Biomedical subjects

Lisa D Chew

Publications and source records attributed to Lisa D Chew.

6 recordsLinked to original sources

PubMed2006

The Single Item Literacy Screener: evaluation of a brief instrument to identify limited reading ability.

BACKGROUND: Reading skills are important for accessing health information, using health care services, managing one's health and achieving desirable health outcomes. Our objective was to assess the diagnostic accuracy of the Single Item Literacy Screener (SILS) to identify limited reading ability, one component of health literacy, as measured by the S-TOFHLA. METHODS: Cross-sectional interview with 999 adults with diabetes residing in Vermont and bordering states. Participants were randomly recruited from Primary Care practices in the Vermont Diabetes Information System June 2003-December 2004. The main outcome was limited reading ability. The primary predictor was the SILS. RESULTS: Of the 999 persons screened, 169 (17%) had limited reading ability. The sensitivity of the SILS in detecting limited reading ability was 54% [95% CI: 47%, 61%] and the specificity was 83% [95% CI: 81%, 86%] with an area under the Receiver Operating Characteristics Curve (ROC) of 0.73 [95% CI: 0.69, 0.78]. Seven hundred seventy (77%) screened negative on the SILS and 692 of these subjects had adequate reading skills (negative predictive value = 0.90 [95% CI: 0.88, 0.92]). Of the 229 who scored positive on the SILS, 92 had limited reading ability (positive predictive value = 0.4 [95% CI: 0.34, 0.47]). CONCLUSION: The SILS is a simple instrument designed to identify patients with limited reading ability who need help reading health-related materials. The SILS performs moderately well at ruling out limited reading ability in adults and allows providers to target additional assessment of health literacy skills to those most in need. Further study of the use of the SILS in clinical settings and with more diverse populations is warranted.

Adult↗

PubMed2006

The association between number of Pap smears performed and self-reported confidence in an internal medicine residency.

BACKGROUND: The American Board of Internal Medicine (ABIM) recommends internal medicine residents perform at least 3-5 Pap smears during training. We evaluated whether doing more than the required minimum Pap smears was associated with greater confidence and less desire for more Pap smear training. METHODS: We surveyed all 142 internal medicine residents at one university training program. Participants were asked how many Pap smears they had performed during residency and to rank their confidence and desire for more training in performing Pap smears. We compared confidence and desire for more training across three groups of residents reporting varying experience ( 10 Pap smears performed). RESULTS: Of 101 responding residents (71% eligible), 42 (42%), 19 (19%), and 36 (36%) reported performing 10 Pap smears, respectively. The number of Pap smears performed was significantly related to confidence and desire for more training in Pap smears (p<0.05). Of residents who reported 10 Pap smears were 14% and 17%, respectively. After adjusting for gender, primary care track, year of training, continuity clinic site, women's health rotation experience, and future plans in primary care, those reporting doing >10 Pap smears were significantly more likely to report confidence (OR 9.08, 95% CI 2.15-36.26) and less likely to want more training (OR 0.23; 0.06-0.93) than those reporting <or=5 Pap smears. CONCLUSIONS: Residents who performed over twice the number of Pap smears recommended by ABIM were much more likely to indicate confidence in their Pap smear skills compared with those completing <or=5.

Attitude of Health Personnel↗

PubMed2005

Association between alcohol consumption and diabetes preventive practices.

BACKGROUND AND OBJECTIVES: Little is known about the effect of alcohol consumption on the quality of care among patients with diabetes. We evaluated the association between alcohol consumption and diabetes preventive practices. METHODS: We analyzed data from the 2001 Behavioral Risk Factor Surveillance System. Based on self-reported alcohol consumption in the past 30 days, we categorized participants into the following groups: nondrinkers, moderate drinkers (average drinks/day: < or = one for women, < or = two for men), or heavy drinkers (average drinks/day: > one for women, > two for men). We then examined the association between alcohol consumption and participants' reports of diabetes preventive practices. RESULTS: Of 10,980 respondents with a self-reported diagnosis of diabetes, 70% were current nondrinkers, 28% moderate drinkers, and 2% heavy drinkers. Heavy drinkers compared with nondrinkers were more likely to report not performing daily glucose self monitoring and not having had an eye examination in the past year, adjusting for age, gender, race, education, income, marital status, health insurance, diabetes duration, health status, and insulin use. Moderate drinkers were more likely than nondrinkers to report not performing daily glucose self monitoring and not having had a provider visit for diabetes in the past year. CONCLUSIONS: Adults with diabetes who report moderate or heavy alcohol consumption may be at risk for adverse diabetes outcomes due to suboptimal preventive practices.

Adult↗

PubMed2004

The impact of low health literacy on surgical practice.

BACKGROUND: We sought to determine the prevalence of low health literacy (LHL) among patients in a preoperative clinic, the characteristics associated with LHL, and the association between LHL and adherence to preoperative instructions. METHODS: We conducted a cohort study and interviewed patients at a VA preoperative clinic. We administered a health literacy test and collected sociodemographic information. When patients returned for their scheduled surgical procedures, adherence to preoperative instructions was assessed. RESULTS: Of 332 participants, 12% (n = 40) had LHL. Low health literacy was more prevalent among older adults (more than 65 years) compared with those under age 65. Patients with LHL were more likely to be nonadherent to preoperative medication instructions (odds ratio = 1.9; 95% confidence interval: 0.8 to 4.8), but this was of borderline statistical significance. CONCLUSIONS: Low health literacy was common among older patients and appeared to be associated with lower adherence to preoperative medication instructions.

Adolescent↗

PubMed2004

Brief questions to identify patients with inadequate health literacy.

BACKGROUND AND OBJECTIVES: No practical method for identifying patients with low heath literacy exists. We sought to develop screening questions for identifying patients with inadequate or marginal health literacy. METHODS: Patients (n=332) at a VA preoperative clinic completed in-person interviews that included 16 health literacy screening questions on a 5-point Likert scale, followed by a validated health literacy measure, the Short Test of Functional Health Literacy in Adults (STOHFLA). Based on the STOFHLA, patients were classified as having either inadequate, marginal, or adequate health literacy. Each of the 16 screening questions was evaluated and compared to two comparison standards: (1) inadequate health literacy and (2) inadequate or marginal health literacy on the STOHFLA. RESULTS: Fifteen participants (4.5%) had inadequate health literacy and 25 (7.5%) had marginal health literacy on the STOHFLA. Three of the screening questions, "How often do you have someone help you read hospital materials?" "How confident are you filling out medical forms by yourself?" and "How often do you have problems learning about your medical condition because of difficulty understanding written information?" were effective in detecting inadequate health literacy (area under the receiver operating characteristic curve of 0.87, 0.80, and 0.76, respectively). These questions were weaker for identifying patients with marginal health literacy. CONCLUSIONS: Three questions were each effective screening tests for inadequate health literacy in this population.

Adult↗

PubMed2003

Junior faculty's perspectives on mentoring.

The prevalence and characteristics of mentorship among junior faculty in clinician-scientist and clinician-educator tracks were evaluated. Comprehensive improvement strategies are needed.

Adult↗