Skip to main content

Advertisement

Log in

Applying Taiwanese indigenous health literacy for designing an elders’ prevention fall course: a statistical analysis and deep learning approach

  • Published:
The Journal of Supercomputing Aims and scope Submit manuscript

Abstract

This study aims at exploring the indigenous elders’ health literacy of chronic diseases, designing a fall prevention textbook needed for the cultural consistency of the ethnic group, and analyzing such elders’ performance of physical strength and activity stability through the teaching materials. The study consisted of two phases; first, it mainly explored the elders’ health literacy of chronic health. A structured questionnaire survey was conducted to collect 60 samples of the Bunun elders. To analyze the data, a statistical software, version 22.0, was employed. The results indicated: (1) The older the person the higher the level of cultural acculturation; (2) the higher the degree of traditional culture, the lower the health knowledge scores; (3) the higher the health knowledge score, the better the self-care behavior of chronic diseases; (4) the health knowledge and self-care behavior of chronic disease predictors include age, education level, and occupation. The second phase mainly uses the factors of the traditional culture to influence health and understand the common health issues of the indigenous elders on chronic disease management and fall prevention. We interviewed 12 elders to summarize the important indigenous traditions. Then, based on the core health concept, we designed the cultural care for 12 weeks, in line with the course for the fall prevention and treatment for such elders. The tribal intervention is carried out with a quasi-experimental design. Via purposive sampling, some Atayal and Tsou participants, aged 55 years and above, 60 people, 30 in each ethnic group, were selected. The data, collected from pre- and post-intervention, were analyzed with the SPSS 22.0. Results showed that after the 12-week intervention course, the intervention group had better health cognitive scores, and the Tinett gait time was shortened. Meanwhile, we selected statistically significant variables include mood adaptation, ADL, IADL, health cognition, POMA-G and POMA-B, plus an ANN model established to incorporate these variables into the input variables to test whether the course can predict the falls and physical activities of the two ethnic groups. Ultimately, we observed that DNN model could accurately predict that the indigenous elders could have better mood adaption, IADL, health cognitive scores, and balance and gait performance, with accuracy of 80% in Tsou elders and 100% in Atayal elders. It is suggested that, in the future, in caring for the elders with chronic diseases in Taiwan, health education should avoid excessive professional terminology or esoteric language. This can be presented in pictures or multimedia languages to enhance the indigenous elders’ health and life quality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Agrawal R, Srikan R (1994) Fast algorithms for mining association rules. In: Proceedings of the 20th International Conference on Very Large Data Bases, Santiago, Chile, p. 478–499

  2. Aranha A, Patel P, Panaich S, Cardozo L (2015) Health literacy and cardiovascular disease risk factors among the elderly: a study from a patient-centered medical home. Am J Manag Care 21(2):140–145

    Google Scholar 

  3. Australian Institute of Health and Welfare (2017) Australia’s Welfare 2017. In: We-lfare AIoHa, Editor. Canberra: AIHW, 2017. https://www.aihw.gov.au/reports/australias-welfare/australias-welfare2017/contents/table-of-contents

  4. Chang CH, Guo JL, Lin E, Tsai YJ (2010) Effects of multifactorial fall prevention program on fall and health-related quality of life in the elderly. J Healthy Life Successful Aging 94(4):606–615

    Google Scholar 

  5. Chesser AK, Woods NK, Reyes J, Rogers NL (2018) Health literacy and older adults: fall prevention and health literacy in a midwestern state. J Ageing Res Healthc 2(2):31–40

    Google Scholar 

  6. Chen H (2005) A Study on Prevalence of Chronic Diseases and Related Factors Among Originals and Other Ethnic Groups in Taiwan. (Unpublished master’s thesis) Health and Management of Taichung College, Taiwan

  7. Chen MS (2014) The health problem of indigenous peoples in the world and in taiwan-a historical and political-economy perspective. Taiwan A Radic Q Soc Stud 97:209–246

    Google Scholar 

  8. Chen YC, Hwang SJ, Lai HY (2009) Potentially inappropriate medication for emergency department visits by elderly patients in Taiwan. Pharmacoepidemiol Drug Saf 18:53–61

    Article  Google Scholar 

  9. Chiou HC, Chen YC, Mau LW, Shiao SH, Hong WL, Huang MS (1997) An evaluation of the reliability and validity of the Chinese-version oars multidimensional functional assessment questionnaire. Chin J Public Health 16:119–132

    Google Scholar 

  10. Chuang YF, Sung HC, Lin LP (2005) Health status and health resource utilization among older people in rural mining area. Tzu Chi Nurs J 4(1):34–41

    Google Scholar 

  11. Crengle S et al (2014) Cardiovascular disease medication health literacy among indigenous peoples: design and protocol of an intervention trial in indigenous primary care services. BMC Public Health 14:714. https://doi.org/10.1186/1471-2458-14-714

    Article  Google Scholar 

  12. Curtis LH, Ostbye T, Sendersky V (2004) Inappropriate prescribing for elderly Americans in a large out patient population. Arch Intern Med 164:1621–1625

    Article  Google Scholar 

  13. DeWalt DA et al (2011) Developing and testing the health literacy universal precautions toolkit. Nurs Outlook 59(2):85–94. https://doi.org/10.1016/j.outlook.2010.1.2.002

    Article  Google Scholar 

  14. Faber MJ, Bosscher RJ, van Wieringen PC (2006) Clinimetric properties of the performance-oriented mobility assessment. Phys Ther 86(7):44–54

    Article  Google Scholar 

  15. Harada N, Chiu V, Fowler Lee M, Reuben DB (1995) Physical therapy to improve functioning of older people in residential care facilities. Phys Ther 75(9):830–838

    Article  Google Scholar 

  16. Harvey L, Close J (2013) Trends in fall-related hospitalisations, persons aged 65 years and over 1998–99 to 2011–12. Falls and Injury Prevention Group, Neuroscience Research Australia, Australia

    Google Scholar 

  17. Hsiao NC (2014) Relationships among health status, aging attitude, and quality of life for the aboriginal tribe elderly in Hsin-chu county (Master’s thesis). National Taipei University of Nursing and Health Science, Taiwan

    Google Scholar 

  18. Hsu HC, Wu SC, Chiang TL (1996) The impact of fall on health-related quality of life among the elderly in community. Chin J Public Health 15(6):525–532

    Google Scholar 

  19. Huang HC, Tsai TF, Subeq YM (2019) Using grey relational analysis and grey integrated multi-objective strategy to evaluate the risk factors of falling of aboriginal elders in Taiwan. Soft Comput. https://doi.org/10.1007/s00500-019-04178-x

    Article  Google Scholar 

  20. Jensen J, Lundin-Olsson L, Nyberg L, Gustafson Y (2002) Fall and injury prevention in older people living in residential care facilities. Ann Int Med 136:733–741

    Article  Google Scholar 

  21. Lambert M et al (2014) Health literacy: health professionals’ understandings and their perceptions of barriers that indigenous patients encounter. BMC Health Serv Res 14:614. https://doi.org/10.1186/s12913-014-0614-1

    Article  Google Scholar 

  22. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    Article  Google Scholar 

  23. Lee YL, Chang Y (2012) The related factors of adult functional health literacy level in chronic disease patients. J Med Health 1(1):61–70

    Google Scholar 

  24. Lee L, Lin S, Yen CF, Chuang JL (2016) Comparing the health needs of older aboriginal and older ethnic Chinese individuals in Taiwan. J Nurs Manag 63(2):58–68

    Google Scholar 

  25. Leininger MM, Mcfarland MR (2005) Culture care diversity and universality: a worldwide nursing theory. Jones & Bartlett Learning, Burlington

    Google Scholar 

  26. Lin MR, Hwang HF, Hu MH, Wu HDI, Wang YW, Huang FC (2010) Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and tinetti balance measures in community-dwelling older people. J Am Geriatr Soc 52(8):1343–1348

    Article  Google Scholar 

  27. Liu YB et al (2013) Health literacy and social support in nursing homes. Chin J Health Manag 05:308–311

    Google Scholar 

  28. Morrow DG, Weiner M, Steinley D, Young J, Murray M (2006) Patients’ experience with instructions and health literacy influence preferences for written heart failure medication instructions. J Aging Health 19(4):575–593

    Article  Google Scholar 

  29. Nutbeam D (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot Int 15(3):259–267

    Article  Google Scholar 

  30. Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR (2005) The prevalence of limited health literacy. J Gen Int Med 20(2):175–184

    Article  Google Scholar 

  31. Pan WH et al (2006) Han’s Chinese cell and genome bank in Taiwan: purpose, design and ethical considerations. Hum Hered 61:27–30

    Article  Google Scholar 

  32. Pulver LJ, Haswell MR, Ring I, Waldon J, Clark W, Whetung V (2010) Indigenous health-Australia, Canada, Aotearoa New Zealand and the United States–laying claim to a future that embraces health for us all. World Health Report. Background Paper, 33. (WHO, Geneva, Switzerland, 2010). http://www.who.int/healthsystems/topics/financing/healthreport/IHNo33.pdf

  33. Rheault H, Coyer F, Jones L, Bonner A (2019) Health literacy in indigenous people with chronic disease living in remote Australia. BMC Health Serv Res 19:523

    Article  Google Scholar 

  34. Scott V (2018) Indigenous Fall Prevention Symposium. Report to the Public Health Agency of Canada (August 24, 2018)

  35. Sørensen K et al (2012) Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 12:80

    Article  Google Scholar 

  36. Smylie J, Williams L, Cooper N (2006) Culture-based literacy and aboriginal health. Can J Public Health 91(2):S21–25

    Google Scholar 

  37. Spector RE (2012) Cultural diversity in health and illness, 8th edn. Prentice Hall, Upper Saddle River

    Google Scholar 

  38. Stanford J, Charlton K, McMahon AT, Winch S (2019) Better cardiac care: health professional’s perspectives of the barriers and enablers of health communication and education with patients of Aboriginal and Torres Strait Islander descent. BMC Health Serv Res 19:106–116

    Article  Google Scholar 

  39. Su CL, Chang SF, Chen RC, Pan FC, Chen CH, Liu W (2008) A preliminary study of Taiwan health literacy scale (THLS). Formos J Med 12(5):525–536

    Google Scholar 

  40. Sun PC (2013) Explore the health literacy and related factors of community adults: an example of Nantun district of Taichung city (master’s thesis). Central Taiwan Univ Sci Technol, Taiwan

    Google Scholar 

  41. Tseng TJ, Wu YS, Tang JH, Chiu YH, Lee YT, Fan IC, Chan TC (2019) Association between health behaviors and mood disorders among the elderly: a community-Based cohort study. BMC Geriatrics 19:60

    Article  Google Scholar 

  42. Vass A, Mitchell A, Dhurrkay Y (2011) Health literacy and Australian indigenous peoples: an analysis of the role of language and worldview. Health Promot J Austr 22:33–37

    Article  Google Scholar 

  43. Wei MH, Wang YW, Chang MC, Hsieh JG (2017) Development of mandarin multidimensional health literacy questionnaire (MMHLQ). Taiwan J Public Health 36(6):556–570

    Google Scholar 

  44. World Health Organisation (2007) World Health Organisation (WHO) Global report on falls prevention in older age. WHO, Geneva, p 5

    Google Scholar 

  45. Zarcadoolas C, Pleasant A, Greer DS (2003) Elaborating a definition of health literacy: a commentary. J Health Commun 8:119–120

    Article  Google Scholar 

Download references

Funding

This study was partially sponsored by the Health Promotion Administration, Ministry of Health and Welfare (Contract No. B107610) and the Ministry of Science and Technology, Taiwan (Contract No. MOST 108-2420-H-025 -001-).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yi-Maun Subeq.

Ethics declarations

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

The ethical review has been approved as CRB-105-013, CRB-107-042, IRB10579-A and IRB024-BE.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balalavi, M., Huang, HC., Tsai, TF. et al. Applying Taiwanese indigenous health literacy for designing an elders’ prevention fall course: a statistical analysis and deep learning approach. J Supercomput 77, 2355–2382 (2021). https://doi.org/10.1007/s11227-020-03358-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11227-020-03358-z

Keywords

Navigation