Iraj Poureslami1, Noah Tregobov2,3, Jessica Shum4, Austin McMillan3, Alizeh Akhtar5, Saron Kassay6, Kassandra Starnes7, Maryam Mahjoob2, J Mark FitzGerald2. 1. University of British Columbia and VGH Divisions of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. iraj.poureslami@ubc.ca. 2. University of British Columbia and VGH Divisions of Respiratory Medicine, Centre for Lung Health, Vancouver Coastal Health Research Institute, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. 3. Queen's University, 94 University Avenue, Kingston, ON, K7L 3N6, Canada. 4. Respiratory Medicine Division, Department of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. 5. School of Medicine, Brookfield Health Sciences Complex, University College Cork, College Road, T12 AK54, Cork, IE-M, Ireland. 6. Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. 7. Faculty of Law, University of Windsor, 401 Sunset Ave, Windsor, ON, N9B 3P4, Canada.
Abstract
BACKGROUND: Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework. METHODS: Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist's on the ideal functional HL skills for asthma and COPD patients. RESULTS: Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT, including application of the obtained information; OUTCOME, covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. CONCLUSIONS: We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. TRIAL REGISTRATION: NCT01474928 - Date of registration: 11/26/2017.
BACKGROUND: Current conceptual models of health literacy (HL) illustrate the link between HL and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into their framework. This article outlines the development of Chronic Airway Disease (CAD) Management and Health Literacy (CADMaHL) conceptual model that integrates the aforementioned elements and factors into a single framework. METHODS: Information obtained during the following stages informed the development of our model: (1) a systematic review of existing CAD HL measurement tools that apply core HL domains; (2) patient-oriented focus group sessions to understand HL barriers to CAD self-management practices; (3) key-informant interviews to obtain potential strategies to mitigate CAD management barriers, and validate disease self-management topics; (4) elicited the perspectives of Canadian respirologist's on the ideal functional HL skills for asthma and COPDpatients. RESULTS: Throughout the study process many stakeholders (i.e., patients, key-informants, and an international HL advisory panel) contributed to and reviewed the model. The process enabled us to organize the CADMaHL model into 6 primary modules, including: INPUT, consisting of four HL core components (access, understand, communicate, evaluate,) and numeracy skills; OUTPUT, including application of the obtained information; OUTCOME, covering patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, consisting of information about functionality and relevancy of CADMaHL; IMPACT, including mediators between HL and health outcomes; CROSSCUTTING FACTORS, consisting of diverse socio-demographics and health-system factors with applicability across the HL domains. CONCLUSIONS: We developed the CADMaHL model, with input from key-stakeholders, which addresses a knowledge gap by integrating various disease management, health-system and socio-demographic factors absent from previous published frameworks. We anticipate that our model will serve as the backbone for the development of a comprehensive HL measurement tool, which may be utilized for future HL interventions for CAD patients. TRIAL REGISTRATION: NCT01474928 - Date of registration: 11/26/2017.
Authors: Iraj Poureslami; Jacek Kopec; Noah Tregobov; Jessica Shum; Rick Sawatzky; Richard Hohn; J Mark FitzGerald Journal: Int J Environ Res Public Health Date: 2021-08-16 Impact factor: 3.390