Health Information Seeking, Receipt, and Use in Diabetes Self-Management

Daniel R. Longo; Shari L. Schubert; Barbara A. Wright; Joseph LeMaster; Casey D. Williams; John N. Clore

doi:10.1370/afm.1115

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Patient Use of Health Information: A Call for A Research Agenda
Daniel R Longo

Published on: 22 March 2011
Health literacy research should include patients from diverse ethnicities and those with limited literacy
M Jawad Hashim

Published on: 29 July 2010

Published on: (22 March 2011)
Page navigation anchor for Patient Use of Health Information: A Call for A Research Agenda
Patient Use of Health Information: A Call for A Research Agenda
Daniel R Longo, Richmond, Virginia, USA
Other Contributors:
In his critique (1) of our article previously published in the Annals of Family Medicine (2) Professor M Jawad Hashim rightfully identifies critical issues that need to be kept in the forefront in interpreting the results of our study as well as in designing future research. The critique identifies clear limitations as a results on the conduct of focus groups in one Midwestern city and the characteristics of its population...
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In his critique (1) of our article previously published in the Annals of Family Medicine (2) Professor M Jawad Hashim rightfully identifies critical issues that need to be kept in the forefront in interpreting the results of our study as well as in designing future research. The critique identifies clear limitations as a results on the conduct of focus groups in one Midwestern city and the characteristics of its population. However, one must go beyond those limitations in understanding qualitative focus group data that allows one an opportunity to delve into the meaning of the participants’ words and specially in this case the descriptions of health information use in patients own words. We included a population as diverse as the city in which the focus group was conducted and do recognize this study needs to be replicated in our areas of the country with more diverse populations. With all due respect I urge Professor M Jawad Hashim and other readers to note that the study was in no way intended to explore “health literacy” with patients from diverse ethnicities; such a task is important and it is hoped that future studies will go into that direction. As stated this is but one study in a research agenda we and others need to conduct to fully understand the issue of health information issue from patients’ perspectives. In fact we conclude with noting in the article “some areas to consider when developing hypotheses for future research, including (1) the relationship between improved self-management and various types of information, (2) issues of health literacy as they affect information use, (3) how self-management changes with time and its impact on information use, and (4) the effect of information on outcomes that matter to patients in the short and long term.”3 It is with additional studies over time that some of the issues rightfully addresses by Professor M Jawad Hashim can be addressed. We intend to do so and urge others to do the same.
1 Health literacy research should include patients from diverse ethnicities and those with limited literacy M Jawad Hashim (29 July 2010) 2-3 Longo DR, Schubert SL, Wright BA, LeMaster J, Williams CD, Clore JN. Health information seeking, receipt, and use in diabetes self-management. Annals of Family Medicine July/August 2010;8(4):334-340, p.340.
Competing interests: 3 Longo DR, Schubert SL, Wright BA, LeMaster J, Williams CD, Clore JN. Health information seeking, receipt, and use in diabetes self-management. Annals of Family Medicine July/August 2010;8(4):334-340 was previously published in this journal
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Competing Interests: None declared.
Published on: (29 July 2010)
Page navigation anchor for Health literacy research should include patients from diverse ethnicities and those with limited literacy
Health literacy research should include patients from diverse ethnicities and those with limited literacy
M Jawad Hashim, Al Ain, UAE
I read with interest this study(1) as it relates to the improving health literacy by exploring health information seeking behavior of patients with diabetes.
Although a well conducted study, its claim of achieving diversity of participants is slightly puzzling.
The article states, “To achieve the broadest possible range of insight, participants were recruited to ensure diversity in … race …...
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I read with interest this study(1) as it relates to the improving health literacy by exploring health information seeking behavior of patients with diabetes.
Although a well conducted study, its claim of achieving diversity of participants is slightly puzzling.
The article states, “To achieve the broadest possible range of insight, participants were recruited to ensure diversity in … race …” and later, “… participants were socioeconomically and ethnically diverse, and we are reasonably certain that the responses reflect the views and background of a diverse population ….”
Yet, in Table 1, about 70% (32) of the participants are reported as white and 22% (10) African American.
No Latino/Hispanic or American Indian patients were included and only one Asian was interviewed.
Even though a caution is mentioned about “regional differences,” the problem is more than area variations.
Even more concerning is that few patients (< 5%) with limited literacy were enrolled. This may explain the skew towards high literacy information sources.
Health literacy research over last decade has underscored the need to enable patients with limited literacy (often from minorities, the disabled, mentally-ill, indigent and the elderly) to access healthcare and achieve self-care.(2-8)
Overall, the authors deserve praise for advancing our understanding in this important subject.
References:
1. Longo DR, Schubert SL, Wright BA, LeMaster J, Williams CD, Clore JN. Health Information Seeking, Receipt, and Use in Diabetes Self- Management. Ann Fam Med. 2010 Jul 1;8(4):334-340.
2. Protheroe J, Wallace L, Rowlands G, Devoe J. Health literacy: setting an international collaborative research agenda. BMC Fam Pract. 2009 Jul 10;10(1):51.
3. Nielsen-Bohlman L, Panzer AM, Kindig D. Health Literacy: A Prescription to End Confusion. Committee on Health Literacy, Board on Neuroscience and Behavioral Health, Institute of Medicine of the National Academies. Washington, DC: National Academies Press; 2004.
4. Howard DH, Sentell T, Gazmararian JA. Impact of health literacy on socioeconomic and racial differences in health in an elderly population. J Gen Intern Med. 2006 Aug;21(8):857-61.
5. Parker RM, Wolf MS, Kirsch I. Preparing for an epidemic of limited health literacy: weathering the perfect storm. J Gen Intern Med. 2008 Aug;23(8):1273-6.
6. Sentell T, Shumway M, Snowden L. Access to mental health treatment by English language proficiency and race/ethnicity. J Gen Intern Med. 2007 Nov;22 Suppl 2:289-93.
7. Cheng E, Chen A, Cunningham W. Primary Language and Receipt of Recommended Health Care Among Hispanics in the United States. Journal of General Internal Medicine. 2007 Nov 25;22(0):283-288.
8. Schenker Y, Wang F, Selig S, Ng R, Fernandez A. The Impact of Language Barriers on Documentation of Informed Consent at a Hospital with On-Site Interpreter Services. Journal of General Internal Medicine. 2007 Nov 25;22(0):294-299.
Competing interests: None declared
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Competing Interests: None declared.