Overcoming health literacy barriers: a model for action.
ABSTRACT A large influx of Indonesian immigrants seeking asylum from racial and religious persecution into our hospital service area alerted providers to the need for specific cultural knowledge about this ethnic group, and to develop new skill sets to effectively care for this population. Health education programs that provide knowledge and tools to overcome misunderstandings that arise from differences between provider and client expectations for behavior will be most effective in overcoming the health literacy barriers that so often contribute to health disparities. A framework to understand factors that affect health literacy for local Indonesian asylum seekers guided community health education, while the written educational materials for programs informed providers about health literacy barriers for this population. Community outreach engaged local pastors and interpreters as cultural brokers to collaborate with nurses to develop and implement culturally sensitive programs that are socially sensitive to the local Indonesian refugee population.
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ABSTRACT: This cross sectional study assessed the physical and mental health, health literacy and social support of the uninsured utilizing a free clinic to develop intervention programs and research projects to improve the health of free clinic patients. Free clinics are nonprofit organizations that provide underserved and uninsured individuals access to a broad array of free or low cost healthcare services. English or Spanish speaking patients (N = 187) aged 18 years or older completed a self-administered survey. Physical, mental and oral health, health literacy, and social support were measured using standardized instruments. Eighty-two participants (45 US born and 37 non-US born) chose the English version of the survey (English speakers) while 105 participants (2 US born and 103 non-US born) chose the Spanish version (Spanish speakers). Overall, both the physical and mental health functioning of the participants was lower than that of the US general population. The participants reported being moderately depressed. US-born English speakers reported the poorest physical and mental health while Spanish speakers reported the best physical health and the lowest level of depression. A higher level of health literacy was associated with better physical health functioning, whereas reporting higher social support was associated with better mental health functioning and less severe depression. Because most free clinics have limited resources, developing services and programs that fit free clinics' circumstances are needed. Our study finding indicates that health literacy education, mental health services, and social support are key services needed by free clinic patients to achieve better health.Journal of Community Health 03/2013; DOI:10.1007/s10900-013-9669-x · 1.28 Impact Factor
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ABSTRACT: Intimate partner violence (IPV) against women is a significant public health concern. This study examines the physical and mental health status and relationship to social support for women seeking services to end IPV at a walk-in community organization that serves the community at large, including a shelter for abused women. One hundred seventeen (117) English-speaking women between the ages of 18 and 61 years participated in a self-administered survey. Physical, mental, and oral health, social support, and IPV homicide lethality were measured using standardized instruments. Social support was the most important factor related to better health. The participants who had more social support reported better physical (p < .05), mental (p < .01), and oral health (p < .05), and a lower level of psychological distress (p < .01) and depression (p < .01) compared with participants who reported less social support. The participants living in the shelter reported worse physical health (p < .05) but better mental health (p < .05) than the participants not living in a shelter. Older age and low income were related to oral health problems, whereas older age, low education level, and unemployment were related to poor mental health. The present study adds to the evidence that social support contributes to improving physical and mental health for women who experience IPV. The findings also suggest the importance of providing or referring women to mental health services.Women s Health Issues 05/2013; 23(3):e179-85. DOI:10.1016/j.whi.2013.02.003 · 1.61 Impact Factor
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ABSTRACT: Health services accessibility is a key health policy issue. However, few in-depth studies have addressed it theoretically. Most distinguish between availability, accessibility, and acceptability, or between geographic, financial, administrative, and cultural accessibility. We discuss and analyze the concept of accessibility as conflictive articulation between supply and demand in health. The article addresses the importance of cultural accessibility, rethinking it as a social interface, i.e., a social arena with clashing worldviews (namely, those of physicians and patients). The approach sheds light on the complex processes of grasping, translating, and reshaping knowledge and recommendations within such interaction.Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública 02/2014; 30(2):231-44. DOI:10.1590/0102-311X00030313 · 0.89 Impact Factor