Poureslami Iraj, Tregobov Noah, Shum Jessica, McMillan Austin, Akhtar Alizeh, Kassay Saron, Starnes Kassandra, Mahjoob Maryam, FitzGerald J Mark
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.
Queen's University, 94 University Avenue, Kingston, ON, K7L 3N6, Canada.
BMC Public Health. 2021 Jan 30;21(1):252. doi: 10.1186/s12889-021-10313-x.
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.
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.
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.
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.
NCT01474928 - Date of registration: 11/26/2017.
当前的健康素养概念模型阐述了健康素养与健康结果之间的联系。然而，这些模型未能将疾病管理、卫生系统因素和社会人口因素的某些要素识别并整合到其框架中。本文概述了慢性气道疾病（CAD）管理与健康素养（CADMaHL）概念模型的开发过程，该模型将上述要素和因素整合到一个单一框架中。
在以下阶段获得的信息为我们模型的开发提供了依据：（1）对应用核心健康素养领域的现有CAD健康素养测量工具进行系统综述；（2）以患者为导向的焦点小组会议，以了解CAD自我管理实践中的健康素养障碍；（3）关键信息提供者访谈，以获取减轻CAD管理障碍的潜在策略，并验证疾病自我管理主题；（4）征求加拿大呼吸科医生对哮喘和慢性阻塞性肺疾病（COPD）患者理想的功能性健康素养技能的看法。
在整个研究过程中，许多利益相关者（即患者、关键信息提供者和国际健康素养咨询小组）参与了模型的构建并对其进行了审查。该过程使我们能够将CADMaHL模型组织成6个主要模块，包括：输入，由四个健康素养核心要素（获取、理解、沟通、评估）和计算能力组成；输出，包括所获信息的应用；结果，涵盖通过应用健康素养技能在自我管理实践中实现患者赋权；评估，包括有关CADMaHL功能和相关性的信息；影响，包括健康素养与健康结果之间的调节因素；交叉因素，由适用于各健康素养领域的各种社会人口因素和卫生系统因素组成。
我们在关键利益相关者的参与下开发了CADMaHL模型，该模型通过整合先前已发表框架中缺失的各种疾病管理、卫生系统和社会人口因素，填补了知识空白。我们预计，我们的模型将成为开发全面的健康素养测量工具的基础，该工具可用于未来针对CAD患者的健康素养干预。
NCT01474928 - 注册日期：2017年11月26日。
