Do health service waiting areas contribute to the health literacy of consumers? A scoping review
- Authors: McDonald, Cassie , Voutier, Catherine , Govil, Dhruv , D'Souza, Aruska , Truong, Dominic , Abo, Shaza , Remedios, Louisa , Granger, Catherine
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Health Promotion International Vol. 38, no. 4 (2023), p.
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- Description: Health service waiting areas commonly provide health information, resources and supports for consumers; however, the effect on health literacy and related outcomes remains unclear. This scoping review of the literature aimed to explore the use of waiting areas as a place to contribute to the health literacy and related outcomes of consumers attending health appointments. Articles were included if they focussed on health literacy or health literacy responsiveness (concept) in outpatient or primary care health service waiting areas (context) for adult consumers (population) and were published after 2010. Ten bibliographic databases, one full-text archive, dissertation repositories and web sources were searched. The search yielded 5095 records. After duplicate removal, 3942 title/abstract records were screened and 360 full-text records assessed. Data were charted into a standardized data extraction tool. A total of 116 unique articles (published empirical and grey literature) were included. Most articles were set in primary and community care (49%) waiting areas. A diverse range of health topics and resource types were available, but results demonstrated they were not always used by consumers. Outcomes measured in intervention studies were health knowledge, intentions and other psychological factors, self-reported and observed behaviours, clinical outcomes and health service utilization. Intervention studies overall demonstrated positive trends in health literacy-related outcomes, although the benefit declined after 3-6 months. Research on using waiting areas for health literacy purposes is increasing globally. Future research investigating the needs of consumers to inform optimal intervention design is needed. © 2023 The Author(s). Published by Oxford University Press.
Barriers, enablers, and consumer design ideas for health literacy responsive hospital waiting areas : a framework method analysis
- Authors: McDonald, Cassie , Remedios, Louisa , Cameron, Kate , Said, Catherine , Granger, Catherine
- Date: 2022
- Type: Text , Journal article
- Relation: Health Environments Research and Design Journal Vol. 15, no. 1 (2022), p. 207-221
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- Description: Aim: The study aim was to (1) investigate the barriers and enablers experienced by consumers to accessing and engaging with health tools in hospital waiting areas and (2) evaluate consumers’ ideas for designing a health literacy responsive waiting area. Background: Health information, resources, and supports (“health tools”) in waiting areas should be responsive to the health literacy needs of consumers. However, consumers’ experiences of using health tools and their ideas for improving them are not known. Methods: Multicenter study was set in hospital waiting areas of outpatient rehabilitation services. Semistructured in-person interviews were conducted with 33 adult consumers attending appointments for various health conditions. Seven stages of the Framework Method were used to analyze data. Results: Six themes were identified which explained barriers and enablers from the perspective of consumers. The barriers were accessibility issues; personal factors—physical condition, emotional state, and preferences; and poorly presented and outdated resources. The enablers were design suits consumer needs and preferences; usable in available time or portable; and compatible environment for engaging and sharing. Consumers shared design ideas which fit within four typologies. Conclusions: A range of barriers and enablers exist which have an impact on consumers’ ability to engage with available health information, resources, and supports in hospital outpatient waiting areas. Practical insights from the perspective of consumers can be applied to future health service design. Consumer’s design ideas suggest that partnerships with consumers should be formed to design health literacy responsive waiting areas. © The Author(s) 2021.
Seeking choice to fulfill health literacy needs : health literacy opportunities for consumers in hospital waiting areas
- Authors: McDonald, Cassie , Granger, Catherine , Said, Catherine , Remedios, Louisa
- Date: 2022
- Type: Text , Journal article
- Relation: Qualitative Health Research Vol. 32, no. 2 (2022), p. 345-359
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- Description: In this research, we explore and theorize on the potential of hospital outpatient rehabilitation waiting areas to respond and contribute to the health literacy needs of consumers. Constructivist grounded theory informed the sampling and analytical procedures. Thirty-three consumers attending outpatient rehabilitation for a range of health conditions were recruited to this multi-site study. Semi-structured interview and participant observation data were collected and analyzed concurrently using the constant comparison method. The substantive theory of “seeking choice to fulfill health literacy needs” and five interdependent categories were developed. Results indicated that consumers sought choice reflective of their needs; however, the waiting area offered limited choice. Consumers shared ideas to address the lack of choice. Results provide insight into the health literacy needs of consumers in hospital outpatient waiting areas and how health services can appropriately respond to these needs. Future research should investigate the effect of health service environments on health outcomes. © The Author(s) 2021.
Health literacy in hospital outpatient waiting areas: an observational study of what is available to and accessed by consumers
- Authors: McDonald, Cassie , Remedios, Louisa , Said, Catherine , Granger, Catherine
- Date: 2021
- Type: Text , Journal article
- Relation: Health Environments Research and Design Journal Vol. 14, no. 3 (2021), p. 124-139
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- Description: Aim: To investigate: (1) the types of health information, resources, and supports available to consumers in hospital outpatient waiting areas and (2) whether these are accessed by consumers. Background: Outpatient waiting areas commonly offer health information, resources, and supports to improve the health literacy of waiting consumers. It is not known what is available to or accessed by consumers in hospital outpatient rehabilitation waiting areas. Methods: A multicenter, prospective, observational, cross-sectional study was conducted in the waiting areas of two hospital outpatient rehabilitation services. Direct observations (in person and video recordings) of the waiting areas were used to describe what health information, resources, and supports were available and, if present, what was being accessed and for how long by consumers. Results: Fifteen hours of in-person and video-recorded observations were documented on purpose-designed instruments across the two sites during 18 observation sessions over 8 days. A total of 68 different health information and resources were identified. Approximately half were specifically for consumers (Site 1: 57%; Site 2: 53%). Only seven (10%) were accessed by consumers across both sites. Each resource (n = 7) was only accessed once. Health resources were used by consumers for 0.8% (3/360 min) of the observation time at each site. Health and social supports and use of other non health resources were also observed. Conclusions: Available health information, resources, and supports were infrequently and briefly accessed by consumers. Further research is required to explore what consumers want and need to improve the health literacy responsiveness of hospital outpatient waiting areas. © The Author(s) 2020.
What factors affect implementation of early rehabilitation into intensive care unit practice? A qualitative study with clinicians
- Authors: Parry, Selina , Remedios, Louisa , Denehy, Linda , Knight, Laura , Beach, Lisa , Rollinson, Thomas , Berney, Sue , Puthucheary, Zudin , Morris, Peter , Granger, Catherine
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Critical Care Vol. 38, no. (2017), p. 137-143
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- Description: Purpose To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. Materials and methods Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. Results Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork. Key strategies identified to facilitate rehabilitation included addressing educational needs for all multidisciplinary team members, supporting junior nursing staff, and potential expansion of physiotherapy staffing hours to closer align with the 24-hour patient care model. Conclusions Key barriers to implementation of early rehabilitation in critical care are diverse and include both clinician- and health care system–related factors. Research targeted at bridging this evidence-practice gap is required to improve provision of rehabilitation. © 2016 Elsevier Inc.
Barriers to translation of physical activity into the lung cancer model of care a qualitative study of clinicians' perspectives
- Authors: Granger, Catherine , Denehy, Linda , Remedios, Louisa , Retica, Sarah , Phongpagdi, Pimsiri , Hart, Nicholas , Parry, Selina
- Date: 2016
- Type: Text , Journal article
- Relation: Annals of the American Thoracic Society Vol. 13, no. 12 (2016), p. 2215-2222
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- Description: Rationale: Evidence-based clinical practice guidelines recommend physical activity for people with lung cancer, however evidence has not translated into clinical practice and the majority of patients do not meet recommended activity levels. Objectives: To identify factors (barriers and enablers) that influence clinicians' translation of the physical activity guidelines into practice. Methods: Qualitative study involving 17 participants (three respiratory physicians, two thoracic surgeons, two oncologists, two nurses, and eight physical therapists) who were recruited using purposive sampling from five hospitals in Melbourne, Victoria, Australia. Nine semistructured interviews and a focus group were conducted, transcribed verbatim, and independently crosschecked by a second researcher. Thematic analysis was used to analyze data. Measurements and Main Results: Five consistent themes emerged: (1) the clinicians perception of patient-related physical and psychological influences (including symptoms and comorbidities) that impact on patient's ability to perform regular physical activity; (2) the influence of the patient's past physical activity behavior and their perceived relevance and knowledge about physical activity; (3) the clinicians own knowledge and beliefs about physical activity; (4) workplace culture supporting or hindering physical activity; and (5) environmental and structural influences in the healthcare system (included clinicians time, staffing, protocols and services). Clinicians described potential strategies, including: (1) the opportunity for nurse practitioners to act as champions of regular physical activity and triage referrals for physical activity services; (2) opportunistically using the time when patients are in hospital after surgery to discuss physical activity; and (3) for all members of the multidisciplinary team to provide consistent messages to patients about the importance of physical activity. Conclusions: Key barriers to implementation of the physical activity guidelines in lung cancer are diverse and include both clinician- and healthcare system-related factors. A combined approach to target a number of these factors should be used to inform research, improve clinical services, and develop policies aiming to increase physical activity and improve survivorship outcomes for patients with lung cancer. © Copyright 2016 by the American Thoracic Society.