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1. Measurement of health literacy to advance global health research: a study based on Demographic and Health Surveys in 14 sub-Saharan countries

Author

Heather McClintock, PhD, Sarah Schrauben, MD, Ashley Andrews, MPH, and Douglas Wiebe, PhD

Subjects
Public aspects of medicine, RA1-1270
Abstract

Background: Education and literacy are key determinants of health, but these do not ensure health literacy. A definition of health literacy from the US Institute of Medicine (IOM) is widely accepted, but there is no consensus on the traits by which health literacy can be measured. Some questions in Demographic and Health Surveys (DHS) represent domains of health literacy as defined by the IOM (ie, the capacity to interpret, obtain, and understand health information; and the ability to make appropriate health decisions), and could be a valuable untapped resource for the measurement of health literacy. Building on pilot work in Zambia, we aimed to derive a measure of health literacy from information recorded in the DHS that aligned with the IOM definition. Methods: We accessed data from surveys conducted between 2006 and 2015 in 14 sub-Saharan African countries: Cameroon, Democratic Republic of the Congo, Ethiopia, Ghana, Guinea, Côte d'Ivoire, Lesotho, Rwanda, Niger, Namibia, Sierra Leone, Swaziland, Togo, and Zambia. Surveys were the same in all countries, but translated to local languages as appropriate. We used factor analysis to extract one measure of health literacy and assessed its reliability and validity. We reclassified the continuous measure into tertiles and collapsed observations in the lower two groups to derive a dichotomous indicator. We then used χ2 tests to assess whether the prevalence of (high) health literacy varied by demographics and country, accounting for sample weights. Findings: We included 259 684 survey respondents aged 15–49 years. We identified eight survey questions that corresponded to elements of the four domains of IOM-defined health literacy. The questions addressed school and reading comprehension (capacity to interpret); reading magazines or listening to the radio or TV (capacity to obtain); learning family planning information (capacity to understand); and knowledge of a place to get an HIV test or acquire condoms (make appropriate health decisions). The derived continuous measure of health literacy demonstrated internal consistency (Cronbach's α = 0·72), and good content validity. Using the dichotomous indicator, overall prevalence of health literacy was 35·2% (95%CI 34·9–36·6%). Health literacy varied by sex (women 34·1% vs men 39·2%, p

Published
2017
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3. Content Validity Assessment of the Revised Illness Perception Questionnaire in CKD Using Qualitative Methods

Author

Eleanor Rivera, Kristin Levoy, Maya N. Clark-Cutaia, Sarah Schrauben, Raymond R. Townsend, Mahboob Rahman, James Lash, Milda Saunders, Rebecca Frazier, Hernan Rincon-Choles, and Karen B. Hirschman

Subjects
Psychometrics, Health, Toxicology and Mutagenesis, Surveys and Questionnaires, Emotions, Public Health, Environmental and Occupational Health, Humans, Perception, Renal Insufficiency, Chronic, illness perceptions, chronic kidney disease, content validity, psychometric testing, illness perception questionnaire, illness representation
Abstract

Background: The Revised Illness Perception Questionnaire (IPQ-R) measures individuals’ unique perceptions of their illness. While psychometric properties of the IPQ-R have been demonstrated in many disease populations, its content validity has not been extensively studied in non-dialysis chronic kidney disease (CKD). Unique features of CKD (e.g., few symptoms in early stages) may impact the measurement of illness perceptions. The purpose of this study was to explore the IPQ-R content validity in a sample of CKD patients. Methods: Thirty-one participants completed the IPQ-R and were interviewed regarding their subscale scores (timeline, consequences, personal control, treatment control, coherence, cyclical, and emotions). Participants’ agreement with their scores was tallied and assessed qualitatively for themes related to the content validity of the measure. Results: Individual participant agreement with their subscale scores averaged 79% (range: 29–100%). Subscale agreement varied: timeline (100%), consequences, coherence, and emotion (83% each), cyclical (75%), personal control (65%), and treatment control (64%). A qualitative exploration of disagreement responses revealed concerns with the relevance and comprehensibility of personal control and treatment control. Conclusions: Some IPQ-R subscales may pose content validity concerns in the non-dialysis CKD population. Item modification for comprehensibility (personal control) and relevance (treatment control) should be considered. Future studies should explore the impact of a patient’s symptom experience on IPQ-R validity, especially in populations like CKD with a higher proportion of asymptomatic patients.

Published
2022

4. Collect the Social History First

Author

Sarah Schrauben

Subjects
Order (business), business.industry, Social history, Public relations, business, Psychology
Published
2019

5. Contributors

Author

Ala Abudayyeh, Horacio J. Adrogué, Michael Allon, Hina Arif-Tiwari, Jonathan Barratt, Jeffrey S. Berns, Petter Bjornstad, Andrew S. Bomback, C. Barrett Bowling, Daniela A. Braun, Ursula C. Brewster, John M. Carson, Daniel C. Cattran, Sindhu Chandran, Arlene B. Chapman, David Cherney, Steven G. Coca, Debbie L. Cohen, Brendan D. Crawford, Gary C. Curhan, Taimur Dad, Vivette D. D'Agati, Vimal K. Derebail, An S. De Vriese, Dick de Zeeuw, Thomas D. DuBose, Michael Emmett, Pieter Evenepoel, Todd Fairhead, Ronald J. Falk, Fernando C. Fervenza, Kevin W. Finkel, Manuela Födinger, Rasheed A. Gbadegesin, Todd W.B. Gehr, Scott J. Gilbert, Jagbir S. Gill, Thomas A. Gonwa, Arthur Greenberg, Martin C. Gregory, Leal Herlitz, Friedhelm Hildebrandt, Gerald A. Hladik, Michelle A. Hladunewich, Melanie P. Hoenig, Jonathan Hogan, Andrew A. House, Alastair J. Hutchison, T. Alp Ikizler, Lesley A. Inker, Michael G. Ison, Matthew T. James, J. Charles Jennette, Renate Kain, Jaya Kala, Kamyar Kalantar-Zadeh, Bobby Kalb, Jeffrey B. Kopp, Greg Knoll, Dhananjay P. Kulkarni, James Lan, Andrew S. Levey, Ed Lewis, Stuart L. Linas, Randy L. Luciano, Yuliya Lytvyn, Etienne Macedo, Nicolaos E. Madias, Diego R. Martin, Gary R. Matzke, Rajnish Mehrotra, Ankit N. Mehta, Ravindra L. Mehta, Catherine M. Meyers, Madhukar Misra, Sharon M. Moe, Patrick H. Nachman, Lindsay E. Nicolle, Thomas D. Nolin, Ann M. O'Hare, Neesh Pannu, Aldo J. Peixoto, Mark A. Perazella, Megan Prochaska, Laura Ferreira Provenzano, L. Darryl Quarles, Jai Radhakrishnan, Bharathi Reddy, Dana V. Rizk, Claudio Ronco, Avi Z. Rosenberg, Norman D. Rosenblum, Matthew G. Sampson, Paul W. Sanders, Mark J. Sarnak, Steven J. Scheinman, H. William Schnaper, Sarah Schrauben, Richard C. Semelka, Anushree C. Shirali, Domenic A. Sica, Gere Sunder-Plassmann, Richard W. Sutherland, Harold M. Szerlip, Manjula Kurella Tamura, Jessica Sheehan Tangren, Joshua M. Thurman, Marcello Tonelli, Raymond R. Townsend, Howard Trachtman, Jeffrey M. Turner, Anand Vardhan, Joseph G. Verbalis, Flavio G. Vincenti, Marina Vivarelli, Raven Voora, Hani M. Wadei, Bradley A. Warady, Darcy K. Weidemann, Daniel E. Weiner, William L. Whittier, Christopher S. Wilcox, Jay B. Wish, and See Cheng Yeo

Published
2018

7. Silicosis and chronic renal disease

Author

Melissa L, Millerick-May, Sarah, Schrauben, Mary Jo, Reilly, and Kenneth D, Rosenman

Subjects
Adult, Aged, 80 and over, Male, Michigan, Silicosis, Middle Aged, Silicon Dioxide, Risk Factors, Creatinine, Occupational Exposure, Prevalence, Humans, Female, Renal Insufficiency, Chronic, Sentinel Surveillance, Aged, Glomerular Filtration Rate
Abstract

Silica has been associated with end stage kidney disease and kidney dysfunction.Calculated glomerular filtration rate, history of kidney disease or chronic dialysis, elevated serum creatinine, and stages of chronic kidney disease among silicotics identified in Michigan's Silicosis Surveillance System from 1987 to 2009 were reviewed to determine the prevalence of kidney disease in confirmed cases of silicosis.Twenty-four percent of 1,072 silicotics had a measure of kidney dysfunction (32.3% if diabetes or hypertension present vs. 20.2% if not). Sixty-nine percent of silicotics had Stage I or greater chronic kidney dysfunction versus 38.8% of the U.S. general population ≥60 years. No association was found between kidney function and measures of silica exposure.Individuals with silicosis have an increased prevalence of kidney disease. More work to define the pathological changes associated with silica exposure is needed to understand the cause of silica's adverse effect on the kidney.

Published
2015

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