(500 words altogether)
Part a) Definition of health (250 words)
There are many definitions of health. Present your preferred definition and explain why you prefer it.
12
Part b) Definition of health equity/equality (250 words)
What is the difference between health equity and health equality? Use an example to illustrate your argument.
Assessment Criteria
The following assessment criteria will be used for marking. Your assignment should comply with the following criteria:
Presents accurate and referenced definitions
Provides evidence of a well-formed argument explaining your preference for one definition Uses a structure that includes an introduction, well-formed arguments and a conclusion
Uses readings to support arguments
Complies with academic standards of legibility, referencing and word length
Is clearly presented with accurate spelling, grammar and sentence and paragraph construction


I want just 500 words

I have resources

when you write refrences you must write like when I put my resources
There are faxes for this order.

Task for this assignment -- write a 4-page paper that addresses the following:

1. What type of organizations collaborated for the Bronx Health REACH project described in the Making Health Equality A Reality: The Bronx Takes Action article? Please include examples.

2. Bronx Health REACH is ?Making Health Equality a Reality By Changing Systems and Changing Communities?. This type of project needs a lot of support from decision-makers. What factors might influence them? Think about decision-makers such as legislators, public policy personnel, leaders of community-based organizations, school boards, funding agencies, etc.

3. The Bronx project addresses several of the 5 levels of influence for health-related behaviors. Please explain which levels and how they are addressed.

4. Bronx Health REACH provides several educational resources on their Web site?s Resource Center. Choose any one of the resources. Describe the item, include the direct link so I can view it, and critique its appropriateness for the selected audience. Consider the factors on the checklist found on Page 29 of Simply Put: A Guide for Creating Easy-to-Understand Materials



In order to earn full credit, you must clearly show that you have read the module homepage and ALL required background materials.

You are welcome to do research in addition to -- but not instead of -- the required readings.

Be sure to cite your references in the text of all papers and on the reference list at the end. (Hint: Look at the way the references are listed in the modules).




Module 3 Required Reading

Bronx Health REACH -- Making Health Equity a Reality at http://www.institute2000.org/bhr/ (2011). Explore this site for your case assignment; in particular, click on the links to About Us, Our Work, and Resource Center.

Calman, C. (2005). Making Health Equality A Reality: The Bronx Takes Action. Health Affairs, 24(2), 491-498. Retrieved May 1, 2011 from http://content.healthaffairs.org/cgi/reprint/24/2/491 NOTE: This is an excellent example of a comprehensive, community-based participatory project. You can read a follow-up report, too. See the Kaplan article listed as an optional reading, below.

National Cancer Institute (2009). How to Evaluate Health Information on the Internet: Questions and Answers. Retrieved May 1, 2011 from http://www.cancer.gov/cancertopics/factsheet/Information/internet

U.S. Office of Disease Prevention and Health Promotion (2011). Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites. Retrieved May 30, 2011 from http://www.health.gov/healthliteracyonline/know.htm and http://www.health.gov/healthliteracyonline/display.htm

For this assignment students need to:
Write a short paper (no more than 5-6 pages of narrative) reflecting on a personal experience with global health through work or in the community.
Examine the global problem and its effect on the person/people.
Include factual information (description of the people, the influence of culture, economy and region and how health is impacted (positively/negatively).
Reflect on how the discussion board and blog sessions dialog contributed to your development of a global health perspective.
Discuss the importance and challenges of impacting global health equity in contemporary nursing practice.

Research of Relevant Literature
Please complete a review of literature paper on this topic.
I searched the following literature to make your job easier.
Let me know if you have any questions.

Ovid Technologies, Inc. Email Service

------------------------------

Search for: 10 or 14

Results: 22



Database: Ovid MEDLINE(R) <1950 to August Week 5 2010>

Search Strategy:

--------------------------------------------------------------------------------

1 Health Literacy/ (136)

2 health liter$.mp. (1738)

3 or/1-2 (1738)

4 newest vital sign.mp. (17)

5 3 and 4 (13)

6 REALM.mp. (2702)

7 Rapid estimate of Adult Literacy in Medicine.mp. (101)

8 6 or 7 (2730)

9 3 and 8 (63)

10 5 and 9 (2)

11 from 5 keep 1-3,8-9 (5)

12 from 9 keep 1,6,8,14,16,19,26-28,33,37,46,51-52,60-61 (16)

13 from 5 keep 1-3,9-10,12-13 (7)

14 11 or 12 or 13 (22)

15 10 or 14 (22)



***************************

Result <1. >

Unique Identifier

19885705

Status

MEDLINE

Authors

Rawson KA. Gunstad J. Hughes J. Spitznagel MB. Potter V. Waechter D. Rosneck J.

Authors Full Name

Rawson, Katherine A. Gunstad, John. Hughes, Joel. Spitznagel, Mary Beth. Potter, Vanessa. Waechter, Donna. Rosneck, James.

Institution

Department of Psychology, Kent State University, P.O. Box 5190, Kent, OH, 44242-0001, USA. [email protected]

Title

The METER: a brief, self-administered measure of health literacy.

Source

Journal of General Internal Medicine. 25(1):67-71, 2010 Jan.

Other ID

Source: NLM. PMC2811598 [Available on 01/01/11]

Abstract

BACKGROUND: Given rapidly accumulating evidence that health literacy is correlated with important health-related measures, assessing patients' health literacy level is of increasing concern for researchers and practitioners. Practical limitations for use of existing health literacy measures include length of time and practitioner involvement in administration. OBJECTIVE: To develop and validate a brief, self-administered measure of health literacy, the Medical Term Recognition Test (METER). PARTICIPANTS: 155 participants were recruited from an outpatient cardiology program at an urban hospital. MEASURES: Patients completed measures of health literacy (METER and REALM), neuropsychological function, psychosocial health, and self-report questionnaires about health behaviors. Indicators of cardiovascular health were also recorded from patients' medical charts. KEY RESULTS: The measure took 2 min to complete. The internal consistency of the METER was 0.93, and it correlated hig!

hly with REALM (r = 0.74). Regarding sensitivity and specificity for identifying individuals below REALM's cutoff for functional literacy, METER resulted in 75% correct identifications and 8% false positives. METER and REALM were both associated with various health-related measures (including significant correlations with measures of neuropsychological function and cardiovascular health). CONCLUSIONS: These initial findings show that the METER is a quick and practical measure of health literacy for use in clinical settings.

Publication Type

Comparative Study. Journal Article. Research Support, N.I.H., Extramural.

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Result <2. >

Unique Identifier

20574878

Status

MEDLINE

Authors

VanGeest JB. Welch VL. Weiner SJ.

Authors Full Name

VanGeest, Jonathan B. Welch, Verna L. Weiner, Saul J.

Institution

School of Community Health and Policy, Morgan State University, Baltimore, Maryland, USA.

Title

Patients' perceptions of screening for health literacy: reactions to the newest vital sign.

Source

Journal of Health Communication. 15(4):402-12, 2010 Jun.

Abstract

Difficulties in caring for patients with limited health literacy have prompted interest in health literacy screening. Several prior studies, however, have suggested that health literacy testing can lead to feelings of shame and stigmatization. In this study, we examine patient reaction to the Newest Vital Sign (NVS), a screening instrument developed specifically for use in primary care. Data were collected in 2008 in the Morehouse School of Medicine, Department of Family Medicine Primary Care Clinics, where health literacy screening was implemented as part of routine intake procedures. Following the visit, patients completed a series of questions assessing their screening experiences. A total of 179 patients completed both the NVS and the reaction survey. Nearly all (> 99%) patients reported that the screening did not cause them to feel shameful. There were also no differences in the reported prevalence of shame (p
ould recommend clinical screening, 97% of patients answered in the affirmative. These results suggest that screening for limited health literacy in primary care may not automatically elicit feelings of shame. Even patients with the lowest levels of literacy were both comfortable with and strongly supportive of clinical screening.

Publication Type

Journal Article. Research Support, Non-U.S. Gov't.

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Result <3. >

Unique Identifier

20606152

Status

MEDLINE

Authors

Powers BJ. Trinh JV. Bosworth HB.

Authors Full Name

Powers, Benjamin J. Trinh, Jane V. Bosworth, Hayden B.

Institution

Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St, Durham, NC 27705, USA. [email protected]

Title

Can this patient read and understand written health information?. [Review] [46 refs]

Source

JAMA. 304(1):76-84, 2010 Jul 7.

Abstract

CONTEXT: Patients with limited literacy are at higher risk for poor health outcomes; however, physicians' perceptions are inaccurate for identifying these patients. OBJECTIVE: To systematically review the accuracy of brief instruments for identifying patients with limited literacy. DATA SOURCES: Search of the English-language literature from 1969 through February 2010 using PubMed, Psychinfo, and bibliographies of selected manuscripts for articles on health literacy, numeracy, reading ability, and reading skill. STUDY SELECTION: Prospective studies including adult patients 18 years or older that evaluated a brief instrument for identifying limited literacy in a health care setting compared with an accepted literacy reference standard. DATA EXTRACTION: Studies were evaluated independently by 2 reviewers who each abstracted information and assigned an overall quality rating. Disagreements were adjudicated by a third reviewer. DATA SYNTHESIS: Ten studies using 6 different ins!

truments met inclusion criteria. Among multi-item measures, the Newest Vital Sign (English) performed moderately well for identifying limited literacy based on 3 studies. Among the single-item questions, asking about a patient's use of a surrogate reader, confidence filling out medical forms, and self-rated reading ability performed moderately well in identifying patients with inadequate or marginal literacy. Asking a patient, "How confident are you in filling out medical forms by yourself?" is associated with a summary likelihood ratio (LR) for limited literacy of 5.0 (95% confidence interval [CI], 3.8-6.4) for an answer of "a little confident" or "not at all confident"; a summary LR of 2.2 (95% CI, 1.5-3.3) for "somewhat confident"; and a summary LR of 0.44 (95% CI, 0.24-0.82) for "quite a bit" or "extremely confident." CONCLUSION: Several single-item questions, including use of a surrogate reader and confidence with medical forms, were moderately effective for quickly id!

entifying patients with limited literacy. [References: 46]

Publication Type

Journal Article. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov't. Research Support, U.S. Gov't, Non-P.H.S.. Review.

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Result <4. >

Unique Identifier

20207930

Status

MEDLINE

Authors

Shah LC. West P. Bremmeyr K. Savoy-Moore RT.

Authors Full Name

Shah, Lisa Ciccarelli. West, Patricia. Bremmeyr, Katazryna. Savoy-Moore, Ruth T.

Institution

Department of Family Medicine, St. John Hospital, Detroit, MI, USA. [email protected]

Title

Health literacy instrument in family medicine: the "newest vital sign" ease of use and correlates.

Source

Journal of the American Board of Family Medicine: JABFM. 23(2):195-203, 2010 Mar-Apr.

Abstract

BACKGROUND: Health literacy has been defined as the ability to obtain, process, and understand the basic information needed to make appropriate health decisions. Half of adults lack the health literacy skills needed for our complex health care environment. In 2005, Weiss et al introduced the Newest Vital Sign (NVS), an instrument that can be used to quickly assess health literacy. The purpose of this study was to determine the acceptability and timeliness of using the NVS to measure the level of health literacy in various suburban, urban, and rural primary care settings. A secondary purpose was to determine the influence of taking a health class on one's level of health literacy. METHODS: In this cross-sectional design, adults were recruited from 4 primary care settings and student athletes were recruited during preparticipation sports physicals. The NVS was administered and health literacy rates were compared with known trends. A subset of 50 patients was timed during tes!

t administration, and refusals were logged throughout. The adults and the athletes were analyzed separately. RESULTS: One thousand fourteen patients (including athletes) agreed to participate (response rate, 97.5%). Average time needed to complete the NVS was 2.63 minutes. Of the adults tested, 48.1% demonstrated adequate health literacy. In logistic regression analysis, younger age, more formal education, health class participation, and body mass index were positive predictors of adequate health literacy among adults. An interaction term was used for gender/race, with white women used as the comparator. The gender/race odds ratio negatively affected literacy, with white men at 0.497 (95% CI, 0.328-0.753), non-white women at 0.177 (95% CI, 0.111-0.282), and non-white men at 0.210 (95% CI, 0.110-0.398). Among the participating middle- and high-school athletes, 59.7% had adequate health literacy. In logistic regression of this population, body mass index was a positive predic!

tor whereas gender/race was a negative predictor. CONCLUSION: The NVS

revealed health literacy status in less than 3 minutes, was widely accepted, and provided results comparable to more extensive literacy tests. Particularly, taking a health education class was associated with higher levels of health literacy among adults.

Publication Type

Journal Article. Research Support, Non-U.S. Gov't.

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Result <5. >

Unique Identifier

20010182

Status

MEDLINE

Authors

Walker J. Pepa C. Gerard PS.

Authors Full Name

Walker, Jane. Pepa, Carole. Gerard, Peggy S.

Institution

School of Nursing, Purdue University Calumet, Hammond, Indiana, USA. [email protected]

Title

Assessing the health literacy levels of patients using selected hospital services.

Source

Clinical Nurse Specialist. 24(1):31-7, 2010 Jan-Feb.

Abstract

PURPOSE: The aim of this study was to assess the health literacy abilities of patients in an urban and suburban hospital. BACKGROUND: Inadequate health literacy is a widespread problem that is associated with insufficient self-care knowledge and behavior, inappropriate use of emergency services, higher rates of hospitalization, and increased healthcare costs. Knowledge of patients' reading ability is necessary to ensure that appropriately leveled printed health education materials are available. METHODS: The health literacy of a convenience sample of 21 inpatients and 34 outpatients from an urban and suburban hospital was measured using the Test of Functional Health Literacy in Adults and the Rapid Estimate of Adult Literacy in Medicine. Variables for analysis included demographic characteristics, perceived health status, highest grade of school completed, socioeconomic status, healthcare costs, and number of inpatient and outpatient admissions over the previous year. RESU!

LTS: Based on the Rapid Estimate of Adult Literacy in Medicine, 33% of patients had health literacy levels that were eighth grade or below, whereas according to the Test of Functional Health Literacy in Adults, 23% had marginal or inadequate functional health literacy. Literacy was significantly related to socioeconomic status (P < .001) and education (P < .001), although 30% of participants had a reading level below the highest grade completed. No other significant correlations were found. IMPLICATIONS: Clinical nurse specialists should ensure that health information materials are written at appropriate levels and educate nurses and other healthcare professionals to use effective communication and teaching strategies.

Publication Type

Journal Article.

Link to the Ovid Full Text or citation

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Result <6. >

Unique Identifier

19531559

Status

MEDLINE

Authors

Barber MN. Staples M. Osborne RH. Clerehan R. Elder C. Buchbinder R.

Authors Full Name

Barber, Melissa N. Staples, Margaret. Osborne, Richard H. Clerehan, Rosemary. Elder, Catherine. Buchbinder, Rachelle.

Institution

Monash Department of Clinical Epidemiology, Cabrini Hospital, Melbourne, Australia. [email protected]

Title

Up to a quarter of the Australian population may have suboptimal health literacy depending upon the measurement tool: results from a population-based survey.

Source

Health Promotion International. 24(3):252-61, 2009 Sep.

Abstract

The objective of this paper is to measure health literacy in a representative sample of the Australian general population using three health literacy tools; to consider the congruency of results; and to determine whether these assessments were associated with socio-demographic characteristics. Face-to-face interviews were conducted in a stratified random sample of the adult Victorian population identified from the 2004 Australian Government Electoral Roll. Participants were invited to participate by mail and follow-up telephone call. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM), Test of Functional Health Literacy in Adults (TOFHLA) and Newest Vital Sign (NVS). Of 1680 people invited to participate, 89 (5.3%) were ineligible, 750 (44.6%) were not contactable by phone, 531 (32%) refused and 310 (response rate 310/1591, 19.5%) agreed to participate. Compared with the general population, participants were slightly older, better ed!

ucated and had a higher annual income. The proportion of participants with less than adequate health literacy levels varied: 26.0% (80/308) for the NVS, 10.6% (51 33/310) for the REALM and 6.8% (21/309) for the TOFHLA. A varying but significant proportion of the general population was found to have limited health literacy. The health literacy measures we used, while moderately correlated, appear to measure different but related constructs and use different cut offs to indicate poor health literacy.

Publication Type

Journal Article. Research Support, Non-U.S. Gov't.

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Result <7. >

Unique Identifier

19051972

Status

MEDLINE

Authors

Reeves K.

Authors Full Name

Reeves, Kathleen.

Title

Health literacy: the newest vital sign.

Source

MEDSURG Nursing. 17(5):288, 296, 2008 Oct.

Publication Type

Journal Article.

Link to the Ovid Full Text or citation

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Result <8. >

Unique Identifier

18660507

Status

MEDLINE

Authors

Ibrahim SY. Reid F. Shaw A. Rowlands G. Gomez GB. Chesnokov M. Ussher M.

Authors Full Name

Ibrahim, S Y. Reid, F. Shaw, A. Rowlands, G. Gomez, G B. Chesnokov, M. Ussher, M.

Institution

Faculty of Health and Social Care, Institute of Primary Care and Public Health, London South Bank University, London, UK. [email protected]

Title

Validation of a health literacy screening tool (REALM) in a UK population with coronary heart disease.

Source

Journal of Public Health. 30(4):449-55, 2008 Dec.

Abstract

BACKGROUND: Health literacy (HL) has been recognized as an important public health issue in other developed countries such as the US. There is currently no HL screening tool valid for use in the UK. This study aimed to validate a US-developed HL screening tool (the Rapid Estimate for Adult Literacy in Medicine; REALM) for use in the UK against the UK's general literacy screening tool (the Basic Skills Agency Initial Assessment Test, BSAIT). METHODS: A cross-sectional survey involving 300 adult patients admitted to hospital for investigation of coronary heart disease were given the REALM and BSAIT tools to complete as well as specific questions considered likely to predict HL. These questions relate to the difficulty in understanding medical information, medical forms or instructions on tablets, frequency of reading books and whether the participant's job involves reading. RESULTS: The REALM was significantly correlated with the BSAIT (r = 0.70; P < 0.001), and significantl!

y related to seven of the eight questions likely to be predictive of HL. CONCLUSIONS: This study has shown that the REALM has face, criterion and construct validity for use as an HL screening tool in the UK, in research and in everyday clinical practice. Further studies are needed to assess the prevalence of low HL in a wider population and to explore the links that may exist between low HL and poor health in the UK.

Publication Type

Journal Article. Research Support, Non-U.S. Gov't. Validation Studies.

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Result <9. >

Unique Identifier

18588408

Status

MEDLINE

Authors

Volandes AE. Paasche-Orlow M. Gillick MR. Cook EF. Shaykevich S. Abbo ED. Lehmann L.

Authors Full Name

Volandes, Angelo E. Paasche-Orlow, Michael. Gillick, Muriel R. Cook, E F. Shaykevich, Shimon. Abbo, Elmer D. Lehmann, Lisa.

Institution

General Medicine Unit, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. [email protected]

Title

Health literacy not race predicts end-of-life care preferences.

Source

Journal of Palliative Medicine. 11(5):754-62, 2008 Jun.

Abstract

BACKGROUND: Several studies have reported that African Americans are more likely than whites to prefer aggressive treatments at the end of life. OBJECTIVE: Since the medical information presented to subjects is frequently complex, we hypothesized that apparent differences in end-of-life preferences and decision making may be due to disparities in health literacy. A video of a patient with advanced dementia may overcome communication barriers associated with low health literacy. DESIGN: Before and after oral survey. PARTICIPANTS: Subjects presenting to their primary care doctors. METHODS: Subjects were asked their preferences for end-of-life care after they heard a verbal description of advanced dementia. Subjects then viewed a 2-minute video of a patient with advanced dementia and were asked again about their preferences. For the analysis, preferences were dichotomized into comfort care and aggressive care. Health literacy was measured using the Rapid Estimate of Adult Lit!

eracy in Medicine (REALM) and subjects were divided into three literacy categories: low (0-45, sixth grade and below), marginal (46-60, seventh to eighth grade) and adequate (61-66, ninth grade and above). Unadjusted and adjusted logistic regression models were fit using stepwise algorithms to examine factors related to initial preferences before the video. RESULTS: A total of 80 African Americans and 64 whites completed the interview. In unadjusted analyses, African Americans were more likely than whites to have preferences for aggressive care after the verbal description, odds ratio (OR) 4.8 (95% confidence interval [CI] 2.1-10.9). Subjects with low or marginal health literacy were also more likely than subjects with adequate health literacy to have preferences for aggressive care after the verbal description, OR 17.3 (95% CI 6.0-49.9) and OR 11.3 (95% CI 4.2-30.8) respectively. In adjusted analyses, health literacy (low health literacy: OR 7.1, 95% CI 2.1-24.2; marginal !

health literacy OR 5.1, 95% CI 1.6-16.3) but not race (OR 1.1, 95% CI

0.3-3.2) was an independent predictor of preferences after the verbal description. After watching a video of advanced dementia, there were no significant differences in the distribution of preferences by race or health literacy. CONCLUSIONS: Health literacy and not race was an independent predictor of end-of-life preferences after hearing a verbal description of advanced dementia. In addition, after viewing a video of a patient with advanced dementia there were no longer any differences in the distribution of preferences according to race and health literacy. These findings suggest that clinical practice and research relating to end-of-life preferences may need to focus on a patient education model incorporating the use of decision aids such as video to ensure informed decision-making.

Publication Type

Comparative Study. Journal Article.

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Result <10. >

Unique Identifier

18467532

Status

MEDLINE

Authors

Johnson K. Weiss BD.

Authors Full Name

Johnson, Kristen. Weiss, Barry D.

Institution

Polyclinic Family Medicine Northgate, North Seattle, Washington, USA.

Title

How long does it take to assess literacy skills in clinical practice?.

Source

Journal of the American Board of Family Medicine: JABFM. 21(3):211-4, 2008 May-Jun.

Abstract

BACKGROUND: Health literacy screening is often not performed in clinical settings. One possible reason is the concern about the time involved in performing such assessments. Our objective was to measure the time required to administer the Newest Vital Sign (NVS) literacy assessment instrument to English-speaking primary care patients. METHODS: The NVS was administered to 78 consecutive English-speaking patients in an outpatient primary care clinic. The length of time to complete the NVS was timed with a stopwatch. RESULTS: The average time to complete the NVS was 2.9 minutes (95% confidence limit, 2.6-3.1 min). CONCLUSION: The NVS is a health literacy screening tool of sufficient brevity to be considered for use in primary care practices.

Publication Type

Journal Article.

Link to the Ovid Full Text or citation

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Result <11. >

Unique Identifier

18335281

Status

MEDLINE

Authors

Chew LD. Griffin JM. Partin MR. Noorbaloochi S. Grill JP. Snyder A. Bradley KA. Nugent SM. Baines AD. Vanryn M.

Authors Full Name

Chew, Lisa D. Griffin, Joan M. Partin, Melissa R. Noorbaloochi, Siamak. Grill, Joseph P. Snyder, Annamay. Bradley, Katharine A. Nugent, Sean M. Baines, Alisha D. Vanryn, Michelle.

Institution

Department of Medicine, Division of General Internal Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA. [email protected]

Title

Validation of screening questions for limited health literacy in a large VA outpatient population.

Comments

Comment in: J Gen Intern Med. 2008 Sep;23(9):1545; PMID: 18636297]

Source

Journal of General Internal Medicine. 23(5):561-6, 2008 May.

Other ID

Source: NLM. PMC2324160

Abstract

OBJECTIVES: Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population. METHODS: We conducted in-person interviews among a random sample of patients from 4 VA medical centers that included 3 health literacy screening questions and 2 validated health literacy measures. Patients were classified as having inadequate, marginal, or adequate health literacy based on the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Rapid Estimate of Adult Literacy in Medicine (REALM). We evaluated the ability of each of 3 questions to detect: 1) inadequate and the combination of "inadequate or marginal" health literacy based on the S-TOFHLA and 2) inadequate and the combination of "inadequate or marginal" health literacy based on the REALM. MEASUREMEN!

TS AND MAIN RESULTS: Of 4,384 patients, 1,796 (41%) completed interviews. The prevalences of inadequate health literacy were 6.8% and 4.2%, based on the S-TOHFLA and REALM, respectively. Comparable prevalences for marginal health literacy were 7.4% and 17%, respectively. For detecting inadequate health literacy, "How confident are you filling out medical forms by yourself?" had the largest area under the Receiver Operating Characteristic Curve (AUROC) of 0.74 (95% CI: 0.69-0.79) and 0.84 (95% CI: 0.79-0.89) based on the S-TOFHLA and REALM, respectively. AUROCs were lower for detecting "inadequate or marginal" health literacy than for detecting inadequate health literacy for each of the 3 questions. CONCLUSION: A single question may be useful for detecting patients with inadequate health literacy in a VA population.

Publication Type

Journal Article. Multicenter Study. Research Support, U.S. Gov't, Non-P.H.S.. Validation Studies.

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Result <12. >

Unique Identifier

17557682

Status

MEDLINE

Authors

Gong DA. Lee JY. Rozier RG. Pahel BT. Richman JA. Vann WF Jr.

Authors Full Name

Gong, Debra A. Lee, Jessica Y. Rozier, R Gary. Pahel, Bhavna T. Richman, Julia A. Vann, William F Jr.

Institution

Department of Pediatric Dentistry CB 7450, University of North Carolina, Chapel Hill, NC 27599-7450, USA.

Title

Development and testing of the Test of Functional Health Literacy in Dentistry (TOFHLiD).

Source

Journal of Public Health Dentistry. 67(2):105-12, 2007.

Abstract

OBJECTIVE: This study aims to evaluate the reliability and validity of the Test of Functional Health Literacy in Dentistry (TOFHLiD), a new instrument to measure functional oral health literacy. METHODS: TOFHLiD uses text passages and prompts related to fluoride use and access to care to assess reading comprehension and numerical ability. Parents of pediatric dental patients (n = 102) were administered TOFHLiD, a medical literacy comprehension test (TOFHLA), and two word recognition tests [Rapid Estimate of Adult Literacy in Dentistry (REALD), Rapid Estimate of Adult Literacy in Medicine (REALM)]. This design provided assessments of dental and medical health literacy by all subjects, both measured with two different methods (reading/numeracy ability and word recognition). Construct validity of TOFHLiD was assessed by entering the correlation coefficients for all pairwise comparisons of literacy instruments into a multitrait-multimethod matrix. Internal reliability of TOFHL!

iD was assessed with Cronbach's alpha. Criterion-related predictive validity was tested by associations between the TOFHLiD scores and the three measures of oral health in multivariate regression analyses. RESULTS: The correlation coefficient for TOFHLiD and REALD-99 scores (monotrait-heteromethod) was high (r = 0.82, P < 0.05). Coefficients between TOFHLiD and TOFHLA (heterotrait-monomethod: r = 0.52) and REALM (heterotrait-heteromethod: r = 0.53) were smaller than coefficients for convergent validity Cronbach's alpha for TOFHLiD was 0.63. TOFHLiD was positively correlated with OHIP-14 (P < 0.05), but not with parent or child oral health. TOFHLA was not related to dental outcomes. CONCLUSIONS: TOFHLiD demonstrates good convergent validity but only moderate ability to discriminate between dental and medical health literacy. Its predictive validity is only partially established, and internal consistency just meets the threshold for acceptability. Results provide solid suppor!

t for more research, but not widespread use in clinical or public heal

th practice.

Publication Type

Evaluation Studies. Journal Article. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov't. Validation Studies.

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Result <13. >

Unique Identifier

17557681

Status

MEDLINE

Authors

Richman JA. Lee JY. Rozier RG. Gong DA. Pahel BT. Vann WF Jr.

Authors Full Name

Richman, Julia A. Lee, Jessica Y. Rozier, R Gary. Gong, Debra A. Pahel, Bhavna T. Vann, William F Jr.

Institution

Department of Pediatric Dentistry CB 7450, University of North Carolina, Chapel Hill, NC 27599-7450, USA.

Title

Evaluation of a word recognition instrument to test health literacy in dentistry: the REALD-99.

Source

Journal of Public Health Dentistry. 67(2):99-104, 2007.

Abstract

OBJECTIVE: This study aims to evaluate a dental health literacy word recognition instrument. METHODS: Based on a reading recognition test used in medicine, the Rapid Estimate of Adult Literacy in Medicine (REALM), we developed the Rapid Estimate of Adult Literacy in Dentistry (REALD-99). Parents of pediatric dental patients were recruited from local dental clinics and asked to read aloud words in both REALM and REALD-99. REALD-99 scores had a possible range of 0 (low literacy) to 99 (high literacy); REALM scores ranged from 0 to 66. Outcome measures included parents' perceived oral health for themselves and of their children, and oral health-related quality of life of the parent as measured by the short-form Oral Health Impact Profile (OHIP-14). To determine the validity, we tested bivariate correlations between REALM and REALD-99, REALM and perceived dental outcomes, and REALD-99 and perceived dental outcomes. We used ordinary least squares regression and logit models to !

further examine the relationship between REALD-99 and dental outcomes. We determined internal reliability using Cronbach's alpha. RESULTS: One hundred two parents of children were interviewed. The average REALD-99 and REALM-66 scores were high (84 and 62, respectively). REALD-99 was positively correlated with REALM (PCC = 0.80). REALM was not related to dental outcomes. REALD-99 was associated with parents' OHIP-14 score in multivariate analysis. REALD-99 had good reliability (Cronbach's alpha = 0.86). CONCLUSIONS: REALD-99 has promise for measuring dental health literacy because it demonstrated good reliability and is quick and easy to administer. Additional studies are needed to examine the validity of REALD-99 using objective clinical oral health measures and more proximal outcomes such as behavior and compliance to specific health instructions.

Publication Type

Evaluation Studies. Journal Article. Research Support, N.I.H., Extramural. Research Support, Non-U.S. Gov't. Validation Studies.

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Result <14. >

Unique Identifier

17557680

Status

MEDLINE

Authors

Lee JY. Rozier RG. Lee SY. Bender D. Ruiz RE.

Authors Full Name

Lee, Jessica Y. Rozier, R Gary. Lee, Shoou-Yih Daniel. Bender, Deborah. Ruiz, Rafael E.

Institution

Department of Pediatric Dentistry, CB 7450 Brauer Hall, Carolina Campus, Chapel Hill, NC 27599-7450, USA. [email protected]

Title

Development of a word recognition instrument to test health literacy in dentistry: the REALD-30--a brief communication.

Source

Journal of Public Health Dentistry. 67(2):94-8, 2007.

Abstract

OBJECTIVE: This study aims to develop and pilot test a dental word recognition instrument. METHODS: The development of our instrument was based on the Rapid Estimate of Adult Literacy in Medicine (REALM), an efficient word recognition instrument used to assess health literacy in the medical arena. Our instrument, Rapid Estimate of Adult Literacy in Dentistry (REALD-30), consisted of 30 common dental words with various degrees of difficulty. It was administered to 202 English-speaking adults recruited from outpatient medical clinics. We examined the instrument's internal reliability using Cronbach's alpha and its validity by correlating the REALD-30 score to two dental outcomes (perceived dental health status and oral health-related quality of life) and medical health literacy. RESULTS: REALD-30 scores were significantly correlated with REALM scores. REALD-30 was significantly related to perceived dental health status in the bivariate analysis. It also was significantly rel!

ated to oral health-related quality of life in a multivariate analysis. In contrast, medical health literacy was not related to either of the dental outcome measures. CONCLUSIONS: The new REALD-30 instrument displays good reliability but only partial validity. Results suggest that dental health literacy may be distinct from medical health literacy and may have an independent effect on dental health outcomes.

Publication Type

Journal Article. Research Support, N.I.H., Extramural. Research Support, U.S. Gov't, P.H.S..

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Result <15. >

Unique Identifier

17178765

Status

MEDLINE

Authors

Shea JA. Guerra CE. Ravenell KL. McDonald VJ. Henry CA. Asch DA.

Authors Full Name

Shea, Judy A. Guerra, Carmen E. Ravenell, Karima L. McDonald, Vanessa J. Henry, Camille A N. Asch, David A.

Institution

Center for Health Equity Research and Promotion, Philadelphia Vetrans Affairs Medical Center, Philadelphia, PA, USA. [email protected]

Title

Health literacy weakly but consistently predicts primary care patient dissatisfaction.

Source

International Journal for Quality in Health Care. 19(1):45-9, 2007 Feb.

Abstract

OBJECTIVES: To study relationships between health literacy and multiple satisfaction domains. Health literacy is related to some domains of patient satisfaction such as communication and understanding, but little is known about relationships of health literacy with other satisfaction domains. Moreover, the importance of health literacy in predicting satisfaction compared with other patient sociodemographics is underexplored. DESIGN: Cross-sectional survey. SETTING: Primary care waiting areas with a Veterans Administration Medical Center and a university health system. PARTICIPANTS: One thousand five hundred and twenty-eight primary care patients. MAIN OUTCOME MEASURES: A brief demographics questionnaire, the Rapid Estimate of Adult Literacy in Medicine, the Veterans Affairs ambulatory care patient satisfaction survey, and an adaptation of the Charlson Comorbidity Index. RESULTS: In unadjusted regression analyses, lower health literacy level was a significant predictor of w!

orse satisfaction in 7 of 10 domains (P < 0.01). When adjusting for patient sociodemographics, predicted relationships remained significant in six of the seven domains (P < 0.05), with each unit change in the 4-stage literacy classification associated with a 3-6 point decrease in dissatisfaction scores (0-100 scale). Health literacy did not predict overall dissatisfaction (P = 0.55). CONCLUSIONS: These results suggest that health literacy, as assessed through a pronunciation exercise that is closely related to more comprehensive measures of literacy, has a consistent, albeit weak relationship with patient satisfaction. Future work is needed to clarify if patients with lower literacy are really receiving different care than those with higher literacy and to pinpoint the sources of their more negative responses.

Publication Type

Journal Article. Research Support, U.S. Gov't, Non-P.H.S..

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Result <16. >

Unique Identifier

16881950

Status

MEDLINE

Authors

Wallace LS. Rogers ES. Roskos SE. Holiday DB. Weiss BD.

Authors Full Name

Wallace, Lorraine S. Rogers, Edwin S. Roskos, Steven E. Holiday, David B. Weiss, Barry D.

Institution

Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN 37920, USA. [email protected]

Title

Brief report: screening items to identify patients with limited health literacy skills.

Source

Journal of General Internal Medicine. 21(8):874-7, 2006 Aug.

Other ID

Source: NLM. PMC1831582

Abstract

BACKGROUND: Patients with limited literacy skills are routinely encountered in clinical practice, but they are not always identified by clinicians. OBJECTIVE: To evaluate 3 candidate questions to determine their accuracy in identifying patients with limited or marginal health literacy skills. METHODS: We studied 305 English-speaking adults attending a university-based primary care clinic. Demographic items, health literacy screening questions, and the Rapid Estimate of Adult Literacy in Medicine (REALM) were administered to patients. To determine the accuracy of the candidate questions for identifying limited or marginal health literacy skills, we plotted area under the receiver operating characteristic (AUROC) curves for each item, using REALM scores as a reference standard. RESULTS: The mean age of subjects was 49.5; 67.5% were female, 85.2% Caucasian, and 81.3% insured by TennCare and/or Medicare. Fifty-four (17.7%) had limited and 52 (17.0%) had marginal health literac!

y skills. One screening question, "How confident are you filling out medical forms by yourself?" was accurate in detecting limited (AUROC of 0.82; 95% confidence interval [CI]=0.77 to 0.86) and limited/marginal (AUROC of 0.79; 95% CI=0.74 to 0.83) health literacy skills. This question had significantly greater AUROC than either of the other questions (P<.01) and also a greater AUROC than questions based on demographic characteristics. CONCLUSIONS: One screening question may be sufficient for detecting limited and marginal health literacy skills in clinic populations.

Publication Type

Comparative Study. Journal Article.

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Result <17. >

Unique Identifier

19531559

Status

MEDLINE

Authors

Barber MN. Staples M. Osborne RH. Clerehan R. Elder C. Buchbinder R.

Authors Full Name

Barber, Melissa N. Staples, Margaret. Osborne, Richard H. Clerehan, Rosemary. Elder, Catherine. Buchbinder, Rachelle.

Institution

Monash Department of Clinical Epidemiology, Cabrini Hospital, Melbourne, Australia. [email protected]

Title

Up to a quarter of the Australian population may have suboptimal health literacy depending upon the measurement tool: results from a population-based survey.[Erratum appears in Health Promot Int. 2009 Dec;24(4):445]

Source

Health Promotion International. 24(3):252-61, 2009 Sep.

Abstract

The objective of this paper is to measure health literacy in a representative sample of the Australian general population using three health literacy tools; to consider the congruency of results; and to determine whether these assessments were associated with socio-demographic characteristics. Face-to-face interviews were conducted in a stratified random sample of the adult Victorian population identified from the 2004 Australian Government Electoral Roll. Participants were invited to participate by mail and follow-up telephone call. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM), Test of Functional Health Literacy in Adults (TOFHLA) and Newest Vital Sign (NVS). Of 1680 people invited to participate, 89 (5.3%) were ineligible, 750 (44.6%) were not contactable by phone, 531 (32%) refused and 310 (response rate 310/1591, 19.5%) agreed to participate. Compared with the general population, participants were slightly older, better ed!

ucated and had a higher annual income. The proportion of participants with less than adequate health literacy levels varied: 26.0% (80/308) for the NVS, 10.6% (51 33/310) for the REALM and 6.8% (21/309) for the TOFHLA. A varying but significant proportion of the general population was found to have limited health literacy. The health literacy measures we used, while moderately correlated, appear to measure different but related constructs and use different cut offs to indicate poor health literacy.

Publication Type

Journal Article. Research Support, Non-U.S. Gov't.

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Result <18. >

Unique Identifier

16338915

Status

MEDLINE

Authors

Weiss BD. Mays MZ. Martz W. Castro KM. DeWalt DA. Pignone MP. Mockbee J. Hale FA.

Authors Full Name

Weiss, Barry D. Mays, Mary Z. Martz, William. Castro, Kelley Merriam. DeWalt, Darren A. Pignone, Michael P. Mockbee, Joy. Hale, Frank A.

Institution

University of Arizona College of Medicine, Department of Family and Community Medicine, Tucson 85719, USA. [email protected]

Title

Quick assessment of literacy in primary care: the newest vital sign.[Erratum appears in Ann Fam Med. 2006 Jan-Feb;4(1):83]

Source

Annals of Family Medicine. 3(6):514-22, 2005 Nov-Dec.

Other ID

Source: NLM. PMC1466931

Abstract

PURPOSE: Current health literacy screening instruments for health care settings are either too long for routine use or available only in English. Our objective was to develop a quick and accurate screening test for limited literacy available in English and Spanish. METHODS: We administered candidate items for the new instrument and also the Test of Functional Health Literacy in Adults (TOFHLA) to English-speaking and Spanish-speaking primary care patients. We measured internal consistency with Cronbach's alpha and assessed criterion validity by measuring correlations with TOFHLA scores. Using TOFLHA scores <75 to define limited literacy, we plotted receiver-operating characteristics (ROC) curves and calculated likelihood ratios for cutoff scores on the new instrument. RESULTS: The final instrument, the Newest Vital Sign (NVS), is a nutrition label that is accompanied by 6 questions and requires 3 minutes for administration. It is reliable (Cronbach alpha >0.76 in English a!

nd 0.69 in Spanish) and correlates with the TOFHLA. Area under the ROC curve is 0.88 for English and 0.72 for Spanish versions. Patients with more than 4 correct responses are unlikely to have low literacy, whereas fewer than 4 correct answers indicate the possibility of limited literacy. CONCLUSION: NVS is suitable for use as a quick screening test for limited literacy in primary health care settings.

Publication Type

Journal Article. Research Support, Non-U.S. Gov't.

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Result <19. >

Unique Identifier

15343422

Status

MEDLINE

Authors

Davis TC. Wolf MS.

Authors Full Name

Davis, Terry C. Wolf, Michael S.

Title

Health literacy: implications for family medicine. [Review] [17 refs]

Source

Family Medicine. 36(8):595-8, 2004 Sep.

Abstract

As many as 90 million Americans have difficulty understanding and acting on health information. This health literacy epidemic is increasingly recognized as a problem that influences health care quality and cost. Yet many physicians do not recognize the problem or lack the skills and confidence to approach the subject with patients. In this issue of Family Medicine, several articles address health literacy in family medicine. Wallace and Lennon examined the readability of American Academy of Family Physicians patient education materials available via the Internet. They found that three of four handouts were written above the average reading level of American adults. Rosenthal and colleagues surveyed residents and found they lacked the confidence to screen and counsel adults about literacy. They used a Reach Out and Read program with accompanying resident education sessions to provide a practical and effective means for incorporating literacy assessment and counseling into p!

rimary care. Chew and colleagues presented an alternative to existing health literacy screening tests by asking three questions to detect inadequate health literacy. Likewise, Shea and colleagues reviewed the prospect of shortening the Rapid Estimate of Adult Literacy in Medicine (REALM), a commonly used health literacy screening tool. Both the Chew and Shea articles highlight the need for improved methods for recognizing literacy problems in the clinical setting. Further research is required to identify effective interventions that will strengthen the skills and coping strategies of both patients and providers and also prevent and limit poor reading and numeracy ability in the next generation. [References: 17]

Publication Type

Editorial. Review.

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Result <20. >

Unique Identifier

15343419

Status

MEDLINE

Authors

Shea JA. Beers BB. McDonald VJ. Quistberg DA. Ravenell KL. Asch DA.

Authors Full Name

Shea, Judy A. Beers, Benjamin B. McDonald, Vanessa J. Quistberg, D Alex. Ravenell, Karima L. Asch, David A.

Institution

Center for Health Equity Research and Promotion (CHERP), Philadelphia Veterans Affairs Medical Center, PA 19104-6021, USA. [email protected]

Title

Assessing health literacy in African American and Caucasian adults: disparities in rapid estimate of adult literacy in medicine (REALM) scores.

Comments

Comment in: Fam Med. 2005 Apr;37(4):234; PMID: 15812684]

Source

Family Medicine. 36(8):575-81, 2004 Sep.

Abstract

BACKGROUND AND OBJECTIVES: The influence of literacy on health and health care is an important area of investigation. Studies with a literacy focus are most valuable when literacy is assessed with psychometrically sound instruments. METHODS: This study used a prospective cohort sample of 1,610 primary care patients. Patients provided sociodemographics and took the Rapid Estimate of Adult Literacy in Medicine (REALM), a 66-item word pronunciation literacy test. RESULTS: The sample was 65% African American; 66% were men; 51% had a high school education or less. REALM scores were significantly related to education, age, and race but not gender. When stratified by education, differences between African Americans and Caucasians remained significant. Using 19 different strategies to shorten the 66-item instrument, reliability coefficients above.80 were maintained. CONCLUSIONS: The REALM is a robust assessment of health literacy. However, the discordance in scores between African!

Americans and Caucasians with similar educational attainment needs to be further addressed. A much shorter instrument would still have internally consistent scores and potentially be more useful in clinical settings.

Publication Type

Comparative Study. Journal Article. Research Support, U.S. Gov't, Non-P.H.S..

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Result <21. >

Unique Identifier

14528569

Status

MEDLINE

Authors

Baker DW. Williams MV. Parker RM. Gazmararian JA. Nurss J.

Authors Full Name

Baker, D W. Williams, M V. Parker, R M. Gazmararian, J A. Nurss, J.

Institution

Department of Medicine, Department of Epidemiology and Biostatistics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109-1998, USA. [email protected]

Title

Development of a brief test to measure functional health literacy.

Source

Patient Education & Counseling. 38(1):33-42, 1999 Sep.

Abstract

We describe the development of an abbreviated version of the Test of Functional Health Literacy in Adults (TOFHLA) to measure patients' ability to read and understand health-related materials. The TOFHLA was reduced from 17 Numeracy items and 3 prose passages to 4 Numeracy items and 2 prose passages (S-TOFHLA). The maximum time for administration was reduced from 22 minutes to 12. In a group of 211 patients given the S-TOFHLA, Cronbach's alpha was 0.68 for the 4 Numeracy items and 0.97 for the 36 items in the 2 prose passages. The correlation (Spearman) between the S-TOFHLA and the Rapid Estimate of Adult Literacy in Medicine (REALM) was 0.80, although there were important disagreements between the two tests. The S-TOFHLA is a practical measure of functional health literacy with good reliability and validity that can be used by health educators to identify individuals who require special assistance to achieve learning goals.

Publication Type

Comparative Study. Journal Article. Validation Studies.

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Result <22. >

Unique Identifier

9768381

Status

MEDLINE

Authors

Davis TC. Michielutte R. Askov EN. Williams MV. Weiss BD.

Authors Full Name

Davis, T C. Michielutte, R. Askov, E N. Williams, M V. Weiss, B D.

Institution

Department of Internal Medicine and Pediatrics, Louisiana State University Medical Center, School of Medicine, LA 71130-3932, USA. [email protected]

Title

Practical assessment of adult literacy in health care. [Review] [58 refs]

Source

Health Education & Behavior. 25(5):613-24, 1998 Oct.

Abstract

Low literacy is a pervasive and underrecognized problem in health care Approximately 21% of American adults are functionally illiterate, and another 27% have marginal literacy skills. Such patients may have difficulty reading and understanding discharge instructions, medication labels, patient education materials, consent forms, or health surveys. Properly assessing the literacy level of individual patients or groups may avoid problems in clinical care and research. This article reviews the use of literacy assessments, discusses their application in a variety of health care settings, and cites issues providers need to consider before testing. The authors describe informal and formal methods of screening for reading and comprehension in English and Spanish including the Rapid Estimate of Adult Literacy in Medicine, the Wide Range Achievement Test-3, the Cloze procedure, the Test of Functional Health Literacy in Adults, and others. Practical implications and recommendations !

for specific use are made. [References: 58]

Publication Type

Journal Article. Review.

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There are faxes for this order.

Health System Issues and Strategic Planning
1. Identify Health Systems issues (per 27 groups) for a patient
2. Collect literature on the issue and deliberating issues in health systems
3. Analyze issues in health systems
4. Writing the strategic plan integrating rigorous knowledge development
5. Summarize the key findings.


Question: Do you guys do powerpoint also?
Thank you!

HEALTH POLICY ANALYSIS PAPER (value 30% of grade)

For this assignment you are to select a single policy issue of interest to you.
Policy analysis is a mechanism used to provide issue-relevant information to decision makers. Typically this involves the systematic investigation of alternative policy options and the gathering and display of evidence for and against each option. It also involves the focused, systematic analysis of the outputs of governments and their effects on society. Policy analysis looks at the connection between goals and the extent to which a given policy achieves those goals. This means it is a problem-solving approach, the collection and interpretation of information, and some attempt to predict the consequences of alternative courses of action.
There are four essential parts to a policy analysis document. They are:

Goals, including normative constraints and relative weights for the goals

Policies, programs, projects, decisions, options, means, or other alternatives that are available for achieving the goals

Relations between the policies and goals, including relations that are established in intuition, authority, statistics, observation, deduction, guesses or other means

Drawing a conclusion as to which policy or combination of policies is best to adopt in light of the goals, policies, and relations

The six basic steps to the policy analysis process are:

1. Verifying, defining, and detailing the problem

2. Establishing goals, objectives or other evaluative criteria

3. Searching for alternatives

4. Evaluating the impacts of alternative policies

5. Evaluating, comparing, and ranking the alternatives

6. Monitoring the implemented policy

The paper should be 5-7 pages in length. In addition, the paper, including the title page, reference page, tables, and appendices must follow APA guidelines for format.

POLICY ANALYSIS GRADING RUBRIC
Parts / Questions Value Answers / Performance Criteria Total Points
1. Verify, define, and detail the problem
(20 points) Did your answer include?

Clearly identify the problem to be resolved?

Identify the interested parties?

Include all stakeholder agendas?

2. Establish evaluation criteria
(15 points) Did your answer include?

Cost, net benefit, effectiveness, efficiency, equity, administrative ease, legality, and political acceptability?

3. Identify alternative policies
(10 points) Did your answer include?

The status quo

Past experiences

Include brainstorming, research, experiments, writing scenarios, or concept mapping

4. Evaluate alternative policies
(10 points) Did your answer include?

Evaluation of how each possible alternative benefits the criteria previously established

Different levels of influence

The economical, political and social dimensions of the problem

5. Display and distinguish among alternative policies
(15 points) Did your answer include?

Comparison of virtues

Economic, political, legal, and administrative ramification of each option

Display of the positive and negative effects in implementing each alternative policy

Analyze how the number of participants will improve or diminish with each implementation

6. Monitoring the implemented policy
(10 points) Did your answer include?

Assure continuity

Determine whether the policy is having impact

Determine whether the selected policy is being implemented


There are faxes for this order.

Healthcare Management.

Our week objective is "Construct marketing and communication strategies aligned with a practices vision that promote the practice and ensure appropriate customer service from reception to service delivery".

So, pretend that this question answered two (2) different students:

"How will you promote the practice, marketing to potential new clients?"

1) First student - at least 600 words and must include 3 online sources (if it is possible, 2 out of 3 peer reviewed). Response should adhere to APA guidelines, including the citation of secondary sources.

2) Second student - at least 300 words and must include 1 online source (if it is possible, it should be peer reviewed). Response should adhere to APA guidelines, including the citation of secondary sources.

*************************************************************************************************************************************
ATTN:

1) Please, identify each student answer. Try not to make answers to look alike. Answer in paragraphs, not in essay type format.

2) Use only online sources (!) and free accessible web sites. Do not use any payable libraries or websites, where you need to log in to view the articles, since I need to go over and review the articles! Please include the link in the references.

Thank you.
Customer is requesting that (Oriented) completes this order.

Equity, Cash Flow, and Notes Analysis Paper

Select any publicly traded U.S. company. Your team is preparing a report to management regarding the Statement of Changes in Owner?s Equity, Statement of Cash Flows, and notes and other financial information. Explain these statements and items and what they mean for your chosen company. Your paper should include discussions of the following:


Important notes to the financial statements and how they help management and investors make good business decisions

Explanations of other financial information (i.e., Management?s Discussion and Analysis, comparative summary of key financial data) and how they help management and investors make good business decisions

Conduct a brief qualitative needs analysis of your community. Using the questions provided below, interview two members of your community about the perceived public health needs. Consider the barriers to addressing significant public health issues within the community and think about resources available that might help to address them:
How long have you lived in your community?
What do you believe are the greatest health issues that exist within your community and who are the populations you believe are most impacted by these health issues?
What are two barriers that exist within your community that you feel could negatively influence these health issues (e.g., no public parks, pollution from a particular factory, no major hospitals or grocery stores)?
Why do you think those barriers exist?
What kinds of resources exist within your community that could help influence the health of individuals within your community (i.e., hospitals, community clinics, non-profits, etc.)?
Consider the resources available within the community to help address the public health issues.

DISCUSS how PRIMARY HEALTH CARE can HELP to ACHIEVE the WHO termed ' Helath for All' (1978). This discussion NEEDS to ADDRRESS the ADVANTAGES and CHALLENGES involved in this process.

NB: The lecturer gave us a tutorial and suggested two SPECIFIC readings:

1. Target 15 of Health 21 (Health for all Programme) - she told us to access the LONG document from the internet, but read only TARGET 15

2. The WHO World Health Report of 2008, which can be downloaded from the WHO website. This report is all about Primary Health Care.


OTHER SUGGESTIONS:

discuss accessibility, less bureaucracy, political commitment, community participation, multi-sectorial approach, universal coverage.

she told us to address all determinants of health but just mention them or else we go out of subject

There are six questions all together please limit each to a page . Resources have been attached

1.. In looking at the Flow of Funds diagram on page 12 noting a health care organizations key stakeholders, identify the financial pressure points faced by health care organizations today. Comment on each stakeholder by noting whether there is pressure for the organization to either pay out more funds, or pressure to receive less funds.
2). After reading Joan Magretta's article, comment on how numbers are used in your life in achieving financial goals.
3). What type of financial information should be routinely provided to board members?
4). Teaching hospitals receive an additional payment to recognize the indirect costs of medical education. What rationale might be used to justify this extra payment?
5. Using information found in resource file skill building . find out about two companies of your choice. Using what you have learned, find the 10-K of one for-profit health care organization, and one 990 for a not-for-profit healthcare organization.
Note the name of the organizations that you selected, their main business, and reflect on your experience in finding this information( Please use resource file skill building )

6. Take the 10-K of a for-profit company of your choice, the one selected in the Skill Building section of this module will do fine. Scan it noting the customers, cash flows, and context (regulations, risks, and returns) for that company. The SEC wants you to be an intelligent reader of the 10-K, and as such has published valuable learning material on their web-site. You may find it helpful to review this material before reading the 10-K. Start at the SEC homepage at http://sec.gov. Then, select "Investor.gov". Select "Researching and Managing Investments", then "Research Public Companies", then "How to Read a 10-K". Take a look at other material from the SEC and follow (please use resource file practicing art )

Click the link below and study this article.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/

Pick one developed, industrialized country (possibilities include Canada, Western Europe, Japan, Australia, or New Zealand), or as an alternative selection, examine the health care initiatives implemented in the state of Massachusetts or Oregon. See what you can find about the operations and financing of its health care delivery system.
Indicate which feature from that system, if any, might be used in the United States to improve our system and what features are commonly employed in the United States that might assist in the greater efficient functioning of the system in your chosen region of study.
You should be able to find everything you need from Google and Google scholar.

Need a compare and contrast essay assignment. The topic is the US healthcare system compared to Singapore. Give a brief background on both systems. Compare the current issues in each system. Identify the pros and cons in each system. Compare the underinsured in both systems. What role does government play as regulators in each system ? Finally, thoughts and opinions on which system has the best plan and why?

Introduction
Topic 1
Topic 2
Topic 1 and 2 together
Conclusion

Use California as the State.

The overall goal of the Session Long Project is to examine health care delivery in the United States from a personal perspective.

Assignment expectations for module 5:

Research your state of residence for health reform initiatives
In a 2-3 page paper identify and discuss health care reform initiatives that have been implemented in the past 2-3 years.
Be sure to properly cite all of your references.

Answer the following question with no less than 300 words each. Please do not quote and make sure the references are in APA format and located under the 300 words it goes with. Please do not combine all the references together at the end. There need to be at least 3 reference for each question. The following questions are listed below.

1. Discuss informatics in Public Health.

2. Ethics and Public Health Model Curriculum - Module 2: The Legacy of the Tuskegee
Syphilis Study. http://www.asph.org/UserFiles/Module2.pdf.
Answer the questions for either Case Study 1, 2, or 3 (pg. 67- 68).

3. Find a site within one of the governmental health agencies devoted to health disparities. Discuss the research or interventions it contains.

Complete a 3-5 page research paper focusing on a policy, management, finance, or access issue in health care or public health. Paper should be in Times New Roman 12 point font, double spaced, with standard margins. Use APA format for citation and should have no less than 4 academic sources.

Topic: What is meant by the Observation, Equity of healthcare access is in the eyes of the beholder? How equitable is the U.S healthcare system according to your definition of equity?

Discuss the positive and/or negative effects that financing health care has on economics. Discuss the positive and/or negative effects that financing health care has on politics.

The textbook for this course is:

Cohen, E., & Cesta, T. (2005) Nursing case management: Advanced practice applications (4th ed.) Philadelphia: Mosby.

I need you to answer 5 health questions in essay form( double space, 12point font) which makes two page. Ineed it by sunday 10-17-2010 morning. I need for you to answer 5 questions in essay form with in the two pages that you are writing for me.

1.The Growing Inequalities. During the second half of the twentieth century, a striking redistribution of earnings occurred in America, as the nation shifted from the rising tides of the postwar quarter-century after World War II into the growing inequalities of the millennial quarter-century after 1975. (a) What would you say is the most compelling explanation for this remarkable change in the economic structure of American society? (b) Describe one specific policy intervention that you would recommend as a way to restore a modicum of equity and fairness to the U.S. economy.

2.Describe the relationship among health disparities, disasters and environmental health hazards in the Gulf of Mexico region.

3.What framework can be used to guide the transformation of public and safety net institutions to reposition them to thrive as health care reform is implemented.

4.When a health care professional encounters an Asian patient in their practice, what are at least three characteristics he/she should consider in order to improve communication and cultural competence in delivering services to this patient and tell why those characteristics are important to consider.

5.Define, differentiate, and demonstrate the interrelationship between values, and culture. Next, provide insight as to how cultural factors in your life may affect your perception(s) regarding the health and well-being of the individuals that you consider part of your "university" culture.

1.Health Care System Evolution,how the evolution of health care delivery systems has influenced current health care system about Medicare/Medicaid. 4 pages that include 2 references


2.Organizational Analysis for the Centers for Disease Control and Prevention that include stakeholders impacted by this component and they affected. 4 page that include 2 reference

3.Continuum of Care for Diabetes care program in U.S. that includes services provided and how theses fit in the continuum of care, how does the entity contribute or not contribute to the overall management of health care resources, and examine the future trends of health care and discuss how these services will be impacted or need to change to meet these future trends 6 page that include 2 reference

There are faxes for this order.

Marketing plan for a healthcare staffing agency with one office in the metro area and one in the suburban area. Would be dealing specifically in the healthcare industry and providing jobs for only those in the medical field. The company intends on helping to staff in home care opportunities, nursing homes, local hospitals and hospice centers in these two areas. It is intended to have two location to serve the metro area as well as suburban areas. The recruitment levels will encompass entry level to experiences healthcare providers including nurses.

Marketing Plan Outline


I. Executive Summary

A high-level summary of the marketing plan.

II. The Challenge

Brief description of product to be marketed and associated goals, such as sales figures and strategic goals.

III. Situation Analysis

Company Analysis

Goals
Focus
Culture
Strengths
Weaknesses
Market share

Customer Analysis

Number
Type
Value drivers
Decision process
Concentration of customer base for particular products

Competitor Analysis

Market position
Strengths
Weaknesses
Market shares

Collaborators

Subsidiaries, joint ventures, and distributors, etc.

Climate

Macro-environmental PEST analysis :

Political and legal environment
Economic environment
Social and cultural environment
Technological environment

SWOT Analysis

A SWOT analysis of the business environment can be performed by organizing the environmental factors as follows:

The firm's internal attributes can be classed as strengths and weaknesses.
The external environment presents opportunities and threats.


IV. Market Segmentation

Present a description of the market segmentation as follows:
Segment 1

Description
Percent of sales
What they want
How they use product
Support requirements
How to reach them
Price sensitivity


Segment 2
.
.
.


V. Alternative Marketing Strategies

List and discuss the alternatives that were considered before arriving at the recommended strategy. Alternatives might include discontinuing a product, re-branding, positioning as a premium or value product, etc.

VI. Selected Marketing Strategy

Discuss why the strategy was selected, then the marketing mix decisions (4 P's) of product, price, place (distribution), and promotion.
Product

The product decisions should consider the product's advantages and how they will be leveraged. Product decisions should include:

Brand name
Quality
Scope of product line
Warranty
Packaging

Price

Discuss pricing strategy, expected volume, and decisions for the following pricing variables:

List price
Discounts
Bundling
Payment terms and financing options
Leasing options

Distribution (Place)

Decision variables include:

Distribution channels, such as direct, retail, distributors & intermediates
Motivating the channel - for example, distributor margins
Criteria for evaluating distributors
Locations
Logistics, including transportation, warehousing, and order fulfilment

Promotion

Advertising, including how much and which media.
Public relations
Promotional programs
Budget; determine break-even point for any additional spending
Projected results of the promotional programs


VII. Short & Long-Term Projections

The selected strategy's immediate effects, expected long-term results, and any special actions required to achieve them. This section may include forecasts of revenues and expenses as well as the results of a break-even analysis.

VIII. Conclusion

Summarize all of the above.

Appendix

You need to talk both about current issues on the United States Health care system and how to resolve them. And comparing our system to other countries is an excellent way of doing so. You must also cite at least 5 outside academic sources (e.g., scholarly journals or books) to support your viewpoint. What constitutes an academic source? In essence, it must be written by someone with an academic affiliation (i.e., PhD) in a non-popular medium. Thus, nothing from pop magazines and newspapers (e.g., Sports Illustrated, New York Times, etc) is legitimate. MLA format is a must!Footnotes are needed as well as parenthetical citations.

Topic: Healthcare system in the Netherlands

A short abstract (or executive summary) should be presented at the beginning of the paper which summarizes key points within the paper. The paper should:

spend no more than one paragraph describing the country,
describe the major health conditions facing the country,
review how the health care system is organized and financed,
what are some of the salient ways in which the system differs from the US system,
end by discussing from the students perspective one lesson that the US might learn from this system to improve access, cost, or quality of our health care.
It is expected that research papers will be original to this course

Discuss the issues related to health disparities in the U.S.including cost, quality, access, and equity. Identify the ethical implications.
Discuss the impact of culture on health status.
S&L talks about the importance of "cultural competence," a concept promoted by Madeline Leininger and others. Another concept promoted by Goldberg and Goldberg (2000) proposes that "maintaining an awareness of one's lack of (cultural) competence" should be our goal rather than the establishment of competence. Given that we live in a culturally pluralistic country and a global society, which approach do you think will help us to most effectively care for and promote the health of individuals and groups from different cultures?

Explain the role of governmental regulatory agencies and its effect on the health care industry. Provide two examples of laws and regulations currently faced by the health care industry. Such as discrimination, health care privacy and security, and so on. Include your analysis of the effect of these laws on the provider, hospital or clinic or insurer that you select. Provide examples and specific cases in your examination. Include ways that you have seen this effect in your own life or community.