model (HBM) for body mass index (BMI). METHODS:This cross-sectional study was conducted among 336 female students recruited from dormitories of Tabriz University of Medical Sciences, using quota sampling technique. Data were collected by a structured questionnaire in seven parts (including perceived severity, perceived susceptibility, perceived benefit, perceived barrier, cue to action, self-efficacy in dieting and physical activity, and behavioral intention of weight management), based on the HBM. Structural equation modeling (SEM) was conducted to identify the relationship between HBM constructs and behavioral intention of weight management. Linear regression model was performed to test the ability of the HBM to predict students' BMIs. RESULTS:Higher level of perceived threats (sum of perceived susceptibility and severity) (? = 0.41, P<0.001), perceived benefits (? = 0.19, P = 0.009), self-efficacy in exercise (? = 0.17, P = 0.001), and self-efficacy in dieting (? = 0.16, P = 0.025) scales was significantly related to greater behavioral intention of weight management. Moreover, perceived threat mediated the relationships between perceived cue to action, perceived benefits, self-efficacy in exercise, and weight management practices. The fit indices of the SEM model seemed acceptable. The final regression model explained approximately 40% of variance in BMI (P<0.001). Additionally, perceived severity, barrier, and self-efficacy in dietary life were the significant variables to predict students' BMIs. CONCLUSIONS:These findings suggest that health education programs based on the HBM needs to be integrated in preventive health programs and health interventions strategies to ensure adherence and well-being of the participants.
Project description:BACKGROUND:Cervical cancer is the most common type of cancer in sub-Saharan Africa, and it is also the cancer disease that most women die from. The high mortality rate is partly due to low attendance rates to screening services and low sensitivity of visual inspection with acetic acid, which is the standard screening method used in screening programs in sub-Saharan Africa. In order to overcome of the burden of disease new screening strategies and methods are warranted. This study aims to explore the acceptability and feasibility of HPV self-sampling compared to provider-based sampling among cervical cancer screening clients living in Dar es Salaam. METHODS:Women attending cervical cancer screening at Ocean Road Cancer Institute in Dar es Salaam, Tanzania between February - April 2017 were invited into the study. The participants had (1) a provider-collected sample, and (2) a self-sample for HPV on top of the regular cervical cancer screening. 50% of the participants conducted the self-sample after receiving a written instruction guide of how to collect the sample (written). The other 50% received both the written and an oral introduction to self-sampling (written+). All participants could ask for nurse assistance during self-sample collection if needed. Individual semi-structured interviews were conducted with the participants post sample collection. Data collection stopped when saturation was reached. Data were analysed using a thematic content analysis. RESULTS:Twenty-one women participated in the study. Regardless of how women were introduced to the self-sample (written or written+), there was a high demand for nurse presence as they felt uncertain of their personal capabilities to collect the self-sample correctly. However, as long as nurse assistance was an option most women perceived self-sampling as easy and comfortable though few experienced bleeding and pain. The majority of women preferred self-sampling over provider-sampling primarily due to the method being more private than the provider-sampling. CONCLUSIONS:HPV self-sampling was well-perceived and accepted, however, for the method to be feasible a nurse needed to be present. HPV Self-sampling may be an alternative method to increase uptake of cervical cancer screening. Larger quantitative studies are recommended to support the study findings.
Project description:This research examines how processing fluency influences people's perceptions of whether a trend will continue into the future. Specifically, three studies hypothesized that people who read descriptions of increasing or decreasing trends in easy-to-read font would be more likely to predict that the trend would continue into the future, compared to people exposed to difficult-to-read font. Studies 1 and 2 establish this effect for an increasing trend, whereas Study 3 replicates the findings with a decreasing trend. Taken together, these results suggest processing fluency as a factor that affects assessment of future potential.
Project description:<h4>Objectives</h4>To assess the degree of readability and the length of the package leaflets of biosimilars.<h4>Setting</h4>The package leaflets analysed were downloaded from the European Medicines Agency (EMA) website.<h4>Participants</h4>The study sample included the package leaflets written in English of all the biosimilars that were authorised by the EMA on 31 August 2017, and whose content was available via the internet on that date (n=35).<h4>Design</h4>This was a cross-sectional analytical study. The readability of the package leaflets of all biosimilars authorised by the EMA in August 2017 was determined applying the Flesch and Flesch-Kincaid formulas. The influence of the following variables on the readability and length was also analysed: package leaflet section, type of biosimilar, date of first authorisation of the biosimilar and type of medicine.<h4>Results</h4>A considerable variation of the package leaflets length was found (3154±803). The readability of all the package leaflets overtook the recommended value for health-related written materials taking into account Flesch-Kincaid Index, and none of the package leaflets were easy to understand according to the Flesch Index. Statistically significant differences (p<0.05) were observed between the sections of package leaflets in readability indices and length. The most difficult sections to understand were those related with the therapeutic indication of medicine and the possible side effects.<h4>Conclusions</h4>Package leaflets for authorised biosimilars may not fulfil the function for which they were designed. The competent organisations could be informed about the possible negative effect on the use of this type of medicines.
Project description:Background: Medical students struggle with heavy workloads and face unique time management challenges, calling for insight on medical students' time use in out-of-class activities and related psychological factors.Objectives: To investigate Chinese medical students' time use in out-of-class activities and its association with self-efficacy and perceived stress.Design: 940 second-year medical students were invited to participate in the survey. A questionnaire was developed to investigate the amount of time participants spent on out-of-class activities. Two existing instruments were used to assess participants' self-efficacy and perceived stress. Descriptive statistics and logistic regression were used to analyze the data.Results: 686 students (72.98%) completed the survey. On average, students spent about 14.4 hours per week (HPW) preparing for class and studying, 13.8 HPW on leisure and recreation, 4.8 HPW on physical exercise, 4.1 HPW on student clubs, 1.9 HPW on volunteering, and 1.9 HPW on part-time jobs on/off-campus. After controlling for demographic factors, higher self-efficacy was associated with more time preparing for class and studying (OR = 1.29, 95%CI: 1.10 ~ 1.52). Higher perceived stress was associated with less time preparing for class and studying (OR = 0.84, 95%CI: 0.72 ~ 0.98), exercising (OR = 0.82, 95%CI: 0.69 ~ 0.97), and volunteering (OR = 0.81, 95%CI: 0.67 ~ 0.97).Conclusions: Chinese medical students reported more time spent on preparing for class and studying and less time spent on volunteering and part-time jobs on/off-campus. Time spent preparing for class and studying was associated with higher self-efficacy and lower perceived stress, while perceived stress was also associated with less time spent on physical exercise and volunteering. Medical schools may need to employ measures to develop their students' self-efficacy and maintain a relatively low level of perceived stress, especially in students who also have a low level of self-efficacy.