Health literacy level of Hispanic college students.

OBJECTIVES: The purpose of this study was to assess the health literacy levels of Hispanic college students. METHODS: Participants were students at a major Hispanic-serving university in the southwestern United States. The design was cross-sectional, and data were collected using the Newest Vital Sign in English. Analyses included frequencies and descriptive statistics, simple and multiple logistic regression, and χ(2)/Fisher exact tests. RESULTS: A total of 331 students participated. The overall Newest Vital Sign mean score was 5.1 (standard deviation 1.18); more than 90% (n = 299) obtained a score equivalent to an "always adequate literacy." A lower percentage than that found by a national survey scored at the "below adequate literacy" level. Language spoken at home was the only covariate that significantly affected test scores (P = 0.01). CONCLUSIONS: The overall health literacy level of the participants was higher than the general Hispanic adult population. Investing in the education of Hispanics may help to address disparities in health literacy.

Understanding public health informatics competencies for mid-tier public health practitioners: a web-based survey.

The literature suggests that there is a need for measuring public health informatics (PHI) competency to further understand whether current educational modules and modalities meet the needs of PHI practitioners and researchers to perform their jobs more effectively, particularly for mid-tier practitioners that constitute the majority of public health workers in the USA. The present study seeks to update current knowledge of the perceptions and experiences of PHI competencies proposed by the U.S. Council on Linkage in Public Health specifically for mid-tier PH practitioners and researchers. The results were collected and analyzed by using a Web-based survey (WBS) method administered among both practitioners and researchers. Researchers first compiled a draft list of candidate competency set by incorporating existing competency areas provided by: 1) the Council on Linkage; and by 2) those proposed by the USA's Centers for Disease Control CDC Public Health Informatics Work Group. Nine sets of competency statements with 120 competency items and demographic information of respondents were included in the WBS. The online survey instruments were pilot-tested accordingly to incorporate feedback from respondents of the pilot. Fifty-six subjects were recruited from PH experts who were: 1) members of the Health Informatics Information Technology (HIIT) group of American Public Health Association; and, 2) members from the Community of Science (COS) Website who were the first authors published in the PHI field from PubMed. The sample included diverse backgrounds of PHI workers. They expressed an increased need for training to improve their PHI competencies. Respondents agreed that four competency sets should be adequately represented, including Leadership and System Thinking Skills (82%), followed by Financial Planning and Management Skills (79%), Community Dimensions of Practice Skills (77%), and Policy Development/Program Planning Skills (63%). The findings parallel current literature indicating that there exists an expressed need for clarification of the public health practitioner's job-specific informatics competency. Findings of expressed needs for basic computer literacy training and community-based practice were consistent with those of the literature. Additional training and resources should be allocated to address the competency of leadership, management, community-based practice and policy advocacy skills for mid-tier public health practitioners to perform their jobs more effectively. Only when healthcare organizations properly identify PHI competency needs will public health practitioners likely improve their overall informatics skills while improving diversification for contribution across multiple settings.

A spatial-temporal approach to surveillance of prostate cancer disparities in population subgroups.

BACKGROUND: Prostate cancer mortality disparities exist among racial/ethnic groups in the United States, yet few studies have explored the spatiotemporal trend of the disease burden. To better understand mortality disparities by geographic regions over time, the present study analyzed the geographic variations of prostate cancer mortality by three Texas racial/ethnic groups over a 22-year period. METHODS: The Spatial Scan Statistic developed by Kulldorff et al was used. Excess mortality was detected using scan windows of 50% and 90% of the study period and a spatial cluster size of 50% of the population at risk. Time trend was analyzed to examine the potential temporal effects of clustering. Spatial queries were used to identify regions with multiple racial/ethnic groups having excess mortality. RESULTS: The most likely area of excess mortality for blacks occurred in Dallas-Metroplex and upper east Texas areas between 1990 and 1999; for Hispanics, in central Texas between 1992 and 1996: and for non-Hispanic whites, in the upper south and west to central Texas areas between 1990 and 1996. Excess mortality persisted among all racial/ethnic groups in the identified counties. The second scan revealed that three counties in west Texas presented an excess mortality for Hispanics from 1980-2001. Many counties bore an excess mortality burden for multiple groups. There is no time trend decline in prostate cancer mortality for blacks and non-Hispanic whites in Texas. CONCLUSION: Disparities in prostate cancer mortality among racial/ethnic groups existed in Texas. Central Texas counties with excess mortality in multiple subgroups warrant further investigation.

Public health preparedness of health providers: meeting the needs of diverse, rural communities.

Meeting the needs of public health emergency and response presents a unique challenge for health practitioners with primary responsibilities for rural communities that are often very diverse. The present study assessed the language capabilities, confidence and training needs of Texas rural physicians in responding to public health emergencies. In the first half of year 2004, a cross-sectional, semistructured survey questionnaire was administered in northern, rural Texas. The study population consisted of 841 practicing or retired physicians in the targeted area. One-hundred-sixty-six physicians (30%) responded to the survey. The responses were geographically referenced in maps. Respondents reported seeing patients with diverse cultural backgrounds. They communicated in 16 different languages other than English in clinical practice or at home, with 40% speaking Spanish at work. Most were not confident in the diagnosis or treatment of public health emergency cases. Geographic information systems were found useful in identifying those jurisdictions with expressed training and cultural needs. Additional efforts should be extended to involve African-American/Hispanic physicians in preparedness plans for providing culturally and linguistically appropriate care in emergencies.

Surveillance of the colorectal cancer disparities among demographic subgroups: a spatial analysis.

OBJECTIVE: The literature suggests that colorectal cancer mortality in Texas is distributed inhomogeneously among specific demographic subgroups and in certain geographic regions over an extended period. To understand the extent of the demographic and geographic disparities, the present study examined colorectal cancer mortality in 15 demographic groups in Texas counties between 1990 and 2001. METHODS: The Spatial Scan Statistic was used to assess the standardized mortality ratio, duration and age-adjusted rates of excess mortality, and their respective p-values for testing the null hypothesis of homogeneity of geographic and temporal distribution. RESULTS: The study confirmed the excess mortality in some Texas counties found in the literature, identified 13 additional excess mortality regions, and found 4 health regions with persistent excess mortality involving several population subgroups. CONCLUSION: Health disparities of colorectal cancer mortality continue to exist in Texas demographic subpopulations. Health education and intervention programs should be directed to the at-risk subpopulations in the identified regions.

Health status and access to health care of documented and undocumented immigrant Latino women.

Immigrant Latino women represent about one fifth of the total Latino population; however, data on health status and access to care for this population is limited. Using secondary data, we used a cross-sectional study to examine sociodemographic, migration, health status, and access to health care characteristics of immigrant documented and undocumented Latino women in North Texas. Undocumented women were less likely to report having health insurance and a regular health care provider, and reported lower education and income. These results support the need for providing immigrant women with health services such as health fairs, affordable health insurance programs, community health services, and increased opportunities for participation in federal and state programs.

Assessing the readiness and training needs of non-urban physicians in public health emergency and response.

Emergency readiness has become a public health priority for United States communities after the 9/11 attacks. Communities that have a less developed public health infrastructure are challenged to organize preparedness and response efforts and to ensure that health care providers are capable of caring for victims of terrorist acts. A survey was used to assess non-urban physicians' prior experience with and self-confidence in treating, and preferred training needs for responding to chemical, biologic, radiologic, nuclear, and explosive (CBRNE) cases. Data were collected through a mailed and Web-based survey. Although the response rate was calculated at 30%, approximately one third of the surveys were not able to be delivered. Most respondents reported never having seen or treated CBRNE-inflicted cases and were not confident in their ability to diagnose or treat CBRNE cases, but many were willing to participate in a state-led response plan. Almost half of the individuals had not participated in any related training but expressed interest in receiving training in small group workshops or through CD-ROM. These results provide potential direction for strategic preparedness planning for non-urban health care providers.