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Objectives: To investigate community health centers' (CHCs) health literacy. Design: A cross‐sectional study. Sample: A total of 374 CHCs were surveyed and 258 CHCs responded, with an effective questionnaire response rate of 69.0%. Measurements: Data were collected by using a self‐developed health literacy assessment tool to survey CHCs' health literacy throughout Taiwan from January to December 2019. Results: The item of organizational health literacy (OHL) with the highest proportion of CHCs not implementing them was "Design of easy‐to‐use computer applications and new media" (47.3% not yet achieved), followed by "Involving target audiences in document and service development" (34.9% not yet achieved). CHCs located in northern Taiwan had higher health literacy achievement scores than those in other regions, and those in urban areas had higher health literacy achievement scores than those in general and remote areas. Conclusions: This study identified items with poor implementation of OHL and found regional differences in health literacy among CHCs. The findings can inform the development of targeted interventions to improve health literacy in underperforming CHCs and guide policymakers in allocating resources to regions and areas in need of. [ABSTRACT FROM AUTHOR]

Background: Early parent-child shared reading has been demonstrated to promote the development of literacy, reading skills and learning achievement in young children. Parent-child shared reading intervention programs may strengthen the willingness and reading competence of parents., Purpose: To explore the attitudes and skills related to parent-child shared reading before and after an intervention program conducted in a nursery room and outpatient pediatric clinic., Methods: A single-group pretest-posttest quasi-experimental design was conducted. Seventy-five parents of newborns in the baby rooms from two hospitals in Hualien County were conveniently sampled. Parents who had just given birth received health education before discharge from the hospital from nurses focusing on the knowledge and skills of shared reading. Three age-matched picture books with reading fact sheets and consultation support were offered free to parents of children in three, respective, age groups (newborn, 4-months old and 6-months old) during parent-child visits to the pediatric clinic for regular health examinations and vaccinations. A self-designed questionnaire was administered to analyze the parents' demographic variables, reading environment, parents' attitudes toward parent-child shared reading, and familiarity with regard to parent-child shared reading skills., Results: Parent-child reading attitudes were positively correlated with skill familiarity (r = .39). The presence or absence of children's books at home, the parent-child relationship, and parental reading habits explained 32.0% of the variance in parent-child shared-reading attitudes (R2 = .32). The presence or absence of children's books at home and the presence or absence of a library card for the child explained 44.0% of the variation in familiarity with co-reading skills (R2 = .44). Parent-child shared reading attitude scores (t = -5.14, p < .001) and skill familiarity of parents (t = -7.52, p < .001) both increased significantly after the intervention program., Conclusions / Implications for Practice: Parent-child shared reading educational intervention programs may be used to improve parental attitudes and skills related to parent-child shared reading.

Objective: To investigate patterns in the relapse frequency after curative surgical intervention, with the intention of determining the feasibility of a complete holiday from chemotherapy for metastatic colorectal cancer (mCRC) patients., Methods: Patients with stage IV mCRC who received curative surgical intervention between January 1999 and December 2009 at Changhua Christian Hospital, Changhua, Taiwan were investigated retrospectively. Factors influencing the frequency and pattern of relapse were analyzed by logistic regression. Factors influencing overall survival (OS) were analyzed with Cox proportional hazard ratios. Significant factors were extracted and relationships to OS were evaluated by Kaplan-Meier with Log-Rank test., Results: One hundred and thirty-two patients were included in the study in which 94 (71.2%) suffered from relapse. The number of relapses peaked between 3 and 6 months. The incidence of relapse and Disease-free survival had a negative influence on OS, with a hazard ratio (HR) of 0.36 (95% CI: 0.01-0.26) and 0.93 (95% CI: 0.90-0.95). The prognosis was significantly worse when the relapse (n=25) occurred within 6 months after metastectomy (p<0.001). Patients exhibited significantly better long-term OS if the relapse does not occur within 28 months after surgery (p<0.001)., Conclusion: Early relapse indicated a worse prognosis. We determined that if mCRC patients remain cancer-free for 28 months after curative surgery, their chance of long-term survival is significantly better.