Scholarship & Research
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Item An assessment of health literacy in independent rural older adults(Montana State University - Bozeman, College of Nursing, 2019) Schubert, Tiffani Paulette; Chairperson, Graduate Committee: M. Jean Shreffler-GrantAdequate health literacy can increase an older adult's ability to manage treatment options, promotes informed decisions concerning self-care, and can play an important part in improving public health while decreasing healthcare costs. The purpose of this project was to assess general health literacy and complementary and alternative medicine (CAM) health literacy in independent older rural adults, explore their use of CAM and over the counter (OTC) medications and their sources of information regarding these therapies, and determine if health literacy and CAM health literacy levels changed based on prior experience with the questionnaire used in this project. Two questionnaires were administered to 30 rural independent older adults approximately 4 weeks apart. Descriptive statistics, paired samples t tests, and correlations were utilized for analysis. To measure general health literacy, three measures were used: Newest Vital Sign (NVS), a single question, and PEPPI. It was found that participants in this project had confidence in their ability to communicate with their provider, had average to above average general health literacy, and on average, were moderately health literate about CAM. Participants were less likely to have used CAM in the last five years than previous research and they frequently referred to their provider for information regarding CAM therapies. The majority of the participants had used OTC medicines in the last year, and mainly received their information regarding OTC medicines from their healthcare provider. There was no change in the participants' scores on the instruments used in this project with repeated exposure to the questionnaires. The results of the Health Information-Seeking Instrument allowed for the exploration of participants' tendency to seek health information. The results suggested that those participants who had a higher average income were more likely to seek health information than those with a lower annual income. This study has implications that are important to patient care. Determining the health literacy of the patient is of utmost importance in order to provide quality care to older adults. As a provider, it is important to understand a patient's health literacy level and to monitor this level over time.Item Increasing health literacy in adolescents(Montana State University - Bozeman, College of Nursing, 2018) Buckingham, Claire; Chairperson, Graduate Committee: Jean M. Shreffler-GrantNearly half of American adults have difficulty understanding and using health information. Despite numerous efforts to address health literacy, measurable improvements have been limited. Measures and improvements in the health literacy of adolescents are even more inadequate. Adolescents are developing important life skills and health behaviors which makes this an opportune stage in life to intervene and improve health literacy. The purpose of this project was to measure and increase health literacy among adolescents. To achieve this purpose, a sample of 23 adolescents, age 15-16, participated in a pre-test survey to measure health literacy using the Newest Vital Sign and eHEALS, attended an educational intervention, and completed a post-test survey to re-measure health literacy. The educational intervention contained information on where to find health information online and how to evaluate those sources. The pre-test survey scores on the Newest Vital Sign indicate that most of the 23 participants (65%) had adequate health literacy prior to the educational intervention. Following the educational intervention, there was no significant change in the participants' Newest Vital Sign scores while there was a significant improvement in the eHEALS scores. The results indicate that the educational intervention improved participants' perceived skills at using electronic health information. Further research and programs are needed to continue to identify successful methods of improving health literacy in adolescents. Measuring the health literacy of patients allows providers to tailor communication and education to each patient and improve the patients' experience.Item Implementation of culturally sensitive and informed health education as a part of the 'wash approach' to controlling soil-transmitted helminth infections in the rural village of Bati Kelo, east Shewa Zone, Adama Wereda, Ethiopia(Montana State University - Bozeman, College of Nursing, 2017) Dean, Courtney Elizabeth; Chairperson, Graduate Committee: Elizabeth KinionProblem Statement: A lack of population-specific approaches and interventions exist with regards to soil-transmitted helminth control measures, thus resulting in significantly reduced effectiveness and lasting impact. Purpose: The purpose of this clinical project was to develop and implement a culturally sensitive and informed health education program to address the health practices of a rural high risk population as a method for controlling soil-transmitted helminth infections. Methods: A culturally sensitive and informed health education program, utilizing the holistic method of the 'WASH Approach,' was implemented in the community of Bati Kelo, East Shewa Zone, Adama Wereda, Ethiopia. The project intervention consisted of three key components: 1) developing a culturally competent and population-specific KAP survey, 2) developing culturally competent health education material for the project population, and 3) conducting the KAP survey and health education sessions in a culturally competent manner. A convenience sample of 234 individuals was collected from the community. The project data were based on self-reported responses to the KAP survey. Ten key health behavior questions were utilized to evaluate the project: two on latrine usage, three on clean water usage, three on hand washing, and two on wearing shoes. Eighty-one surveys qualified for final inclusion. Data were analyzed using SPSS version 2.4. Descriptive statistics were utilized for the evaluation of the entire project. McNemar's test was used to analyze the differences between pre and post intervention (survey) results involving dichotomous variables. Wilcoxon's signed-rank test was used to analyze the differences between pre and post intervention (survey) results involving paired ordinal data. Findings: Positive health behavior/practice change was demonstrated post-intervention in the areas of 'latrine use,' 'clean water (treating water),' and 'handwashing;' however, it was not shown in the area of 'wearing shoes.' Conclusions: The overall findings of this clinical project were consistent with prior research studies, which found the WASH approach impactful on STH infection prevention measures (health behavior practices). A gap in the literature regarding 'cultural competence' in health education as a part of the WASH approach and STH control measures still exists. Much more inquiry and work still remains to be done.Item Formation of a guidebook for primary care providers to access specific printed consumer health information for their patients(Montana State University - Bozeman, College of Nursing, 2000) Fieselmann, Emily (Emily Jane); Chairperson, Graduate Committee: Patricia G. ButterfieldItem Breast and cervical health awareness project : dissemination of information to older rural women(Montana State University - Bozeman, College of Nursing, 1997) Grossman, Linda Lee; Chairperson, Graduate Committee: Kathleen ChafeyItem The nurse practitioner's use of printed health education materials : a process of selection and evaluation(Montana State University - Bozeman, College of Nursing, 1998) Youderian, Rosemary Gibson; Chairperson, Graduate Committee: Daryl T. RiesItem Three methods of health education and related behavioral changes of each(Montana State University - Bozeman, 1964) Self, Evelyn LatimerItem Evaluation of nurse practitioners' assessment of patient reading literacy levels(Montana State University - Bozeman, College of Nursing, 2004) Fouhy-Thurston, Mary Kay; Chairperson, Graduate Committee: Pat Lynes-HayesBased on results of the National Adult Literacy Survey of 1992, it was possible one fourth of patients who received health care from nurse practitioners may not have been able to understand instructions on prescription bottles, or patients’ education materials, use written directions for tests, or give true informed consent. Because of shame and fear, patients do not tend to self-report low literacy. This study compared nurse practitioners’ utilization of indirect literacy assessment, that is, assessment strictly based on clinic interaction, and direct literacy assessment, by a word recognition test. The Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) was administered to 35 patients to screen for low literacy. Two nurse practitioners were asked “Do you think this patients reads at or above the 6th grade level, or below the 6th grade level?” after clinical interaction with the patients. Nurse practitioners accuracy, utilizing the indirect method of literacy assessment, the clinic interaction, was accurate 83% of the time, (n=29). Based on direct assessment by REALM-R testing, nurse practitioners inaccurately assessed patient reading literacy 17% (n=6) of the time. Of the patients who were inaccurately assessed for literacy levels, 67% of the time the reading skill level was overestimated, (n=4), and 33% of the time (n=2) the literacy level was underestimated. Chi-square results indicated no significant relationship between nurse practitioners’ indirect assessment methodology and REALM-R instrumentation. Nurse practitioners correctly assessed patient reading literacy skill levels in approximately 8 of 10 patients based solely on clinical interaction. When inaccuracy occurred, the tendency was to overestimate patients’ literacy ability; in the study, 12% of patients were unable to read six of eight common medical words, indicating a reading skill level below the 6th grade. Written materials, such as most prescriptions and package inserts, consent and registration forms, and many patient education materials would be intelligible for those four patients placing them at greater risk for poor health outcomes associated with poor literacy skills. Nurse practitioners could have utilized the REALM-R word recognition tool to detect patient illiteracy not recognized during the clinical interaction.Item Relationship of health belief model, knowledge of breast cancer, and sociodemographic variables to breast self-examination in rural women(Montana State University - Bozeman, College of Nursing, 1988) Gray, Mary EllenItem Perceptions of students and faculty regarding selected health care practices at Montana State University(Montana State University - Bozeman, College of Nursing, 1977) Burgett, Joyce Elaine Lubbers