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The U.S. Department of Health and Human Services implemented the Healthy People initiative to set national health objectives for four different decades since 1979. This national effort has promoted a shared vision for improving the health of all Americans in a very fragmented health care delivery system. The current Healthy People 2020 initiative being implemented by the Department's Office of Disease Prevention and Health Promotion differs from previous efforts in several important ways. This paper explores one of these changes: implementation of a new communication strategy based in modern information technology. This strategy conceptualized a Healthy People 2020 online space that would be a user-focused, 'one-stop shop' for public health and health care professionals, policymakers, and community members to learn about the objectives, plan interventions, and implement strategies to reach the 2020 objectives. The communication strategy incorporated new digital media, including building a following on LinkedIn and Twitter. At present, membership in the Healthy People LinkedIn group is more than 7700 people, and the Healthy People Twitter account (@gohealthypeople) has nearly 50 000 followers. In addition to the growth in number of users, the success of the communication strategy is also confirmed by the consistently high customer satisfaction rankings the site receives from the American Customer Satisfaction Index E-government Satisfaction Index. New developments in digital communication technology have the potential to advance three principal functions originally conceptualized for Healthy People 2020 online: benchmarking, advocacy, and connecting with others. Several exciting digital tools can be used to implement each of these key Healthy People 2020 functions, including mobile Web site optimization, smartphone/tablet apps, social media, and cloud computing. Ultimately, HHS can conduct research with Healthy People target audiences and stakeholders to inform the types of digital tools that will be most helpful to Healthy People 2020 users. [ABSTRACT FROM AUTHOR]

The delivery of comprehensive breast care seems to be undergoing a paradigm shift driven by advances in technology, interprofessional collaboration and patient dissatisfaction with interruptions in care. This paradigm shift includes the emergence of new models of care that optimize the use of embedded radiology services and encourage greater interprofessional collaboration. This paper briefly reviews the three drivers (advances in technology, expectations regarding interprofessional collaboration and patient dissatisfaction with interrupted care) underlying the paradigm shift in comprehensive breast care as well as introduces the environment of care model, which describes the proximity of radiology services and interprofessional collaboration between the Women's Wellness Clinic (WWC) and Radiology at the Karmanos Cancer Institute (KCI) - both based in the United States. In addition, this model is proposed as a way to facilitate improved patient satisfaction and early appropriate referral. Finally, plans for evaluating the effectiveness of this model are presented. [ABSTRACT FROM AUTHOR]

Research suggests that women with intellectual and developmental disabilities are at increased risk for adverse pregnancy outcomes. Further, they report unmet perinatal care needs. This qualitative study examined clinician perspectives on barriers to providing perinatal care to women with intellectual and developmental disabilities. We conducted semi-structured interviews and one focus group with US obstetric care clinicians (n = 17). We used a content analysis approach to code data and analyse them for larger themes and relationships. the majority of participants were white, non-Hispanic, and female. Participants reported barriers providing care to pregnant women with intellectual and developmental disabilities across individual (e.g., communication challenges), practice (e.g., identification of disability status), and system levels (e.g., lack of clinician training). clinician training and evidence-based guidelines for perinatal care of women with intellectual and developmental disabilities as well as services and supports during pregnancy are needed. [ABSTRACT FROM AUTHOR]

U.S. suicide rates have risen every year over the past two decades with self-directed firearm use as the method accounting for the highest proportion of deaths. This pattern is particularly pronounced among veterans and members of the U.S. Armed Forces. The numerical burden of firearmrelated suicide accompanied by characteristics of self-directed firearm injury have motivated the development of lethal means safety initiatives focused on firearms. Simultaneously, research has sought to characterize patterns of firearm ownership and use among veterans as well as optimal strategies for clinicians to deliver suicide prevention messages to firearm owners. Increasingly, findings from research have been understood as cultural factors that warrant greater attention to improve the quality of lethal means counseling. Here, we review and interpret selected research on cultural aspects of firearm ownership and suggest that cultural differences between health care practitioners and firearm owners may result in health care practitioners delivering clinical interventions that are broadly divergent from perspectives within the cultural frameworks of firearm owners. We follow by organizing these cultural factors into existing frameworks of cultural competency training as a basis for developing curriculum for health care practitioners to improve clinical care. [ABSTRACT FROM AUTHOR]

A considerable portion of the US population still lacks access to technology, which causes challenges for marginalized communities to access information and services. Research on the digital divide exists in various contexts, but few have examined it in the context of human services. This study examines the impact of socioeconomic status on the methods of communication used when searching for service-related information. We analyzed both quantitative and qualitative data collected from 63 low-income and/or current human service users in Albany, New York. Education showed positive associations with smartphone ownership and personal computer use. Income was found only significant for tablet use. Non-whites were more likely to use mobile apps to web browsers compared to whites. Qualitative analysis revealed three key themes (i.e., availability, ease of use, and usefulness) as influencers of individual preference of methods. Our findings suggest that the digital divide is not merely about the income level but also educational background and culture. Human service professionals need to consider multiple channels to reach targeted populations for service delivery. Particularly, the collaboration between service providers and public libraries is worth examining to ensure the physical access and skills training for those who experience the digital divide at multiple levels. [ABSTRACT FROM AUTHOR]

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With implementation of Centers for Medicare and Medicaid's Hospital Readmissions Reduction Program, which lowers payments to hospitals with high 30-day readmission rates, hospitals have a financial incentive to improve hospital-to-home care transitions. Brain injury is a leading cause of 30-day hospital readmissions. Traditional discharge planning has not met the needs of brain injury survivors and caregivers especially Latinas/os whom experience worse rates of depression and caregiver burden. Trabajadora de Salud, a bilingual, bicultural, 90-day home visitation, family-focused, care transitions intervention, has demonstrated efficacy in improving outcomes among Latinas/os with brain injuries and their caregivers. This study described three case examples from the intervention to illustrate common needs among Latinas/os with brain injuries and methods of intervention. [ABSTRACT FROM AUTHOR]

This article compares the doctor-patient communication styles of the United States with those of three Asian countries: Pakistan, Japan, and Thailand. Based on intercultural comparisons drawn between those countries, this analysis reveals that, overall, the United States has very little in common with the philosophical, cultural, societal, and communicative approaches to the traditional doctor-patient communication styles used in these three Asian nations. However, major similarities have been found across all three Asian nations. Although the doctor-patient relationship has been studied extensively in the United States and most of the Western world, rarely do those studies integrate, concurrently within their doctor-patient communication framework, dimensions such as power distance, individualism-collectivism, and communication styles. These are three important concepts in this analysis; they improve our understanding of what constitutes effective doctor-patient communication across dissimilar cultures. [ABSTRACT FROM PUBLISHER]

Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly. [ABSTRACT FROM PUBLISHER]

Chronic conditions place a significant burden on the Australian health care system, and this burden continues to increase. This literature review examines the concepts of chronic illness and chronic condition self-management (CCSM), particularly in the context of asthma. It explores the implementation of, and barriers to, CCSM in the modern health care system with a focus on CCSM in children and adolescents, and the differences that need to be recognized when dealing with Indigenous Australian children. [ABSTRACT FROM AUTHOR]

Doc.com© is the American Academy of Communication in Healthcare's web-based resource for learning core communication skills. To date, very few doc.com© modules have been evaluated formally. This study sought to assess four modules' effectiveness at improving internal medicine interns' communication skills knowledge. Interns were asked to complete four modules early in internship and complete web-based five-item pre/post multiple choice tests and a satisfaction survery for each module. The participation rate was 97 per cent (31 of 32 interns). Knowledge improved significantly with module completion (average pre-test score 89 per cent versus post-test 95 per cent, p = 0.006). Most (86 per cent) felt that the modules were clearly presented and met stated learning objectives, 67 per cent felt that completing the modules would improve their outpatient communication skills, and 62 per cent their inpatient skills. However, only 16 per cent indicated that the modules should replace faculty-led communication skills instruction. Although baseline knowledge of basic patient--doctor communication skills among interns was high, the use of four basic doc.com© modules improved interns' communication skills knowledge on multiple choice tests. Interns were satisfied with the modules as a curricular intervention. Use of the doc.com© modules may be a valuable adjunct to faculty-led communication skills training aimed at helping trainees achieve competency in the areas of interpersonal and communication skills. [ABSTRACT FROM AUTHOR]

Hispanics are the fastest growing minority population in the United States today. Providing health information services to Hispanic patients and their family members can be challenging because of diversity. Library staff should be familiar with the specific health care needs and sociocultural characteristics of Hispanics. This article discusses the movement toward providing culturally competent health care and identifies socioeconomic challenges and barriers to health care faced by Hispanics. Suggestions are offered for communicating with this group in the reference setting, and a selective bibliography of Internet consumer health resources available in both Spanish and English is provided. [ABSTRACT FROM PUBLISHER]