Journal of Health Education Research & Development

Cancer, as a disease, has found a place in the social imaginary. Individuals construct ideas based on pre-established discourses-be they medical, media, or popular-which often hinder its prevention. Educational interventions have tended to focus on spreading information about the disease, ignoring its social connotations. The objective of the present study is to investigate the concept of cancer prevention in 980 adolescents, aged between 12 and 18 years, attending primary and secondary school in three public schools and one private school in the metropolitan region of São Paulo and the municipality of Dom Viçoso, Minas Gerais.

The notion of prevention implies the dominant feeling of performing medical examinations from a symptom, against the idea of preventing, even when there is no clinical manifestation of the body.

The majority of students emphasize the advantages of early diagnosis and that the decisive factor for the cure corresponds to the moment of detection: "cancer must be discovered in time". This is a solid belief within the body of knowledge about the disease that can be used as a starting point in prevention messages.

However, even when the importance of early detection of cancer is understood as an essential element for its cure, care practices do not accompany the set of principles that regulate prevention or its demands.

Purpose: Patient satisfaction is one of the most important components of assessing the quality of healthcare facilities. In 2006, the Centers for Medicare and Medicaid Services (CMS) implemented the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to capture specific elements of patient satisfaction. The publicly reported survey data is meant to create incentives for quality improvement and enhance accountability. In 2010, the Affordable Care Act allowed CMS to include HCAHPS scores among the measures to be used to calculate value-based incentive payments which help determine reimbursement rates for hospitals. This study will assess the impact that pharmacists and pharmacy students can have on HCAHPS scores through the discharge medication delivery (DMD) service with counseling. Additionally, this study will evaluate changes in 30-day readmission rates before and after implementation.

Methods: Patients were eligible for the DMD program if they were being discharged from one of three units of the hospital, the pulmonary, the cardiac, and the orthopedic unit, and were not being admitted to a rehabilitation or long-term care facility. When enrolled, patient’s new medications were delivered to bedside prior to discharge. Patients were counseled on indication, duration, and common side effects of new medications from January 2019 through March 2019 throughout St. Elizabeth Edgewood. Top-box responses to HCAHPS survey questions from January 2017 through March 2017 prior to the DMD service were utilized to compare the impact of the service with counseling. In addition, readmission rates within 30 days of discharge have been obtained from retrospective chart review during the same timeframe and have been compared to rates following implementation of the DMD service with counseling.

Results: A total of 112 patients were counseled across three units. HCAHPS scores for question 25 (patient understood purpose of medication at discharge), question 16 (hospital staff told patient what the medicine was for), and question 17 (hospital staff told patient about medicine’s side effects) were evaluated. HCAHPS scores across all three units were either maintained or increased in the intervention period. In some instances, the percentage of top-box responses decreased, however, relative to other hospitals the score improved, resulting in higher percentile rankings. Only the pulmonary unit showed a statistically significant increase in response to question 16, increasing from 77% (below average) in Quarter 1 of 2017 to 92% (90th percentile) in Quarter 1 of 2019 (P=0.03). Readmission rates for Quarter 1 of 2017 were 19.8% (N=630) for the pulmonary unit, 14.9% (N=767) for the cardiac unit, and 6.1% (N=784) for the orthopedic unit. Readmission rates for Quarter 1 of 2019 of patients that were counseled were 8.3% (N=24) for the pulmonary unit, 22.2% (N=18) for cardiac unit, and 2.9% (N=70) for orthopedic unit. No data for readmission rates was statistically significant.

Conclusions: HCAHPS survey top-box responses were increased or maintained post-intervention. An increase in patient responses to question 16 of the HCAHPS survey (hospital staff told patient what the medicine was for) was statistically significant. No other values were statistically significant. Although pharmacy can have a positive impact on HCAHPS scores and readmission rates, a larger study will be needed to show outcomes from additional counseling.

The main purpose of this study was to identify sanitation practices among undergraduate students in the halls of residents in University of Benin. In order to achieve this objective four research questions were raised. The descriptive research design was used for the study and the population of the study consists of all the undergraduate students residing in the halls of residents in Ugbowo campus at University of Benin. The sample size for the study was 400 students and was selected through the multistage sampling procedure. A structured questionnaire designed by the researchers titled personal attributes influencing sanitation practices among undergraduate students was used for the study. The instrument was content validated by three experts and when subjected to reliability testing, a reliability coefficient of 0.72 was obtained. The questionnaires were administered to the students in their various halls of residence. The completed ones were retrieved immediately, coded and annalysed using frequency counts and simple percentages. The results of the study among others revealed that:

Sanitation practices among undergraduate students in the University of Benin are low, age and gender influence sanitation practices. And also, inadequate water supply, poor toilet facilities, insufficient toilet, bathroom and waste disposal facilities and poor drainage system are the major causes of poor sanitation in the hostel environment. It was recommended that there is need to educate the students on cleanliness during their orientation exercise and that keeping the environment clean on campus should be a joint responsibility of the school authority and students.

The main objective of this paper was to analyse indigenous technologies that can be developed for sustainable management of epilepsy in African countries. The authors reviewed literature on mainstreaming traditional counselling in epilepsy management, traditional medicines in epilepsy management and developing a multi-cultural approach in epilepsy management. From the discussions, the authors concluded that cultural competence is dynamic, an ongoing developmental process which require a long-term commitment that is achieved over time. Traditional herbs are very useful and indispensable in the struggle for seizure management and future Anti-Epilepsy Drugs development. Finally, the authors concluded that the role of traditional healers in epilepsy management should not be discredited because in many instances the person suffering from epilepsy tends to obtain a degree of secondary benefit in the way of reassurance and emotional support from this form of intervention. To this end, the authors recommended non-Western practitioners to strive in constructing their indigenous practices with a sufficiently high degree of indigenousness and then be satisfied that they are less perfect than western practices but still useful in psychology. Medical educators also need teaching, learning approaches and philosophies that enable health attributions, practices and beliefs of patients. The majority of people with epilepsy consult traditional healers, thus a non-competitive relationship between modern practices and indigenous must be encouraged.

Background: Data reported in the Youth Risk Behavior Surveillance System (YRBSS) showed that 24.2% of Puerto Rican adolescents (grades 9th through 12th) were overweight or obese, 14.3% did not eat fruit, and 16.4% did not eat vegetables “during the 7 days before the survey”. The need for culturally-sensitive-age-appropriate nutrition education materials in Spanish is imperative for the success of obesity prevention initiatives.

Objective: To promote changes in dietary behaviors, among 12 to 14 years old adolescents, through the development of culturally sensitive and age-appropriate nutrition education materials for an educational intervention on healthy eating.

Design: A pretest and two post-tests design was employed to measure changes in dietary behaviors, with a Post-test II after one month to evaluate if changes were maintained.

Participants/Setting: Participants were 339 adolescents aged 12-14 years. Interventions, conducted by trained Extension educators, took place in 10 Extension’s 4-H clubs, including rural and urban settings.

Intervention: The intervention consisted of the implementation of the six lessons curriculum moving to Healthy Eating. Every lesson was taught face-to-face on a period of 45 to 60 minutes followed by experiential learning activities on the topics.

Main outcome measures: Changes in the frequency of consumption of vegetables, fruits, 100% fruit juices, whole-grain rice and cereals, low-fat milk, fried foods, sweet desserts, water and sugared beverages.

Statistical analysis performed: Data was analyzed through Analysis of Variance ANOVA using a Linear Mixed Model (P˂0.05).

Results: Pre vs. post-I comparisons showed a significant increase in the frequency of consumption of vegetables and a decrease in consumption of sweet desserts. After one month (post-II), participants showed a significant increase in the frequency of consumption of dietary fiber consumption on fruits, vegetables, fruits, whole grain rice, cereals and 100% fruit juices while decreased their consumption of sweet desserts, compared to pre-test.

Conclusion: Tailored culturally sensitive nutrition intervention promotes positive healthy eating in Puerto Rican adolescents by increasing dietary fiber consumption of fruits, vegetables and whole grain-cereals.