Media use in gynecological and obstetric care and women’s knowledge on lifestyle-related risks: A cross-sectional multi-center study

Introduction: Obstetric and gynaecological care are undoubtedly one of the most important elements in protecting a woman’s health. From the period of puberty characterised by many hormonal changes, until late old age, every woman should be cared for depending on her age and state of health. However, women and girls living in rural areas have difficulties in accessing reproductive health care, especially public services that are financed by the National Health Fund (Narodowy Fundusz Zdrowia — NFZ). There is a significant gap in access to antenatal and gynaecological health care services between women living in urban and rural areas. Objective: The goal of this paper is to explore current state of knowledge and data from recent reports on access to reproductive health care services in rural areas of Poland with a special focus on people living with disabilities and to share recommendations and solutions to improve access to universal reproductive healthcare services. Conclusions: Family policy should be coordinated with health policy to ensure comprehensive, tailored and free maternal and child healthcare at primary, local and national levels. The observed insufficient access to obstetric and gynaecological care in rural areas is probably associated with increased outlays, and thus the more efficient functioning of health care facilities in large cities. Additional campaigns, introducing mobile clinics and quality improvement in fulfilling the national standards of antenatal and gynaecological care are pivotal to universal access of reproductive health services of Polish women. People living with disabilities are facing structural and information barriers in order to access reproductive health services they need and deserve. Efforts should be made in order to develop the standards of care in order to facilitate and increase access to obstetrics and gynaecological care.

PurposeThe aim of this descriptive study was to evaluate the knowledge and attitudes of nurses and social caregivers in relation to falls among elderly patients.Materials/MethodsA total of 442 nurses and social caregivers working in acute or chronic care settings participated in our study. Data were gathered on the participants' general characteristics, the characteristics of their workplace, and their levels of knowledge in relation to risk factors and types of falls. Our questionnaire also included a survey of attitudes towards fall prevention. Data were analysed using IBM SPSS software.ResultsOur results showed a significant correlation between the participants' level of knowledge and age, level of professional education, workplace localisation, form and type of care, risk evaluation scale score, and the existence of a healthcare protocol at the workplace. Participants demonstrated a positive attitude towards fall prevention: the mean value for attitude was 48.03 out of 65 points. Participants who experienced a lower number of falls among elderly patients at their workplace demonstrated a significantly more positive attitude to prevention compared to those experiencing falls more frequently.ConclusionsIn our professional opinion, trainings focusing on fall prevention are required. In addition to knowledge transfer, these should emphasise the formation of attitudes, especially in the context of chronic healthcare, among professionals working in institutions in smaller towns.

Background:Wisconsin Literacy Incorporated is a statewide adult and family literacy coalition representing 75 community-based literacy organizations. This coalition focuses its work in four areas: (1) building capacity of its member agencies, (2) advocating for literacy, (3) preparing adults in worker readiness and career pathways, and (4) improving how health information is communicated through its division, Wisconsin Health Literacy (WHL).Brief Description of Activity:This article outlines how an adult basic education coalition successfully developed a statewide health literacy coalition that later transformed into a division of Wisconsin Literacy through a three-phase approach that included: (1) raising awareness and educating health care and literacy providers about health literacy, (2) implementing health literacy interventions through various grant funding, and (3) disseminating and sharing findings from such health literacy interventions to a broad audience.Implementation:Beginning its awareness work in 2003 with help from a physician champion, WHL implemented best practices within each of the three areas of approach. After being implemented, the initial volunteer-based health literacy coalition was transformed into a division of Wisconsin Literacy Incorporated.Results:The division now includes a full-time director, its own website, funding for community interventions, and a business plan for fee-for-service efforts with health care providers, public health agencies, and other stakeholders. Key relationships with Wisconsin health care organizations provided WHL venues to present about health literacy throughout the state and beyond. Wisconsin Literacy Incorporated helped secure a solid infrastructure by hosting two planning retreats and implementing both strategic and business plans for the newly formed division. Offering fee-for-service health literacy training to health care providers brought in new revenue to sustain the division and obtain buy-in from health care agencies on the importance of health literate organizations. Finally, participating in key partner coalitions and Communities of Practice allowed WHL to share experiences and best practices with a national audience.Lessons Learned:The importance of intentionally raising awareness in strategic health care settings across the state fostered many partnerships. Investing in a strategic planning retreat and a business plan guided the division's success. Delivering educational workshops in community-based literacy organizations and trusted settings where adults regularly go to learn was key to successful implementation. [HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S8–S14.]Plain Language Summary:Wisconsin Literacy Incorporated is an adult basic education coalition that built a health literacy division over several years. Using best practices such as raising awareness, implementing pilot projects, and broadly sharing its experience, the Wisconsin Health Literacy division advanced the understanding and commitment to health literacy in and beyond Wisconsin.

Prevention of coronavirus disease 2019 (COVID-19) transmission to newborns is one of the basic components of perinatal care in the era of the COVID-19 pandemic. As such, scientific evidence is compulsory for evidence-based practices. However, there was a scarcity of evidence on health care providers' awareness of breastfeeding practice recommendations during the COVID-19 pandemic in Ethiopia, particularly in the study setting. The study aimed at assessing healthcare providers' awareness of breastfeeding practice recommendations during the COVID-19 pandemic and associated factors among healthcare providers in northwest Ethiopia, 2021. A multicenter cross-sectional study was conducted among 405 healthcare providers working in hospitals of Gondar province from November 15, 2020, to March 10, 2021. A simple random sampling technique was employed to select the study subjects. Data were collected via a structured-self-administered questionnaire. EPI INFO version 7.1.2 and SPSS version 25 were used for data entry and analysis respectively. Binary logistic regression analyses were done to identify associated factors and the adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of <0.05 was used to declare significant association. The healthcare providers' awareness of breastfeeding practice recommendations during the COVID-19 pandemic was 40.7% (95% CI: 35.9, 45.6). Working in a tertiary hospital (AOR = 3.69; 95% CI: 2.24, 6.08), using COVID-19 guideline updates (AOR = 3.34; 95% CI: 2.1, 5.3), being trained on COVID-19 (AOR = 2.78; 95% CI: 1.74, 4.47), owning a smartphone and/or a computer (AOR = 2.26; 95% CI: 1.39, 3.68), and perceiving that COVID-19 is dangerous (AOR = 1.78; 95% CI: 1.05, 3.01) were factors positively associated with healthcare providers' awareness of breastfeeding practice recommendations during the pandemic of COVID-19. Only two in five healthcare providers were aware of recommendations on breastfeeding practice during the COVID-19 pandemic and related to information of accessibility information on COVID-19. Therefore, expanding COVID-19 related information through the provision of COVID-19 training and guidelines to all levels of hospitals would improve health care providers' awareness of breastfeeding practice recommendations amid the COVID-19 pandemic.

BACKGROUND:Health literacy (HL) enables a person to make good decisions regarding health care, disease prevention, and health promotion to maintain and improve health. In Thailand, most existing studies focus on adults’ HL rather than children. This research aimed to determine the influence of sociocultural and health knowledge on HL among children ages 9–10 years in Thailand.MATERIALS AND METHODS:A cross-sectional study was conducted among 1650 children aged 9–10 years. The respondents were recruited using multistage random sampling from 39 primary schools of 13 provinces in all four regions of Thailand. A self-administered structured questionnaire was used to collect the required data. The multilevel analysis was used to determine the association between sociocultural, health knowledge, and HL while controlling the effects of covariates. The result was presented as adjusted odd ratios and its 95% confidence interval (CI).RESULTS:Of the total 1650 respondents, 86.24% (95% CI: 84.49%–87.82%) had adequate and excellent levels of HL. The multivariable analysis indicated factors that were significantly associated with adequate and excellent levels HL including adequacy of per diem (adjusted odds ratio [adj. OR] = 6.78; 95% CI: 3.54–12.97) and had good relationship with teachers (adj. OR = 2.19; 95% CI: 1.55–3.09). Sources of health education which were received health education from parents (adj. OR = 3.51; 95% CI: 2.39–5.14), from teachers (adj. OR = 2.03; 95% CI: 1.43–2.89), and from the Internet (adj. OR = 1.83; 95% CI: 1.12–2.99) were also significantly associated with HL. Another significant factor was had good level of health knowledge (adj. OR = 1.86; 95% CI: 1.30–2.66) when control clustering effect of region, provinces, school, and classroom size.CONCLUSIONS:More than 85% of children ages 9–10 years in Thailand had adequate and excellence levels of HL. Sociocultural and health knowledge had influence on children HL.

Introduction. The task of social medicine is to deepen the medical and social aspects of developing mechanisms for improving the quality of medical care in obstetric and gynecological health care institutions and building an effective quality system to ensure the reproductive health of the population. Aim. Update of factors of the effectiveness of the management of the quality system of obstetric and gynecological care in health care institutions and determination of the combinatorics of influencing factors that should be taken into account for the harmonization of its functioning, which characterize the specifics and features of its development. Materials and methods. General scientific and theoretical approaches (system-complex, alarm-process, structural-functional) and methods were used: generalization; analysis and synthesis; grouping, comparison, identification and visual reproduction of results, structural and functional. The theoretical basis is the achievements of foreign and domestic scientists in the field of social medicine, Laws of Ukraine on the organization of the quality system, EU Directives and Recommendations of the Council of Europe on the introduction of standards and maintenance of ethical aspects of reproductive medicine. Results. The conceptual and categorical apparatus of the theory of social medicine was developed by defining the essence of the concept of "resilient system of quality of medical care in health care institutions of the obstetric and gynecological profile" as a complex resource-functional structure, which: has ten subsystems and is built taking into consideration the provisions of the system-complex and the alarm-process approach to determining its goals and prioritizing the performance of three groups of tasks; takes into account the combinatorics of influencing factors; aimed at ensuring stability and adaptability to changing conditions, incorporating into its composition a system of monitoring, analysis and improvement of medical care, ensuring high quality of medical care, safety and meeting the needs of patients in the field of obstetrics and gynecology practice. Conclusions. The urgency has been proven: the introduction into practice of a resilient quality system of medical care; justification of the multi-level system of relative indicators of its evaluation according to a single criterion; determination of priorities for the localization of efforts to eliminate shortcomings and implementation of strategies to achieve the defined goals. Scientific and applied research identified the need for building a resilient quality system of medical care in obstetric and gynecological health care institutions, developing an algorithm of management actions for its formation and putting it into practice with the development of a multidimensional system of relative indicators to assess the effectiveness of its implementation.

* Abbreviations: NAM — : National Academy of Medicine NHES — : National Health Education Standards Only 12% of American adults have proficient health literacy, defined as a set of skills needed to effectively function in the health care system.1 This is troubling given that health literacy is a stronger predictor of health than age, income, employment status, educational level, or race.2 A growing body of research also shows that low health literacy is associated with worse child health outcomes,3 higher health care costs, and elevated mortality rates.1 Although Americans are increasingly expected to be knowledgeable consumers of health care, it is clear that many individuals lack the core health literacy skills needed to understand their health insurance.4 This inadequate understanding of health care information creates challenges beyond the selection of a health insurance plan or payment calculations. Poor health literacy, including health numeracy, extends into one’s ability to seek care at an appropriate time, navigate through the health system, and share in important medical decisions. In this Perspective, we describe national efforts to combat low health literacy rates and argue that they fail to adequately prepare children and adolescents to be health-literate adults. We then propose several steps for educators, health care providers, and policymakers to improve health literacy among children and adolescents in the United States. The US Department of Health and Human Services, the National Academy of Medicine … Address correspondence to Tyler N.A. Winkelman, MD, MSc, University of Michigan, Robert Wood Johnson Foundation Clinical Scholars Program, North Campus Research Center, 2800 Plymouth Rd, Building 14, Room G100-20, Ann Arbor, MI 48109-2800. E-mail: tywink{at}med.umich.edu

Background and Aims Depression and anxiety is common in dialysed patients (Ng et al., 2015; de Brito et al., 2019) and associated with decreased quality of life, worse health outcomes and increased mortality (Schouten et al., 2019, Lopes at al., 2002). Health literacy (HL) as the ability to gain access, understand, and use information to promote and maintain good health (WHO, 1998) may be hampered by emotional problems such as depression and anxiety. The aim of our study is to examine the association of HL with depression and anxiety in dialysed patients in Slovakia. Method Cross-sectional study on 542 dialysed patients (mean age = 63.6, males = 60.7%) was conducted in 20 dialysis clinics in Slovakia from January to November 2018. Socio-demographic data, data on 9 domains of HL and data on depression and anxiety were collected by questionnaires. Hierarchical cluster analysis was used to create three clusters of patients (low, moderate, high HL). Depression and anxiety was dichotomized as 0-no/low symptoms and 1-moderate/severe symptoms. Association of HL clusters with depression and anxiety was analysed using logistic regression adjusted for age and gender. Results We found that patients in low HL cluster and moderate HL cluster were more likely to have moderate/severe symptoms of depression and anxiety than patients in high HL cluster. Odds ratio (OR) for depression for low HL cluster: 7.60; 95% Confidence Interval (CI): 2.88 – 20.06; p&amp;lt;0.000 and for moderate HL cluster: OR: 4.85; 95% CI: 1.87 – 12.56; p&amp;lt;0.001. OR for anxiety for low HL cluster: 3.14; 95% CI:1.55 – 6.35; p&amp;lt;0.001 and for moderate HL cluster: OR 2.16;95% CI: 1.10 – 4.24; p&amp;lt;0.05. Conclusion Patients with lower levels of HL suffer from anxiety and depression more than patients with higher levels of HL. These findings point to the need of regular screening of emotional problems such as depression and anxiety and their treatment as they may hamper capacities of dialysed patients for self-management as well as effective treatment of the disease from the perspective of healthcare providers.

Maternity care satisfaction for pregnant women and recently delivered mothers is linked to both short- and long-term complications. For health care providers, dissatisfaction can lead to high turnover, reduced efficiency, and decreased service quality. Increased midwifery care coverage enhances satisfaction; however, the Government of Bangladesh-sanctioned midwife positions are limited to the primary health care level only, not extending to secondary or tertiary health tiers. We aimed to evaluate the impact of introducing midwifery care at secondary-level health care facilities in Bangladesh by comparing the satisfaction levels of both providers and patients with those receiving regular care. We conducted a quasi-experimental study from September 2021 to December 2023 at two secondary-level health facilities - Sunamganj District Hospital (DH) (intervention) and Khagrachari DH (control). The primary outcome was the mean (x̄) percentage score of maternal satisfaction with antenatal care (ANC), delivery, and postnatal care (PNC) services, along with providers' satisfaction regarding their working environment, training, logistical support, and overall patient and service satisfaction at both facilities. We screened for eligibility a total of 200 pregnant women or recently delivered mothers who visited the facility for ANC, delivery, or PNC services. The satisfaction scores were significantly higher among women who received midwifery care compared to those who received regular care. The scores were for ANC x̄ = 97.8 (95% confidence interval (CI) = 96.6-99.0) vs. x̄ = 71.0 (95% CI = 68.7-73.4), for delivery x̄ = 97.9 (95% CI = 97.4-98.3) vs. x̄ = 83.3 (95% CI = 80.2-86.3), and for PNC x̄ = 97.5 (95% CI = 96.5-98.4) vs. x̄ = 77.7 (95% CI = 73.8-81.6). Similarly, the satisfaction score among midwives was significantly higher than among providers in regular care facilities (x̄ = 88.7; 95% CI = 82.9-94.5 vs. x̄ = 77.7; 95% CI = 73.0-82.3). Our study highlights that midwifery care significantly enhances patient and provider satisfaction compared to regular care across antenatal, delivery, and postnatal services.

Gynecologic Care provides a succinct yet comprehensive discussion of critical knowledge required for gynecologists. Concise, easily accessible chapters allow the reader to quickly review essential material for patient care, or comprehensively study the modern management of gynecology. New residents can quickly cover the breadth of gynecology, while more experienced physicians will find the materials useful for review purposes. Each chapter covers key topics listed by the Committee for Resident Education in Obstetrics and Gynecology. Gynecologic Care is part of a three book series which covers the breadth of the Obstetrics and Gynecology specialty. The other books in the series are Obstetric Care and Office Care of Women.

BackgroundLow health literacy often has an association with poor health outcomes such as low levels of self-efficacy, increased mortality, poor health status and reduced quality of life (QOL). The aim of the study was to quantitatively evaluate the relationship between health literacy (HL) and QOL based on a systematic review and meta-analysis.MethodsEMBASE, PubMed, Web of Science, Elsevier, Cochrane Library, and Chinese electronic databases such as CNKI, and Wanfang were searched from 1970 until February 1, 2018. The pooled correlation coefficient (PCOR) and its 95% confidence interval (CI) between HL and QOL were estimated using R software. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression.ResultsTwenty-three studies, with a total of 12,303 subjects,were included. The PCOR between HL and QOL was 0.35 (95%CI: 0.25–0.44). Considering different dimensions of HL, the PCOR between QOL and health knowledge, health behavior, health belief, and health skill were 0.36 (95% CI: 0.04–0.61), 0.36 (95%CI: 0.13–0.55), 0.39 (95%CI: 0.10–0.62), and 0.42 (95%CI: 0.03–0.69), respectively. The PCOR between HL and the two dimensions of QOL was lower than the total PCOR between HL and QOL. In subgroup analysis, the PCOR between HL and QOL was 0.46 (95%CI: 0.13, 0.69) among community residents, 0.45 (95%CI: 0.27, 0.61) in China, and 0.45 (95%CI: 0.24, 0.62) based on cohort studies. Sensitivity analyses showed that the stability of results had no significant after excluding the study (p < 0.001). Meta-regression showed that cohort study design, studies conducted in China, and publication before 2012 may be important influencing factors.ConclusionsHealth literacy was moderately correlated with quality of life, but this finding needs to be supported by more evidence.

Formerly incarcerated individuals (FIIs) encounter difficulties with covering the cost of dental and medical care, adhering to medication regimens, and receiving fair treatment from health care providers. Yet, no published research has examined modifiable pathways to increase FIIs' health literacy (HL), which is essential for addressing the health needs of this vulnerable population. The aim of this article is to examine neighborhood characteristics (neighborhood deprivation, racial and economic polarization, and residential segregation) and public assistance program enrollment as structural determinants of limited health literacy (LHL) among FIIs. Using a socioecological framework, we analyzed a subsample of 578 FIIs from the 2023 Survey of Racism and Public Health, an online cross-sectional survey spanning U.S. Department of Health & Human Services Regions 1, 2, and 3. HL was assessed using the Brief Health Literacy Screen. Logistic regression models estimated unadjusted and adjusted associations of LHL with neighborhood characteristics and public assistance program enrollment. Adjusted models controlled for age, race and ethnicity, gender identity, educational attainment, marital and employment status, number of children, chronic health conditions, and incarceration length. The 578 FIIs had an average age of 46, with 42% having LHL. We observed a statistically significant association between public assistance program enrollment and LHL (unadjusted odds ratio [OR] = 2.72, 95% confidence interval [CI]: 1.87, 4.01; adjusted OR = 2.50, 95% CI: 1.62, 3.88). We found no statistically significant associations of LHL with neighborhood deprivation, racial and economic polarization, and residential segregation. Our findings suggest that there may be an opportunity to develop tailored interventions for increasing HL among FIIs through public assistance programs. Dissemination of HL resources among this marginalized group can improve their self-management of chronic diseases. This is of paramount importance because FIIs must simultaneously navigate other challenges after incarceration (e.g., unstable housing). [HLRP: Health Literacy Research and Practice. 2025;9(1):e8-e18.].

Improvement of primary care for patients with type 2 diabetes mellitus (T2DM) through the promotion of good knowledge, attitude, and practice is of paramount importance for preventing its related complications. This study aimed to assess the levels of knowledge, attitude, and practice and associated factors among patients with T2DM. This was a cross-sectional multicenter hospital-based study that included 979 patients from 8 health facilities in Tanzania. A standardized semi-structured interviewer-administered questionnaire was used to extract the required data. Factor analysis was used to determine the level of knowledge, attitude, and practice. Multivariable analysis under binary logistic regression analysis was used to determine the predictors of knowledge, attitude, and practice. P<0.05 was considered significant. The levels of adequate knowledge, positive attitude, and appropriate practice were 62.1%, 54%, and 30.9%, respectively. Being self-employed (AOR = 1.74, 95% CI = 0.28–0.91, p = 0.040) predicted adequate knowledge. Being male (AOR = 1.46, 95% CI = 1.06–2.01, p = 0.021 and visiting regional hospitals (AOR = 2.17, 95% CI = 1.33–2.51, p = 0.013) were predictors of positive attitude. Residing in rural areas and not having adequate knowledge of diabetes were less likely associated with appropriate practice. This study has shown a significantly low level of appropriate practice among patients with T2DM towards general issues on diabetes, risk factors, and related complications. Therefore, emphasis should be placed on improving good practices that can help prevent related complications.

Health literacy may constitute a modifiable determinant of smoking behavior and intention to quit. Little is known about the extent to which health literacy affects smoking or quitting smoking. We assessed the nationally representative cross-sectional datasets from the China Health Literacy Surveillance (CHLS) initiated in 2018. Using polytomous logistic regression models, the study investigated the association of health literacy with smoking behavior and the intention to quit smoking among men aged 15-69 in China. After confounding factors were controlled, compared with having below basic health literacy, having adequate health literacy appeared to be an independent protective factor from current smoking [current smoking vs never smoking: adjusted odds ratio [OR], 0.88; 95% confidence interval (CI), 0.81-0.96; p = 0.003; current smoking vs former smoking: adjusted OR, 0.77; 95% CI, 0.64-0.92; p = 0.003], while having intermediate health literacy was associated with current smoking vs never smoking (adjusted OR, 1.09; 95% CI, 1.02-1.17; p = 0.011) or former smoking vs never smoking (adjusted OR, 1.22; 95% CI, 1.06-1.40; p = 0.005). And having adequate health literacy was associated with intending to quit among current smokers (adjusted OR, 1.25; 95% CI, 1.10-1.42; p < 0.001). Findings provide evidence that health literacy may serve as a critical and independent protective factor for reducing poor smoking behavior or enhancing cessation intention among men. Efforts should focus on developing and evaluating intervention to control tobacco use among men with low health literacy level.

Human Papilloma Virus Vaccination Among Female Patients Attending French Pediatric Cystic Fibrosis Centers.