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1.  Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence 
It has been argued that only 12 percent of adults have the necessary health literacy to manage their health care effectively, which can lead to difficulties in self-care activities, such as medication adherence. Prior research suggests that health literacy may influence knowledge, self-efficacy and self-care, but this has not been fully examined.
To test a model to explain the relationships between health literacy, heart failure knowledge, self-efficacy, and self-care.
Prior to receiving clinic-based education, newly referred patients to 3 heart failure clinics completed assessments of health literacy, heart failure knowledge, self-efficacy, self-care, and demographics. Structural equation modeling was completed to examine the strength of the inter-variable relationships.
Of 81 participants recruited, data from 63 patients were complete. Health literacy was independently associated with knowledge (p<0.001). Health literacy was not related to self-care. Self-efficacy was independently-associated with self-care adherence (p=0.016). No other relationships were statistically significant. The model had good fit (comparative fit index=1.000) and explained 33.6% of the variance in knowledge and 27.6% in self-care.
Health literacy influences knowledge about heart failure but not self-care adherence. Instead, self-efficacy influenced self-care adherence. Future research should incorporate additional factors that may better model the relationships between health literacy, knowledge, self-efficacy, and self-care.
PMCID: PMC3923851  PMID: 23953756
heart failure; health literacy; self-care; self-efficacy; heart failure knowledge
2.  An Instrument to Assess Subjective Task Value Beliefs Regarding the Decision to Pursue Postgraduate Training 
Objectives. To develop and validate an instrument to assess subjective ratings of the perceived value of various postgraduate training paths followed using expectancy-value as a theoretical framework; and to explore differences in value beliefs across type of postgraduate training pursued and type of pharmacy training completed prior to postgraduate training.
Methods. A survey instrument was developed to sample 4 theoretical domains of subjective task value: intrinsic value, attainment value, utility value, and perceived cost. Retrospective self-report methodology was employed to examine respondents’ (N=1,148) subjective task value beliefs specific to their highest level of postgraduate training completed. Exploratory and confirmatory factor analytic techniques were used to evaluate and validate value belief constructs.
Results. Intrinsic, attainment, utility, cost, and financial value constructs resulted from exploratory factor analysis. Cross-validation resulted in a 26-item instrument that demonstrated good model fit. Differences in value beliefs were noted across type of postgraduate training pursued and pharmacy training characteristics.
Conclusions. The Postgraduate Training Value Instrument demonstrated evidence of reliability and construct validity. The survey instrument can be used to assess value beliefs regarding multiple postgraduate training options in pharmacy and potentially inform targeted recruiting of individuals to those paths best matching their own value beliefs.
PMCID: PMC3930235  PMID: 24558279
faculty members; residency; fellowship; graduate education; career; motivation
3.  Health Literacy Influences Heart Failure Knowledge Attainment but Not Self-Efficacy for Self-Care or Adherence to Self-Care over Time 
Nursing Research and Practice  2013;2013:353290.
Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time. Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally. Methods. Prior to education, newly referred patients at three HF clinics (N = 51, age: 64.7 ± 13.0 years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes. Results. Health literacy was associated with HF knowledge longitudinally (P < 0.001) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate (P < 0.001) but not marginal (P = 0.073) health literacy. Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patients' health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined.
PMCID: PMC3741959  PMID: 23984058
4.  The Influence of Faculty Mentors on Junior Pharmacy Faculty Members’ Career Decisions 
Objective. To assess junior faculty members’ perceptions regarding the impact of past faculty-mentoring relationships in their career decisions, including the decision to pursue postgraduate training and ultimately an academic career.
Methods. A mixed-mode survey instrument was developed and an invitation to participate in the survey was sent to 2,634 pharmacy faculty members designated as assistant professors in the American Association of Colleges of Pharmacy (AACP) directory data.
Results. Usable responses were received from 1,059 pharmacy faculty members. Approximately 59% of respondents indicated that they had received encouragement from 1 or more faculty mentors that was very or extremely influential in their decision to pursue postgraduate training. Mentor and mentee pharmacy training characteristics and postgraduate training paths tended to be similar. US pharmacy degree earners rated the likelihood that they would have pursued an academic career without mentor encouragement significantly lower than did their foreign pharmacy and nonpharmacy degree colleagues (p = 0.006, p = 0.021, respectively).
Conclusions. For the majority of junior pharmacy faculty members, faculty mentoring received prior to completing their doctor of pharmacy degree or nonpharmacy undergraduate degree influenced their subsequent career decisions.
PMCID: PMC3631726  PMID: 23610469
mentor; faculty; career; postgraduate training
5.  Health Literacy and Self-Care of Patients with Heart Failure 
Background and Research Objective
Today’s complex health care system relies heavily on sophisticated self-care regimens. To navigate the system and follow self-care protocols, patients must be able to understand and use health information, which requires health literacy. However, nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Understanding how to effectively care for one’s self is thought to improve heart failure symptoms and patient outcomes, but little is actually known about how health literacy influences self-care in patients with heart failure. The purpose of this pilot study was to examine the relationship between health literacy and self-care of patients with heart failure.
Subjects and Methods
Patients with a diagnosis of heart failure were recruited from a variety of community settings. Participants completed the Short-Form Test of Functional Health Literacy (measured health literacy), the Self-Care Index of Heart Failure (measured self-care maintenance, management, and confidence), and a demographic questionnaire. Spearman’s Rho correlations were used to assess the strength of the relationship between health literacy level and self-care scores.
Results and Conclusions
Among the 49 participants recruited, health literacy was positively related to self-care maintenance (Rs=0.357, p=0.006). Health literacy had a negative relationship with self-care management (Rs=−0.573, p=0.001). There was no association between health literacy and self-care confidence (Rs=0.201, p=0.083). This project provides preliminary data regarding the association between health literacy and self-care in heart failure, showing support for higher health literate patients performing more self-care maintenance, which has been shown to improve patient outcomes in heart failure. Patients with higher health literacy trended toward having greater self-care confidence, which can increase the likelihood of performing self-care, but this finding was not significant. It was unexpected to find that lower health literate patients performed more self-care management.
PMCID: PMC3134625  PMID: 21263340
health literacy; self-care; heart failure
6.  Junior Pharmacy Faculty Members’ Perceptions of Their Exposure to Postgraduate Training and Academic Careers During Pharmacy School 
Objective. To determine the perceptions of junior pharmacy faculty members with US doctor of pharmacy (PharmD) degrees regarding their exposure to residency, fellowship, and graduate school training options in pharmacy school. Perceptions of exposure to career options and research were also sought.
Methods. A mixed-mode survey instrument was developed and sent to assistant professors at US colleges and schools of pharmacy.
Results. Usable responses were received from 735 pharmacy faculty members. Faculty members perceived decreased exposure to and awareness of fellowship and graduate education training as compared to residency training. Awareness of and exposure to academic careers and research-related fields was low from a faculty recruitment perspective.
Conclusions. Ensuring adequate exposure of pharmacy students to career paths and postgraduate training opportunities could increase the number of PharmD graduates who choose academic careers or other pharmacy careers resulting from postgraduate training.
PMCID: PMC3327237  PMID: 22544956
pharmacy faculty members; residency programs; fellowships; graduate education; careers
7.  Job and Career Satisfaction Among Pharmacy Preceptors 
Objectives. To examine the perceived benefit of job and career satisfaction among pharmacist preceptors and to explore other factors that might influence satisfaction.
Methods. A cross-sectional self-administered survey instrument was mailed to pharmacists in the South Central region of the United States who had active 2010 licenses to investigate whether being a pharmacist preceptor increases job and career satisfaction.
Results. Twenty-three percent of the 363 respondents were active preceptors and 62% of these reported that they had been preceptors at some point in the past. Being an active preceptor was significantly related to increased job satisfaction (p = 0.01) but not to career satisfaction. Having a perceived benefit of continuing education and being professionally challenged at work also were associated with increased job and career satisfaction (p < 0.001).
Conclusions. Pharmacist preceptors have higher levels of self-reported job satisfaction.
PMCID: PMC3220334  PMID: 22102743
preceptor; job satisfaction; career satisfaction practice experiences
8.  Economic Analysis of Earning a PhD Degree After Completion of a PharmD Degree 
To determine the net present value (NPV) and internal rate of return (IRR) for earning a doctor of philosophy (PhD) degree and pursuing careers commonly associated with that degree after completion of a doctor of pharmacy (PharmD) degree compared to entering pharmacy practice directly upon completion of the PharmD degree.
Income profiles were constructed based on 2008 annual salary data. NPV and IRR were calculated for careers resulting from the PhD degree and compared to those of the practicing community pharmacist. Trends in IRR also were examined across career paths from 1982 to 2008. A priori assumptions were developed and sensitivity analyses were conducted.
The NPVs for all careers associated with the PhD degree were negative compared to that of the practicing community pharmacist. IRRs ranged from -1.4% to 1.3% for PhD careers. Longitudinal examination of IRRs indicated a negative trend from 1982 to 2008.
Economic financial incentives for PharmD graduates to pursue graduate school are lacking. The study illustrates the need to consider financial incentives when developing recruitment methods for PharmD graduates to pharmacy graduate programs.
PMCID: PMC3049656  PMID: 21451769
salary; internal rate of return; graduate education; economic analysis; career

Results 1-9 (9)