SaferCare Texas

‘Pandemic’ vs. ‘infodemic’ which is causing more harm?

Health information around COVID-19 arrives relentlessly through email, social media, traditional media, personal messages, health care providers, government press conferences and organizations trying to contextualize advice in a relevant way for their communities. People are bombarded with information using words like “underlying conditions” and abstract statements like “flatten the curve” and “trajectory models.” In an article discussing this “global epidemic” of hard to understand information spreading rapidly through social media platforms and other outlets, Zarocostas proposes this lack of health literate information has already had devastating consequences to public health, wellbeing and economies across the world.

The U.S. Department of Health and Human Services defines health literacy as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (USDHHS, 2015). Health literacy has been shown to have a direct link to poor health outcomes such as being seen in Covid-19 especially disproportionately in minorities across the country. It is estimated that approximately 80 million U.S. adults have limited health literacy, with rates higher among the elderly, minorities, poor persons and those with less than a high school education (Kutner, Greenberg, Jin, & Paulsen, 2006).

The CDC reported data on coronavirus racial breakdowns released on April 9, 2020 which indicated a population of 59% white, 14% Latino and 18% black. In contrast, 45% of hospitalized coronavirus patients were white and 8% were Latino, while 33% were black, “suggesting that black populations might be disproportionately affected by COVID-19” (ABC News, 2020). At the same time, Louisiana released data showing that while African-Americans only make up 32% of the population they account for 70% of the deaths in the state (LDOH, 2020). In an interview with NPR, Director of the Maryland Center for Health Equity, Dr. Stephen Thomas stated, “The impact of this virus will follow the same patterns that we see in other diseases in our country, which is that there is a differential outcome for racial and ethnic minority groups” (Summers, 2020).

Why do these disparities exist? Do people understand the health messages being abundantly released? If so, why were they slow to self-isolate or take other precautions to prevent the spread of Covid-19? The pandemic has left everyone scrambling for answers. What we do know, in the United States, studies have shown that those with lower education, less income, and individuals from ethnic/racial minorities are more often afflicted by worse health compared to more socially advantaged groups (Braveman, Cubbin, Egerter, Williams, & Pamuk, 2010). However, enhancing health literacy in populations and systems is critical not only in socially disadvantaged groups but across all demographics. According to White House Coronavirus Response Coordinator Dr. Deborah Birx, “We really need to make sure that every household is aware of what it’s going to take to protect the individuals in the household.”

In the face of a crisis, such as the current COVID-19 pandemic, health literacy becomes a global resource and community asset. Health literacy issues have been traditionally viewed as deficits in knowledge and skills of people affecting their ability to manage health issues. Recently, adverse outcomes have been recognized as dynamic systems issues involving the complexity of navigating technical health information and exceedingly complicated health care systems. In this emerging view, much more of the responsibility for patient knowledge is borne by the source of communication. As we move forward into recovery of this pandemic, we need to abate the preventable harm and “flatten the curve” of complex information. By using health literate approaches to stop the “infodemic,” we can provide understandable and actionable information, where people need information and how they need the information to stay safe, healthy and well.

At SaferCare Texas, we offer a variety of toolkits and resources to enhance your health literacy: What About MomWebLitLegitC.L.A.S Training. Feel free to contact us with your health literacy questions. 

Author:  Teresa Wagner, DrPH, MS, CPH, RD/LD, CHWI, DipACLM, CHWC

 

Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010). Socioeconomic disparities in health in the United States: what the patterns tell us. American Journal of Public Health, 100 (Suppl 1), S186–S196. https://doi.org/10.2105/AJPH.2009.166082

Haslet, C. (April 8, 2020). CDC releases new data as debate grows over racial disparities in coronavirus deaths. ABC News. Retrieved from https://abcnews.go.com/Politics/cdc-releases-data-debate-grows-racial-disparities-coronavirus/story?id=70041803

Kutner, M., Greenberg, E., Jin, Y., and Paulsen, C. (2006). The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). U.S. Department of Education. Washington, DC: National Center for Education Statistics.

Louisiana Department of Health (LDOH). (2020). Public Health: Coronavirus (Covid-19). (2020). Retrieved from http://ldh.la.gov/coronavirus/

Summers, J. (2020). Racial Disparities in Covid-19 impact emerge as data is slowly released. National Public Radio: All Things Considered. Retrieved from https://www.npr.org/2020/04/09/831174878/racial-disparities-in-covid-19-impact-emerge-as-data-is-slowly-released

U.S. Department of Health and Human Services (USDHHS), Office of Disease Prevention and Health Promotion. (2015). Health Literacy Online: A guide to simplifying the user experience. Retrieved from https://health.gov/healthliteracyonline/

Zarocostas, J. (2020). How to fight an infodemic. The Lancet, 395, 676.doi:10.1016/S0140-408 6736(20)30461-X.

                       

How SaferCare Texas is Carrying on Through the COVID-19 Outbreak

The Coronavirus hit us by surprise and is presenting new and unique challenges. Nobody predicted it would force countries to lockdown, shut schools and public places for months, and cause disruptions to daily routines. These unchartered waters can cause added anxiety, stress and strain—physically, mentally, and financially, and that is completely natural. 

Now more than ever it is important to find new ways to work and interact while also taking care of our mental health and well-being. It is also important to remember that although we are all practicing social distancing, that does not mean social isolation.

With that in mind, our team spent some time discussing how we are responding and coping to quarantine life.  Below are quotes from each member of our team describing what he/she is doing to keep mentally and physically healthy. 

Working out

I am purposely limiting access to news to 15 minute intervals in the morning and evening. I also workout twice a week with my son, drink at least 64 ounces of water, and plan for 6-8hrs of sleep/night."

Like others, I am being intentional about healthy nutrition, physical activity, and sleep patterns. Focusing on what I can positively influence – work objectives! Taking more time to enjoy family meals and frequent virtual connections with family and friends in other locations, and also practicing gratitude."

Walking in the park
Bike riding

Like most people, I am trying to keep active and stay positive. I try to do one activity a day outside: riding my bike, taking a walk, or working on the yard. I have also made an effort to keep up my relationships with family and friends through Zoom happy hours. We play virtual games and celebrate wins throughout the week. Also, I have limited my time watching the news and on social media and have started reading more books. Reading has helped keep my mind right. Finally, everyday my husband and I say something that we are grateful for. It is a great way to end the day on a positive note.”

I deal with the stress of the situation by adhering to a regular schedule. Both my husband and I still get up at 5:30 am and put in a normal workday.

I also avoid staying glued to the TV – we watch the news at the end of the day and then have “date time” at 6:30 pm to watch Wheel of Fortune and leave our computers or work spaces!

Trying to pay attention to nutrition and overall fitness has also been key – my Fitbit keeps me focused! I do at least 10 stairs a day. But I do miss “Taco Tuesday!”

Finally, I’m so grateful for a wonderful family who text quite a bit – we have a family group text and often send funny emoji or sayings to help us laugh! The situation in New Orleans is very depressing, so we try to break the “bad news” cycle with funny thoughts."

Working from home
Doggie

I'm purposely following a somewhat normal schedule, eating regular meals, showering and getting dressed by normal work hours. Secondly, I'm taking breaks to get outside and walk my dog during the day as well as a long walk at night."

I am doing some of the same things like keeping a schedule. We are also trying to support the local economy with curbside take out! "

eating
walking the dogs

I spend a lot of time at the UNTHSC COVID-19 test site. In order to wind down, I am working to better my “yoga” technique by participating in a driveway yoga session in my neighborhood at least 2 days a week (we keep a safe distance from each other). I am also getting back to cooking healthy meals, ditching the junk food, and have fun facetime conversations with the family. I have found during this time that I need to find some “me” time, so I am working on getting caught up on my devotional time, time for prayers, and time for just sitting outside and enjoying the quiet."

Something that has helped me stay grounded is that I am cooking and baking a lot more as well as working out daily. It brings me joy knowing that I can still practice my creativity in a different way and create something that is also delicious! I have also made sure to take advantage of good weather days by walking my dogs and working outside. A big practice that I have incorporated into my daily life is gratitude. I always take time every day to point out what I am grateful for that day, even if it is a small thing, such as more time to cuddle with my dogs or not having to worry about traffic. I think being purposeful about ending each day on a positive note, while still acknowledging what I am feeling throughout the day, whether is it good or bad, has helped me tremendously."

Baking

Everyone reacts differently to stressful situations. We hope our quarantine activities give you a variety ideas and tips on how you can stay mentally and physically healthy during these challenging times. 

You can also visit https://coviddayxday.com for additional COVID-19 updates and resources. 

Meet Our New Director, John Sims

We are excited to introduce SaferCare Texas’ new Director, John Sims, MSN, RN, CNL, CMSRN!  As SaferCare Texas’ Director, Johns leads a team of professionals and leaders who create innovative/transformative solutions to eliminate preventable harm around the state of Texas and in local communities.

John Sims

John’s first day in the role was March 23, 2020. Although it’s a challenging time to change careers, John has done an outstanding job jumping right in leading SaferCare Texas and taking on new processes and responsibilities due to COVID-19.

 

John brings 20+ years of experience in the health-care industry with a diverse clinical background. Through innovation, his influence has led team initiatives responsible for patient safety and satisfaction improvements across 14 wholly owned hospitals. His passions include vulnerable patient populations, diabetes management, and health literacy. 

 

To get to know John better, we asked him some personal and fun questions. See what he had to say below. 

 

1.    What are you looking forward to the most being the Director of SaferCare Texas? I thoroughly enjoy building new relationships, especially those who share my passion for a safer community. Building strong relationships is what I look forward to most.  

 

2.    What has been the most exciting part of your first week on the job? I was able to “jump right in” to the Covid-19 Testing site and help our first responders get back to serving our community. 

 

3.    What made you pursue a career in health care? I have always been fascinated by how the human body functions and compensates during injury/disease. I also enjoy translating complicated patient scenarios into understandable terms for patients/families. 

 

4.    If you could be on any sitcom as a reoccurring character, what sitcom would it be? Ha, when I was younger, many told me I resembled Al Bundy in Married with Children. I cannot say that I ever watched a full episode, but I suppose that would be my choice. 

 

5.    Would you rather go 200 years into the future or the past for a day? I would like to go 200 years in the past, but only if I can apply present-day knowledge. This way, perhaps I could work to improve our past so that our present would be that much better. 

 

6.    What’s your favorite fast food restaurant? Taco Cabana

 

7.    Aisle or window seat on a plane? Window-but have to close while taking off

 

8.    Favorite color? Blue

 

9.    Cat or dog person? Dog, but only small breeds

 

10. If you could meet one person, living or dead, who would that person be? Florence Nightingale was truly a pioneer for the nursing profession.  

 

11. If you could fly anywhere in the world for lunch, where would you go? Italy!

 

12. If you could master any sport overnight, what would the sport be? Soccer. 

 

13. What’s a quote you live your life by? “Honesty yields temporary consequences, but permanent rewards, whereas dishonesty yields temporary rewards, but permanent consequences.” 

 

14. What do you enjoy doing when you aren’t working? I love the outdoors-hunting and camping

 

15. What are you most proud of? (my belief) I am most proud that my past, present, and future sins have been forgiven through the blood of Jesus Christ and I will one day live eternally with Him.

 

 

We are looking forward to SaferCare Texas’ future with John as our leader! 

 

 

Feel Great while you Self-Isolate!

working out at home

We’ve all had our world turned upside down acting to prevent the spread of Covid-19. We must self-isolate during the risk of this highly contagious disease. Equally important, we must maintain health and wellness to promote a strong immune system and good mental health. Act on the tips provided to “Feel Great while you Self-Isolate.”

Lifestyle Medicine recommends that we pay attention to our Forks, Fingers, Feet, Sleep, Stress and Social Connections. These tips work every day not just during social distancing. During this time, maintain a regular schedule although regular activities may be on hold.

First, Forks: What you put on your fork matters! Good nutrition is the foundation to good health and sets the tone for all of the other recommended activities to feel great.

Remember Regular Meals – It is important to maintain a regular eating routine of three meals and scheduled snacks. This will help avoid mindless snacking. For scheduled snacks, choose nutritious foods such as popcorn, fruit & yogurt or nuts.

    • This is especially important for people living with chronic diseases like diabetes or high blood pressure who need to tend to nutrition on a daily basis. 
    • Careful with canned fruits in sugar for people with diabetes or gestational diabetes (look for juice packed or low- or no-sugar).
    • Careful with prepared foods and canned foods due to high salt content for people with heart disease or high blood pressure.

Provide Plants – Use shelf stable ingredients to cook healthy meals. It may be hard to find or keep fresh fruits and vegetables during this time. Canned, frozen and dried fruits and vegetables, dried grains (such as oatmeal or rice), beans and other plant-based foods are great shelf-stable items to have on hand for recipes. 

The American Heart Association (AHA) has lots of healthy recipes such as Vegetarian 3-Bean Chili and Slow Cooker Bar-B-Q Chicken. If your busy working from home and home-schooling children, a slow cooker makes an easy option for healthy meals!

You can find a variety of recipes online and substitute any ingredients you don’t have on hand. Don’t normally cook? The AHA also has tutorials on cooking-skills basic cooking skills.

Maintain MyPlate Balance – Although, you might not have a wide variety of foods on hand during this time, MyPlate can help you keep a balanced diet while minding your personal restrictions or preferences with what you have on hand.

  • Protein helps build your body’s immune system, especially for healing and recovery. Eat a variety of protein foods such as seafood, lean meat, poultry, eggs, beans and peas, soy products and unsalted nuts and seeds.
  • Plant-based proteins are low-cost, easy to store and easy to use: Red Beans/Rice, Corn/Black-Eyed Peas, Pea Soup/Bread, Refried Beans/Tortillas, Hummus/Bread or Crackers, Tofu/Rice, Corn/Lima Beans, Wheat such as Bulgur/Lentils.
  • Remember that nutrients work together. Plant foods provide vitamins and minerals that act with protein to build your ability to fight off sickness such as viruses.
Myplate

Second, Fingers: Keep your fingers busy washing your hands rather than using tobacco! According to the CDC, patients with COVID-19 have had mild to severe shortness of breath. Avoid smoking, vaping, or inhaling any substance, which can be toxic to the lungs.

Third, Feet: Use your feet to stay active! Regular, moderate physical activity helps keep the immune system strong! Physical Activity Guidelines say get at least 30 minutes, 5 days a week. Take a walk outside or create an at home circuit workout. Choose three or four exercises you can do at home like jumping jacks, lunges or jogging in place. Staying active helps your body fight off sickness such as viruses.

Fourth, Sleep: Sleep helps the body repair and be fit and ready for another day! Lifestyle Medicine recommends 7 to 9 hours of sleep using these tips:

  • Maintain regular sleep: Set an alarm for when to go to sleep and when to wake up.
  • Prepare a cool, dark, quiet, and comfortable room to improve sleep.
  • Avoid screens at least 90 minutes before bedtime.
  • “Wind down” before bed (listen to soft music, write in a journal, or read a book).

Fifth, Stress: The stress hormone, cortisol, suppresses your immune response. Lifestyle Medicine also recommends managing your stress. Stress management may include:

  • Taking a pause or meditating.
  • Take a few seconds to consider your breathing.
  • Listen to a favorite song or watch a funny video.
  • Being mindful, even in small doses, reduces stress and as a result, cortisol production.

Lastly, Social Connections: Social distancing does not need to feel isolated or lonely! Lifestyle Medicine says connect with friends and family via FaceTime, Zoom, texting, and phone calls. Positive emotions can help improve immunity and arise from even brief, virtual social connections.

An unexpected change in circumstance is stressful. Use the additional time at home as an opportunity to start or maintain good health habits. Take a few minutes each day to eat right, wash your hands, move your body, improve your sleep, manage your stress and reach out to friends and family to stay socially connected. Although these tips cannot guarantee against Covid-19 infection, they can help improve your health and wellness!

 

 

 

Author:  Teresa Wagner, DrPH, MS, CPH, RD/LD, CHWI, DipACLM, CHWC

Dr. Wagner is a registered dietitian certified in Health Coaching & Lifestyle Medicine as well as a Doctor of Public Health. She combines her passion for health literacy and wellness education to helping people stay healthy and well.

Is Your WebLitLegit? Helping Teens Discern Health Information Truth from Trash on the Internet

Would you trust Internet health information for your teen? A study in 2016, found that 70% of youth use the internet as their first source of health information (Sansom-Daly et al., 2016). This is problematic because during this phase of pre-adulting, many teens have limited e-health literacy, lacking the knowledge and skills to filter and distinguish reliable from unreliable health information on the internet (Freeman, et al. 2018; Jain & Bickham, 2014). Locating health topics on the internet is challenging because searches return large, robust amounts of information, making it difficult to recognize whether information is reputable. 

In a 2018 study, youth reported “difficulty in determining the quality of information,” indicating that they were unsure of “the trueness and correctness of the information,” “validity and reliability of the information,” and “understandability of the information” (Esmaeilzadeh, Shahrzadi, & Mostafavi, 2018, p. 9).  Consequently, they may obtain poor quality or even misinformation about health for themselves, their family members, or friends.

To address these issues, a new study funded by the National Network of Libraries of Medicine (NNLM) called WebLitLegit aims to develop an interactive, teen-driven program to improve the health literacy of teens empowering them to ascertain credible health information on the Internet. Created with teens, WebLitLegit is innovative as it can be delivered in a wide range of teen settings and by a range of diverse educators such as school librarians, public librarians, secondary school teachers (health, science, etc.), school nurses, museum educators, and community volunteers. WebLitLegit aims, goals and objectives align with the NNLM mission to improve the public’s access to health information and to make informed decisions about health. 

There are several reliable online information resources currently available for teens to address their health. WebLitLegit exposes teens to these reliable sources of online health information while improving their health literacy about topics they identified as important (Ghaddar, Valerio, Garcia, & Hansen, 2012).  Credible online teen health information resources include but are not limited to the following list:

General teen health

Teen sexual health

Healthy and unhealthy relationships

Mental health

Violence

Medline Plus suggests considering using the internet to find health information like going on a treasure hunt. Your teen could find some real gems but could also end up in some strange and dangerous places! So how can they tell if a website is reliable?

There are five quick steps to check out a website. Let’s consider the clues to look for when checking out websites.

  • Who runs or created the site? Can you trust them?
  • What is the site promising or offering? Do claims seem too good to be true?
  • Where does the information come from? Is it based on research?
  • Why does the site exist? Is it selling something or a scam? What do they want from you?
  • When was the information written or reviewed? Is it up-to-date?

Launching in October for Health Literacy Month, WebLitLegit can be implemented in venues where teens typically go to learn and socialize including local libraries, museums, and schools.  In addition to being shown and demonstrating known, reliable online health resources, teens will have the opportunity during the WebLitLegit workshop to independently locate new websites. 

Educators adopting the workshop will empower teens with functional e-health literacy to locate information, critical e-health literacy to critically appraise the quality of health information, and interactive e-health literacy to apply the health information and make informed decisions about health (Jain & Bickham, 2014; Nordheim, Gundersen, Espehaug, Guttersrud, & Flottorp, 2016).

Contact us to learn more about the WebLitLegit study. Also, join our #WordsToLose campaign to spread the word about Health Literacy Month. Learn more here

References

Esmaeilzadeh S, Ashrafi-rizi H, Shahrzadi L, Mostafavi F (2018). A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. PLOS ONE, 13(11): e0206647.
https://doi.org/10.1371/journal.pone.0206647

Freeman, J.L., Caldwell, P.H., Med, B., Bennett, P.A.,& Scott, K.M. (2018). How adolescents search for and appraise online health information: A systematic review. Journal of Pediatrics, 195, 244-255.

Ghaddar, S. F., Valerio, M. A., Garcia, C. M., & Hansen, L. J. J. o. s. h. (2012). Adolescent health literacy: the importance of credible sources for online health information. Journal of School Health, 82(1), 28-36.

Jain, A.V., & Bickham, D. (2014). Adolescent health literacy and the internet: Challenges and
opportunities. Current Opinion in Pediatrics, 26, 435-439.

Nordheim, L.V., Gundersen, M.W., Espehaug, B., Guttersrud, Ø., Flottorp, S. (2016) Effects of school-based educational interventions for enhancing adolescent’s abilities in critical appraisal of health claims: A systematic review. PLOS ONE,11(8): e0161485. doi:10.1371/journal.pone.0161485

Sansom-Daly, U.M., Lin, M., Robertson, E.G., Wakefield, C.E., McGill, B.C., Girgies, A., Cohn, R.J. (2016).  Health literacy in adolescents and young adults: an updated review.  Journal of Adolescent and Young Adult Oncology, 5(2), 106-118.  Doi: 10.1089/jayao.2015.0059