Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UMLS:C0018799 (
heart disease
)
34,133
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Background:
The relative value of universal compared to contingent approaches to communication and behavioral interventions for persons of low health literacy remains unknown.
Objective:
To examine the effectiveness of interventions that are tailored to individual health literacy level compared to nontailored interventions on health-related outcomes.
Design:
Systematic review.
Data Sources:
PubMed and Embase databases.
Eligibility Criteria:
Studies were eligible if they were in English, used an experimental or observational design, included an intervention that was tailored based on the individual's level of education, health literacy or health numeracy, and had a comparator group in which the intervention was not tailored to individual characteristics.
Review Methods:
Databases were searched from inception to January 2016, and the retrieved reference lists hand searched. Abstracts that met PICOS criteria underwent dual review for data extraction to assess study details and study quality. A qualitative synthesis was conducted.
Results:
Of 2,323 unique citations, 458 underwent full review, and 9 met criteria for the systematic review. Five studies were positive and rated as good quality, 3 were negative with 2 of those of good quality, and 1 had mixed results (fair quality). Positive studies were conducted in the clinical domains of hypertension, diabetes, and depression with interventions including educational materials, disease management sessions, literacy training, and physician notification of limited health literacy among patients. Negative studies were conducted in the clinical domains of
heart disease
, glaucoma, and nutrition with interventions including medication reconciliation and educational materials.
Conclusions:
Tailoring communication and behavioral interventions to the individual level of health literacy may be an effective strategy to improve knowledge and indicators of disease control in selected clinical settings.
MDM
Policy Pract
PMID:Tailoring Educational and Behavioral Interventions to Level of Health Literacy: A Systematic Review. 3028 24
Background.
Reference life expectancies inform frequently used health metrics, which play an integral role in determining resource allocation and health policy decision making. Existing reference life expectancies are not able to account for variation in geographies, populations, and disease states. Using a computer simulation, we developed a reference life expectancy estimation that considers competing causes of mortality, and is tailored to population characteristics.
Methods.
We developed a Monte Carlo microsimulation model that explicitly represented the top causes of US mortality in 2014 and the risk factors associated with their onset. The microsimulation follows a birth cohort of hypothetical individuals resembling the population of the United States. To estimate a reference life expectancy, we compared current circumstances with an idealized scenario in which all modifiable risk factors were eliminated and adherence to evidence-based therapies was perfect. We compared estimations of years of potential years life lost with alternative approaches.
Results.
In the idealized scenario, we estimated that overall life expectancy in the United States would increase by 5.9 years to 84.7 years. Life expectancy for men would increase from 76.4 years to 82.5 years, and life expectancy for women would increase from 81.3 years to 86.8 years. Using age-75 truncation to estimate potential years life lost compared to using the idealized life expectancy underestimated potential health gains overall (38%), disproportionately underestimated potential health gains for women (by 70%) compared to men (by 40%), and disproportionately underestimated the importance of
heart disease
for white women and black men.
Conclusion.
Mathematical simulations can be used to estimate an idealized reference life expectancy among a population to better inform and assess progress toward targets to improve population health.
MDM
Policy Pract
PMID:An Alternative Mathematical Modeling Approach to Estimating a Reference Life Expectancy. 3074 97
