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多米尼加共和国基于诊所候诊室的健康教育项目的混合方法评估。

Mixed method evaluation of a clinic waiting room-based health education program in the Dominican Republic.

机构信息

Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.

Clínica de Familia La Romana, C. Gaston Fernando Deligne 168, La Romana 22000, Dominican Republic.

出版信息

Health Educ Res. 2023 Mar 23;38(2):177-191. doi: 10.1093/her/cyad001.

Abstract

Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.

摘要

候诊室是传播健康信息的理想场所。在这项混合方法研究中,我们评估了多米尼加共和国两家诊所的候诊室健康教育讲座,并探讨了在类似环境中实施这一干预措施的建议。讲座涉及非传染性疾病、性传播感染、计划生育和基于性别的暴力。我们进行了预测试和后测试,以评估参与者知识的变化,并对其中一部分人进行了半结构化访谈。我们与教育者进行了半结构化焦点小组讨论。分析包括预测试和后测试的 Wilcox 符号秩检验和 McNemar 检验、个人访谈的常规内容分析和焦点小组的转录编码。患者参与者在一家诊所的平均年龄为 39.6 岁(SD=13.5),女性占 69.3%(n=127),在另一家诊所的平均年龄为 17.4 岁(SD=1.3),女性占 100%(n=24)。焦点小组参与者(n=5)的平均健康教育经验为 4.8 年(SD=3.3)。所有讲座的预测试和后测试都显示出显著的改善(P<0.05)。定性访谈强调了以患者为中心的设计、具有文化一致性的内容传递以及使用视觉辅助工具的方法。焦点小组强调了以患者为中心的设计、具有文化一致性的内容传递和确定实施挑战的重要性。研究结果表明,候诊室教育讲座可以提高知识水平,并为类似的干预措施提供建议。

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Understanding and Responding to Health Literacy as a Social Determinant of Health.理解和应对健康素养作为健康的社会决定因素。
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