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Objective: To gain retina physicians' and diabetic retinopathy (DR) patients' perspectives on needs and opportunities in DR education, and then develop and pilot test an educational video. Design: This study utilised qualitative interview data for video creation, and interview and survey data for assessment. Setting: This study was conducted in a single large academic medical centre. Method: We conducted semi-structured interviews with attending retina physicians and DR patients (Cohort A) which were coded for themes about needs in DR patient education. Using these interviews, we designed and piloted a 6-minute user-centred animated video among a second patient cohort (Cohort B), who completed post-intervention interviews. Results: Four physicians and 14 DR patients participated in the study. Themes from Cohort A included accessible information, early management, lifestyle factors and emotional context. Physician themes included effective communication, visual information delivery and individual-level diabetes management. Cohort B commented on the subsequently created video's improved accessibility, engagement and supplementation of their existing DR knowledge. Conclusion: Physicians and patients showed an interest in video education and identified unique educational needs. We used these insights to create a video that demonstrated positive patient uptake. Close attention to retina physicians' and DR patients' perspectives can offer a valuable approach in developing materials to increase patients' health knowledge. Within the context studied, videos may be more accessible and engaging than the use of traditional print-based education materials.

Limited research on diabetes education and support implementation in Appalachia, which is a critical knowledge gap considering barriers to care, and high prevalence rates. The aim was to understand what each facility is providing regarding diabetes education and services within West Virginia. This study reports cognitive interview qualitative findings from a multi-methods study. Individuals were recruited through an online search to identify clinics, organizations, and hospital staff that provided diabetes education in the state of West Virginia. Eligible participants were individuals who facilitated and managed diabetes education and support in counties of West Virginia. The interviews followed an 11-item interview guide, approved, and reviewed by a practicing Registered Dietitian and Certified Diabetes Care Education Specialist in West Virginia. All qualitative data from the interviews were hand-coded using grounded theory, by two researchers. 15 participating organizations from the state of West Virginia were included and described three phenomena: Diabetes Education Implementation (differences in: evaluation measures, modality, delivery format, topical areas); Barriers to Care (staffing, lack of training, evaluation, loss of research partnerships and funding); and Facilitators to Care (community-based involvement, interdisciplinary collaboration, capacity building (trainings). There are concerns with program drift and "risky" adaptations such as inconsistent evaluative measures, lack of training for program facilitators, variety of delivery formats, and content material. Findings recommend more alignment in program delivery to better implementation. Further studies should assess patient experiences with implemented diabetes education programs in West Virginia to further support the current research findings.

Background: People with intellectual disabilities are more likely to be prescribed psychotropic medication than the general population and are frequently prescribed multiple medications. Understanding people with intellectual disabilities and carer perspectives is essential to improving the quality of psychotropic medication prescribing and usage. Method: A rapid review explored people with intellectual disabilities' understanding of psychotropic medications, as well as family members and paid carers, and how this understanding can be improved. Results: Twenty-one journal articles were included. Lack of understanding of medication was universal, with participants often unaware of adverse effects, alternatives, and rights around medication. There was also a lack of involvement in decision making for all participants. Some interventions aimed at people with intellectual disabilities or paid carers helped to improve knowledge. Conclusion: Evaluating how best to improve psychotropic medication understanding for people with intellectual disabilities, family members and paid carers should be a focus for future research.

Objective: Extended reality (XR) has emerged as an innovative educational modality that offers the potential for the creation of more interactive and engaging forms of patient education experiences and products. The purpose of this article is to describe the field of XR technologies and review its potential through a critical lens as well as its possible adoption as a mainstream technology for providing patient education in the future. Method: A review of the literature was undertaken to summarise the emerging evidence concerning the effectiveness of XR as a patient education modality. The findings of several reviews are summarised and a critical discussion of potential issues and challenges in the adoption and use of XR among particular marginalised populations are explored. Results: The emerging evidence suggests that different forms of XR technology applications have the potential to create immersive and engaging patient education experiences that can lead to enhanced patient satisfaction, positive educational outcomes and reduced patient anxiety. Nonetheless, there have been calls for greater consideration of how patient characteristics, including socioeconomic status, gender, cultural and generational differences, influence the learning effects of virtual reality educational applications, as well as its adoption and implementation for patient education purposes. Conclusion: The evidence surrounding the effectiveness of XR in patient education is growing; however, various factors could influence the successful adoption and implementation of XR in different patient populations who have traditionally experienced challenges with digital health literacy. The paper offers some recommendations for enhancing the evidence base and potential approaches to advance the design and evaluation of XR applications in patient education.

Black men have a greater risk of prostate cancer as well as worse quality of life and more decisional regret after prostate cancer treatment compared to non-Hispanic White men. Furthermore, patients with prostate cancer who primarily obtain information on the internet have significantly more decisional regret compared to other information sources. Our objective was to explore the perspectives of Black patients on the use and impact of the internet for their prostate cancer care. In 2022-2023, we conducted seven virtual focus groups with Black patients with prostate cancer (n = 22). Transcripts were independently analyzed by two experienced researchers using a constant comparative method. Online sources were commonly used by participants throughout their cancer journey, although informational needs varied over time. Patient factors affected use (e.g., physical health and experience with the internet), and family members played an active role in online information-seeking. The internet was used before and after visits to the doctor. Key topics that participants searched for online included nutrition and lifestyle, treatment options, and prostate cancer in Black men. Men reported many downstream benefits with internet use including feeling more empowered in decision-making, reducing anxiety about treatment and providing greater accountability for research. However, they also reported negative impacts such as feeling overwhelmed or discouraged sorting through the information to identify high-quality content that is personally relevant, as well as increased anxiety or loss of sleep from overuse. In summary, online sources have the potential to positively impact the cancer journey by reinforcing or supplementing information from health care providers, but can be harmful if the information is poor quality, not representative, or the internet is overused.

Background: In people with intellectual disabilities and mental disorders and/or challenging behaviours, rates of psychotropic drug prescription are high. In clinical treatments and evaluations, all stakeholders should be involved in a process of shared decision-making (SDM). We aimed to investigate the perspectives of clients and their carers on clients' treatments with psychotropic drugs. Methods: We conducted a survey among adults with intellectual disabilities in a Dutch mental healthcare centre providing community, outpatient and inpatient care. Data were collected between January and June 2022. Questions focused on experiences with the provision of information, treatment involvement and SDM and participants' wishes in this regard. Findings: Respondents (57 clients and 21 carers) were largely satisfied with the overall care from their clinicians, and with how information on the pharmacological treatment was provided verbally, but written information was insufficient or not provided. Seventy per cent of clients and 60% of carers reported being involved in medication decision-making. However, over 75% of participants desired greater involvement in SDM and over 60% in medication reviews. Conclusions: Service users and representatives were satisfied about the treatment and verbal information on their psychotropic drug use. The provision of written information, the SDM process and ongoing evaluation of psychotropic medication use could be improved.

While patient engagement in healthcare professions education (HPE) has significantly increased in the past decades, a theoretical gap remains. What are the varied reasons as to why patients get involved with HPE programs? With a focus on understanding what drives patient involvement with HPE programs, this study examined how a patient as teacher (PAT) program was experienced by medical students, patient teachers, and faculty within a medical school. Through a phenomenographic approach, this study captures and describes the different ways our study participants experienced a PAT program (the 'phenomenon'). 24 semi-structured interviews were conducted in total, comprised of interviews with patient teachers (N = 10), medical students (N = 10) and program facilitators (N = 4) who participated in a PAT program. Our focus was on participants' description of the program and was grounded in their experiences of as well as their beliefs about it. Our findings captured 4 layers representing the qualitatively different (yet interrelated) ways in which participants experienced/perceived and conceptualized the various aspects of their experience with the PAT program: (1) A productive disruption of the learning space; (2) A re-humanization within healthcare; (3) A means of empowerment and agency; (4) A catalyst for change and emancipation. Our outcome space results can be visually illustrated by a nesting "Matryoshka" doll, representing the four layers and depicting the process of uncovering the less conscious layers of sense-making within this phenomenon. HPE programs that are co-produced with patients and actively involve patients as teachers have the potential, but not guarantee, to be emancipatory. To engage in PAT programs that exhibit an emancipatory potential, we need to consider transformative paradigms of education, which are aligned with social change, and disrupt the traditional teacher-learner hierarchy.

Background: Person-centred services are inherently related to patients/caregivers' needs. However, the extent to which dysphagia services within Singapore meet consumer needs is largely unknown. Involving patients/caregivers in service evaluation/redesign deepens the understanding of consumer needs. This process also increases the success of implementing service enhancements through relevant and meaningful change. Aim: This study aimed to identify aspects of dysphagia services, within acute and subacute settings in Singapore, perceived as highly important and easy to change by patients/caregivers. Methods & Procedures: Using concept mapping methodology, 5 patients and 11 caregivers reflected on their experiences of receiving dysphagia care and proposed 59 unique suggestions to improve dysphagia services within Singapore. Then, each individual sorted the suggestions into groups based on similarity and rated each statement for its perceived importance and changeability for service enhancement. Data were analysed using multidimensional scaling, hierarchical cluster analysis, and bivariate analysis to generate clusters of conceptually similar suggestions and a prioritised list of suggestions for service enhancement. Results: Twelve clusters were identified, with most rated as more important than changeable for service improvement. Participants prioritised 23 (39%) of the suggestions as highly important and easy to change, and these focused on ensuring effective communication among consumers and healthcare team, enhancing patients and carers' access to support at home, increasing patients and carers' access to educational resources, and improving service quality and access through technology. Conclusion: These findings provide future directions on how to develop and implement dysphagia services in Singapore to better meet the needs of patients/caregivers.

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT-FPOCC) models can assist assessment of low-risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best-practice care, consideration of other low-risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT-FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT-FPOCC procedures, with ENT triaging referrals, then SLT completing pre- and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post-service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty-three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre-/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT-FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre- and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services.

Objective: This study evaluated Tummy Time recommendations in patient education materials and informal sources found on the Internet. Methods: Patient education materials, available from health professionals online, and informal sources, found outside of healthcare, were evaluated for consistency with evidence-informed recommendations. Patient education materials were also evaluated for readability and visual presentation. Results: Twelve sets of patient education materials were included in the top 20 search results. Only one of them addressed all the evidence-informed recommendations accurately. Fifty informal sources were included in analysis, ranging from search rank #1 to #57. Nearly half of the informal sources were judged fully consistent with evidence-informed recommendations. Counter to best practice recommendations, two-thirds of the patient education materials were written above the reading level expected of a student with no more than an elementary school education. All used strategies to enhance clarity, although none met all standards for visual presentation. Conclusion: Although some good resources are available, healthcare providers should exercise caution when selecting or recommending patient education materials online, even when they are available from healthcare professionals. Parents turning to the Internet will find accurate information. However, to develop a comprehensive understanding, they may need to visit multiple sites. Practice Implications: Healthcare professionals are responsible for providing or directing their clients to reliable, comprehensive sources of information, and for being aware of the quality of information they may discover through their own searches. Healthcare websites are responsible for communicating clearly and comprehensively with their clients and the public. Some parent education materials require revision for readability, formatting and consistency with Tummy Time recommendations.

The informed consent process is integral to medical procedures, including skin biopsies, which are the definitive method for diagnosing challenging skin lesions. Educational videos are recognized for effective delivery of information for informed consent. This study aimed to evaluate the efficacy of an informed consent process using educational videos to improve patient understanding and reduce preprocedural anxiety. This multicenter, randomized controlled study was conducted during December 2021-June 2023. Participants were randomly assigned to either the video or verbal group in a 1:1 ratio. They completed knowledge and anxiety questionnaires before and after biopsy. The final analysis included 54 participants (verbal group: n=28; video group: n=26) with a mean age of 51.9 years (standard deviation [SD] 18.1), and a balanced gender distribution. Post-intervention knowledge scores (median 10.0; IQR 8.0-10.0) significantly increased compared to pre-intervention scores (median 6.0; IQR 4.0-9.0), p<0.001. Post-intervention Spielberger state-trait anxiety inventory (STAI) scores (median 5.0; interquartile range, IQR 5.0-6.0) significantly decreased compared to pre-intervention scores (median 7.0; IQR 5.0-10.0), p<0.001. Knowledge scores increased more in the video group (median, 2.5; IQR 1.0-5.0) than in the verbal group (median, 1.5; IQR 0.0-4.0), p=0.217. There was no significant difference in STAI score changes between the video group (median 1.0, IQR 0.0-4.0) and the verbal group (median 1.0, IQR 0.0-3.0), p=0.824. Despite statistical insignificance, educational videos exhibited greater effectiveness in enhancing comprehension and demonstrated comparable efficacy in reducing anxiety compared to conventional intervention.

The aim of this study was to evaluate the effect of nursing interventions applied to elderly individuals to improve rational use of medicines (RUM) and awareness through home visits. It was carried out in a prospective, randomized controlled experimental design with the pretest-post-test control group. The study was completed with 74 elderly individuals aged [greater than or equal to]65 years living in a rural area. The intervention group received education, counselling, brochures and pill boxes through home visits to increase RUM and awareness. The study data were collected between September and December 2022 using the face-to-face interview method, the elderly identification form, the Rational Use of Medicines Scale and the Rational Drug Use Awareness Scale. After nursing interventions were applied at home, it was determined that, the mean scores of RUM and Awareness of RUM of the intervention group increased compared to the control group and that, interventions to improve RUM and awareness were effective. In line with these results, training sessions on RUM should be organized periodically for elderly individuals and home visits should be planned by nurses at regular intervals to ensure the sustainability of RUM in the home environment.

Background: HPV is associated with several cancers, yet HPV vaccine uptake rates remain suboptimal. Enhancing HPV vaccine promotion requires looking beyond individual characteristics and conducting a thorough evaluation of how health-related and health system factors may influence HPV vaccine uptake. Purpose: Our study explores the relationship of health-related and health-system factors with patient-centered communication, HPV-related knowledge, and perceived effectiveness of the HPV vaccine. Methods: We used data from HINTS 5, Cycle 1, and performed structural equation modeling to explore the impact of health-related and health system factors on perceived HPV vaccine effectiveness, both directly and via HPV knowledge and patient-centered communication. The predictors in our model included health-related factors and health-system factors. Results: Findings suggest a direct relationship between HPV knowledge and perceived vaccine effectiveness ([beta] = 0.73; p < 0.05), and patient-centered communication and perceived vaccine effectiveness ([beta] = 0.07; p < 0.05). Frequency of doctor visits directly and negatively predicted patient-centered communication ([beta] = -0.04, p < 0.05). Self-reported health status was directly and positively related to HPV vaccine acceptability ([beta] = 0.147, p < 0.05). Having a chronic condition ([beta] = -0.09, p =< 0.05) and depression/anxiety ([beta] = 0.141, p < 0.05) was related to HPV vaccine acceptability, via knowledge. Discussion: These findings enhance our nuanced understanding of the intricate interplay between health-related and health-system factors in shaping perceptions and attitudes toward HPV vaccination. Translation to Health Education Practice: Accounting for health-related and health system factors is essential for effective dissemination of HPV information.

Dehydration is a typical problem among the elderly people who live in nursing homes. It is a condition that is costly in terms of health care costs and length of treatment due to the illnesses it causes. It is a condition that can be prevented, and elderly people can benefit from initiatives to increase their fluid intake. This study aimed to find out how the hydration status of elderly people is affected by hydration education. It was also an assessment of the participants' hydration status and water intake from sources. Forty-three elderly people from two nursing homes participated in this quasi-experimental study. There were 25 elderly in the intervention group (IG) and 18 in the control group (CG). For one month, 40-minute sessions per week (20 minutes of education and 20 minutes of activity) were devoted to teaching about fluid consumption. To evaluate the effectiveness of the education, the water balance questionnaire, urine USG and pH measurement, and the Physical Activity Scale for the Elderly were assessed before, at the end of the intervention, and three months after. The results showed that the IG group's hydration improved, and their short-term water consumption increased. Education needs to be carefully implemented and the results followed up to ensure that elderly people develop a habit of drinking water.

Background: The National Heart, Lung, and Blood Institute (NHLBI) "Learn About Chronic Obstructive Pulmonary Disease (COPD)" YouTube playlist educates the public on diagnosing, treating, and managing COPD. Despite its potential benefits, it is unknown if users with inadequate health literacy will likely understand and apply the information described in these videos. Purpose: Assess the "Learn About COPD" playlist's readability, actionability, and understandability. Methods: Central tendency statistics were computed to describe the meta-data of 28 videos available as of April 2023. Assessments included the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV), Accessible Health IT for Limited-Literacy Populations Checklist (LLPC), and the Modified Centers for Disease Control and Prevention (CDC)-Clear Communication Index (CCI) for audiovisual materials. Results: Playlist videos received an average of over 2,000 views (Mdn = 2,220, IQR = 496-8336), with very few "likes" (Mdn = 13, IQR = 1-48 "likes"). PEMAT-understandability (Mdn = 81.81%, IQR = 80-97.72%) and LLPC (Mdn = 87.50%, IQR = 75-93.75%) scores were high (above 80%). However, the modified CDC-CCI median score was 57.14% (IQR = 42.86-75%), and the median PEMAT-actionability score was 50% (IQR = 0-66.67%). Discussion: The playlist earned passing understandability, acceptability, and usability scores but scored poorly on actionability and communication clarity. Translation to Health Education Practice: Findings could inform enhancements to NHLBI's "Learn About COPD" YouTube playlist.

The aim of this pilot study was to assess the efficacy of a desensitization program developed by dentists and occupational therapists, targeted at autistic adults, to encourage their cooperation in the dental setting. The study group consisted of 18 individuals with autism (10 men and 8 women, aged 18 - 45 years). The patients underwent a baseline examination, after which they were progressively exposed to oral examination maneuvers and ultimately dental procedures. To this end, the participants engaged in a weekly desensitization session performed by an occupational therapist and a monthly assessment session by a dentist applying the Frankl scale, for a maximum period of 30 weeks. During the first session, 44% of the participants completed all oral examination procedures, reaching 94% by the fourth visit and 100% by the seventh visit. None of the participants completed a simple dental treatment up to the third session, subsequently increasing the percentage progressively until reaching a maximum of 61% in the seventh visit. In conclusion, a dental desensitization program implemented by dentists and occupational therapists could help in performing oral examinations and simple therapeutic procedures for a considerable percentage of adults with autism, without having to resort to pharmacological behavioral control techniques.

Artificial intelligence (AI) influences many aspects of modern life and has multiple applications in the delivery of healthcare. AI is designed to mimic human capabilities including pattern recognition, data analysis, and decision-making and perform tasks more efficiently. It is capable of detecting patterns in large datasets that might elude human beings. AI has potential to improve patient care, patient safety, disease diagnosis and treatment; public health; health research; health administration; and the daily work of health professionals. In 2019, the US National Academy of Medicine emphasized the need for "physicians, nurses, and other clinicians, data scientists, health care administrators, public health officials, policy makers, regulators, purchasers of health care services, and patients to understand the basic concepts, current state of the art, and future implications of the revolution in AI and machine learning." Therefore, it is incumbent on adult educators to incorporate AI training into health professions education and patient education.

Primary care health checks, screenings and GP consultations are often the gateway for people with intellectual disabilities to access their physical and mental healthcare. For a population who experience greater levels of health difficulties alongside significant health inequality, improving care quality and access is of major importance. This meta-ethnographic, qualitative review aims to explore people with intellectual disabilities experiences of health checks, screenings and GP visits, while assessing the quality of the current literature and synthesising findings to consider clinical and research recommendations based on third order constructs. A systematic search identified 20 studies that met inclusion criteria. Quality assessment of each paper was conducted. Meta-ethnography methods were used to analyse and synthesis findings. One overarching concept was identified: Include Me, along with seven core concepts; Empowerment and Disempowerment, Communication and Interpersonal Factors, Access and Adaptations and Biased Narratives and Shifting Perspectives. Implications for practice and future direction are discussed.

This study investigates pharmacy students' reasoning while solving a case task concerning an acute patient counselling situation in a pharmacy. Participants' (N = 34) reasoning processes were investigated with written tasks utilizing eye-tracking in combination with verbal protocols. The case was presented in three pages, each page being followed by written questions. Eye movements were recorded during case processing. Success in the task required differentiating the relevant information from the task redundant information, and initial activation of several scripts and verification of the most likely one, when additional information became available. 2nd (n = 16) and 3rd (n = 18)-year students' and better and worse succeeding students' processes were compared. The results showed that only a few 2nd-year students solved the case correctly, whereas almost all of the 3rd-year students were successful. Generally, the average total processing times of the case material did not differ between the groups. However, better-succeeding and 3rd-year students processed the very first task-relevant sentences longer, indicating that they were able to focus on relevant information. Differences in the written answers to the 2nd and 3rd question were significant, whereas differences regarding the first question were not. Thus, eye-tracking seems to be able to capture illness script activation during case processing, but other methods are needed to depict the script verification process. Based on the results, pedagogical suggestions for advancing pharmacy education are discussed.

Background: Saudi Arabia has the second-highest prevalence of diabetes in the Middle East. Therefore, providing patients with high-quality materials is essential to help them understand their illness. The Patient Education Materials Assessment Tool (PEMAT) contrasts and evaluates materials regarding understandability and actionability. Purpose: This study aimed to evaluate materials for type 2 diabetes using a printed version of the PEMAT. Methods: This observational study was conducted in Riyadh from December 2022 to May 2023. Sixty-nine samples were collected from hospitals affiliated with the Ministry of Health and the government sector. Results: Materials evaluated in this study had an excellent understandability score of 78.9% and a low actionability score of 66.6%, with significant differences between the sources. Some of the materials (42%) achieved high quality regarding understandability and actionability. Discussion: Less than half of the materials were considered high quality. Approximately 99% of the materials made their purposes completely evident and logically presented the information, and approximately 97% identified at least one action. However, only 17.4% of the materials provided summaries and tangible tools. Translation to Health Education Practice: Health Educators should consider including summaries and tangible tools when developing patient education materials to make them more understandable and actionable.

Objective: Participating in an escape room is not just an entertainment but can also be a form of education. Because of this, the New Jersey Department of Health (NJDOH), Project Firstline (PFL) created an escape room interactive training tool and skills-building exercise to encourage the identification and use of key infection control principles by current and future healthcare workers. Design and Setting: PFL is a US initiative that aims to provide infection prevention and control (IPC) knowledge to frontline healthcare workers. This article details health educators' descriptions and experiences of an escape room developed as part of this initiative; guidance on how to incorporate this modality of learning into present and future teaching; and assessment data and feedback from participants to begin to understand the impact and effectiveness of this approach to learning. Methods: A total of 8 sessions, conducted in 3 locations, with 64 participants, yielded survey assessment data from 41 participants. Results: Quantitative results indicated that participants were highly satisfied with the escape room experience and reported an increased level of knowledge after participation. In addition, participants reported extremely high levels of intention to implement the training they received, and all would recommend the escape room experience to a friend or a colleague. Qualitative data supports the overall findings and provides specific examples of how participants said they would implement the knowledge they learned, along with additional positive feedback. Conclusion: Current and continuing efforts to promote PFL's escape room are described, along with improvements and future actions.

Diabetes and heart disease are among the leading causes of death and disability in the United States, and these conditions are especially prevalent in the South. South Carolina's persistent racial and socioeconomic disparities in chronic disease outcomes are well-documented, yet little is known about how health care practices in medically underserved areas are addressing these challenges. Data were collected through a cross-sectional survey as part of two complementary 5-year cooperative agreements between the Centers for Disease Control and Prevention and the Division of Diabetes and Heart Disease Management (the Division) at the South Carolina Department of Health and Environmental Control. The Division fielded a survey to (a) assist in determining which Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) were best poised to implement specific strategies as part of these cooperative agreements and (b) provide data to establish the baseline for performance measures. FQHCs and RHCs in the top 25% of counties with the highest diabetes and heart disease burden were surveyed about eight domains: staffing/services, electronic health records, team-based care policies, lifestyle change programs, medication therapy management, telehealth, quality improvement collaboratives, and patient demographics. Data representing 71 practices revealed contrasts between RHCs and FQHCs and opportunities for improvement. For example, while most practices reported they were not implementing evidence-based lifestyle change programs (e.g., the National Diabetes Prevention Program), most RHCs and FQHCs expressed interest in starting such programs. Findings are being used to guide efforts to improve diabetes and heart disease prevention and management in South Carolina.

Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.

This article meta-analyzed 21 studies that tested the effectiveness of animated videos in improving learning in clinical and nonclinical settings compared with standard education. Animation was defined as the use of moving objects that are typically drawn or simulated. Videos ranged from just over 2 min in duration to 16 min in duration in articles published from 2009 through 2020. Mayer's Cognitive Theory of Multimedia Learning provided the theoretical model to frame the current analyses. Findings indicated an overall positive effect (d = 0.35) for use of animation in improving viewers' learning across a variety of health and clinical contexts, including surgery and diabetes. Moderator analyses indicated learning effects were greater in patient samples and samples with a higher proportion of male participants. Study findings were discussed in terms of the theoretical and practical implications for health communication scholars and practitioners.

Background: Rapid advances in prenatal genetic testing highlight the need for technology-based tools to assist in informed decision-making. Purpose: This study evaluates the feasibility, acceptability, and efficacy of a Computer-Aided Genetics Education Module (CAGEM) as an e-counseling tool and decision aid in a busy obstetric clinic among a socially disadvantaged patient population. Methods: A randomized controlled trial with patients randomized (1:1) to receive the intervention in addition to standard of care or standard of care only. Participants responded to pre- and posttest questionnaires. Results: Although limited in recruitment by the COVID-19 pandemic, this tool scored 81.0% acceptability and 91.0% feasibility among 88 participants. No statistically significant difference was detected between the overall improvement in knowledge scores and the total posttest knowledge scores among the intervention and control groups. However, the intervention group scored significantly higher on the posttest questions regarding NIPT interpretation (61.7 ± 49.1 vs 80.9 ± 39.8, p = 0.049), Down syndrome (78.7 ± 41.4 vs 93.6 ± 24.7, p = 0.016), and inheritance of recessive conditions (59.6 ± 49.6 vs 91.4 ± 28.2, p < 0.001). The intervention group also showed a greater improvement in knowledge scores for inheritance of recessive conditions (31.9 ± 8.1 vs 0 ± 7.8, p = 0.006) and a protective effect in knowledge scores for Down syndrome (0 ± 6.1 vs -17.1 ± 6.0, p = 0.049). Discussion: CAGEM may be a feasible and acceptable e-counseling tool and decision aid, especially when compared to standard of care prenatal counseling. Although overall knowledge did not show significant improvement, CAGEM showed promise in enhancing knowledge acquisition for certain genetic education topics, showing that technology-based tools may be beneficial in informed consent. Future iterations may be revised to improve clarity, especially around invasive testing methods, race congruency, and insurance coverage. Translation to Health Education Practice: This study's method creates a model for Health Educators to design and evaluate technology-based tools for improving informed decision-making around prenatal genetic testing. Tools like CAGEM may be utilized to improve patient education prior to prenatal appointments and thus serve as an adjunct to provider counseling. Specifically, CAGEM addresses multiple NCHEC Responsibilities and Competencies including #1.1.2, 1.3.2, 1.3.4, 4.2.9, and 6.4.3. Translation to Health Education Practice

An interprofessional pulmonary standardized patient simulation case was used for medical and social work students to work together using motivational interviewing. Following the case, 68 medical students and 20 social work students responded to open-ended questions eliciting reflection on the encounter. Using thematic text analysis, results indicated students learned how different professions approached healthcare issues and communicated to patients, the importance of collaboration, and the need to be patient-centered with an integrated care approach. This case met all four Interprofessional Education Collaborative Competencies. Our results suggest interprofessional standardized patient simulations can assist students in addressing substance use using a team-based approach. With barriers such as time, instructor availability, and limited funding for interprofessional activities, meaningful high-yield activities are essential.

This article examines implementational factors associated with an HIV patient navigation training intervention for health care professionals working with Black sexual minority men to improve access to and uptake of HIV prevention services among Black MSM. Utilizing qualitative analysis to better understand healthcare professionals' perceptions of the training program, we conducted a thematic content analysis based on constructs from Professional Network and Reach Model-Systems Model Approach (PNRSMA) framework. Data analysis revealed four major themes: 1) Knowledge and skill building, 2) Novel and Innovation, 3) Barriers to Implementation, and 4) Recommendations and Future Directions. Implementation factors such as appropriate facilitators, content, mode of delivery, learning strategies, and understanding structural barriers were important to training success. Participants highlighted innovation strategies such as the use of social media and interactive communication (e.g. role-playing and bi-directional communication) enhanced learning and skill-building. The expansion of training to include other affected groups such as women and bisexual individuals and increasing the duration of the training emerged as areas for improvement and effectiveness. Our analysis of an HIV patient navigation training revealed important findings to improve the implementation process to increase uptake of PrEP and other HIV prevention, care and treatment services.

Diabetes self-management education through peer support has been beneficial, especially in regions with limited medical resources. Studying the effects of education offered by trained peers of patients will facilitate tailoring the peer-led education programs to the regions' specific needs. Here, we evaluated changes in diabetes-related indicators in Filipino patients who received a peer-led education. We used data on 23 patients (age, 67.83 ± 6.69 years; 82.6% female) who participated in all five surveys performed every 6 months from March 2017 to March 2019. After the second survey until the end of this study, the participants were educated in diabetes self-management by their 13 peers who previously had received the training in diabetes self-management. Participants' knowledge of diabetes and the related 'cause, risk factors, nature of diabetes and complications' subindicator were greater on all surveys after starting the peer-led education compared with those on the second survey (i.e. before starting the education); these values did not differ between the first two surveys. Because increasing patients' knowledge can enhance their ability to self-manage their disease and thus improve their quality of life, strategies to expand patients' knowledge about diabetes should be included when organizing peer-led education in regions with limited medical resources.

Objective: Partnering with patients and staff to develop and evaluate falls prevention education could better enable patient learning and engagement. This study aimed to create a revised version of the Safe Recovery falls prevention education programme in partnership with older patients and hospital staff, to improve patient engagement in undertaking falls preventive strategies in hospital. Design: Two-phase sequential mixed methods participatory design. Setting: Hospital rehabilitation wards in Western Australia. Method: Phase 1--older patients (n = 10) and staff (n = 10) were surveyed before and after original programme delivery to ascertain their reaction and learning. Consumer-focused discussions were undertaken with staff and patients online to inform programme revision. A patient video and workbook were co-produced, and staff were trained to deliver the revised programme. Phase 2: older patients (n = 10) and staff (n = 10) were surveyed before and after receiving the revised programme to gain reactions and learning. Deductive content analysis and Wilcoxon signed-rank tests were used to analyse the qualitative and quantitative data. Results: Patients and staff perceived the original programme to be outdated and expressed low levels of satisfaction with the original resources. In contrast, both patients and staff were highly satisfied with the revised programme. Both original and revised Safe Recovery programme patient groups demonstrated significant improvements in knowledge and awareness to reduce their risk of falling after receiving the education (p = 0.008, p = 0.005, respectively). However, patients receiving the revised programme were significantly more likely to intend to take action (p = 0.024) and have a clear action plan (p = 0.010). Staff perceived that the revised resources showed significant improvements in aesthetic appeal (p = 0.007) and ability to engage patients in learning (p = 0.007). Conclusion: Patients and staff contributed to successfully revising the Safe Recovery programme with positive reactions to the co-produced resources. Participating in falls education significantly improved older patients' knowledge and attitudes regarding falls prevention.

Objectives: Patients with Type A aortic dissections are often overwhelmed by the influx of new information and changes necessary to adjust to life with an aortic disease. This article uses psychoeducation about life after dissection to dispel common myths about aortic disease and empower patients to live full lives. It is written in clear and easy-to-understand language to maximise patient comprehension and knowledge of their condition to help them feel more confident after Type A aortic dissection. Design: An interdisciplinary group of professionals (including cardiothoracic surgeons, a clinical cardiac psychologist, clinical cardiac psychology trainees, and genetic counsellors) were asked about their interest in creating an article written for patients who have undergone Type A aortic dissection repair. Those who agreed were then asked to report some of the myths commonly heard in practice about the procedure and its ramifications. Setting: The myths confronted in this article come from professionals working for a comprehensive heart care institute, the East Carolina Heart Institute in Greenville, NC, USA and Johns Hopkins Hospital in Baltimore, MD, USA. Methods: A multi-disciplinary group of professionals focused on aortic disease contributed myths commonly reported by patients seen in practice. Results: Common myths are presented and include safety fears about physical activity, diet, and recurrence of aortic dissection. By educating yourself about the facts of your diagnosis, you can feel as though you have more control over your health and your life. Conclusion: The takedown of common myths about life post-dissection can be helpful for patients with aortic disease and their families. Understanding the facts about a loved one's new diagnosis can help partners and caregivers to be more fully involved in the patient's care and feel confident. An important limitation of the present work is the lack of prior research on patient quality of life and mental health following Type A aortic dissection. Future work should explore the unique mental health needs of patients with aortic disease to create interventions that target mental health symptomatology to help patients live longer, healthier and richer lives.

Background: Type 1 diabetes mellitus (T1DM) is on the rise globally. Patient education is a major cornerstone in diabetes management. Diabetes educators play a pivotal role in educating patients with diabetes mellitus. Objectives: To estimate the impact of a diabetes educator-led clinic on the control of T1DM among adults. This was measured through mean changes in HbA1c levels and alterations in perceived dietary and physical activity compliance among patients attending a Diabetes Centre in the Qassim region of Saudi Arabia. Methods: We enrolled 97 adult T1DM patients in a quasi-experimental study, conducted at a certified diabetes educator-led clinic. All patients were followed up for 6 months pre-intervention and for a minimum of 6 months post-intervention. Patients' weight, self-monitoring of blood glucose, hypoglycaemic events frequency, HbA1c level and lipid profiles were routinely recorded. In addition, compliance with advice on dietary plan and physical activity recommendations was also assessed at the pre-intervention, baseline and post-intervention stages. Results: Post-intervention, participants reported better compliance with dietary and physical activity advice. Fewer hypoglycaemic events and higher self-monitoring of blood glucose frequencies were also noted. While there was no significant difference between pre-intervention and baseline mean HbA1c levels, mean baseline and post-intervention HbA1c levels showed a clinical and statistically significant difference of 1.01 (95% confidence interval [CI]: 0.74-1.28). Mean low-density lipoprotein (LDL) and triglyceride differences also showed small but significant changes. Conclusion: Attendance at a diabetes educator-led clinic had a positive and significant impact on the control of T1DM among adults. We recommend diabetes educator employment at outpatient clinics for adults with T1DM.

Persons with chronic health conditions, such as heart disease, diabetes, hypertension, and others, often experience self-management problems that are not disease-specific. These include disrupted sleep, pain, memory issues, and challenges in working with healthcare providers. These patients may benefit from information and skill development for these problems, but simply providing them information in brief sessions during clinical appointments or in handouts or pamphlets may have little impact on their behavior. Providing information tailored to persons' needs and individual characteristics significantly impacts patients' behavior and may increase their abilities to manage their health. However, creating tailored information for each person is labor intensive, making it difficult to use in everyday clinical practice. Computer-based tailoring is an alternative, allowing automated tailoring of information presented to patients based on their interactions with a computer app. This article describes our process in developing a series of modules for chronic disease self-management for persons 40 or older with one or more chronic health conditions.

Objectives: The incidence of type 2 diabetes in UK Black African and Caribbean communities is up to three times higher than in the general population, and engagement with self-management advice is poorer. This study explores the perspective of those living with diabetes to understand how the cultural salience of advice could be improved. Design: Participants were recruited via community venues, faith institutions and primary care. Eight focus groups were conducted with 41 individuals (Black African n = 23, Black Caribbean n = 18). Grounded theory methods were used for analysis. Results: Although motivated to manage the condition, individuals experienced a misalignment between elements of the care provision and cultural norms. Explanatory models of diabetes differed from the biomedical model reducing trust in treatment protocols. A lack of cultural salience reduced the accessibility of advice. Furthermore, elements of self-management advice were seen to conflict directly with some cultural traditions and practices. Individuals had to reconcile the two perspectives in order to proceed with self-management, often prioritising cultural norms and advice from informal sources over healthcare advice. Building personal relationships with the healthcare team improved trust and engagement. Conclusion: Findings suggest the needs in these communities were not being fully met. The healthcare interaction was pivotal in improving trust and engagement and reducing misinformation. However, appropriately informed community support also offers the potential to mitigate misalignment and to improve equity of access.

In China, despite the rapid increase in percutaneous coronary interventions (PCIs), cardiac rehabilitation (CR) is just burgeoning, leaving a need for comprehensive evidence-based education curricula. This pilot study assessed the acceptability of Simplified Chinese CR education delivered via booklets and videos on WeChat asynchronously and the impact on improving knowledge, risk factors, health behaviors and quality of life. In this pre-post, controlled, observational study, interested PCI patients received the 12-week intervention or usual care and WeChat without education. Participants completed validated surveys, including the Coronary Artery Disease Education--Questionnaire and Self-Management Scale. Acceptability (14 Likert-type items), engagement (minutes per week) and satisfaction were assessed in intervention participants. Ninety-six patients consented to participate (n = 49 intervention), of which 66 (68.8%) completed the follow-up assessments. Twenty-seven (77.1%) retained intervention participants engaged with the materials, rating content as highly acceptable (all means [greater than or equal to]4/5) and satisfactory (2.19 ± 0.48/3); those engaging more with the intervention were significantly more satisfied (P = 0.03). While participants in both groups achieved some improvements, only intervention participants had significant increases in disease-related knowledge, reductions in body mass index and triglycerides, as well as improvements in diet (all P < 0.05). In this first study validating the recently translated CR patient education intervention, acceptability and benefits have been supported.

Patients report that adhering to diet is the most challenging aspect of diabetes management. Provision of diet education is often delegated to health care providers, despite a lack of nutrition education and training and limited awareness of environmental and cultural challenges faced by patients. Aim: We examined perceived barriers to diet self-management among low-income minority patients with type 2 diabetes and their health care providers within a single ecosystem, to test whether providers understood patient barriers. Method: We surveyed 149 members of a safety-net clinic (99 patients, 50 providers), using barriers derived from the literature. Binomial logistic regression was applied to investigate relationships between barriers and patients' sociodemographic variables and Pearson's X[superscript 2] was used to compare differences in perceived barriers between patients and providers. Results: Providers expressed divergent perceptions of patients' barriers to healthy eating, including more total barriers and little agreement with patients on their relative importance. Largest differences in providers' perceptions of patient barriers included poor motivation, high use of fast food, inadequate family support, and lack of cooking skills--all suggesting patient inadequacy. In contrast, patients showed evidence of high motivation--in rate of blood glucose measurement and desire for diet education. Patients identified primary care providers as a main source of nutrition education, yet providers indicated lack of time for diet discussion and preferred other staff do the teaching. Conclusion: The findings from this study strongly suggest that health systems need to consider patient, provider, and system barriers when implementing nutrition education and management programs.

Background: Individuals with intellectual and developmental disabilities demonstrate disparities in sexual and reproductive health (SRH) compared to individuals without disabilities (e.g., lack of sexual education and knowledge, increased rates of abuse, unplanned pregnancies and sexually transmitted infections). Therefore, the purpose of this study was to identify topics healthcare providers address and perceived barriers and supports to SRH education. Methods: We conducted semi-structured interviews with healthcare providers (N = 12). Results: Providers address relationships, safety, protection and appropriate sexual behaviours with clients with intellectual and developmental disabilities. Parent education and client-centred care were identified as supports, while the patient's level of understanding, the provider's lack of knowledge or access to resources and to appropriate referrals were identified as barriers to SRH education. Conclusion: Future studies are needed to link providers to resources they can use to provide comprehensive, accessible SRH education for clients with intellectual and developmental disabilities.

This phenomenological qualitative study explored how eight speech-language pathology specialists in augmentative and alternative communication (AAC) (who self-identified as adult-focused) would approach the AAC assessment process when presented with a case study of an adult with amyotrophic lateral sclerosis (ALS). The general research questions were: What areas are assessed by AAC specialists evaluating individuals with ALS? How do specialists evaluate the areas identified: In all, four themes emerged: (a) Area of Assessment, (b) Method of Assessment, (c) Patient Education, and (d) Decision Criteria. These results support authoritative models of AAC assessment. AAC assessment is a complex task and understanding the behaviors of specialists, as outlined in this article, may be a first step in assisting general practice SLPs to complete AAC assessments for individuals with ALS with greater confidence and comfort.

Objective: Familial hypercholesterolaemia (FH), an autosomal dominant disorder causing elevated low-density lipoprotein (LDL) cholesterol from birth resulting in premature cardiovascular disease, is only diagnosed in 10% of affected patients. This study involved partnering with patients with FH and with primary care providers (PCPs) to understand health priorities and translate them into hypotheses for future research and enhancement of health practices via electronic health records (EHRs). The goal was to strengthen genetic health education for clinicians and for patients and their families, including improved diagnosis, knowledge and treatment. Perceptions regarding genetic health education and healthcare related to FH facilitated by the use of an EHR for diagnosis and treatment have not been studied. Design: Mixed-methods exploratory qualitative research and surveys. Setting: Qualitative research included five focus groups, 34 semi-structured key informant interviews and open-ended survey items with patients and PCPs at a large medical centre in Western New York. Method: Data were thematically coded to identify themes as formative work for the improvement of relevant EHR features, diagnosis, treatment and genetic health education via information sharing between clinicians and patients. Results: Themes included genetic health knowledge; the importance of being diagnosed; communication between patients, family members and medical professionals; outreach via patients' own advocacy; and treatment, technology, motivation, trust, outside resources (for further genetic health education and support) and awareness of effective treatments. Conclusion: Patients and clinicians can contribute to the development of EHR support for the genetic health education of patients and their families, and for improved diagnosis and treatment of FH. Using their ideas in the development of effective strategies could improve the currently low rate of FH diagnosis and cascade screening (for family members), as well as enhance physician and patient genetic health knowledge and self-empowerment.

Objective: In low tuberculosis (TB) incidence countries, linguistic and cultural dissonance between families experiencing infectious TB and TB health care providers is a barrier to effective communication and successful treatment. The purpose of this research was to explore infectious TB education and counselling from the perspective of patients and family members who are foreign-born. Design/Setting: One component of a multiphase, qualitative case study conducted in Calgary, a large city in western Canada. Method: Data were collected through semi-structured interviews, chart review and field notes and analysed thematically. Eight families were represented in the 6 patient and 13 family member participants who had recently experienced infectious TB. Results: Three themes were generated from the data: 'learning about TB from many sources', 'reassurance and connection' and 'missing information'. Participants described learning about TB in different ways, feeling reassured once they knew more and sharing information with others. Overall, participants expressed satisfaction with education and counselling received. However, there were indications that communication problems had occurred. Participants asked questions during the interview, described areas of lingering confusion and shared TB-related behaviours incongruent with medical understanding. Knowledge gaps often increased isolation. Conclusion: Gaps in infectious TB education and counselling have negative impacts on patient and family member well-being. Education and counselling can be improved using multiple modes of communication, proactively addressing common misperceptions and reducing barriers to patient participation. Improvements could empower families to better manage their own experience and share accurate TB information with their communities.

Background: Educational video is a productive means to advocate lifestyle modifications such as changes in the dietary routine. This study assesses the understandability, actionability and suitability of newly developed educational videos aimed at encouraging dietary adjustments among hypertension patients. Method: In all, 183 participants were recruited via convenience sampling and rated the understandability, actionability and suitability of the videos using the Patient Education Materials Assessment Tool for Audio-Visual material (PEMAT-A/V) and the Suitability Assessment of Materials (SAM) scale. Results: Eleven videos were developed from five main topics related to the dietary management of hypertension. Participants agreed that all videos were highly understandable, actionable and suitable for use as educational tools, with scores of more than 85%, 89% and 80%, respectively. Conclusion/Implications: Overall, the newly developed videos gained high scores for understandability, actionability and suitability. This finding reflects positive acceptance of the videos among various healthcare professionals and patients with hypertension.

The aim of this study is to determine the effect of fall prevention education given to patients with scheduled total knee arthroplasty (TKA) on their fear of falling in the postoperative period. The study had a quasi-experimental design. The study sample included 70 patients. Data were gathered with a patient characteristics form and the Falls Efficacy Scale-International (FES-I) at face to face interviews. The intervention group was given a brochure and face-to-face education about fall prevention before surgery. Activities such as the first mobilization, assisted walking, climbing stairs, getting out of bed and sitting in bed after the surgery were demonstrated and performed. Patients were followed up to 16 weeks after surgery. The mean age of the control and intervention groups, respectively; 62.26 ± 6.38 and 59.46 ± 7.33. The fear of falling scores before the operation and in the postoperative 6th-8th weeks were high in the intervention group (40.17 ± 8.32 and 31.71 ± 7.83 respectively) and the control group (44.14 ± 8.86 and 40.91 ± 8.43 respectively). The fear of falling scores in the postoperative 14th-16th weeks were high in the control group (37.2 ± 9.03) and moderate in the intervention group (26.42 ± 5.59). The scores for FES-I in the 6th-8th weeks and 14th-16th weeks after surgery were very significantly lower in the intervention group than in the control group(p < .001). The results of the study showed that the patients experienced a great fear of falling before and after surgery. It can be said that the education given reduces the fear of falling significantly and in the early period.

Type 1 diabetes (T1D) is an endocrine and metabolic disorder affecting approximately 1.4 million adults living in the United States. Psychosocial factors have been identified as key barriers to improvements in self-care among T1D adults, including emotional well-being, social support and self-efficacy, and personal motivation. It is posited that nonclinical approaches, such as peer-based outdoor adventure education programs, could assist T1D adults with their individual psychosocial needs. However, very little research exists to support this unique approach to care. The purpose of this study was to explore the meaning that adults living with T1D ascribe to participation in a wilderness backpacking trip. Eighteen participants with T1D completed a 5-day backpacking trip on the Chilkoot Trail in Alaska and British Columbia. Once on the trip, participants were invited to participate in two semi-structured interviews within 48 hours of the trip start and end date. Using a phenomenological approach, three themes were constructed: a) seeking and finding a diabetes community, b) revealing capabilities to yourself and the world, and c) enhancing diabetes management and self-care on the trail and in life. A common thread across the three constructed themes was the sense of belonging to the diabetes community, which was described by the participants as paramount to their positive overall trip experience. This finding extends assertions that peer relationships during OAE programs may play a central role in improving psychosocial functioning for individuals living with T1D. This provides evidence on the power of using outdoor recreation to positively impact the community of individuals with T1D.

Purpose: This study aimed to analyze and define the concept of readiness for hospital discharge (RHD) in patients with myocardial infarction (MI). Design/methodology/approach: Walker and Avant's approach was used for concept analysis. Electronic text searches were performed using valid databases with "readiness for hospital discharge" and "MI" keywords. The research included quantitative and qualitative studies related to RHD published between 1997 and 2021 in English and Persian. Out of 103 obtained articles, 29 met the inclusion criteria. Findings: In the analysis, the authors identified stable physical state, desirable individual and social conditions, psychological stability, adequate support, adequate information and knowledge, and multidisciplinary care as the attributes of the determinants of RHD. Antecedents were divided into two categories, including preadmission conditions (economic and social, etc.) and postadmission conditions (disease severity and patient health needs, etc). The consequences were also identified as both positive (e.g. self-care) and side effects (e.g. reduced readmission). Originality/value: The results showed that the concept of RHD in MI patients is a complex and multidimensional condition that applies to all patients on discharge. It is critical for the care team to pay attention to its attributes and scopes in the process of preparing the patient for discharge. It is also suggested that the concept be used as a nursing diagnosis on the North American Nursing Diagnosis Association (NANDA) list. The Association provides nurses with an up-to-date list of nursing diagnoses.

Background: Diabetes education and treatment is a public health priority. Student-delivered strategies have the potential to offer low-cost, high-quality healthcare services to underserved patients while giving students practice experience. However, the effectiveness of these interventions is unknown. Purpose: To document study characteristics and the effectiveness of student-delivered interventions on diabetes health outcomes. Methods: Databases searched included Medline, CINAHL Plus, and others. Appropriate keywords/ subject headings were used to identify studies meeting inclusion criteria. Two reviewers independently extracted data which were compared, and conflicts resolved by discussion. Results: Seven studies met inclusion criteria. Six had statistically significant improvement in outcomes including HbA1c, a long-term glycemic control indicator (n = 4), blood pressure (n = 3), physical activity (n = 1), and exercise stage of change (n = 1). Studies involved medical (n = 3), pharmacy (n = 2), nursing (n = 1), and exercise science (n = 1) students. Studies with improved outcomes tended to have more patient contact. Discussion: This review provides evidence that student-led diabetes interventions may be effective at improving outcomes, although studies reviewed are limited by lack of comparison groups and representative samples. Translation to Health Education Practice: Student-delivered diabetes interventions may improve outcomes, especially with adequate patient contact time. Studies of theory- and evidence-based student-led diabetes interventions involving health education/promotion students are warranted.

With only about 12% of U.S. adults having what is considered proficient health literacy, a plain language "universal precautions" approach toward the writing of patient education materials is warranted. In practice, however, this is seldom done. One persistent reason for this is that the market research that informs the writing of patient education materials frequently ignores respondent health literacy levels when setting quotas and recruiting participants. Since market research respondents traditionally have higher levels of health literacy, this can result in patient education materials that are too complex for optimal accessibility and comprehension. CHES and MCHES professionals have both an opportunity and a responsibility to hold pharmaceutical companies and market researchers accountable and encourage them to incorporate diverse patient voices reflecting a wide range of health literacy levels in their studies.