Health Literacy – Not “Feeling” It?

health-literacy

Bernadette Keefe MD

Health Literacy – It’s still not catching on.

The Center for Disease Control and Prevention (CDC) defines health literacy as

“the degree to which an individual has the capacity to obtain, communicate, process and understand basic health information and services to make appropriate health decisions”.

 As a believer in improved general literacy for citizens, I have assumed that health literacy, achieved through quality health information, having been easily accessed and well understood, would be akin to the process of general literacy. But just as education involves more than the conveyance of information, it is similar for achieving health literacy.

Although considerable efforts have been made regarding the formulation and dissemination of health and self-care information, we are seeing little effect on health outcomes. All parameters of health and wellness in the U.S. remain stubbornly poor, including the high incidence of obesity, type 2 diabetes, heart disease, cancer, mental health, and addiction. Healthcare systems and healthcare professionals continue to tout patient engagement strategies and the importance of health literacy, but as Michael Friedman states in his excellent piece on the topic:

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Got Sleep?

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Bernadette Keefe MD

Introduction

The most recent data is that 20-40% of the U.S. adult population is sleep deprived: meaning they are not getting the recommended 7-8 hours of sleep per night. The consequences of inadequate sleep on both the individual and society as a whole, are significant. The worst of these include increased obesity, decreased attention and learning, increase in mood disorders, and an increase in accidents. Working against our desire for optimal sleep are our fast paced lives, inevitable work/life stressors, and 24/7 online media, entertainment, and socializing. Although these are formidable obstacles, we must make strides towards the holy grail of a “great night’s sleep” . 
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{Ultra}Processed Food: Too Sexy for Our Own Good?

FrenchFries

Bernadette Keefe MD

“If we are what we do and what we eat, we’re potatoes: couched and fried.” – Ellen Goodman, Wall Street Journal

Introduction

Fast Food has a rich and storied history. In Roman times, through the middle ages, fast food, sold by venders, was a necessity, as many dwellings had no kitchen.

The British “Fish ‘N Chips” was popularized in the mid-1800s by coastal towns that needed to service the large trawling industry. The undisputed King of the Fast Food Industry, however, is the United States. With the introduction of the automobile in the early 1900s, there was ever greater access to fast-cook restaurant fare. America fell in love with “White Castle” hamburgers; the rest is history. America has the largest fast food industry, and, has peppered the world’s landscape with Subway, McDonalds, Kentucky Fried Chicken, Burger King, Starbucks, Dunkin Donuts, Wendy’s among others, whose outlets can be found in over 100 countries.

Due to its worldwide dominance of the Fast Food Industry, U.S. citizens are particularly immersed in the fast food culture, and sadly have “drunk the cool-aid”. While this essay addresses the effects of fast food and other ultra-processed food in America, similar consequences are occurring around the globe.

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Gamification in Healthcare – Let’s Play!

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Bernadette Keefe MD

 “Playing a game is the voluntary effort to overcome unnecessary obstacles.” (Bernard Suits)

Introduction

Game-play focuses and controls our attention, taps into our innate strengths, thrills us utterly, and compels us to greater resilience in the attainment of more powerful and effective skills. For these reasons, some believe that game-play is an invaluable tool to employ in tackling the biggest problems in our world today.

The ability of gaming to focus human attention so completely has attracted all those who wish to harness just a piece of that attention for their own ends. Business, education, and healthcare have all used gamification with the hopes of affecting certain desired behaviors. The goals of gamification in healthcare would be no less than to effect personal and societal behavior change, to achieve improved individual health, and the health of populations.

A flurry of aspirational papers and some early results propelled gamification in healthcare to a Gartner’s Hype Cycle * peak ‘hype’ in 2011-2013. Years 2014-2015 found gamification in healthcare in a period of disillusionment. Now the sentiment for gaming seems to be on the upswing, as more attention is being paid to high quality game design and targeted use.

 In this paper, I will give some history and context to game play, video game design, and the gameful mindset to show how gamification in health and healthcare can and does happen successfully when done well. I will also include demonstrative examples and a large number of references for further perusal.

What is A Game

Games are a structured “form of play or sport, especially a competitive one played according to rules and decided by skill, strength, or luck.” –wikipedia

The history of gaming goes back to ancient times and game-play is one of the oldest forms of social interaction. In essence, the games we play are a celebration of our potential, our dreams, and our innermost passions. Game-play is self-revelatory, and, at the same time, takes us ‘out of ourselves’.

The vast variety of game forms, both ancient and modern, speaks to the centrality of games, and game-play in human life. We play games seated, across from each other, standing, poised ‘in combat’ at the 50 yard line in stadiums, and across the world, in online video games. We stand, jump, kick, run for both online and offline physical games. ‘Exergaming’, the combination of video gaming and exercise, has taken individual and group exercise to a new level. The brilliant ancient Chinese game of ‘Go’, a territorial board game of strategy, is played with as much passion today, as it was several centuries ago!

Game-Collage

Collage of Non-Sport Gaming

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The Power and The Glory of Walking

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Introduction  

Walking

Definition: to move at a regular and fairly slow pace by lifting and setting down each foot in turn, never having both feet off the ground at once.-

Synonyms:  stroll, saunter, amble, trudge, plod, dawdle, hike, tramp, tromp, slog, stomp, trek, march, stride, sashay, glide, troop, patrol, wander, ramble, tread, prowl, promenade, roam, traipse

Wikipedia

“What if a simple act could change the world?” – Born to Walk: The Transformative Power of the Pedestrian Life

Born to Walk – Trailer

Walking for Health 

The U.S. Surgeon General regularly announces public health campaigns, “Calls to Action”, which are deemed particularly important for the overall health of the nation. A “Call to Action” is defined as “a science-based document to stimulate action nationwide to solve a major public health problem”.

For 2015, the U.S. Surgeon General, Dr. Vivek H. Murthy chose walking as the focus, when he announced the ‘Step It Up’ campaign. The ‘Step It Up’ campaign was designed to promote walking and walkable communities. Here is the video which accompanied the launch:

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Sports/American Football & Concussions – A Love/Hate Bond

Bernadette Keefe M.D.

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Introduction 

“If just 10% of the mothers in this country think that football is a dangerous sport, then that is the end of football” – The NFL 

The sports of American football, European football (U.S. soccer), ice hockey (a Canadian favorite), wrestling, lacrosse, and field hockey, among others, are associated with a significant risk of concussions. In the early 2000s, investigations of early, untimely deaths of several retired National Football League (NFL) players, showed similar microscopic findings in their brains. With this discovery, the disease of chronic traumatic encephalopathy (CTE), associated with multiple concussions on the football field, was introduced to the world.

Concussion, The Movie

League of Denial, The Documentary 

“You’re going to war with a corporation that owns a day of the week! “

Two books, one feature film and one television documentary have been released recounting the story of Dr. Bennett Omalu, the man who linked characteristic brain abnormalities, which he later named chronic traumatic encephalopathy, to the progressive dementia and erratic behavior in the pro-football players he studied. Countless scientific articles have been written, and the issue of traumatic brain injury in contact sports has now become front-page news. 

Concussion Movie Trailer 

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Time to Decouple Fear and Health

FearBlog?

Bernadette Keefe M.D.

“Pseudo-dangers represent further opportunities to avoid problems we do not wish to confront….” – Barry Glassner, The Culture of Fear

Introduction

For a while now, I’ve been concerned about the increasing role that fear has played as a tactic in persuading patients to choose certain treatments in healthcare, and to adopt certain habits. Fear is also, often a dominant driver for patients in their health decision-making process.

Fear, however, is an unwanted distraction when making decisions. In contrast to a calm state of mind, it creates added anxiety and stress, in a citizenry already burdened with increasing stressors. How can adding to this be constructive, or further, even moral? How can healthcare decisions, made from fear, be in any way conducive to optimal health outcomes, or conducive to sustainable well-being throughout our lifespans? 
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