It is an objective vocabulary test, designed as a screening instrument to identify the health literacy levels of patients in clinics, which uses item recognition of 66 ... of the REALM, using words gathered from health information and promotional texts in local clinics, hypothesising that this would improve its applicability.
Kaper, Marise S; Sixsmith, Jane; Koot, Jaap A R; Meijering, Louise B; van Twillert, Sacha; Giammarchi, Cinzia; Bevilacqua, Roberta; Barry, Margaret M; Doyle, Priscilla; Reijneveld, Sijmen A; de Winter, Andrea F
Objective: Skills to address different health literacy problems are lacking among health professionals. We sought to develop and pilot test a comprehensive health literacy communication training for various health professionals in Ireland, Italy and the Netherlands. Methods: Thirty health
Currie Leanne M
Full Text Available Abstract Background Low health literacy has a detrimental effect on health outcomes, as well as ability to use online health resources. Good health literacy assessment tools must be brief to be adopted in practice; test development from the perspective of item-response theory requires pretesting on large participant populations. Our objective was to develop a novel classification method for developing brief assessment instruments that does not require pretesting on large numbers of research participants, and that would be suitable for computerized adaptive testing. Methods We present a new algorithm that uses principles of measurement decision theory (MDT and Shannon's information theory. As a demonstration, we applied it to a secondary analysis of data sets from two assessment tests: a study that measured patients' familiarity with health terms (52 participants, 60 items and a study that assessed health numeracy (165 participants, 8 items. Results In the familiarity data set, the method correctly classified 88.5% of the subjects, and the average length of test was reduced by about 50%. In the numeracy data set, for a two-class classification scheme, 96.9% of the subjects were correctly classified with a more modest reduction in test length of 35.7%; a three-class scheme correctly classified 93.8% with a 17.7% reduction in test length. Conclusions MDT-based approaches are a promising alternative to approaches based on item-response theory, and are well-suited for computerized adaptive testing in the health domain.
... Improvement, April 19, 2017 Considerations for a New Definition of Health Literacy, April 04, 2016 Health Literacy Online, Office of Disease Prevention & Health Promotion Connect with Us Contact Us Twitter Facebook Instagram YouTube Flickr More Social Media from NIH ...
... medical words, and of how their health care system works Abilities, such as physical or mental limitations Personal factors, such as age, education, language abilities, and culture More than 90 million adults in the United States have low health literacy. It affects their ability ...
Prins, Esther; Mooney, Angela
This chapter explores the relationship between literacy and health disparities, focusing on the concept of health literacy. Recommendations are provided for ways to bridge the health literacy gap for learners in adult basic education and family literacy programs.
Lee, Shoou-Yih D; Bender, Deborah E; Ruiz, Rafael E; Cho, Young Ik
The study was intended to develop and validate a health literacy test, termed the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA), for the Spanish-speaking population. The design of SAHLSA was based on the Rapid Estimate of Adult Literacy in Medicine (REALM), known as the most easily administered tool for assessing health literacy in English. In addition to the word recognition test in REALM, SAHLSA incorporates a comprehension test using multiple-choice questions designed by an expert panel. Validation of SAHLSA involved testing and comparing the tool with other health literacy instruments in a sample of 201 Spanish-speaking and 202 English-speaking subjects recruited from the Ambulatory Care Center at UNC Health Care. With only the word recognition test, REALM could not differentiate the level of health literacy in Spanish. The SAHLSA significantly improved the differentiation. Item response theory analysis was performed to calibrate the SAHLSA and reduce the instrument to 50 items. The resulting instrument, SAHLSA-50, was correlated with the Test of Functional Health Literacy in Adults, another health literacy instrument, at r=0.65. The SAHLSA-50 score was significantly and positively associated with the physical health status of Spanish-speaking subjects (peducation. The instrument displayed good internal reliability (Cronbach's alpha=0.92) and test-retest reliability (Pearson's r=0.86). The new instrument, SAHLSA-50, has good reliability and validity. It could be used in the clinical or community setting to screen for low health literacy among Spanish speakers.
Chang, Li-Chun; Hsieh, Pei-Lin; Liu, Chieh-Hsing
The purpose of this study is to develop and evaluate the psychometric properties of the Chinese version of short-form Test of Functional Health Literacy in Adolescents. Assessing health literacy is vital to design health education programme; however, there are no measurement tools exist for use specifically in Chinese adolescents. A non-experimental design was used to test the psychometric properties of the Test of Functional Health Literacy in Adolescents. The short-form Test of Functional Health Literacy in Adolescents was translated and back translated into a Chinese language version. Thirty high school students were recruited to validate the scenario of Test of Functional Health Literacy in Adolescents. Based on the multiple-stage stratified random sampling method, 300 high school students from four counties in Taiwan were invited to participate in this study to evaluate the psychometric properties of Test of Functional Health Literacy in Adolescents. The Functional Health Literacy in Adolescents had good internal consistency reliability and excellent test-retest reliability. Confirmatory factor analysis resulted in a one-factor solution. Contrary to the original version of the Test of Functional Health Literacy in Adolescents, the findings revealed that the 36-item, one-factor model for the Test of Functional Health Literacy in Adolescents is the best-fit model. This is a suitable instrument to assess health literacy levels in Chinese adolescents before health education programmes can be appropriately planned, implemented and evaluated. © 2012 Blackwell Publishing Ltd.
Yost, Kathleen J; Webster, Kimberly; Baker, David W; Choi, Seung W; Bode, Rita K; Hahn, Elizabeth A
Current health literacy measures are too long, imprecise, or have questionable equivalence of English and Spanish versions. The purpose of this paper is to describe the development and pilot testing of a new bilingual computer-based health literacy assessment tool. We analyzed literacy data from three large studies. Using a working definition of health literacy, we developed new prose, document and quantitative items in English and Spanish. Items were pilot tested on 97 English- and 134 Spanish-speaking participants to assess item difficulty. Items covered topics relevant to primary care patients and providers. English- and Spanish-speaking participants understood the tasks involved in answering each type of question. The English Talking Touchscreen was easy to use and the English and Spanish items provided good coverage of the difficulty continuum. Qualitative and quantitative results provided useful information on computer acceptability and initial item difficulty. After the items have been administered on the Talking Touchscreen (la Pantalla Parlanchina) to 600 English-speaking (and 600 Spanish-speaking) primary care patients, we will develop a computer adaptive test. This health literacy tool will enable clinicians and researchers to more precisely determine the level at which low health literacy adversely affects health and healthcare utilization.
Kaper, Marise S; Sixsmith, Jane; Koot, Jaap A R; Meijering, Louise B; van Twillert, Sacha; Giammarchi, Cinzia; Bevilacqua, Roberta; Barry, Margaret M; Doyle, Priscilla; Reijneveld, Sijmen A; de Winter, Andrea F
Skills to address different health literacy problems are lacking among health professionals. We sought to develop and pilot test a comprehensive health literacy communication training for various health professionals in Ireland, Italy and the Netherlands. Thirty health professionals participated in the study. A literature review focused on evidence-informed training-components. Focus group discussions (FGDs) explored perspectives from seventeen professionals on a prototype-program, and feedback from thirteen professionals following pilot-training. Pre-post questionnaires assessed self-rated health literacy communication skills. The literature review yielded five training-components to address functional, interactive and critical health literacy: health literacy education, gathering and providing information, shared decision-making, enabling self-management, and supporting behaviour change. In FGDs, professionals endorsed the prototype-program and reported that the pilot-training increased knowledge and patient-centred communication skills in addressing health literacy, as shown by self-rated pre-post questionnaires. A comprehensive training for health professionals in three European countries enhances perceived skills to address functional, interactive and critical health literacy. This training has potential for wider application in education and practice in Europe. Copyright © 2017 Elsevier B.V. All rights reserved.
Yin, H Shonna; Sanders, Lee M; Rothman, Russell L; Mendelsohn, Alan L; Dreyer, Benard P; White, Richard O; Finkle, Joanne P; Prendes, Stefania; Perrin, Eliana M
To assess the health literacy and numeracy skills of Spanish-speaking parents of young children and to validate a new Spanish language health literacy assessment for parents, the Spanish Parental Health Literacy Activities Test (PHLAT Spanish). Cross-sectional study of Spanish-speaking caregivers of young children (validated tests of health literacy (S-TOFHLA) and numeracy (WRAT-3 Arithmetic). Psychometric analysis was used to examine item characteristics of the PHLAT-10 Spanish, to assess its correlation with sociodemographics and performance on literacy/numeracy assessments, and to generate a shorter 8-item scale (PHLAT-8). Of 176 caregivers, 77% had adequate health literacy (S-TOFHLA), whereas only 0.6% had 9th grade or greater numeracy skills. Mean PHLAT-10 score was 41.6% (SD 21.1). Fewer than one-half (45.5%) were able to read a liquid antibiotic prescription label and demonstrate how much medication to administer within an oral syringe. Less than one-third (31.8%) were able to interpret a food label to determine whether it met WIC (Special supplemental nutrition program for Women, Infants, and Children) guidelines. Greater PHLAT-10 score was associated with greater years of education (r = 0.49), S-TOFHLA (r = 0.53), and WRAT-3 (r = 0.55) scores (P Spanish-speaking parents have difficulty performing health-related literacy and numeracy tasks. The Spanish PHLAT demonstrates good psychometric characteristics and may be useful for identifying parents who would benefit from receiving low-literacy child health information. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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Heide, van der Iris; Uiters, Ellen; Sørensen, Kristine; Röthlin, Florian; Pelikan, Jürgen; Rademakers, Jany; Boshuizen, Hendriek
Background: Health literacy is an important determinant of health, but national health literacy levels are known for only some European countries. This study aims to examine to what extent national health literacy levels can be estimated based on publicly available census data. Method:
Diemer, Frederieke S.; Haan, Yentl C.; Nannan Panday, Rani V.; van Montfrans, Gert A.; Oehlers, Glenn P.; Brewster, Lizzy M.
Low health literacy is an independent predictor of cardiovascular mortality. However, data on health literacy in low- and middle-income countries are scarce. Therefore, we assessed the level of health literacy in Suriname, a middle-income country with a high cardiovascular mortality. We estimated
Vamos, Cheryl A; Lockhart, Elizabeth; Vázquez-Otero, Coralia; Thompson, Erika L; Proctor, Sara; Wells, Kristen J; Daley, Ellen M
This study explored narrative responses following abnormal Pap tests among Hispanic migrant farmworkers ( N = 18; ages 22-50 years) via in-depth interviews in Florida. Qualitative analyses utilized health literacy domains (obtain/process/understand/communicate) as a conceptual framework. Participants described how they (1) obtained information about getting a Pap test, (2) processed positive and negative reactions following results, (3) understood results and recommended health-promoting behaviors, and (4) communicated and received social support. Women had disparate reactions and understanding following an abnormal Pap result. Health literacy was a meaningful conceptual framework to understand assets and gaps among women receiving an abnormal Pap test result. Future interventions should incorporate health literacy domains and facilitate patient-provider communications and social support to assist women in decision-making and health-promoting behaviors, ultimately decreasing cancer disparities.
Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel
The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…
Echeverri, Margarita; Anderson, David; Nápoles, Anna María
This article describes the adaptation and initial validation of the Cancer Health Literacy Test (CHLT) for Spanish speakers. A cross-sectional field test of the Spanish version of the CHLT (CHLT-30-DKspa) was conducted among healthy Latinos in Louisiana. Diagonally weighted least squares was used to confirm the factor structure. Item response analysis using 2-parameter logistic estimates was used to identify questions that may require modification to avoid bias. Cronbach's alpha coefficients estimated scale internal consistency reliability. Analysis of variance was used to test for significant differences in CHLT-30-DKspa scores by gender, origin, age and education. The mean CHLT-30-DKspa score (N = 400) was 17.13 (range = 0-30, SD = 6.65). Results confirmed a unidimensional structure, χ(2)(405) = 461.55, p = .027, comparative fit index = .993, Tucker-Lewis index = .992, root mean square error of approximation = .0180. Cronbach's alpha was .88. Items Q1-High Calorie and Q15-Tumor Spread had the lowest item-scale correlations (.148 and .288, respectively) and standardized factor loadings (.152 and .302, respectively). Items Q19-Smoking Risk, Q8-Palliative Care, and Q1-High Calorie had the highest item difficulty parameters (difficulty = 1.12, 1.21, and 2.40, respectively). Results generally support the applicability of the CHLT-30-DKspa for healthy Spanish-speaking populations, with the exception of 4 items that need to be deleted or revised and further studied: Q1, Q8, Q15, and Q19.
Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies
... 1998. Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes. Archives of Internal Medicine. 158(2): 166-172. ...
Hemingway, Steve; Stephenson, John; Trotter, Fiona; Clifton, Andrew; Holdich, Phillip
This paper presents the pre- and post-test results of the outcomes of a workshop designed to increase learning disability and mental health nurses' knowledge and skill to undertake interventions for service users at risk of, or with a diagnosis of, type 2 diabetes. Health literacy is also discussed as a way of explaining why such nurses may lack expertise in physical health care. Findings from the workshop show that learning disability and mental health nurses have the motivation to increase their health literacy (skills and knowledge) in diabetes care. The potential of such workshops, and how organisations looking forward to the future can build health literacy, is discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kurtz-Rossi, Sabrina; Funk, Carla J.
Objectives: This research studied hospital administrators' and hospital-based health care providers' (collectively, the target group) perceived value of consumer health information resources and of librarians' roles in promoting health information literacy in their institutions. Methods: A web-based needs survey was developed and administered to hospital administrators and health care providers. Multiple health information literacy curricula were developed. One was pilot-tested by nine hospital libraries in the United States and Canada. Quantitative and qualitative methods were used to evaluate the curriculum and its impact on the target group. Results: A majority of survey respondents believed that providing consumer health information resources was critically important to fulfilling their institutions' missions and that their hospitals could improve health information literacy by increasing awareness of its impact on patient care and by training staff to become more knowledgeable about health literacy barriers. The study showed that a librarian-taught health information literacy curriculum did raise awareness about the issue among the target group and increased both the use of National Library of Medicine consumer health resources and referrals to librarians for health information literacy support. Conclusions: It is hoped that many hospital administrators and health care providers will take the health information literacy curricula and recognize that librarians can educate about the topic and that providers will use related consumer health services and resources. PMID:19851494
Literacy testing has been researched as a social practice from different perspectives (McNamara & Roewer, 2006; Shohamy, 2001). Drawing on a Faucault inspired concept og governmentality in which literacy testing practices are seen as social technologies (Dean, 1999) and as a phenomenon closely...... related to supra- and transnational agencies this paper investigates the relation between state, pedagogy and conceptualizations of literacy. Drawing on data and findings from three ethnographic oriented studies of institutional testing practices of literacy in preschool, primary school and adult second...... language teaching in Denmark (Holm, 2004; 2007; 2009) this paper reveals the construction of values, ideologies and practices around institutional testing of litaracy in education. The analyses of testing instruments and assessment practices indicate among other things that testing of literacy have become...
Kayser, Lars; Karnoe, Astrid; Furstrand, Dorthe; Batterham, Roy; Christensen, Karl Bang; Elsworth, Gerald; Osborne, Richard H
For people to be able to access, understand, and benefit from the increasing digitalization of health services, it is critical that services are provided in a way that meets the user's needs, resources, and competence. The objective of the study was to develop a questionnaire that captures the 7-dimensional eHealth Literacy Framework (eHLF). Draft items were created in parallel in English and Danish. The items were generated from 450 statements collected during the conceptual development of eHLF. In all, 57 items (7 to 9 items per scale) were generated and adjusted after cognitive testing. Items were tested in 475 people recruited from settings in which the scale was intended to be used (community and health care settings) and including people with a range of chronic conditions. Measurement properties were assessed using approaches from item response theory (IRT) and classical test theory (CTT) such as confirmatory factor analysis (CFA) and reliability using composite scale reliability (CSR); potential bias due to age and sex was evaluated using differential item functioning (DIF). CFA confirmed the presence of the 7 a priori dimensions of eHLF. Following item analysis, a 35-item 7-scale questionnaire was constructed, covering (1) using technology to process health information (5 items, CSR=.84), (2) understanding of health concepts and language (5 items, CSR=.75), (3) ability to actively engage with digital services (5 items, CSR=.86), (4) feel safe and in control (5 items, CSR=.87), (5) motivated to engage with digital services (5 items, CSR=.84), (6) access to digital services that work (6 items, CSR=.77), and (7) digital services that suit individual needs (4 items, CSR=.85). A 7-factor CFA model, using small-variance priors for cross-loadings and residual correlations, had a satisfactory fit (posterior productive P value: .27, 95% CI for the difference between the observed and replicated chi-square values: -63.7 to 133.8). The CFA showed that all items loaded
Hunter, Susan L.
This study analyses warehoused data collected by Georgia State University and Centers for Disease Control and Prevention (GSU/CDC) researchers after developing an HIV testing message for urban adults with low functional health literacy. It expands previous work by examining data collected when 202 primarily African-American homeless clients of an urban community based organization (CBO) reviewed both the low literacy brochure (Wallace et al., 2006) and a standard HIV brochure (Georgia Department of Human Resources, 1997). Participants' health literacy was assessed using 2 measures; the Rapid Estimate of Adult Literacy in Medicine or REALM (Davis, Crouch, Long & Green) and the Test of Functional Health Literacy Assessment or TOFHLA (Nurss, Parker & Baker, 2001). HIV risk was determined using an interview questionnaire developed by the research group (Belcher, Deming, Hunter & Wallace, 2005) which allowed participants to self-report recent alcohol and drug use, sexual behavior, sexually transmitted disease (STD) history and exposure to abuse and sexual coercion. Open-ended response questions regarding readability, understanding, main message, and importance for each brochure provided the qualitative data. This analysis confirms previous work showing accessibility, readability, cultural sensitivity and user-friendly formatting are important when attempting to engage at-risk adults with varying levels of functional health literacy in an HIV testing message. The visual aspects of the brochure can be essential in capturing the reader's attention and should be relevant to the target audience (Wallace, Deming, Hunter, Belcher & Choi, 2006). Mono-colored graphics may be perceived as dated and irrelevant or worse yet, threatening to some readers. Whenever possible culturally appropriate color photos of people depicting relevant content should replace excess text and difficult medical terms should be eliminated. Wording on the cover and within the brochure should be used to
Chesser, Amy K.; Keene Woods, Nikki; Smothers, Kyle; Rogers, Nicole
Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults. PMID:28138488
Abdel-Latif, Mohamed M M; Saad, Sherif Y
Health literacy is a major problem worldwide and adversely affects an individual's health. The aim of the present study was to assess health literacy level among Saudi population. A cross-sectional study was conducted among a randomly selected population (n = 500) in Saudi Arabia. The questionnaire comprised of questions pertaining to demographic characteristics, health literacy and health information. Health literacy was measured by REALM-R test. Internal reliability was determined using Cronbach's alpha coefficient. The majority of the respondents had intermediate (43.8%) and basic (34.4%) health literacy levels. A higher percentage among men had intermediate (59.8%) and basic (70.93%) health literacy levels compared with women. About 30% of respondents had difficulty in understanding health screening tests and disease treatment. More than half of participants (52.4%) had difficulty in finding health information. The REALM-R test revealed that about 42.6% of individuals with score of >6 had adequate health literacy compared with 57.4% with score of ≤6 had inadequate health literacy. The present study demonstrated that a majority of Saudi individuals had inadequate health literacy that associated with poor knowledge of health information. Our findings highlighted the importance of understanding the status of health literacy among Saudis and the need for educational programs to raise the health literacy awareness among Saudi population. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Megwalu, Uchechukwu C; Lee, Jennifer Y
To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.
Full Text Available Abstract Health communication consists of interpersonal or mass communication activities focused on improving the health of individuals and populations. Skills in understanding and applying information about health issues are critical to this process and may have a substantial impact on health behaviors and health outcomes. These skills have recently been conceptualized in terms of health literacy (HL. This article introduces current concepts and measurements of HL, and discusses the role of HL in health communication, as well as future research directions in this domain. Studies of HL have increased dramatically during the past few years, but a gap between the conceptual definition of HL and its application remains. None of the existing instruments appears to completely measure the concept of HL. In particular, studies on communication/interaction and HL remain limited. Furthermore, HL should be considered not only in terms of the characteristics of individuals, but also in terms of the interactional processes between individuals and their health and social environments. Improved HL may enhance the ability and motivation of individuals to find solutions to both personal and public health problems, and these skills could be used to address various health problems throughout life. The process underpinning HL involves empowerment, one of the major goals of health communication.
Full Text Available Objectives: Health literacy has received attention as an important issue for pharmacists to consider when interacting with patients. Yet, there is little information about methods pharmacists use to communicate with patients and their extent of use of health literacy based interventions during patient interactions. The purpose of this study was to examine methods of communication and types of health literacy based interventions that practicing pharmacists use in Illinois. Methods: A survey instrument addressing the study purpose was designed along with other items that were part of a larger study. Eleven items in the survey referred to pharmacist-patient communication. The instrument was pilot tested before administering to a random sample of 1457 pharmacists from the Illinois Pharmacists Association. Data were primarily collected via a mailed survey using Dillman’s five step total design method (TDM. Two reminder letters were mailed at two week intervals to non-respondents. Results: Usable responses were obtained from 701 respondents (48.1% response rate. Using simple words (96% and asking patients open-ended questions to determine comprehension (85% were the most frequent methods that pharmacists used to communicate with patients. Only 18% of respondents always asked patients to repeat medication instructions to confirm understanding. The various recommended types of health literacy interventions were “always” performed by only 8 to 33% of the respondents. More than 50% of respondents indicated that they rarely or never had access to an interpreter (51%, or employed bilingual pharmacists (59%. Only 11% of pharmacists said that they rarely/never pay attention to nonverbal cues that may suggest low health literacy. Conclusions: Pharmacists infrequently use action oriented health literacy interventions such as using visual aids, having interpreter access, medication calendars, etc. Additional training on health literacy, its scope, and
Full Text Available Introduction: Health literacy is the capacity of individuals to obtain, process and understand basic health information and services needed to make healthy decisions. Therefore, this study was designed to determine health literacy of adults Tuyserkan district. Materials and Methods: This cross-sectional descriptive-analytical study was performed on 285 subjects aged 20-60 years attending Tuyserkan health centers through convenience sampling method in 2014. Iranian health literacy questionnaire was used to collect data. Data was analyzed using Stata-11 by Independent T-test and one way ANOVA. Results: Most participants aged 20 to 30 years (52.3% and 53.7 % were males. Most participants had postgraduate diploma level (55.8 % and were students (31.9 %. Participants had a weak level to access information (42.1%, weak level to perceive data (54.4%, moderate in judgment and assessment (64.9% and moderate in use of information (88.8%. Conclusion: Overall, there was a poor health literacy in adults. This indicates the need for more attention to health education and health promotion programs. It seems necessary to design and implement comprehensive plans using media and simple training methods for adults with a low level of health literacy.
In this paper, I use a social practices view of literacy to challenge dominant conceptions of health literacy. Health literacy is frequently defined as an abstract skill that can be measured through individual performance tests. The concept of health literacy as a skill neglects the contextual nature of reading and writing in health care settings. It risks ignoring the many ways in which patients access and comprehend health information, make sense of their experience and the resources they d...
Monkman, Helen; Kushniruk, Andre W; Barnett, Jeff; Borycki, Elizabeth M; Greiner, Leigh E; Sheets, Debra
Many researchers assume that there is a relationship between health literacy and eHealth literacy, yet it is not clear whether the literature supports this assumption. The purpose of this study was to determine if there was a relationship between health and eHealth literacy. To this end, participants' (n = 36) scores on the Newest Vital Sign (NVS, a health literacy measure) were correlated with the eHealth Literacy Scale (eHEALS, an eHealth literacy measure). This analysis revealed no relationship (r = -.041, p = .81) between the two variables. This finding suggests that eHealth Literacy and health literacy are dissimilar. Several possible explanations of the pattern of results are proposed. Currently, it does not seem prudent to use the eHEALS as the sole measure of eHealth literacy, but rather researchers should continue to complement it with a validated health literacy screening tool.
Gu, Yulong; Orr, Martin; Warren, Jim
Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology's potential.
In this podcast, Dr. Lynda Anderson, former Director of CDCâs Healthy Aging Program, discusses the importance of improving health literacy among older adults. Created: 9/20/2011 by Office of the Associate Director for Communication (OADC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 9/20/2011.
Akbarinejad, Farideh; Soleymani, Mohammad Reza; Shahrzadi, Leila
The ability to access, analyze, evaluate, and convey information in various forms of media including print and nonprint requires media literacy, but the capacity to obtain, process, and understand basic information and services needed for appropriate decisions regarding health, considered an important element in a woman's ability to participate in health promotion and prevention activities for herself and her children, is needed to a level of health literacy. The purpose of this study was to determine the relationship between media literacy and health literacy among pregnant women in health centers in Isfahan. This study used a descriptive correlation study. Data collection tools include Shahin media literacy and functional health literacy in adults' questionnaires. The population include pregnant women in health centers of Isfahan (4080 people). Ten out of the 351 health centers in Isfahan were selected as cluster. Data were analyzed using both descriptive and inferential statistics. Media literacy of respondents in the five dimensions was significantly lower than average 61.5% of pregnant women have inadequate health literacy, 18.8% had marginal health literacy, and only 19.7% of them have had adequate health literacy. There was a significant positive relationship between media literacy and health literacy among pregnant women. This study showed that the majority of pregnant women covered by health centers had limited health literacy and media literacy. Since one of the basic requirements for the utilization of health information is needed for adequate media literacy, promotion of media literacy is necessary for the respondents.
The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583
Full Text Available Background and objective: Health literacy represents the cognitive and social skills that determine the motivation and ability of individuals to acquire, access and understand the information to maintain and promote health. This study aimed to assess the health literacy of adults in Karaj. Methods: In this cross-sectional and descriptive study, 525 subjects aged 18-65 years old were selected using multistage sampling in Karaj. Relevant information was obtained using demographic questionnaire and HELIA questionnaire (18-65 years-old, respectively. Data were analyzed using SPSS and appropriate tests. Results: The mean age of participants was 33.48 ± 11.39 years old. 48.8% (n=250 the participants were male and 51.2% (n=262 were female. 24.2% (n=124 of the participants had inadequate health literacy, 23.4 % (n=120 not so inadequate health literacy, 37.9 % (n=194 adequate health literacy and 14.5 (n = 74 had higher health literacy. Health literacy was significantly associated with age, gender, marital status, education, BMI, smoking and physical activity (p<0.05. Conclusion: Due to low health literacy and the importance of adult role in society, it is necessary educational programs aimed at improving their health literacy skills , designed and implemented. Paper Type: Research Article.
Quaglio, Gianluca; Sørensen, Kristine; Rübig, Paul; Bertinato, Luigi; Brand, Helmut; Karapiperis, Theodoros; Dinca, Irina; Peetso, Terje; Kadenbach, Karin; Dario, Claudio
Health literacy can be defined as the knowledge, motivation and competence to access, understand, appraise and apply information to make decisions in terms of healthcare, disease prevention and health promotion. Health literacy is a European public health challenge that has to be taken seriously by policy-makers. It constitutes an emerging field for policy, research and practice. However, recent research has shown that health literacy advancement is still at its infancy in Europe, as reflected in the scarce scientific health literacy literature published by European authors. From a total of 569 articles published until 2011 on this subject, the first author of only 15% of them is from Europe. This article conveys recommendations of different European stakeholders on how to accelerate the health literacy agenda in Europe. A general introduction on the current status of health literacy is provided, followed by two cases applying health literacy in the areas of prevention of communicable diseases and promotion of digital health. The current EU strategies integrating health literacy are listed, followed by examples of challenges threatening the further development of health literacy in Europe. Recommendations as to how European stakeholders involved in research, policy, practice and education can promote health literacy are given. It is vital that the European Commission as well as European Union Member States take the necessary steps to increase health literacy at individual, organizational, community, regional and national levels. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Pander Maat, Henk; Essink-Bot, Marie-Louise; Leenaars, Karlijn E. F.; Fransen, Mirjam P.
An earlier attempt to adapt the REALM (Rapid Estimate of Adult Literacy in Medicine) word recognition test to Dutch was not entirely successful due to ceiling effects. In contrast to REALM, the Short Assessment of Health Literacy (SAHL) assesses both word recognition and comprehension in the health
Horvath, Keith J; Bauermeister, José A
We assessed whether young men who have sex with men's acceptability with the online Get Connected! intervention and subsequent sexual health decision making were influenced by their baseline eHealth literacy (high vs. low competency) and intervention tailoring (tailored or nontailored intervention condition). Compared to the high eHealth literacy/tailored intervention group: (1) those in the low eHealth literacy/tailored intervention condition and participants in the nontailored intervention condition (regardless of eHealth literacy score) reported lower intervention information quality scores; and (2) those in the low eHealth literacy/nontailored intervention group reported lower intervention system quality scores and that the intervention had less influence on their sexual health decision making. Future similar intervention research should consider how eHealth literacy might influence participants' abilities to navigate intervention content and integrate it into their sexual decision making.
Solhi, Mahnaz; Jormand, Hanieh
Health literacy is one of the major determinants of health promotion among individuals and within society. The present study is aimed to determine the health literacy status of office employees in Shemiranat using the native instruments of health literacy for Iranian adults (HELIA). The present descriptive-analytical cross-sectional study was done in 2016-17. It was conducted on 360 office employees in Shemiranat. The samples were selected using a multi-stage simple random sampling method. Data collection tools in this study included HELIA questionnaire. The data were imported into SPSS v.18 software and then analyzed using descriptive statistical indices (mean, SD, number, and percentage) and inferential statistics (Chi-square, Pearson's correlation coefficient, Spearman's correlation coefficient, and Kruskal-Wallis test). Written informed consent was obtained from the employees participating in the study and they were assured about confidentiality. Also, they were informed that participation was voluntary. The mean and standard deviation of the total health literacy score among the studied individuals was 125.99±16.01. The mean score of health literacy in the areas of reading (15.36±2.89) and evaluation (5.01±2.8) among the studied individuals was lower than other dimensions of health literacy. Based on the Chi-square test, there was a statistically significant relationship between health literacy and education level, occupational rank, work place, and work experience (p=0.0001 in all the cases). The individuals with medium and good levels of health literacy acquired most of their health-related information through the Internet, friends, relatives, physicians, and health staff. Health literacy status was not sufficient among the studied staff. Thus, it is recommended to perform promotional interventions in order to improve the health literacy status and its dimensions among these staff.
Lindgren, Kurt; Koldkjær Sølling, Ina; Carøe, Per; Siggaard Mathiesen, Kirsten
The purpose of this study is to develop an interdisciplinary learning environment between education in technology, business, and nursing. This collaboration creates natural interest and motivation for welfare technology. The aim of establishing an interaction between these three areas of expertise is to create an understanding of skills and cultural differences in each area. Futhermore, the aim is to enable future talents to gain knowledge and skills to improve health literacy among senior citizens. Based on a holistic view of welfare technology, a Student Academy was created as a theoretically- and practically-oriented learning center. The mission of the Student Academy is to support and facilitate education in order to maintain and upgrade knowledge and skills in information technology and information management related to e-health and health literacy. The Student Academy inspires students, stakeholders, politicians, DanAge Association members, companies, and professionals to participate in training, projects, workshops, and company visits.
Lindgren, Kurt; Sølling, Ina Koldkjær; Carøe, Per
The purpose of this study is to develop an interdisciplinary learning environment between education in technology, business, and nursing. This collaboration contributes to the creation of a natural interest and motivation for welfare technology. The aim of establishing an interaction between the 3...... as a theoretical and practical learning center. The mission of the Student Academy is to support and facilitate education in order to maintain and upgrade knowledge and skills in information technology and information management in relation to e-health and Health Literacy. The Student Academy inspires students...... areas of expertise is to create an understanding for each other's skills and cultural differences. Futhermore enabling future talents to gain knowledge and skills to improve Health Literacy among senior citizens. Based on a holistic view on welfare technology a Student Academy was created...
Lindgren, Kurt; Sølling, Ina Koldkjær; Carøe, Per
Abstract The purpose of this study is to develop an interdisciplinary learning environment between education in technology, business, and nursing. This collaboration contributes to the creation of a natural interest and motivation for welfare technology. The aim of establishing an interaction...... as a theoretical and practical learning center. The mission of the Student Academy is to support and facilitate education in order to maintain and upgrade knowledge and skills in information technology and information management in relation to e-health and Health Literacy. The Student Academy inspires students...... between the 3 areas of expertise is to create an understanding for each other's skills and cultural differences. Futhermore enabling future talents to gain knowledge and skills to improve Health Literacy among senior citizens. Based on a holistic view on welfare technology a Student Academy was created...
Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Bennett, David A
Literacy is an important determinant of financial and health outcomes in old age, and cognitive decline has been linked with lower literacy. We tested the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and health literacy. Participants (n = 730) from the Rush Memory and Aging Project were given a clinical evaluation and an assessment of total, financial, and health literacy. Regression was used to examine whether MCI was associated with lower literacy. In secondary analyses, we investigated the association of particular cognitive systems with literacy. MCI was associated with lower total, financial, and health literacy. An interaction was observed such that higher education reduced the effect of MCI on total and financial literacy. Multiple cognitive systems were associated with literacy in participants with MCI, and semantic memory accounted for the most variance. Persons with MCI exhibit poorer financial and health literacy, and education mitigates this effect. © The Author(s) 2015.
Bailey, Stacy Cooper; Brega, Angela G.; Crutchfield, Trisha M.; Elasy, Tom; Herr, Haley; Kaphingst, Kimberly; Karter, Andrew J.; Moreland-Russell, Sarah; Osborn, Chandra Y.; Pignone, Michael; Rothman, Russell; Schillinger, Dean
Purpose Inadequate literacy is common among patients with diabetes and may lead to adverse outcomes. We reviewed the relationship between literacy and health outcomes in patients with diabetes and potential interventions to improve such outcomes. Methods We reviewed 79 articles covering three key domains: 1) evaluation of screening tools to identify inadequate literacy and numeracy; 2) the relationships of a range of diabetes-related health outcomes with literacy and numeracy; and 3) interventions to reduce literacy-related differences in health outcomes. Results Several screening tools are available to assess patients' print literacy and numeracy skills, some of which specifically address diabetes. Literacy and numeracy are consistently associated with diabetes-related knowledge. Some studies suggest literacy and numeracy are associated with intermediate outcomes, including self-efficacy, communication, and self-care (including adherence), but the relationship between literacy and glycemic control is mixed. Few studies have assessed more distal health outcomes, including diabetes-related complications, health care utilization, safety, or quality of life, but available studies suggest low literacy may be associated with an increased risk of complications, including hypoglycemia. Several interventions appear effective in improving diabetes-related outcomes regardless of literacy status, but it is unclear if these interventions can reduce literacy-related differences in outcomes. Conclusions Low literacy is associated with less diabetes-related knowledge and may be related to other important health outcomes. Further studies are needed to better elucidate pathways by which literacy skills affect health outcomes. Promising interventions are available to improve diabetes outcomes for patients with low literacy, but more research is needed to determine their effectiveness outside of research settings. PMID:24947871
Full Text Available The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature search conducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, self-esteem, and self-efficacy; and an ability to utilize these resources to engage in social and political action for change. This article suggests that for health literacy to be critical to empowerment, there must be a focus on social health determinants and individuals’ subjective perceptions of health and health needs. The article proposes functional and interactive health literacy as a form of capacity building for health and empowerment and critical health literacy as a way to describe empowerment. This scoping review indicates a research gap and a need for future research examining the relationship between health literacy and empowerment.
Pander Maat, Henk; Essink-Bot, Marie-Louise; Leenaars, Karlijn EF; Fransen, Mirjam P.
Abstract Background: An earlier attempt to adapt the REALM (Rapid Estimate of Adult Literacy in Medicine) word recognition test to Dutch was not entirely successful due to ceiling effects. In contrast to REALM, the Short Assessment of Health Literacy (SAHL) assesses both word recognition and
Heide, I. van der; Uiters, E.; Boshuizen, H.; Rademakers, J.
Introduction: Health literacy is considered an important determinant of health disparities. It is therefore important to have insight into health literacy skills of the general population within countries. Little is known on the health literacy skills of the general population in EU member states.
Heide, I. van der; Uiters, E.; Sorensen, K.; Rothlin, F.; Pelikan, J.; Rademakers, J.; Boshuizen, H.
Background: Health literacy is an important determinant of health, but national health literacy levels are known for only some European countries. This study aims to examine to what extent national health literacy levels can be estimated based on publicly available census data. Method: Multivariate
... skills. For example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills. Choosing between health plans or comparing prescription ...
Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M
The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.
Full Text Available Background: Inadequate health literacy in adults is a nationwide issue that is associated with worse health outcomes. There is a paucity of literacy regarding rates of inadequate health literacy in psychiatric populations. Objective: The aim of the study was to identify an existing tool that would easily identify patients who had inadequate health literacy, so that a targeted intervention could be performed. Secondarily we attempted to compare rates of inadequate health literacy with providers’ perception of patients’ health literacy. Methods: We assessed health literacy in a psychiatric population by administering the Brief Health Literacy Survey (BHLS. Additionally, all psychiatry residents, psychiatrists, nurse practitioners, pharmacists, and social workers were surveyed to assess their perception of patient health literacy. Differences between patient health literacy and provider expectations of patient health literacy were compared. Results: Inadequate health literacy was identified in 31 out of 61 patients (50.8% using 2 questions from the BHLS. Only 9 (29% of patients who were identified as having inadequate health literacy were identified by both BHLS questions. In contrast, almost 100% of providers identified their patients, in general, as having inadequate health literacy. Conclusions: These results identify a higher rate of health literacy in a psychiatric inpatient population than in the general population. However, providers at this institution likely over-identify health literacy. This highlights the need for a health literacy tool that can easily target patients with inadequate health literacy for an intervention.
Maindal, Helle Terkildsen; Kayser, Lars; Nørgaard, Ole
Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor......, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was ‘Social support for health’, and the hardest were ‘Navigating the healthcare system’ and ‘Appraisal of health information...... with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes....
Simmons, Robert A; Cosgrove, Susan C; Romney, Martha C; Plumb, James D; Brawer, Rickie O; Gonzalez, Evelyn T; Fleisher, Linda G; Moore, Bradley S
Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Quinlan, Patricia; Price, Kwanza O; Magid, Steven K; Lyman, Stephen; Mandl, Lisa A; Stone, Patricia W
Patients with poor health literacy often lack the knowledge needed to manage their treatment. The aim of this cross-sectional study is to determine whether health literacy is a predictor of health knowledge and/or adherence to medication treatment in patients with rheumatoid arthritis. The study was completed in an urban, outpatient rheumatology setting. Health literacy was measured using the Test of Functional Health Literacy in Adults. The Arthritis Knowledge Questionnaire was modified to measure medication specific health knowledge, and the Morisky Medication Adherence scale was used to measure adherence. Researchers used regression analyses to determine if health literacy was a predicator of knowledge and/or adherence. Participants (N = 125) had high mean health literacy scores. The average medication knowledge score was 0.73. Adherence to medication regimen was 0.84. Controlling for patient covariates, health literacy was positively associated with education, race, and age. In adjusted analyses, health literacy was a significant predictor of health knowledge but not adherence. Race, neighborhood income, and confidence with contacting provider about medications were predictors of adherence. Study findings indicate that health literacy is independently associated with medication knowledge but not medication adherence in patients with rheumatoid arthritis. These results provide useful information for planning initiatives to support individuals with disease self-management.
Crondahl, Kristine; Eklund Karlsson, Leena
The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature...... search onducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that Health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health...... literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, selfesteem, and self-efficacy; and an ability...
Richman, Julia Anne; Huebner, Colleen E; Leggott, Penelope J; Mouradian, Wendy E; Mancl, Lloyd A
Parental oral health literacy is proposed to be an indicator of children's oral health. The purpose of this study was to test if word recognition, commonly used to assess health literacy, is an adequate measure of pediatric oral health literacy. This study evaluated 3 aspects of oral health literacy and parent-reported child oral health. A 3-part pediatric oral health literacy inventory was created to assess parents' word recognition, vocabulary knowledge, and comprehension of 35 terms used in pediatric dentistry. The inventory was administered to 45 English-speaking parents of children enrolled in Head Start. Parents' ability to read dental terms was not associated with vocabulary knowledge (r=0.29, P.06) of the terms. Vocabulary knowledge was strongly associated with comprehension (r=0.80, PParent-reported child oral health status was not associated with word recognition, vocabulary knowledge, or comprehension; however parents reporting either excellent or fair/poor ratings had higher scores on all components of the inventory. Word recognition is an inadequate indicator of comprehension of pediatric oral health concepts; pediatric oral health literacy is a multifaceted construct. Parents with adequate reading ability may have difficulty understanding oral health information.
Sharp, Michele L; Hall, Lori; Eleftherion, Anthony; Simpson, Katherine; Neuhauser, Linda
Print pharmaceutical advertisements in the United States require inclusion of a brief summary of side effects, warnings, precautions, and contraindications from the labeling. The full package insert, which sponsors have traditionally used to fulfill the brief summary requirement, does not adhere to health literacy best practices, limiting its value to consumers. This study compared the understandability and usability of brief summaries in 3 formats designed to be more consumer friendly. Three brief summary formats were tested: (1) 2-column "Question and Answer"; (2) "Prescription Drug Facts Box," similar to current US over-the-counter drug facts labeling; and (3) "Health Literacy," based on clear communication principles. Researchers evaluated the formats using the Suitability Assessment of Materials (SAM) tool and conducted structured, scripted, one-on-one interviews (usability tests) with participants with estimated low to average education levels. This research was replicated across 2 therapeutic areas (type 2 diabetes and plaque psoriasis). SAM scores showed that the Health Literacy format outperformed the Question and Answer format and the Prescription Drug Facts Box format in both therapeutic areas, with both Health Literacy brief summaries rated on the SAM as "superior." Qualitative usability tests supported the SAM findings, with the Health Literacy format preferred consistently over the Question and Answer format, and more often than not over the Prescription Drug Facts Box format. Sponsors can employ a user-tested Health Literacy format to improve the understandability and usability of brief summaries with patients.
Ratzan, S C
This article builds upon a presentation at the Fifth Global Health Conference on Health Promotion (Mexico City, 9 June 2000), seeking to advance the development of health literacy through effective communication. First, it offers a timely reflection for health promotion epistemology in particular, and the potential approach to framing health promotion activities in general, with health literacy as a bridging concept. The concept of health literacy is briefly explained and defined, followed by identification of some promising communication interventions to diffuse health literacy. Four predominant areas within the communication field are described that shed light on approaches for developing health literacy: integrated marketing communication, education, negotiation and social capital. Each component can contribute to strategic science-based communication. Finally, the article elucidates that communication and developing health literacy are not simple solutions. Communication is not simply message repetition, but includes the development of an environment for community involvement to espouse common values of humankind. With effective communication, worldwide health literacy can become a reality in the 21st century, embodying health as a central tenet of human life.
Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757
Health literacy, cited as essential to achieving Healthy People 2010's goals to "increase quality and years of healthy life" and to "eliminate health disparities," is defined by Healthy People 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." Accessibility, by definition, the aforementioned "capacity to obtain," thus is health literacy's primary prerequisite. Accessibility's designation as the global gateway to health literacy is predicated also on life's realities: global aging and climate change, war and terrorism, and life-extending medical and technological advances. People with diverse access needs are health professionals' raison d'être. However, accessibility, consummately cross-cultural and universal, is virtually absent as a topic of health promotion and practice research and scholarly discussion of health literacy and equity. A call to action to place accessibility in its rightful premier position on the profession's agenda is issued.
... Health Promotion Quick Guide to Health Literacy and Older Adults skip to content ODPHP Health Communication Healthy People ... and Patient e-Health Resources Health Literacy and Older Adults Who is this guide for? Why are health ...
Jarahi, Lida; Asadi, Reza; Hakimi, Hamid Reza
In women's health, literacy determines their participation in self and family health promotion. Low health literacy is as barrier for understanding medical recommendations, disease prevention and health care. To assess women's health literacy and relative factors in Mashhad (Iran). Women referring to healthcare centers in Mashhad in 2012 and 2013, participated in this cross-sectional study by stratified sampling method. The validated Persian version of Rapid Estimate of Adult Literacy in Medicine-revised questionnaire was used. Vocabulary comprehension and reading scores of health literacy was assessed. Comparisons were done in demographic subgroups by ANOVA, Mann-Whitney U, Kruskal-Wallis, Pearson correlation coefficient, and Chi-Square tests. In total, 250 women with a mean age of 32.1±10.23 years and the mean education level of 10.58±3.67 years were studied. The mean reading score was 11.58±2.51 and the mean vocabulary comprehension score was 17.24±4.73. Participants' health literacy score had positive correlation with age and education, and significant difference in health literacy scores between occupational groups was seen. Housewives' health literacy scores were lower than others (pliteracy was a common problem amongst younger women, especially among women who had less education. These women are at risk of early marriage and child bearing and require more health care. Health care professionals should use effective methods for easier transfer recommendation, also, producing medical information booklets, texts, and videos for different community subgroups through public media or even in cyberspace with clear and common words consisting of essential information.
Full Text Available OBJECTIVE: To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS: The Short Assessment of Health Literacy for Portuguese-speaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defined as failure to fully understand standard medical prescriptions. RESULTS: Moderate to high correlations were found in the assessment of construct validity (Spearman's coefficients ranging from 0.63 to 0.76. The instrument showed adequate internal consistency (Cronbach's alpha=0.93 and adequate test-retest reliability (intraclass correlation coefficient=0.95. The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS: The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy.
Dukić, Nikolina; Arbula Blecich, Andrea; Cerović, Ljerka
The main goal of this paper is to elaborate the importance of health literacy in cost-effective utilization of health care services which influence the efficiency of the entire health care sector. In order to complement the theoretical framework of the economic implications and the circular influence of health literacy on the economy, an empirical analysis was carried out using S–TOFHLA. The results suggest that the patients’ personal characteristics and the accessibil...
Wynia, Matthew K.; Osborn, Chandra Y.
The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197
Smith, Scott R.; Samar, Vincent J.
Deaf and hard-of-hearing (D/HH) adults have lower health literacy compared to hearing adults but it is unclear if this disparity also occurs in adolescence. We used the Health Literacy Skills Instrument-Short Form (HLSI-SF), Short Form of the Test of Functional Health Literacy (S-TOFHLA), Comprehensive Heart Disease Knowledge Questionnaire (CHDKQ) and newly constructed interactive and critical health literacy survey items to quantify D/HH and hearing adolescents’ health literacy. We adapted and translated survey materials into sign language and spoken English to reduce testing bias due to variable English language skills. Participants were 187 D/HH and 94 hearing college-bound high school students. Adjusting for age, gender, race/ethnicity, school grade, and SES, D/HH adolescents demonstrated weaker general and functional health literacy and cardiovascular health knowledge than hearing adolescents on the HLSI, S-TOFHLA, and CHDKQ (all p’s<.0001). Standard health literacy or knowledge scores were associated with several interactive and critical health literacy skills (all p’s<.05). D/HH adolescents who reported greater hearing-culture identity, having hearing aids, experiencing better hearing with assistive devices, having good quality of communication with parents, and attending hearing schools at least half of the time had higher functional health literacy (all p’s<.025). Those who reported English as their best language and attending hearing schools at least half the time had higher cardiovascular health knowledge scores (all p’s< .03). Results suggest that interventions to improve D/HH adolescents’ health literacy should target their health-related conversations with their families, access to printed health information, and access to health information from other people, especially health care providers and educators. PMID:27548284
Smith, Scott R; Samar, Vincent J
Deaf and hard-of-hearing (D/HH) adults have lower health literacy compared to hearing adults, but it is unclear whether this disparity also occurs in adolescence. We used the Health Literacy Skills Instrument-Short Form (HLSI-SF), Short Form of the Test of Functional Health Literacy in Adults (S-TOFHLA), Comprehensive Heart Disease Knowledge Questionnaire (CHDKQ), and newly constructed interactive and critical health literacy survey items to quantify D/HH and hearing adolescents' health literacy. We adapted and translated survey materials into sign language and spoken English to reduce testing bias due to variable English language skills. Participants were 187 D/HH and 94 hearing college-bound high school students. When we adjusted for age, gender, race/ethnicity, school grade, and socioeconomic status, D/HH adolescents demonstrated weaker general and functional health literacy and cardiovascular health knowledge than hearing adolescents on the HLSI, S-TOFHLA, and CHDKQ (all ps < .0001). Standard health literacy or knowledge scores were associated with several interactive and critical health literacy skills (all ps < .05). D/HH adolescents who reported greater hearing-culture identity, having hearing aids, experiencing better hearing with assistive devices, having good quality of communication with parents, and attending hearing schools at least half of the time had higher functional health literacy (all ps < .025). Those who reported English as their best language and attending hearing schools at least half of the time had higher cardiovascular health knowledge scores (all ps < .03). Results suggest that interventions to improve D/HH adolescents' health literacy should target their health-related conversations with their families; access to printed health information; and access to health information from other people, especially health care providers and educators.
Digital health information is widely available, but not everyone fully benefits due to limited health literacy. Until now, little was known about how health literacy influences information processing and how design features of digital health information can be used to create optimal health messages
Maria Auristela Magalhães Coelho
Full Text Available Objective: To assess the relationship between the functional health literacy of Unified Heath System users and the understanding of food servings in the pocket version of the Brazilian Food Guide. Methods: Functional health literacy was assessed by the Brief Test of functional health literacy. Two dialogue rounds were conducted with patients with adequate functional health literacy (Group 1 and inadequate functional health literacy (Group 2. The dialogues were recorded and analyzed according to the discourse of the collective subject. Results: Most (58.0% users had inadequate functional health literacy. Five core areas were identified: understands serving sizes; does not understand serving sizes; serving sizes are confusing; unfamiliar/uncommon foods; small letters. Group 2 had more trouble understanding. Conclusion: Difficulty understanding hinders health promotion. Individuals need to have access to educational materials that are easier to understand and developed taking their functional health literacy into account.
Cajita, Maan Isabella; Rodney, Tamar; Xu, Jingzhi; Hladek, Melissa; Han, Hae-Ra
The ubiquity of the Internet is changing the way people obtain their health information. Although there is an abundance of heart failure information online, the quality and health literacy demand of these information are still unknown. The purpose of this study is to evaluate the quality and health literacy demand (readability, understandability, and actionability) of the heart failure information found online. Google, Yahoo, Bing, Ask.com, and DuckDuckGo were searched for relevant heart failure Web sites. Two independent raters then assessed the quality and health literacy demand of the included Web sites. The quality of the heart failure information was assessed using the DISCERN instrument. Readability was assessed using 7 established readability tests. Finally, understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Print Materials. A total of 46 Web sites were included in this analysis. The overall mean quality rating was 46.0 ± 8.9 and the mean readability score was 12.6 grade reading level. The overall mean understandability score was 56.3% ± 16.2%. Finally, the overall mean actionability score was 34.7% ± 28.7%. The heart failure information found online was of fair quality but required a relatively high health literacy level. Web content authors need to consider not just the quality but also the health literacy demand of the information found in their Web sites. This is especially important considering that low health literacy is likely prevalent among the usual audience.
Vellar, Lucia; Mastroianni, Fiorina; Lambert, Kelly
Objective The aim of the present study was to describe how one regional health service the Illawarra Shoalhaven Local Health District embedded health literacy principles into health systems over a 3-year period. Methods Using a case study approach, this article describes the development of key programs and the manner in which clinical incidents were used to create a health environment that allows consumers the right to equitably access quality health services and to participate in their own health care. Results The key outcomes demonstrating successful embedding of health literacy into health systems in this regional health service include the creation of a governance structure and web-based platform for developing and testing plain English consumer health information, a clearly defined process to engage with consumers, development of the health literacy ambassador training program and integrating health literacy into clinical quality improvement processes via a formal program with consumers to guide processes such as improvements to access and navigation around hospital sites. Conclusions The Illawarra Shoalhaven Local Health District has developed an evidence-based health literacy framework, guided by the core principles of universal precaution and organisational responsibility. Health literacy was also viewed as both an outcome and a process. The approach taken by the Illawarra Shoalhaven Local Health District to address poor health literacy in a coordinated way has been recognised by the Australian Commission on Safety and Quality in Health Care as an exemplar of a coordinated approach to embed health literacy into health systems. What is known about the topic? Poor health literacy is a significant national concern in Australia. The leadership, governance and consumer partnership culture of a health organisation can have considerable effects on an individual's ability to access, understand and apply the health-related information and services available to them
As a consideration in the design of a test of academic literacy, the face validity of such a test is determined by its perceived suitability and usefulness in addressing the literacy requirements of specific academic contexts. This article focuses on one such a literacy context: that of postgraduate academic literacy at a South ...
Murphy, Jessica E; Smock, Laura; Hunter-Adams, Jo; Xuan, Ziming; Cochran, Jennifer; Paasche-Orlow, Michael K; Geltman, Paul L
Little is known about the impacts of health literacy and English proficiency on the health status of Somali refugees. Data came from interviews in 2009-2011 of 411 adult Somali refugees recently resettled in Massachusetts. English proficiency, health literacy, and physical and mental health were measured using the Basic English Skills Test Plus, the Short Test of Health Literacy in Adults, and the Physical and Mental Component Summaries of the Short Form-12. Associations were analyzed using multiple linear regression. In adjusted analyses, higher English proficiency was associated with worse mental health in males. English proficiency was not associated with physical health. Health literacy was associated with neither physical nor mental health. Language proficiency may adversely affect the mental health of male Somali refugees, contrary to findings in other immigrant groups. Research on underlying mechanisms and opportunities to understand this relationship are needed.
The increasing importance of digital technologies can disenfranchise individuals who lack digital literacy skills. As clinics adopt online health portals, even health care services require digital skills. Patients are often expected to check test results and perform other health-related tasks online, but few clinics provide support for those who…
Cutilli, Carolyn Crane; Bennett, Ian M.
Health literacy refers to an individual’s ability to understand healthcare information to make appropriate decisions (S. C Ratzen & R. M. Parker, 2000). Healthcare professionals are obligated to make sure that patients understand information to maximize the benefits of healthcare. The National Assessment of Adult Literacy (NAAL) provides information on the literacy/health literacy levels of the U.S. adult population. The NAAL is the only large-scale survey of health literacy. The results of t...
Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S
Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068
Kang, Soo Jin; Lee, Tae Wha; Paasche-Orlow, Michael K; Kim, Gwang Suk; Won, Hee Kwan
The purpose of this study is to develop and validate the Korean Health Literacy Instrument, which measures the capacity to understand and use health-related information and make informed health decisions in Korean adults. In Phase 1, 33 initial items were generated to measure functional, interactive, and critical health literacy with prose, document, and numeracy tasks. These items included content from health promotion, disease management, and health navigation contexts. Content validity assessment was conducted by an expert panel, and 11 items were excluded. In Phase 2, the 22 remaining items were administered to a convenience sample of 292 adults from community and clinical settings. Exploratory factor and item difficulty and discrimination analyses were conducted and four items with low discrimination were deleted. In Phase 3, the remaining 18 items were administered to a convenience sample of 315 adults 40-64 years of age from community and clinical settings. A confirmatory factor analysis was performed to test the construct validity of the instrument. The Korean Health Literacy Instrument has a range of 0 to 18. The mean score in our validation study was 11.98. The instrument exhibited an internal consistency reliability coefficient of 0.82, and a test-retest reliability of 0.89. The instrument is suitable for screening individuals who have limited health literacy skills. Future studies are needed to further define the psychometric properties and predictive validity of the Korean Health Literacy Instrument.
Mackley, Amy; Winter, Michael; Guillen, Ursula; Paul, David A.; Locke, Robert
BACKGROUND Health Literacy is the ability to obtain, process, and understand health information to make knowledgeable health decisions. PURPOSE To determine baseline health literacy of NICU parents at a tertiary care hospital during periods of crucial information exchange. METHODS Health Literacy of English speaking NICU parents was assessed using the Newest vital Sign (NVS) on admission (n=121) and discharge (n=59). A quasi-control group of well newborn (WBN) parents (n=24) and prenatal obstetric clinic (PRE) parents (n=18) were included. A single, Likert-style question measured nurse’s assessment of parental comprehension with discharge teaching. Suspected limited health literacy (SLHL) was defined as NVS score of ≤3. FINDINGS / RESULTS Forty-three percent of parents on NICU admission and 32% at NICU discharge had SLHL (pNICU parents and 25% of WBN parents with SLHL at time of admission/infant birth had a college education. Nurse subjective measurement of parental comprehension of discharge instructions was not correlated to the objective measurement of health literacy (p=0.26). IMPLICATIONS FOR PRACTICE SLHL is common during peak time periods of complex health discussion in the NICU, WBN, and PRE settings. NICU providers may not accurately gauge parent’s literacy status. IMPLICATIONS FOR RESEARCH Methods for improving health communication are needed. Studies should evaluate SLHL in a larger NICU population and across different languages and cultures. PMID:27391562
Bruselius-Jensen, Maria; Bonde, Ane Høstgaard; Christensen, Julie Hellesøe
counts and associated reflections positively influencing learning. However, in this study, classroom teaching was limited to a focus on cognitive skills and only partially supported the development of more critical health literacy skills. Our findings call for further research into approaches to support...... and teachers could change their daily practices. Only a limited number of discussions supported the development of critical health literacy. Conclusion: Our findings suggest that educators can successfully integrate health literacy development into classroom-based curriculum teaching, with pupils’ own step......Objective: Research has shown that developing health literacy in early life is critical to reducing lifestyle-related diseases, with schools being identified as central settings for this purpose. This paper examines how one classroom-based health educational programme, IMOVE, helped Danish primary...
Soto Mas, Francisco; Ji, Ming; Fuentes, Brenda O; Tinajero, Josefina
Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits.
MAS, FRANCISCO SOTO; JI, MING; FUENTES, BRENDA O.; TINAJERO, JOSEFINA
Although Hispanics have a documented high risk of limited health literacy, there is a scarcity of research with this population group, and particularly with Hispanic immigrants who generally confront language barriers that have been related to low health literacy. The National Action Plan to Improve Health Literacy identified community-based English-language instruction as a strategy that can facilitate a health literate society. However, the literature lacks discussion on this type of intervention. This randomized control trial aimed to test the feasibility of using conventional English-as-a-second-language (ESL) instruction for improving health literacy among Spanish-speaking adults. Objectives included the development, implementation, and evaluation of a health literacy/ESL curriculum. The Test of Functional Health Literacy in Adults (TOFHLA) in English was used to assess health literacy levels. Analyses included independent sample t test, chi-square, and multiple linear regression. A total of 155 people participated. Results showed a significantly higher increase in the TOFHLA posttest score in the intervention group (p = .01), and noticeable differences in health literacy levels between groups. Results indicate that ESL constitutes a promising venue for improving health literacy among Spanish-speaking adults. Incorporating health literacy-related content may provide additional benefits. PMID:25602615
Sørensen, Kristine; Pelikan, Jürgen M; Röthlin, Florian; Ganahl, Kristin; Slonska, Zofia; Doyle, Gerardine; Fullam, James; Kondilis, Barbara; Agrafiotis, Demosthenes; Uiters, Ellen; Falcon, Maria; Mensing, Monika; Tchamov, Kancho; van den Broucke, Stephan; Brand, Helmut
Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29-62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.
Berens, Eva-Maria; Vogt, Dominique; Messer, Melanie; Hurrelmann, Klaus; Schaeffer, Doris
Health literacy is of increasing importance in public health research. It is a necessary pre-condition for the involvement in decisions about health and health care and related to health outcomes. Knowledge about limited health literacy in different age groups is crucial to better target public health interventions for subgroups of the population. However, little is known about health literacy in Germany. The study therefore assesses the prevalence of limited health literacy and associated factors among different age groups. The Health Literacy Survey Germany is a cross-sectional study with 2,000 participants aged 15 years or older in private households. Perceived health literacy was assessed via computer-assisted personal interviews using the HLS-EU-Q-47 questionnaire. Descriptive analyses, chi-square tests and odds ratios were performed stratified for different age groups. The population affected by limited perceived health literacy increases by age. Of the respondents aged 15-29 years, 47.3 % had limited perceived health literacy and 47.2 % of those aged 30-45 years, whereas 55.2 % of the respondents aged 46-64 years and 66.4 % aged 65 years and older showed limited perceived health literacy. In all age groups, limited perceived health literacy was associated with limited functional health literacy, low social status, and a high frequency of doctor visits. The results suggest a need to further investigate perceived health literacy in all phases of the life-course. Particular attention should be devoted to persons with lower social status, limited functional health literacy and/or a high number of doctor visits in all age groups.
Sørensen, Kristine; Van den Broucke, Stephan; Pelikan, Jürgen M; Fullam, James; Doyle, Gerardine; Slonska, Zofia; Kondilis, Barbara; Stoffels, Vivian; Osborne, Richard H; Brand, Helmut
Several measurement tools have been developed to measure health literacy. The tools vary in their approach and design, but few have focused on comprehensive health literacy in populations. This paper describes the design and development of the European Health Literacy Survey Questionnaire (HLS-EU-Q), an innovative, comprehensive tool to measure health literacy in populations. Based on a conceptual model and definition, the process involved item development, pre-testing, field-testing, external consultation, plain language check, and translation from English to Bulgarian, Dutch, German, Greek, Polish, and Spanish. The development process resulted in the HLS-EU-Q, which entailed two sections, a core health literacy section and a section on determinants and outcomes associated to health literacy. The health literacy section included 47 items addressing self-reported difficulties in accessing, understanding, appraising and applying information in tasks concerning decisions making in healthcare, disease prevention, and health promotion. The second section included items related to, health behaviour, health status, health service use, community participation, socio-demographic and socio-economic factors. By illuminating the detailed steps in the design and development process of the HLS-EU-Q, it is the aim to provide a deeper understanding of its purpose, its capability and its limitations for others using the tool. By stimulating a wide application it is the vision that HLS-EU-Q will be validated in more countries to enhance the understanding of health literacy in different populations.
Sudbury-Riley, Lynn; FitzPatrick, Mary; Schulz, Peter J
The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and
Park, Hyejin; Moon, Mikyung; Baeg, Jung Hoon
Cancer is a critical disease with a high mortality rate in the US. Although useful information exists on the Internet, many people experience difficulty finding information about cancer prevention because they have limited eHealth literacy. This study aimed to identify relationships between the level of eHealth literacy and cancer information seeking experience or prior experience with cancer screening tests. A total of 108 adults participated in this study through questionnaires. Data covering demographics, eHealth literacy, cancer information seeking experience, educational needs for cancer information searching, and previous cancer screening tests were obtained. Study findings show that the level of eHealth literacy influences cancer information seeking. Individuals with low eHealth literacy are likely to be less confident about finding cancer information. In addition, people who have a low level of eHealth literacy need more education about seeking information than do those with a higher level of eHealth literacy. However, there is no significant relationship between eHealth literacy and cancer screening tests. More people today are using the Internet for access to information to maintain good health. It is therefore critical to educate those with low eHealth literacy so they can better self-manage their health.
Kreps, Gary L
This chapter examines the importance of health literacy to the design and use of mobile digital health information technology (mHealth) applications. Over the past two decades mHealth has evolved to become a major health communication channel for delivering health care, promoting health, and tracking health behaviors. Yet, there are serious communication challenges that must be addressed concerning the best way to design and utilize mHealth application to achieve key health promotion goals, including assuring the appropriateness and effectiveness of mHealth messaging for audiences with different communication competencies, styles, and health literacy levels, to ensure that mHealth applications are truly effective tools for health promotion. Health literacy is one of the major communication issues relevant to the effective use of mHealth. To be effective, mHealth applications need to match the messages conveyed via these mobile media to the specific health communication needs, orientations, and competencies of intended audience members. Unfortunately, current evidence suggests that many mHealth applications are difficult for audiences to utilize because they provide health information that is not easy for many consumers to understand and apply. Health literacy refers to the ability of participants within the health care system to accurately interpret and utilize relevant health information and resources to achieve their health goals. Evidence suggests that many consumers possess limited levels of health literacy to adequately understand health information, especially when they are feeling ill, since health literacy is both a trait (limited education, language facility, etc.), and a state condition (based on how their current physical and mental states influence their abilities to communicate effectively). Therefore, it is incumbent upon mHealth developers to design and utilize message systems. Strategies for designing and implementing mHealth applications to meet
Horvath, Keith J.; Bauermeister, José A.
We assessed whether young men who have sex with men’s acceptability with the online Get Connected! intervention and subsequent sexual health decision making were influenced by their baseline eHealth literacy (high vs. low competency) and intervention tailoring (tailored or non-tailored intervention condition). Participants (n=127) were on average 21 years old, 55% non-Hispanic white, and used the Internet 1–3 hours a day (54%). Compared to the high eHealth literacy/tailored intervention group...
Technical Report 1360 Validation of the Information /Communications Technology Literacy Test D. Matthew Trippe Human Resources Research...TITLE AND SUBTITLE Validation of the Information /Communications Technology Literacy Test 5a. CONTRACT OR GRANT NUMBER W91WAS-09-D-0013 5b...validate a measure of cyber aptitude, the Information /Communications Technology Literacy Test (ICTL), in predicting trainee performance in Information
Meppelink, Corine S; Smit, Edith G; Diviani, Nicola; Van Weert, Julia C M
The usefulness of the Internet as a health information source largely depends on the receiver's health literacy. This study investigates the mechanisms through which health literacy affects information recall and website attitudes. Using 2 independent surveys addressing different Dutch health websites (N = 423 and N = 395), we tested the mediating role of cognitive load, imagination ease, and website involvement. The results showed that the influence of health literacy on information recall and website attitudes was mediated by cognitive load and imagination ease but only marginally by website involvement. Thus, to improve recall and attitudes among people with lower health literacy, online health communication should consist of information that is not cognitively demanding and that is easy to imagine.
Brosnan, Susan; Barron, Elizabeth; Sahm, L J
To estimate the prevalence of limited health literacy in patients receiving clozapine for schizophrenia. To develop and produce a pharmacist-designed clozapine patient information leaflet (PIL) which has a higher readability score than the company-produced PIL. This was a cross sectional prevalence study. Ethical approval for the study was granted by the local ethics committee. Patients, over 18 years, attending the Clozapine Clinic of a Cork urban teaching hospital, were asked to participate in the study. Demographics such as gender, age, employment and smoking status, were gathered from all participants. The total daily clozapine dose, duration of clozapine treatment, and information regarding the clozapine DVD was also noted. The Rapid Estimate of Adult Literacy in Medicine (REALM) health literacy (HL) screening tool was then administered to each patient. A user-friendly PIL on clozapine was designed by the pharmacist, which was assessed for readability and compared to the company-produced PIL using the FRES and FKGL. Data were analysed using SPSS Version 15. Forty patients (65% male, 95% unemployed and 70% smokers) of average age 38.0 years (+/- 11.2) completed the REALM. The average score was 60.6 (+/- 8.7). Twenty-nine patients (72.5%) were found to have "adequate" health literacy. The remaining eleven patients were found to have either "marginal" or "low" health literacy. The pharmacist-designed PIL would have been readable by 95% of the study population, in contrast to 72.5% with the company-designed PIL. More than a quarter of the population were found to have marginal or low health literacy. Patient information should be matched to the health literacy level of the target population.
Bailey, Stacy Cooper; Fang, Gang; Annis, Izabela E; O'Conor, Rachel; Paasche-Orlow, Michael K; Wolf, Michael S
Objective To assess the validity of a predictive model of health literacy, and to examine the relationship between derived health literacy estimates and 30-day hospital readmissions for acute myocardial infarction (AMI). Design Retrospective cohort study. Setting and participants A National Institute of Aging (NIA) study cohort of 696 adult, English-speaking primary care patients, aged 55–74 years, was used to assess the validity of derived health literacy estimates. Claims from 7733 Medicare beneficiaries hospitalised for AMI in 2008 in North Carolina and Illinois were used to investigate the association between health literacy estimates and 30-day hospital readmissions. Measures The NIA cohort was administered 3 common health literacy assessments (Newest Vital Sign, Test of Functional Health Literacy in Adults, and Rapid Estimate of Adult Literacy in Medicine). Health literacy estimates at the census block group level were derived via a predictive model. 30-day readmissions were measured from Medicare claims data using a validated algorithm. Results Fair agreement was found between derived estimates and in-person literacy assessments (Pearson Correlation coefficients: 0.38–0.51; κ scores: 0.38–0.40). Medicare enrollees with above basic literacy according to derived health literacy estimates had an 18% lower risk of a 30-day readmission (RR=0.82, 95% CI 0.73 to 0.92) and 21% lower incidence rate of 30-day readmission (IRR=0.79, 95% CI 0.68 to 0.87) than patients with basic or below basic literacy. After adjusting for demographic and clinical characteristics, the risk of 30-day readmission was 12% lower (p=0.03), and the incidence rate 16% lower (pliteracy. Conclusions Health literacy, as measured by a predictive model, was found to be a significant, independent predictor of 30-day readmissions. As a modifiable risk factor with evidence-based solutions, health literacy should be considered in readmission reduction efforts. PMID:26068508
Naghibi Sistani, Mohammad Mehdi; Yazdani, Reza; Virtanen, Jorma; Pakdaman, Afsaneh; Murtomaa, Heikki
Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 partici...
health, economic and social impacts; it will also discuss the implications for ... Key words: Low health literacy, healthcare impact, health outcomes. .... mouth every 6 hours as needed”. To test ... media and many more need to collaborate to take.
Rowlands, Gillian; Shaw, Adrienne; Jaswal, Sabrena
Health literacy, 'the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health', is key to improving peoples' control over modifiable social determinants of health (SDH...... and culture. Basic (functional) health literacy skills were needed to gather and understand information. More complex interactive health literacy skills were needed to evaluate the importance and relevance of information in context, and make health decisions. Critical health literacy skills could be used......). This study listened to adult learners to understand their perspectives on gathering, understanding and using information for health. This qualitative project recruited participants from community skills courses to identify relevant 'health information' factors. Subsequently different learners put...
Chesser, Amy K.; Keene Woods, Nikki; Wipperman, Jennifer; Wilson, Rachel; Dong, Frank
Low health literacy is associated with poor health outcomes. Research is needed to understand the mechanisms and pathways of its effects. Computer-based assessment tools may improve efficiency and cost-effectiveness of health literacy research. The objective of this preliminary study was to assess if administration of the Short Test of Functional…
Flecha, Ainhoa; Garcia, Rocio; Rudd, Rima
Health literacy has firmly established the links between literacy skills and health outcomes and is subsequently considered a key strategy for improving the health of disadvantaged populations and addressing social inequality. However, current research findings for improving health literacy have primarily focused on adults and actions within…
Samuel G Smith
Full Text Available There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal 'activation' or motivation to manage health. This research examines 1 the association between patient activation and health literacy as they are most commonly measured and 2 the independent and combined associations of patient activation and health literacy skills with physical and mental health.A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697 were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA, the Patient Activation Measure (PAM, the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS short form subscales for depression and anxiety.The relationship between health literacy and patient activation was weak, but significant (r = 0.11, p<0.01. In models adjusted for participant characteristics, lower health literacy was associated with worse physical health (β = 0.13, p<0.001 and depression (β = -0.16, p<0.001. Lower patient activation was associated with worse physical health (β = 0.19, p<0.001, depression (β = -0.27, p<0.001 and anxiety (β-0.24, p<0.001.The most common measures of health literacy and patient activation are weakly correlated with each other, but also independently correlated with health outcomes. This suggests health literacy represents a distinct skill-based construct, supporting the Institute of Medicine's definition. Deficits in either construct could be useful targets for behavioral intervention.
determine whether Grade 12 learners have mastered subject knowledge at the ... the NSC Mathematical Literacy examination and the Quantitative Literacy test of the ..... Method. Sample. The sample for this study consisted of 6,363 Grade. 12 ...
Gruhn, C.M.S.; Weideman, A.J.
In addition to a large body of evidence supporting the relevance of the home environment for literacy development, tests of cognitive-based skills are commonly employed to predict literacy acquisition. The Test of Emergent Literacy (TEL) has been designed to account for the early interaction of
Zhou, J; Liu, F; Zhou, H
With the popularity of social media, Twitter has become an important tool to promote health literacy. However, many health-related messages on Twitter are dead-ended and cannot reach many people. This is unhelpful for health literacy promotion. This article aims to examine the features of online health food messages that people like to retweet. We adopted rumour theory as our theoretical foundation and extracted seven characteristics (i.e. emotional valence, attractiveness, sender's authoritativeness, external evidence, argument length, hashtags, and direct messages). A total of 10,025 health-related messages on Twitter were collected, and 1496 messages were randomly selected for further analysis. Each message was treated as one unit and then coded. All the hypotheses were tested with logistic regression. Emotional valence, attractiveness, sender's authoritativeness, argument length, and direct messages in a Twitter message had positive effects on people's retweet behaviour. The effect of external evidence was negative. Hashtags had no significant effect after consideration of other variables. Online health food messages containing positive emotions, including pictures, containing direct messages, having an authoritative sender, having longer arguments, or not containing external URLs are more likely to be retweeted. However, a message only containing positive or negative emotions or including direct messages without any support information will not be retweeted.
Lambert, Veronica; Keogh, Deborah
This is the second of two articles exploring the concept of health literacy, an often hidden barrier to effective healthcare communication. Part 1 was published in April ( Lambert and Keogh 2014 ). This article explains how to detect low levels of health literacy among parents and children, and outlines the challenges to assessing health literacy levels, including the stigma and discrimination some people experience. Some basic healthcare communication strategies for supporting health literacy in practice are suggested.
One of the fundamental public health challenges in the 21st century should be the improvement of people's health literacy, namely the understanding of health messages. The acquired high level of health literacy means that one knows how and where information concerning health determinants can be found, is able to assess it critically and in favorable conditions even modify them, which seems to be of particular importance from the perspective of heath promotion, prevention or treatment of diseases. Therefore, for professionals in these fields, knowledge of ways how to improve health literacy, as well as awareness of related benefits and the consequences of its poor level, seems to be indispensable. Thus, the aim of this paper is to explain the term of "health literacy", its determinants and implications.
The present study investigated the influence of maternal health literacy on healthy pregnancy and pregnancy outcomes. It was carried out among 231 pregnant women and nursing mothers using the descriptive survey research design of the expost-facto type. Three hypotheses were tested by using pearson product moment ...
Soto Mas, Francisco; Schmitt, Cheryl L; Jacobson, Holly E; Myers, Orrin B
Spanish speakers in the United States are in need of effective interventions that address both cardiovascular disease (CVD) and health literacy. However, the literature lacks interventions that have used and evaluated a strategies that focus on both, particularly at the community level. The aim of this study was to explore the effect of a health literacy curriculum on cardiovascular health behavior among Spanish speaking adults. It used a randomized controlled pre-posttest design. Participants included Hispanic adults with a low-to-intermediate level of English proficiency. The intervention group received the health literacy and English as a second language (ESL) Curriculum with CVD specific content, while the control group received a conventional ESL curriculum. Tools included the Spanish Cardiovascular Health Questionnaire (CSC), the test of functional health literacy in adults (TOFHLA), and the Combined English Language Skills Assessment. Analysis of change scores included independent sample t test and multiple linear regression. A total of 155 participants completed the study. There was a significant greater improvement for the intervention group in change of CSC score from pretest to posttest (P = 0.049) compared to controls. The study also found significantly improved TOFHLA (P = 0.011), however it did not find a relationship between changes in CVD behavior and health literacy or English proficiency. The Health Literacy and ESL Curriculum constitutes a valuable resource for addressing the cardiovascular health, literacy, and language needs of Spanish-speaking adults. Interventions that take a multilevel education and health approach may be more effective in addressing the needs of immigrants. Research should further explore the interactions between CVD behavior, health literacy, and English proficiency.
Zhuang, Runsen; Xiang, Yueying; Han, Tieguang; Yang, Guo-An; Zhang, Yuan
The ubiquity of cell phones, which allow for short message service (SMS), provides new and innovative opportunities for disease prevention and health education. To explore the use of cell phone-based health education SMS to improve the health literacy of community residents in China. A multi-stage random sampling method was used to select representative study communities and participants ≥ 18 years old. Intervention participants were sent health education SMSs once a week for 1 year and controls were sent conventional, basic health education measures. Health literacy levels of the residents before and after the intervention were evaluated between intervention and control groups. Public health literacy scores increased 1.5 points, from 61.8 to 63.3, after SMS intervention for 1 year (P<0.01); the increase was greater for males than females (2.01 vs. 1.03; P<0.01) and for Shenzhen local residents than non-permanent residents (2.56 vs. 1.14; P<0.01). The frequency of high health literacy scores was greater for the intervention than control group (22.03% to 30.93% vs. 22.07% to 20.82%). With health literacy as a cost-effective index, the cost-effectiveness per intervention was 0.54. SMS may be a useful tool for improving health literacy.
Hsu, WanChen; Chiang, ChiaHsun; Yang, ShuChing
College students' health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual's health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated. This study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU. The Health Behavior Scale is a 12-item instrument developed to measure college students' eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants' health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects. The study found that perceptions of better health status (t520=2.14-6.12, PeHealth literacy and adoption of healthy eating, exercise, and sleep behaviors. Moreover, eHealth literacy played an intermediary role in the association between individual factors and health behaviors (Sobel test=2.09-2.72, PeHealth
Wilson, Robert S; Yu, Lei; James, Bryan D; Bennett, David A; Boyle, Patricia A
We tested the hypothesis that higher financial and health literacy is associated with better cognitive health in 755 older persons who completed a literacy measure (M = 67.9, SD = 14.5) and then had annual clinical evaluations for a mean of 3.4 years. In proportional hazards models, higher literacy was associated with decreased risk of developing incident Alzheimer's disease (n = 68) and results were similar for financial and health literacy subscales and after adjustment for potential confounders. In mixed-effects models, higher literacy was related to higher baseline level of cognition and reduced cognitive decline in multiple domains. Among the 602 persons without any cognitive impairment at baseline, higher literacy was associated with a reduced rate of cognitive decline and risk of developing incident mild cognitive impairment (n = 142). The results suggest that higher levels of financial and health literacy are associated with maintenance of cognitive health in old age.
Madison, Anna; Gao, Xuefei; Graumlich, James F.; Conner-Garcia, Thembi; Murray, Michael D.; Stine-Morrow, Elizabeth A. L.; Morrow, Daniel G.
Abstract Purpose of the Study: Health literacy is associated with health outcomes presumably because it influences the understanding of information needed for self-care. However, little is known about the language comprehension mechanisms that underpin health literacy. Design and Methods: We explored the relationship between a commonly used measure of health literacy (Short Test of Functional Health Literacy in Adults [STOFHLA]) and comprehension of health information among 145 older adults. Results: Results showed that performance on the STOFHLA was associated with recall of health information. Consistent with the Process-Knowledge Model of Health Literacy, mediation analysis showed that both processing capacity and knowledge mediated the association between health literacy and recall of health information. In addition, knowledge moderated the effects of processing capacity limits, such that processing capacity was less likely to be associated with recall for older adults with higher levels of knowledge. Implications: These findings suggest that knowledge contributes to health literacy and can compensate for deficits in processing capacity to support comprehension of health information among older adults. The implications of these findings for improving patient education materials for older adults with inadequate health literacy are discussed. PMID:26209450
Chin, Jessie; Madison, Anna; Gao, Xuefei; Graumlich, James F; Conner-Garcia, Thembi; Murray, Michael D; Stine-Morrow, Elizabeth A L; Morrow, Daniel G
Health literacy is associated with health outcomes presumably because it influences the understanding of information needed for self-care. However, little is known about the language comprehension mechanisms that underpin health literacy. We explored the relationship between a commonly used measure of health literacy (Short Test of Functional Health Literacy in Adults [STOFHLA]) and comprehension of health information among 145 older adults. Results showed that performance on the STOFHLA was associated with recall of health information. Consistent with the Process-Knowledge Model of Health Literacy, mediation analysis showed that both processing capacity and knowledge mediated the association between health literacy and recall of health information. In addition, knowledge moderated the effects of processing capacity limits, such that processing capacity was less likely to be associated with recall for older adults with higher levels of knowledge. These findings suggest that knowledge contributes to health literacy and can compensate for deficits in processing capacity to support comprehension of health information among older adults. The implications of these findings for improving patient education materials for older adults with inadequate health literacy are discussed. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Chang, Fong-Ching; Chiu, Chiung-Hui; Chen, Ping-Hung; Miao, Nae-Fang; Lee, Ching-Mei; Chiang, Jeng-Tung; Pan, Ying-Chun
This study examined the relationship between parental and adolescent eHealth literacy and its impact on online health information seeking. Data were obtained from 1,869 junior high school students and 1,365 parents in Taiwan in 2013. Multivariate analysis results showed that higher levels of parental Internet skill and eHealth literacy were associated with an increase in parental online health information seeking. Parental eHealth literacy, parental active use Internet mediation, adolescent Internet literacy, and health information literacy were all related to adolescent eHealth literacy. Similarly, adolescent Internet/health information literacy, eHealth literacy, and parental active use Internet mediation, and parental online health information seeking were associated with an increase in adolescent online health information seeking. The incorporation of eHealth literacy courses into parenting programs and school education curricula is crucial to promote the eHealth literacy of parents and adolescents.
Black, Stephen; Balatti, Jo; Falk, Ian
This paper makes the case for adult literacy (including numeracy) practitioners to play a greater role in health literacy initiatives in Australia. The paper draws on data from a national research project that investigated adult literacy partnerships and pedagogy viewed from a social capital perspective. The primary purpose of the project was to…
Lee, Eun-Hyun; Kim, Chun-Ja; Lee, Jiyeon; Moon, Seung Hei
The aims of this study were to identify all available self-administered instruments measuring health literacy in people with diabetes and to determine the current instrument that is the most appropriate for applying to this population in both practice and research. A systematic review of measurement properties. MEDLINE, EMBASE and CINAHL electronic databases from their inception up to 28 March 2016. The methodological quality of each included study was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The reported results for measurement properties in the studies were assessed according to Terwee's quality criteria. Thirteen self-administered instruments measuring health literacy in people with diabetes were identified, of which six (44%) were diabetes-specific instruments. The instruments that covered the broadest contents of health literacy were the Health Literacy Scale and Health Literacy Questionnaire. The (test-retest) reliability, measurement error and responsiveness were not evaluated for any instrument, while internal consistency and hypothesis testing validity were the most frequently assessed measurement properties. With the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale. © 2017 John Wiley & Sons Ltd.
Kutcher, Stan; Bagnell, Alexa; Wei, Yifeng
"Mental health literacy is an integral component of health literacy and has been gaining increasing attention as an important focus globally for mental health interventions. In Canada, youth mental health is increasingly recognized as a key national health concern and has received more focused attention than ever before within our health system. This article outlines 2 unique homegrown initiatives to address youth mental health literacy within Canadian secondary schools." Copyright © 2015 Elsevier Inc. All rights reserved.
Vassy, Jason L; O'Brien, Kelsey E; Waxler, Jessica L; Park, Elyse R; Delahanty, Linda M; Florez, Jose C; Meigs, James B; Grant, Richard W
Type 2 diabetes genetic risk testing might motivate at-risk patients to adopt diabetes prevention behaviors. However, the influence of literacy and numeracy on patient response to diabetes genetic risk is unknown. The authors investigated the association of health literacy, genetic literacy, and health numeracy with patient responses to diabetes genetic risk. and Measurements Overweight patients at high phenotypic risk for type 2 diabetes were recruited for a clinical trial of diabetes genetic risk testing. At baseline, participants predicted how their motivation for lifestyle modification to prevent diabetes might change in response to hypothetical scenarios of receiving "high" and "low" genetic risk results. Responses were analyzed according to participants' health literacy, genetic literacy, and health numeracy. Two-thirds (67%) of participants (n = 175) reported very high motivation to prevent diabetes. Despite high health literacy (92% at high school level), many participants had limited health numeracy (30%) and genetic literacy (38%). Almost all (98%) reported that high-risk genetic results would increase their motivation for lifestyle modification. In contrast, response to low-risk genetic results varied. Higher levels of health literacy (P = 0.04), genetic literacy (P = 0.02), and health numeracy (P = 0.02) were associated with an anticipated decrease in motivation for lifestyle modification in response to low-risk results. While patients reported that high-risk genetic results would motivate them to adopt healthy lifestyle changes, response to low-risk results varied by patient numeracy and literacy. However, anticipated responses may not correlate with true behavior change. If future research justifies the clinical use of genetic testing to motivate behavior change, it may be important to assess how patient characteristics modify that motivational effect.
Mantwill, Sarah; Schulz, Peter J
This study aimed at investigating the association between functional health literacy and knowledge on when to seek medical help for potentially harmless (overutilization) or serious (underutilization) situations among immigrants and non-immigrants in Switzerland. Data was collected among three immigrant groups and the native population (N=1146) in the German- and Italian-speaking part of Switzerland. Health literacy was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) and three Brief Health Literacy Screeners. Over- and underutilization of healthcare services was assessed with items asking participants about when to seek medical help for minor, respectively major, physical symptoms. Immigrants were more likely to seek medical help when unwarranted (overutilization). Health literacy, when assessed with the S-TOFHLA, was significantly associated with over- and underutilization. Yet, once controlled for covariates, the association between health literacy and overutilization was negative. Immigration background and micro-cultural differences emerged as important predictors of utilization. Results suggest that functional health literacy is directly related to healthcare utilization. The effects might be amplified by (micro-)cultural differences. Healthcare providers should be aware of differences in health literacy and utilization patterns among different population groups. Communication between patients and providers should be literacy and culturally sensitive. Copyright © 2017 Elsevier B.V. All rights reserved.
Milne, Robin A; Puts, Martine T E; Papadakos, Janet; Le, Lisa W; Milne, Victoria C; Hope, Andrew J; Catton, Pamela; Giuliani, Meredith E
Lung cancer survivors are likely to have low health literacy which is an independent risk factor for poorer health outcomes. The eHealth literacy in lung cancer survivors has not been reported. The purposes of this study were to determine self-perceived eHealth literacy levels in lung cancer survivors and to explore predictors of higher eHealth literacy. A cross-sectional study was conducted at the Princess Margaret Cancer Centre in Toronto, Canada. Survivors completed a survey that collected demographic, self-perceived eHealth literacy (using the eHealth Literacy Scale), and quality of life information. Tumor and treatment details were extracted from medical records. Demographic data was summarized using descriptive statistics and compared against those with high and low eHealth literacy using Fisher's exact test. Eighty-three survivors were enrolled over 7 months. Median age was 71 years (range 44-89); 41 survivors (49%) were male. Forty-six (55%) survivors had some college education or higher. Most had access to eResources (78%) via computer, Internet, or smartphone. Fifty-seven (69%) scored 5 or greater (7=excellent) on the overall health scale. Twenty-eight (33.7%) perceived themselves to have high eHealth literacy. There was no statistically significant correlation between eHealth literacy groups and age (p=1.00), gender (p=0.82), living situation (p=1.00), overall health (p=1.00), overall quality of life (QoL) (p=1.00), or histology (p=0.74). High eHealth literacy correlated with the level of education received (p=0.003) and access to eResources (p=0.004). The self-perceived eHealth literacy of lung cancer survivors is generally low.
Background: Healthy literacy has been shown to improve health care access and adherence to Tuberculosis (TB) treatment. Still it remains largely unstudied in many high risks, underserved and low literacy African populations. This study aims to bridge the existing knowledge gap by assessing health literacy among ...
Ringsberg, K C; Olander, E; Tillgren, P; Thualagant, N; Trollvik, A
Health literacy is an essential social determinant for promoting and maintaining the health of a population. From a health promotion perspective, explore health literacy issues, concerns and future challenges among Nordic practitioners and researchers. Data were collected in a workshop at the 8 th Nordic Health Promotion Conference, and in a literature review, with articles from five databases. The search included title and abstract with the search terms health literacy* and health literacy as a MeSH term and all the Nordic countries. Qualitative and quantitative analysis were used. Twenty-five persons participated in the workshop. The discussions were summarized in six themes: concept of health literacy in national language; risk of victim blaming; measuring health literacy; content in school curricula on health literacy; new technologies for information and communication; communication and collaboration between different actors in support of health. Forty-three articles on health literacy were identified, mainly conducted within three fields: development, test and adaptation of instruments for measuring health literacy; measurement of health literacy among patients, or other defined target groups and on populations; and developing and evaluating methods/tools for the training of personnel groups or different target groups. There is a need for further studies providing a more in-depth understanding of the health literacy concept, knowledge on how to measure health literacy, ethical aspects, application in intersectoral collaboration as well as the adaptation to new technologies for information and communication in education supporting health literacy. As health literacy is an essential social health determinant, a concern and a future challenge must be, to make the health literacy concept familiar and visible in health promotion policies, research and practice such as health education.
Šedová, Lenka; Doskočil, Ondřej; Brabcová, Iva; Hajduchová, Hana; Bártlová, Sylva
This study aimed to map the selected indicators of health literacy in the senior population via a qualitative survey that focused specifically on its relationship with autonomy in the context of health literacy among seniors. A qualitative survey focused on the selected indicators of health literacy of seniors living in the South Bohemian Region of the Czech Republic (R1-19). The snowball sampling method was intentionally selected. Completed interviews were transcribed and data was reduced, analyzed, and categorized. The identified categories were 1) information comprehension, 2) decision-making in healthcare, and 3) compliance with nonpharmacologic treatment. The 'information comprehension' category clearly shows that the seniors involved in this study rated the comprehensibility of information provided by medical professionals as being good. An especially positive finding was that seniors do seek information through the internet, print sources, or other media, even though, as one senior (80-year-old woman) said, comprehension of medical information is becoming "more and more complex". The 'decision-making in healthcare' category touched upon opinions regarding informed consent and opinions regarding seniors' own involvement in healthcare. Results from this category suggest that seniors accept informed consent as a routine necessity. Inhibition regarding personal involvement in healthcare was also apparent: "... I come from a family accustomed to not bothering the doctor unnecessarily, so I just stick out my arm..." The last category of 'compliance with nonpharmacologic treatment' clearly shows that respondents are informed regarding lifestyle modifications that would benefit their treatment, although, few respondents had achieved the desired lifestyle changes. Results of this qualitative research show clear health literacy limits among seniors. As shown in this study, age itself could also be a limiting factor of health literacy.
Monkman, Helen; Kushniruk, Andre
Usability and health literacy are two critical factors in the design and evaluation of consumer health information systems. However, methods for evaluating these two factors in conjunction remain limited. This study adapted a set of existing guidelines for the design of consumer health Web sites into evidence-based evaluation heuristics tailored specifically for mobile consumer health applications. In order to test the approach, a mobile consumer health application (app) was then evaluated using these heuristics. In addition to revealing ways to improve the usability of the system, this analysis identified opportunities to augment the content to make it more understandable by users with limited health literacy. This study successfully demonstrated the utility of converting existing design guidelines into heuristics for the evaluation of usability and health literacy. The heuristics generated could be applied for assessing and revising other existing consumer health information systems.
Vitko, Michelle; O'Conor, Rachel; Bailey, Stacy Cooper
Abstract Background: Health literacy is thought to impact women's reproductive health, yet no comprehensive systematic reviews have been conducted on the topic. Our objective was to systematically identify, investigate, and summarize research on the relationship between health literacy and women's reproductive health knowledge, behaviors, and outcomes. Methods: PRISMA guidelines were used to guide this review. English language, peer-reviewed research articles indexed in MEDLINE as of February 2015 were searched, along with study results posted on Clinicaltrials.gov. Articles were included if they (1) described original data-driven research conducted in developed countries, (2) were published in a peer-reviewed journal, (3) measured health literacy using a validated assessment, (4) reported on the relationship between health literacy and reproductive health outcomes, related knowledge, or behaviors, and (5) consisted of a study population that included reproductive age women. Results: A total of 34 articles met eligibility criteria and were included in this review. Data were abstracted from articles by two study authors using a standardized form. Abstracted data were then reviewed and summarized in table format. Overall, health literacy was associated with reproductive health knowledge across a spectrum of topics. It was also related to certain health behaviors, such as prenatal vitamin use and breastfeeding. Its relationship with other reproductive behaviors and outcomes remains unclear. Conclusions: Health literacy plays an important role in reproductive knowledge and may impact behaviors and outcomes. While further research is necessary, healthcare providers should utilize health literacy best practices now to promote high-quality care for patients. PMID:27564780
Park, Hyojung; Rodgers, Shelly; Stemmle, Jon
This study explored health-related organizations' use of Twitter in delivering health literacy messages. A content analysis of 571 tweets from health-related organizations revealed that the organizations' tweets were often quoted or retweeted by other Twitter users. Nonprofit organizations and community groups had more tweets about health literacy than did other types of health-related organizations examined, including health business corporations, educational institutions, and government agencies. Tweets on health literacy topics focused predominantly on using simple language rather than complicated language. The results suggest that health organizations need a more strategic approach to managing positive organizational self-presentations in order to create an optimal level of exposure on social networking sites.
Cutilli, Carolyn Crane; Simko, Lynn C; Colbert, Alison M; Bennett, Ian M
Low health literacy in older adults has been associated with poor health outcomes (i.e., mortality, decreased physical and cognitive functioning, and less preventive care utilization). Many factors associated with low health literacy are also associated with health disparities. Interaction with healthcare providers and sources of health information are influenced by an individual's health literacy and can impact health outcomes. This study examined the relationships between health literacy, sources of health information, and demographic/background characteristics in older adults (aged 65 years and older) related to health literacy and disparities. This descriptive, correlational study is a secondary analysis of the 2003 National Assessment of Adult Literacy, a large-scale national assessment. Older adults with lower health literacy have less income and education, rate their health as poor or fair, have visual or auditory difficulties, need help filling out forms, reading newspaper, or writing notes, and use each source of health information less (print and nonprint). Many of these characteristics and skills are predictive of health literacy and associated with health disparities. The results expand our knowledge of characteristics associated with health literacy and sources of health information used by older adults. Interventions to improve health outcomes including health disparities can focus on recognizing and meeting the health literacy demands of older adults.
Dastani, Meisam; Sattari, Masoume
Background and aims In the information society the production, distribution and use of information is freely and widely available for all issues of life. Correct and appropriate use of appropriate and reliable information is especially important in health care. The present study introduces the concepts and benefits of health literacy and information literacy and its role in improving health literacy. Methods This study is a review based on a review of the concepts of the information society, ...
Armenia, Joanne Elizabeth
Limited health literacy is a national public health problem contributing to adverse health outcomes and increasing healthcare costs. Both health and educational systems are intervention points for improvement; however, there is paucity in empirical research regarding the role of educational systems. This needs assessment study explored health…
Liechty, Janet M.
One-third of U. S. adults do not have adequate health literacy to manage their health care needs; and low health literacy is a major concern due to its association with poor health outcomes, high health care costs, and health communication problems. Low health literacy is a potential driver of health disparities, and its alleviation is central to…
Full Text Available In the information society, the production, distribution and use of information are freely and widely available for all issues of life. Proper and appropriate use of reliable information is especially important in health care. The present study introduces the concepts and benefits of health literacy and information literacy and its role in improving health literacy. This study was a review based on the concepts of information society, information literacy and information education to present importance of promoting information literacy on health literacy in the information society. The information society is presented by providing a platform of information technology and computer systems to attempt to exchange and develop information among people in the community. Currently, electronic and web-based health information in the mass form is available. Information as a fundamental base of the information society is a phenomenon that our decisions are affected in relation to various issues such as safety and health issues. It is important to avoid the mass of invalid, incorrect and inappropriate information which is available on the internet. This requires information literacy skills such as identifying, accessing and evaluating information. In general, it can be said that the promotion of health literacy in communities requires learning different skills in the form of information literacy.Data obtained from this study can be used in developing the long term health programs to prevention of non-communicable diseases in our country
Al-Jumaili, Ali Azeez; Al-Rekabi, Mohammed Dakhil; Sorofman, Bernard
Low health literacy is associated with lack of medical information, less use of preventive measures, low medication adherence rates, high health care costs and high risk of hospitalization. The aims were to compare the results of the three health literacy tests, to measure for the first time the health literacy level of Iraqis, to describe the use of standardized health literacy tests, to evaluate reliability and validity of the Arabic versions of these tests, and to investigate whether there is relationship between the participant characteristics and the health literacy level. A convenience sample of 95 subjects was studied in five community pharmacies in Al-Najaf and Babylon governorates, Iraq. Three health literacy tests, the Single Item Literacy Screener (SILS), the New Vital Sign (NVS) and the Short version of the Test of Functional Health Literacy in Adults (S-TOFHLA), were translated in the Arabic language and administered to the pharmacy customers. There were no statistically significant associations between age, gender, education and current education status and NVS score, but there were significant positive associations between the level of education and each one of SILS, New SILS, and S-TOFHLA scores. SILS has one subjective, possibly culturally biased question. Since Iraqis are generally not exposed to reading product labels, the NVS test might be not an accurate measure for them. S-TOFHLA was the most comprehensive test and gave equitable results. The Arabic version of S-TOFHLA can be used to measure health literacy in 22 Arabic speaking countries. Copyright © 2015 Elsevier Inc. All rights reserved.
Hoffman, Steven; Marsiglia, Flavio F; Nevarez, Lucinda; Porta, Maria
Health literacy (HL) is recognized as an important health construct that is correlated with various health-related outcomes, but outside of the United States there is limited HL research available, particularly among youth. This study looked at the HL and harmful health behavior (i.e., substance use) of 210 youth across 10 schools in Guatemala City. Based on results from the Newest Vital Sign (NVS) HL assessment, fewer than one third of youth sampled had adequate HL. Training/education to improve adolescent HL is needed in Guatemala City, and the unique skillset of social workers could be an idea method of reaching at-risk youth.
Dastani, Meisam; Sattari, Masoume
Background and aims In the information society the production, distribution and use of information is freely and widely available for all issues of life. Correct and appropriate use of appropriate and reliable information is especially important in health care. The present study introduces the concepts and benefits of health literacy and information literacy and its role in improving health literacy. Methods This study is a review based on a review of the concepts of the information society, information literacy and information educated to present importance of promoting information literacy on health literacy in the information society. Results and Conclusion The information society by providing a platform of information technology and computer systems to attempts exchange and development information between people in the community. Currently, electronic and web-based health information in the form of mass is available for people. Information as a fundamental base of the information society is a phenomenon that our decisions are affect in relation to various issues such as safety and health issues. It is important point to avoid the mass of information invalid, incorrect and inappropriate available on the internet. This requires information literacy skills such as identifying, accessing and evaluating information. In general, it can be said that the promotion of health literacy in communities are required to learn different skills in the form of information literacy.
van der Heide, Iris; Wang, Jen; Droomers, Mariël; Spreeuwenberg, Peter; Rademakers, Jany; Uiters, Ellen
Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by which level of education affects health status. Health literacy was measured by the Health Activities and Literacy Scale, using data from a subsample of 5,136 adults between the ages of 25 and 65 years, gathered within the context of the 2007 Dutch Adult Literacy and Life Skills Survey. Linear regression analyses were used in separate models to estimate the extent to which health literacy mediates educational disparities in self-reported general health, physical health status, and mental health status as measured by the Short Form-12. Health literacy was found to partially mediate the association between low education and low self-reported health status. As such, improving health literacy may be a useful strategy for reducing disparities in health related to education, as health literacy appears to play a role in explaining the underlying mechanism driving the relationship between low level of education and poor health.
Providing teacher candidates with a strong foundation in mental health literacy during their teacher education program is crucial in ensuring novice teachers are prepared to support the mental health needs of their students. In addition to responding to students, teacher candidates are typically at an age when mental health disorders are common…
Haghdoost, Ali Akbar; Rakhshani, Fatemeh; Aarabi, Mohsen; Montazeri, Ali; Tavousi, Mahmoud; Solimanian, Atoosa; Sarbandi, Fatemeh; Namdar, Hosein; Iranpour, Abedin
Promoting Health Literacy (HL) is considered as an important goal in strategic plans of many countries. In spite of the necessity for access to valid, reliable and native HL instruments, the number of such instruments in the Persian language is scarce. Moreover, there is no good estimation of HL status in Iran. The aim of this study was to provide a valid, reliable and native instrument to measure and monitor community HL in Iran and also, to provide an estimation of HL status in two Iranian provinces. By applying the multistage cluster sampling, 1080 respondents (540 from each gender) were recruited from Kerman and Mazandaran provinces of Iran, from February to June 2014 to participate in this cross-sectional study. The development of the Iranian Health Literacy Questionnaire (IHLQ) was initiated with a comprehensive review of the literature. Then, face, content and construct validity as well as reliability were determined. Internal consistency and test-retest reliability (ICC) of the factors was in the range of 0.71 to 0.96 and 0.73 to 0.86, respectively. In order to construct validity, Exploratory Factor Analysis (EFA) Kaiser-Meyer-Olkin (KMO) = 0.95 and Bartlett's test result of 3.017 with P < 0.001) with varimax rotation was used. Optimal reduced solution, including 36 items and seven factors, was found in EFA. Five of the factors identified were reading/comprehension skills, individual empowerment, communication/decision-making skills, social empowerment and health knowledge. It was concluded that IHLQ might be a practical and useful tool for investigating HL for Persian language speakers around the world. Since HL is dynamic and its instruments should be regularly revised, further studies are recommended to assess HL with application of IHLQ to detect its potential imperfections.
Brega, A. G.; Thomas, J. F.; Henderson, W. G.; Batliner, T. S.; Quissell, D. O.; Braun, P. A.; Wilson, A.; Bryant, L. L.; Nadeau, K. J.; Albino, J.
Health literacy is ‘the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions’. Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale studies have assessed these relationships among American Indians, a population at risk for limited health literacy and oral health problems. This analysis was condu...
Dahlke, Allison R; Curtis, Laura M; Federman, Alex D; Wolf, Michael S
Studies have documented strong associations between cognitive function, health literacy skills, and health outcomes, such that outcome performance may be partially explained by cognitive ability. Common cognitive assessments such as the Mini Mental Status Exam (MMSE) therefore may be measuring the same latent construct as existing health literacy tools. We evaluated the potential of the MMSE as a surrogate measure of health literacy by comparing its convergent and predictive validity to the three most commonly used health literacy assessments and education. 827 older adults recruited from an academic general internal medicine ambulatory care clinic or one of five federally qualified health centers in Chicago, IL. Non-English speakers and those with severe cognitive impairment were excluded. Pearson correlations were completed to test the convergent validity of the MMSE with assessments of health literacy and education. Receiver Operating Characteristic (ROC) curves and the d statistic were calculated to determine the optimal cut point on the MMSE for classifying participants with limited health literacy. Multivariate logistic regression models were completed to measure the predictive validity of the new MMSE cut point. The MMSE was found to have moderate to high convergent validity with the existing health literacy measures. The ROC and d statistic analyses suggested an optimal cut point of ≤ 27 on the MMSE. The new threshold score was found to predict health outcomes at least as well as, or better than, existing health literacy measures or education alone. The MMSE has considerable face validity as a health literacy measure that could be easily administered in the healthcare setting. Further research should aim to validate this cut point and examine the constructs being measured by the MMSE and other literacy assessments.
Logan, Robert A
This study explores how diverse attitudes about health literacy are assessed by medical librarians and other health care professionals. An online survey of thirty-six items was conducted using Q methodology in two phases in spring 2005 and winter 2006. Respondents (n = 51) were nonrandomly self-selected from a convenience sample of members of the Medical Library Association and a group of environmental health consultants to the National Library of Medicine. Three factors were identified. Factor 1 is optimistic and supportive of health literacy's transformative sociocultural and professional potential, if clinical settings become a launching point for health literacy activities. Factor 2 is less optimistic about health literacy's potential to improve clinical or patient outcomes and prefers to focus health literacy initiatives on classroom education settings. Factor 3 supports improving the nation's health literacy but tends to support health literacy initiatives when people privately interact with health information materials. Each factor's attitudes about the appropriate educational venue to initiate health literacy activities are different and somewhat mutually exclusive. This suggests that health literacy is seen through different perceptual frameworks that represent a possible source of professional disagreement.
Pignone Michael P
Full Text Available Abstract Background An estimated one-half of Americans have limited health literacy skills. Low literacy has been associated with less receipt of preventive services, but its impact on colorectal cancer (CRC screening is unclear. We sought to determine whether low literacy affects patients' knowledge or receipt of CRC screening. Methods Pilot survey study of patients aged 50 years and older at a large, university-affiliated internal medicine practice. We assessed patients' knowledge and receipt of CRC screening, basic sociodemographic information, and health literacy level. We defined limited literacy as reading below the ninth grade level as determined by the Rapid Estimate of Adult Literacy in Medicine. Bivariate analyses and exact logistic regression were used to determine the association of limited health literacy with knowledge and receipt of CRC screening. Results We approached 105 patients to yield our target sample of 50 completing the survey (recruitment rate 48%. Most subjects were female (72%, African-American (58%, and had household incomes less than $25,000 (87%. Overall, 48% of patients had limited literacy skills (95% CI 35% to 61%. Limited literacy patients were less likely than adequate literacy patients to be able to name or describe any CRC screening test (50% vs. 96%, p Conclusion Patients with limited literacy skills are less likely to be knowledgeable of CRC screening compared to adequate literacy patients. Primary care providers should ensure patients' understanding of CRC screening when discussing screening options. Further research is needed to determine if educating low literacy patients about CRC screening can increase screening rates.
Brega, A. G.; Thomas, J. F.; Henderson, W. G.; Batliner, T. S.; Quissell, D. O.; Braun, P. A.; Wilson, A.; Bryant, L. L.; Nadeau, K. J.; Albino, J.
Health literacy is "the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions". Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale…
Bodie, Graham D; Dutta, Mohan Jyoti
Even despite policy efforts aimed at reducing health-related disparities, evidence mounts that population-level gaps in literacy and healthcare quality are increasing. This widening of disparities in American culture is likely to worsen over the coming years due, in part, to our increasing reliance on Internet-based technologies to disseminate health information and services. The purpose of the current article is to incorporate health literacy into an Integrative Model of eHealth Use. We argue for this theoretical understanding of eHealth literacy and propose that macro-level disparities in social structures are connected to health disparities through the micro-level conduits of eHealth literacy, motivation, and ability. In other words, structural inequities reinforce themselves and continue to contribute to healthcare disparities through the differential distribution of technologies that simultaneously enhance and impede literacy, motivation, and ability of different groups (and individuals) in the population. We conclude the article by suggesting pragmatic implications of our analysis.
Potvin-Boucher, Jacqueline; Szumilas, Magdalena; Sheikh, Tabinda; Kutcher, Stan
Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions…
Yu, Lei; Wilson, Robert S; Schneider, Julie A; Bennett, David A; Boyle, Patricia A
Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. We test the hypothesis that domain specific literacy is associated with Alzheimer's disease (AD) dementia and AD pathology after controlling for cognition. Participants were community-based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years, and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined postmortem by quantifying plaques and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (p literacy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β= 0.07, p = 0.035). Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition.
Truman, Emily; Raine, Kim; Mrklas, Kelly; Prowse, Rachel; Carruthers Den Hoed, Rebecca; Watson-Jarvis, Katherine; Loewen, Jewel; Gorham, Megan; Ricciardi, Carolin; Tyminski, Sheila; Elliott, Charlene
This consensus statement reflects the views of a diverse group of stakeholders convened to explore the concept of "food literacy" as it relates to children's health. Evidence-based conceptions of food literacy are needed in light of the term's popularity in health promotion and educational interventions designed to increase food skills and knowledge that contribute to overall health. Informed by a comprehensive scoping review that identified seven main themes of food literacy, meeting participants ranked those themes in terms of importance. Discussions highlighted two key points in conceptualizing food literacy: the need to recognize varying food skill and knowledge levels, and the need to recognize critical food contexts. From these discussions, meeting participants created two working definitions of food literacy, as well as the alternative conception of "radical food literacy". We conclude that multiple literacies in relation to food skills and knowledge are needed, and underline the importance of ongoing dialogue in this emergent area of research.
Full Text Available Health literacy refers to personal competencies for the access to, understanding of, appraisal of and application of health information in order to make sound decisions in everyday life. The aim of this study was to develop and evaluate the psychometric properties of an instrument for the measurement of health literacy among adolescents (the Health Literacy Measure for Adolescents-HELMA.This study was made up of two phases, qualitative and quantitative, which were carried out in 2012-2014 in Tehran, Iran. In the qualitative part of the study, in-depth interviews with 67 adolescents aged 15-18 were carried out in 4 high schools to generate the initial item pool for the survey. The content validity of the items was then assessed by an expert panel review (n = 13 and face validity was assessed by interviewing adolescents (n = 16. In the quantitative part of the study, in order to describe the psychometric properties of the scale, validity, reliability (internal consistency and test-retest and factor analysis were assessed.An item pool made up of 104 items was generated at the qualitative stage. After content validity was considered, this decreased to 47 items. In the quantitative stage, 582 adolescents aged 15-18 participated in the study with a mean age of 16.2 years. 51.2% of participants were females. In principal component factor analysis, 8 factors were loaded, which accounted for 53.37% of the variance observed. Reliability has been approved by α = 0.93 and the test-retest of the scale at two-week intervals indicated an appropriate stability for the scale (ICC = 0.93. The final questionnaire was approved with 44 items split into eight sections. The sections were titled: gain access to, reading, understanding, appraise, use, communication, self-efficacy and numeracy.The Health Literacy Measure for Adolescents (HELMA is a valid and reliable tool for the measurement of the health literacy of adolescents aged 15-18 and can be used to evaluate
Walstad, William B.; Rebeck, Ken
The "Test of Financial Literacy" (TFL) was created to measure the financial knowledge of high school students. Its content is based on the standards and benchmarks stated in the "National Standards for Financial Literacy" (Council for Economic Education 2013). The test development process involved extensive item writing and…
Devraj, Radhika; Herndon, Christopher M; Griffin, Jake
Chronic pain is a significant burden to the U.S. health care system. Patient-related barriers such as low health literacy can prevent optimal management of pain. This study aimed to determine the relationship between health literacy, pain awareness, and medication knowledge. Chronic pain patients visiting a family health center were administered a survey addressing the study objectives. Health literacy was measured using the Newest Vital Sign. A total of 139 chronic pain patients participated in the study. Patients with low health literacy had significantly lower overall pain medication knowledge (mean score = 63.3± 18.9 versus 74.3 ± 18.5, p literacy lacked knowledge of non-medication modes of treating pain, and did not know which non-prescription medications could provide pain relief. The mean Visual Analogue Scale score for the entire sample was 51.54 mm (range = 0 - 100 mm). Pain intensity was not related to health literacy (p > 0.05). Multivariate analyses showed a significant relationship between health literacy and medication knowledge after controlling for demographics. Patients with low health literacy have poor knowledge of pain medications. Educational interventions to meet the needs of patients with low health literacy are essential to safely relieve pain.
Vyas, Shaleen; Nagarajappa, Sandesh; Dasar, Pralhad L; Mishra, Prashant
Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English (2013), consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers. The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire - Hindi Version using the World Health Organization recommended translation back-translation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted (June-July 2015) and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Intra-class correlation coefficient (ICC), respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and pLiteracy Adult Questionnaire - Hindi Version were 0.94 and 0.70, respectively. Comparisons of varying levels of oral health literacy with self-reported oral health established significant concurrent validity (p=0.01). Significant
Boyle, Patricia A; Yu, Lei; Wilson, Robert S; Segawa, Eisuke; Buchman, Aron S; Bennett, David A
Literacy is an important determinant of health and well-being across the life span but is critical in aging, when many influential health and financial decisions are made. Prior studies suggest that older persons exhibit lower literacy than younger persons, particularly in the domains of financial and health literacy, but the reasons why remain unknown. The objectives of this study were to: (a) examine pathways linking diverse resources (i.e., education, word knowledge, cognitive function, and decision making style) to health and financial literacy among older persons and determine the extent to which the relation of age with literacy represents a direct effect versus an indirect effect due to decrements in specific cognitive functions (i.e., executive functions and episodic memory); and (b) test the hypothesis that declines in executive function and episodic memory are associated with lower literacy among older persons without dementia. Six-hundred and forty-five community-based older persons without dementia underwent detailed assessments of diverse resources, including education, word knowledge, cognitive function (i.e., executive function, episodic memory) and decision making style (i.e., risk aversion), and completed a measure of literacy that included items similar to those used in the Health and Retirement Study, such as numeracy, financial concepts such as compound inflation and knowledge of stocks and bonds, and important health concepts such as understanding of drug risk and Medicare Part D. Path analysis revealed a strong effect of age on literacy, with about half of the effect of age on literacy due to decrements in executive functions and episodic memory. In addition, executive function had an indirect effect on literacy via decision making style (i.e., risk aversion), and education and word knowledge had independent effects on literacy. Finally, among (n = 447) persons with repeated cognitive assessments available for up to 14 years, regression
Full Text Available Introduction: Linguistically adapted oral health literacy tools are helpful to assess oral health literacy among local population with clarity and understandability. The original oral health literacy adult questionnaire, Oral Health Literacy Adult Questionnaire, was given in English (2013, consisting of 17 items under 4 domains. The present study rationalizes to culturally adapt and validate Oral Health Literacy Adult Questionnaire into Hindi language. Thus, we objectified to translate Oral Health Literacy Adult Questionnaire into Hindi and test its psychometric properties like reliability and validity among primary school teachers. Methods: The Oral Health Literacy Adult Questionnaire was translated into Oral Health Literacy Adult Questionnaire – Hindi Version using the World Health Organization recommended translation backtranslation protocol. During pre-testing, an expert panel assessed content validity of the questionnaire. Face validity was assessed on a small sample of 10 individuals. A cross-sectional study was conducted (June-July 2015 and OHL-AQ-H was administered on a convenient sample of 170 primary school teachers. Internal consistency and testretest reliability were assessed using Cronbach’s alpha and Intra-class correlation coefficient (ICC, respectively, with 2 weeks interval to ascertain adherence to the questionnaire response. Predictive validity was tested by comparing OHL-AQ-H scores with clinical indicators like oral hygiene scores and dental caries scores. The concurrent and discriminant validity was assessed through self-reported oral health and through negative association with sociodemographic variables. The data was analyzed by descriptive tests using chi-square and bivariate logistic regression in SPSS software, version 20 and p<0.05 was considered as the significance level. Results: The mean OHL-AQ-H score was 13.58±2.82. ICC and Cronbach’s alpha for Oral Health Literacy Adult Questionnaire – Hindi Version
Changes in economic conditions and healthcare delivery models have shifted more healthcare costs to patients, resulting in greater patient financial responsibilities. As a result, it is important to understand the potential impact of financial literacy on patients' healthcare behavior. With the focus on delivering better health outcomes at lower costs, factors that influence patient behavior are important considerations for healthcare providers. Although researchers have proposed a variety of conceptual models that identify influential factors, those models do not fully address financial literacy and its potential impact patients' healthcare decisions. This article examines existing models of patient healthcare decision-making and current research on factors affecting patient decision-making and behavior and then presents recommendations for closing the identified gap in our current knowledge.
This chapter marks the territory and leadership potential found in research, practice and policy related to the role of health literacy in higher education and professional training. There is limited published work that has summarized the role and scope of health literacy in higher education and professional training. This chapter will provide a review of the research in the area, a description of some of the educational practices in health literacy, and a case example of how policy might influence the role of health literacy in professional higher education.
Tse, Carrie Kw; Bridges, Susan M; Srinivasan, Divya Parthasarathy; Cheng, Brenda Ss
While health literacy has gained notice on a global stage, the initial focus on seeking associations with medical conditions may have overlooked its impact across generations. Adolescent health literacy, specifically in dentistry, is an underexplored area despite the significance of this formative stage on an individual's approach to healthy lifestyles and behaviors. The aim is to conduct a pilot study to evaluate the efficacy of three major social media outlets - Twitter, Facebook, and YouTube - in supporting adolescents' oral health literacy (OHL) education. A random sample of 22 adolescents (aged 14-16 years) from an English-medium international school in Hong Kong provided informed consent. Sociodemographic information, including English language background, social media usage, and dental experience were collected via a questionnaire. A pre- and post-test of OHL (REALD-30) was administered by two trained, calibrated examiners. Following pre-test, participants were randomly assigned to one of three social media outlets: Twitter, Facebook, or YouTube. Participants received alerts posted daily for 5 consecutive days requiring online accessing of modified and original OHL education materials. One-way ANOVA ( analysis of variance) was used to compare the mean difference between the pre- and the post-test results among the three social media. No associations were found between the social media allocated and participants' sociodemographics, including English language background, social media usage, and dental experience. Of the three social media, significant differences in literacy assessment scores were evident for participants who received oral health education messages via Facebook (P=.02) and YouTube (P=.005). Based on the results of the pilot study, Facebook and YouTube may be more efficient media outlets for OHL promotion and education among adolescent school children when compared to Twitter. Further analyses with a larger study group is warranted.
Zakaria, Nasriah; AlFakhry, Ohoud; Matbuli, Abeer; Alzahrani, Asma; Arab, Noha Samir Sadiq; Madani, Alaa; Alshehri, Noura; Albarrak, Ahmed I
Health literacy has become a global issue, and it is important that patients and individuals are able to use information technology to access health information and educational services. The research objective is to develop a Saudi e-health literacy scale (SeHL) for measuring e-health literacy among Saudis suffering from non-communicable diseases (NCD). Overall, 14 relevant papers in related interdisciplinary fields were reviewed to select the most useful literacy dimensions. From these articles, we extracted the most common dimensions used to measure e-health literacy across the disciplines. Multiple workshops with multidisciplinary team members reviewed and evaluated items for SeHL. Four key aspects of e-health literacy-use of technology/media, information-seeking, usefulness and confidence-were identified and integrated as e-health literacy dimensions. These will be used to measure e-health literacy among Saudi patients with NCDs. A translation from Arabic to English was performed in order to ensure that translation process was accurate. A SeHL scale was developed to measure e-health literacy among Saudi patients. By understanding e-health literacy levels, we will be able to create a patient-education system to be used by patients in Saudi Arabia. As information technology is increasingly used by people of all ages all over the world, e-health literacy has been identified as a key factor in determining health outcomes. To date, no comprehensive scale exists to assess e-health literacy levels among speakers of Arabic, particularly among people with NCD such as diabetes, cardiovascular diseases and hypertension.
z Rezaee Esfahrood
Full Text Available Introduction:The ability to use skills such as reading, listening, analysis and decision making in health status depends on the degree to which individuals have the capacity to obtain, process, and understanding basic health information and services needed which is defined in term of health literacy. The purpose of this study was to determine the level of health literacy in referred patients to Yazd Diabetes Research Center. Methods: This cross-sectional study performed on 432 patients referred to Yazd Diabetes Research Center in 2014. Health literacy was measured by the Test of Functional Health Literacy in Adults (TOFHLA and analyzed using the SPSS-17 software and analytical statistics (T-Test, Chi-Square, A-Nova and linear regression. Results: The mean age of studied population was 55.02 ± 6.32 years old and the mean duration of diabetes was 10.24 ± 7.13 years old. Increase age and decrease the Duration of diabetes, Increase health literacy scores. The average of Health literacy scores was significantly higher in men than women. Retired people, people living in the city, people with high educational level and good economic situation were more literate. (P-Value <0.001 Conclusion: The results showed that health literacy in 59.3 percent of patients was insufficient, in 18.5 percent was border and only 22.2 percent of patients had adequate health literacy that providing facilities and health literacy education seems to be necessary for them.
Full Text Available Children's health and wellbeing is high on the research and policy agenda of many nations. There is a wealth of epidemiological research linking childhood circumstances and health practices with adult health. However, echoing a broader picture within child health research where children have typically been viewed as objects rather than subjects of enquiry, we know very little of how, in their everyday lives, children make sense of health-relevant information.This paper reports key findings from a qualitative study exploring how children understand food in everyday life and their ideas about the relationship between food and health. 53 children aged 9-10, attending two socio-economically contrasting schools in Northern England, participated during 2010 and 2011. Data were generated in schools through interviews and debates in small friendship groups and in the home through individual interviews. Data were analysed thematically using cross-sectional, categorical indexing.Moving beyond a focus on what children know the paper mobilises the concept of health literacy (Nutbeam, 2000, explored very little in relation to children, to conceptualise how children actively construct meaning from health information through their own embodied experiences. It draws on insights from the Social Studies of Childhood (James and Prout, 2015, which emphasise children's active participation in their everyday lives as well as New Literacy Studies (Pahl and Rowsell, 2012, which focus on literacy as a social practice. Recognising children as active health literacy practitioners has important implications for policy and practice geared towards improving child health. Keywords: Children, Health literacy, Qualitative, UK
Wickstead, Robert; Furnham, Adrian
This study compared mental health and physical health literacy using five health problems from each area. The aim was to determine whether the same group had better physical than mental health literacy Method: A sample of 263 participants completed an online questionnaire requiring them to name a problem/illness described in 10 vignettes and suggest treatment options. Five vignettes described mental health problems (anxiety, bipolar-disorder, depression, OCPD and schizophrenia) and five physical problems (angina, COPD, diabetes, a heart attack, and sinusitis). Participants were also asked to rate their sympathy and estimates of prevalence for each disorder. Recognition of the mental health disorders was superior compared recognition of the physical disorders. Analysis of treatment beliefs, sympathy and prevalence ratings also showed significant differences between disorders. Results highlight the importance of education and the lack of public knowledge regarding major physical health conditions.
Full Text Available Background and Objectives: Health literacy represents the cognitive and social skills, which are used to determine the motivation and ability of individuals to acquire access and understand the methods to use the information in order to maintain and improve the health. This study aimed to assess the level of health literacy in students and identify the factors influencing it in the 2015-2016 academic year. Materials and Methods: In this cross-sectional, descriptive and analytical study, 360 students inhabiting the dormitories of Shahid Beheshti University of Medical Sciences in Tehran were randomly selected using the cluster sampling method. To collect the data, an inventory of Health Literacy for Iranian Adults was used. Data were analyzed using descriptive statistics and Chi-square test with the SPSS software version 21. Results: The mean age of the students was 22.93±4.05 years. The results showed that 9.2% (n=31 of the students had low health literacy, 27.6% (n=94 not so inadequate literacy, 42.6% (n=145 adequate health literacy, and 19.7% (n=67 excellent health literacy. Health literacy was significantly associated with gender and family income (P<0.001. Conclusions: Due to the limited level of health literacy in many students, it is necessary to design training programs commensurate with their level of health literacy and media interests.
This study investigated the ICT literacy among the health workers of Igbinedion University Teaching Hospital. The emergence of Internet for Telemedicine and health information revolution necessitates that issue of computer and other communication technology literacy among the health workers of Igbinedion University ...
Kuczmarski, Marie F; Adams, Erica L; Cotugna, Nancy; Pohlig, Ryan T; Beydoun, May A; Zonderman, Alan B; Evans, Michele K
Research has shown that health literacy may be a stronger predictor of health than age, employment status, education level, race, and income. Evidence supports a strong link between low health literacy and poor dietary management of chronic diseases. The aim was to evaluate the relationship of micronutrient quality of diet, health numeracy and health literacy in White and African American adults randomly selected from 13 Baltimore neighborhoods. Cross-sectional analysis of Wave 3 (2009-2013) of the longitudinal Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study initiated in 2004. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Health numeracy was measured using the numeracy subscale of the Test of Functional Health Literacy in Adults (TOFHLA). Nutrient-based diet quality was measured using Mean Adequacy Ratio (MAR-S) scores calculated from 17 micronutrients from diet plus dietary supplement intake. The relationship of MAR-S scores to the health literacy measures were explored with multiple ordinary least square regression models, adjusting for a number of potential confounders. REALM but not numeracy was associated with MAR-S; significant covariates included age, current cigarette smoking status, and energy intake. The interactions of race and educational attainment, and REALM and educational attainment were significant, with the relationship between REALM and MAR-S becoming stronger as education level increased. There is a synergistic relationship between health literacy and educational attainment in predicting nutrient-based diet quality. Education was a stronger predictor for Whites compared to African Americans emphasizing the need for health professionals to focus on both education and literacy when creating and providing diet and health-related interventions and resources.
Stewart, Christopher C; Boyle, Patricia A; James, Bryan D; Yu, Lei; Han, S Duke; Bennett, David A
Older adults often exhibit low health and financial literacy, but the reasons why remain unclear. One possibility is that those older adults at high risk for developing dementia demonstrate low literacy even in the absence of marked cognitive impairment. We therefore examined associations of health and financial literacy with the APOE ε4 allele, the chief genetic risk factor for Alzheimer's disease, among older adults without dementia. Participants were 487 older adults without dementia enrolled in the Rush Memory and Aging Project (mean age = 83, mean years of education = 15, 77% female, 91% non-Hispanic White). Participants underwent APOE genotyping and assessments of cognition, health literacy, and financial literacy. Health and financial literacy scores were also averaged into a total literacy score. ε4 was associated with lower total and health literacy, with a trend toward an association with lower financial literacy, after adjustment for age, sex, and education. Associations of ε4 with lower total and health literacy persisted after further adjustment for global cognitive function and 5 specific cognitive domains. ε4 affects literacy even in the absence of clinical dementia and does so relatively independent of performance on traditional cognitive tests. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
James, Bryan D; Boyle, Patricia A; Bennett, Jarred S; Bennett, David A
Health and financial literacy have been linked to the health and well-being of older adults, yet there are few data on how health and financial literacy actually impact decision making regarding healthcare and economic choices in advanced age. To examine the association of health and financial literacy with decision making in older adults. Data came from 525 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Health and financial literacy were assessed via a series of questions designed to measure comprehension of health and financial information and concepts. The two scores were averaged to yield a total literacy score. A modified, 12-item version of the Decision-Making Competence Assessment Tool was used to measure financial and healthcare decision making (6 items each), using materials designed to approximate those used in real world settings. All 12 items were summed to yield a total decision-making score. Associations were tested via linear regression models adjusted for age, sex and education. Secondary models adjusted for global cognitive function, income, depression and chronic medical conditions. On average, participants correctly answered 67% of the literacy questions (health literacy = 61.6%, SD = 18.8% and financial literacy = 72.5%, SD = 16.0%). After adjustment for cognitive function, the total literacy score was positively associated with the decision-making total score (estimate = 0.64, SE = 0.08, p financial decision making (estimate = 0.28, SE = 0.05, p literacy, health and financial literacy all were independently associated with decision making in models adjusted for covariates including income, depression, and chronic medical conditions (all p values literacy and healthcare decision making was stronger among older persons, poorer persons and persons at the lower ranges of cognitive ability. Among community based older persons without dementia, higher levels of health
This article explores the relationship between these two standardised assessments in the domain of mathematical/quantitative literacy. This is accomplished through a Pearson correlation analysis of 6,363 test scores obtained by Grade 12 learners on the NSC Mathematical Literacy examination and the Quantitative ...
van der Heide, Iris; Wang, Jen; Droomers, Mariël; Spreeuwenberg, Peter; Rademakers, Jany; Uiters, Ellen
Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by
Heide, I. van der; Wang, J.; Droomers, M.; Spreeuwenberg, P.; Rademakers, J.; Uiters, E.
Health literacy has been put forward as a potential mechanism explaining the well-documented relationship between education and health. However, little empirical research has been undertaken to explore this hypothesis. The present study aims to study whether health literacy could be a pathway by
Conclusion: Health literacy of women in general was unacceptable, and recommendations were made to establish continuous training for women to improve their views. Also consideration should be given to centers to plan the transformation of health literacy which has been launched, to increase the Health literacy of the population being studied as recipients of health services.
Yu, Lei; Wilson, Robert S.; Schneider, Julie A.; Bennett, David A.; Boyle, Patricia A.
Background Domain specific literacy is a multidimensional construct that requires multiple resources including cognitive and non-cognitive factors. Objective We test the hypothesis that domain specific literacy is associated with AD dementia and AD pathology after controlling for cognition. Methods Participants were community based older persons who completed a baseline literacy assessment, underwent annual clinical evaluations for up to 8 years and agreed to organ donation after death. Financial and health literacy was measured using 32 questions and cognition was measured using 19 tests. Annual diagnosis of AD dementia followed standard criteria. AD pathology was examined post-mortem by quantifying plaques and tangles. Cox models examined the association of literacy with incident AD dementia. Performance of model prediction for incident AD dementia was assessed using indices for integrated discrimination improvement and continuous net reclassification improvement. Linear regression models examined the independent association of literacy with AD pathology in autopsied participants. Results All 805 participants were free of dementia at baseline and 102 (12.7%) developed AD dementia during the follow-up. Lower literacy was associated with higher risk for incident AD dementia (pliteracy measure had better predictive performance than the one with demographics and cognition only. Lower literacy also was associated with higher burden of AD pathology after controlling for cognition (β=0.07, p=0.035). Conclusion Literacy predicts incident AD dementia and AD pathology in community-dwelling older persons, and the association is independent of traditional measures of cognition. PMID:28157101
Kukubajska, Marija Emilija; Koceva, Sonja
Economic disadvantage in less developed regions of the world is expected to result into higher illiteracy rate, among children in particular. Some developed countries do not follow this pattern. A paradox indicates: they pay special attention to nutrition and dietetics, yet record surprising illiteracy. Poor regions welcome new concepts of healthy nutrition and healthy education, while they also integrate existing traditional nutrition, just as developed societies promote health agricultural ...
Seo, Joann; Goodman, Melody S; Politi, Mary; Blanchard, Melvin; Kaphingst, Kimberly A
Participation in the decision-making process and health literacy may both affect health outcomes; data on how these factors are related among diverse groups are limited. This study examined the relationship between health literacy and decision-making preferences in a medically underserved population. We analyzed a sample of 576 primary care patients. Multivariable logistic regression was used to examine the independent association of health literacy (measured by the Rapid Estimate of Adult Literacy in Medicine-Revised) and patients' decision-making preferences (physician directed or patient involved), controlling for age, race/ethnicity, and gender. We tested whether having a regular doctor modified this association. Adequate health literacy (odds ratio [OR] = 1.7;P= 0.009) was significantly associated with preferring patient-involved decision making, controlling for age, race/ethnicity, and gender. Having a regular doctor did not modify this relationship. Males were significantly less likely to prefer patient-involved decision making (OR = 0.65;P= 0.024). Findings suggest health literacy affects decision-making preferences in medically underserved patients. More research is needed on how factors, such as patient knowledge or confidence, may influence decision-making preferences, particularly for those with limited health literacy. © The Author(s) 2016.
Reavley, Nicola J; McCann, Terence V; Jorm, Anthony F
With approximately 50% of young people aged 18-24 in tertiary education, these are potential settings for programmes to improve mental health literacy. A survey was carried out with students and staff of a tertiary education institution to investigate recognition of depression, help-seeking intentions, beliefs about interventions and stigmatizing attitudes. Students of an Australian metropolitan university (with staff as a comparison group) participated in a telephone interview. They answered questions relating to mental health literacy. Of the completed interviews, 774 (65%) were students and 422 (35%) were staff. Over 70% of students and staff were able to recognize depression in a vignette, with greater likelihood of recognition in students associated with older age, female gender, being born in Australia and a higher level of education. Over 80% of respondents said they would seek help if they had a problem similar to that of the vignette. However, rates of specific help-seeking intentions for students were relatively low, with only 26% nominating a general practitioner and only 10% nominating a student counsellor. Factors associated with stigmatizing attitudes included male gender, younger age, lower level of education, being born outside Australia and lack of recognition of depression. There is a need for mental health literacy interventions targeted at students, particularly those who are younger, male, born outside Australia and of a lower level of education. As rates of specific help-seeking intentions for students were relatively low, there is a need for further exploration of the barriers to help seeking from professional sources. © 2011 Blackwell Publishing Asia Pty Ltd.
Full Text Available Background and objective: Health Literacy refers to cognitive and social skills which determine the motivation and knowledge intended for people to obtain information and access to understand and using them to promote and keeping fitness. Regular physical activity is necessary for human. The purpose of this study was to investigate the relationship between Health Literacy and physical activity level of elderly women in the of Urmia city. Methods: In this descriptive – correlation study of 120 elderly women of Urmia were selected. In Order to collect data, two questionnaire Functional Health Literacy of TOFHLA adults and a physical activity questionnaire of Baekce was used. It was used SPSS software and one-sample T- test, and it was also conducted Pearson correlation and stepwise regression. Results: of 30% of the elderly had adequate Health Literacy 38/34 had inadequate health literacy and 31/64 had cross-border Health Literacy. Correlations were positive and significant correlation between adequate Health Literacy and physical activity were cross-border health physical activity in respectively. One-sample T-Tak results showed that the level Health Literacy in both access and reading in elderly women is higher than the average level in Urmia. Stepwise regression analysis showed that adequate health and cross-border Health Literacy can account for more than 80 percent of their sporting activities. Conclusion: In order to promote physical activity levels of elderly women it should be improved their health literacy. By planning and designing useful training in the field of Health Literacy programs tailored to the elderly it can be done effective step to develop literacy skills in community health and physical health of elderly. Paper Type: Research Article
May 20, 2011 ... Mobile Phone No: +2348034670349. Abstract ... significant relationships between maternal health literacy and antenatal care. (r = .445, df = 229, ... health literacy include knowledge and use of a healthy diet, taking actions to ... it is especially problematic among those of modest financial means, many of.
Braun, Bonnie; Kim, Jinhee; Anderson, Elaine A.
Families are at-risk of or experiencing a diminished quality of living and life in current economic times and difficult decisions are required. Health and financial literacy are the basis for wise personal and public decision making. Family and consumer sciences (FCS) professionals can forge connections between health and financial literacy to…
Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James
Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…
Braun, Robert T; Hanoch, Yaniv; Barnes, Andrew J
Under the Affordable Care Act (ACA), millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy - a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy. Whether tobacco users choose enough coverage in the marketplaces given their expected health care needs and are able to access health care services effectively is fundamentally related to understanding health insurance. However, no studies to date have examined this important relationship. Data were collected from 631 lower-income, minority, rural residents of Virginia. Health insurance literacy was assessed by asking four factual questions about the coverage options presented to them. Adjusted associations between tobacco use and health insurance literacy were tested using multivariate linear regression, controlling for numeracy, risk-taking, discount rates, health status, experiences with the health care system, and demographics. Nearly one third (31%) of participants were current tobacco users, 80% were African American and 27% were uninsured. Average health insurance literacy across all participants was 2.0 (SD 1.1) out of a total possible score of 4. Current tobacco users had significantly lower HIL compared to non-users (-0.22, p financial burdens on them and potentially limiting access to tobacco cessation and treatment programs and other needed health services.
Stableford, Sue; Mettger, Wendy
Low health literacy is a major challenge confronting American and international health organizations. Research in the past decade has documented the prevalence of limited literacy and limited health literacy skills among adults worldwide. This creates a major policy challenge: how to create text-based health information - a common method of health communication - that is accessible to the public. Plain language is a logical, flexible response. While touted by American, Canadian, and European health policy makers, adoption and promotion of plain language standards and skills in health-focused organizations have lagged. Most text-based health information continues to be too hard for most adults to read. Barriers to more rapid diffusion of plain language are reflected in a set of myths perpetuated by critics. These myths are identified and refuted. While plain language is only one of many broad-based solutions needed to address low health literacy, the benefits to everyone demand increased use by health organizations.
Lubetkin, Erica I; Zabor, Emily C; Isaac, Kathleen; Brennessel, Debra; Kemeny, M Margaret; Hay, Jennifer L
To assess heath literacy, health information seeking, and trust in health-related information among Haitian immigrants seen in primary care. Health literacy was measured by the Brief Health Literacy Screen (BHLS); items on health information use were from the 2007 Health Information National Trends Survey. BHLS scores differed according to age, education, and survey language. Participants with lower levels of health literacy tended to be more likely to place "a lot" or "some" trust in family and friends and religious organizations and leaders as sources of information about health or medical topics. Constructing a culturally-tailored and appropriate intervention regarding health promotion requires understanding how the population accesses and conveys health information.
Marks, David F
Kanazawa (2006) presented data allegedly supporting a racist version of evolutionary psychology that claims that the populations of wealthier and more egalitarian societies live longer and stay healthier, not because they are wealthier and more egalitarian, but because they are more intelligent. The objectives of this study are: (i) to determine the relationship between IQ and literacy in Kanazawa's sample of countries and (ii) to reanalyse Kanazawa's dataset using measures of literacy in lieu of national IQ test scores. Correlation and regression were employed. National literacy scores across the countries in the sample are highly skewed. In spite of this, the literacy measures are highly correlated with alleged differences in national IQ (r = .83-.86). The measure of literacy together with economic development (GDPpc) and income inequality (Gini coefficient) control at least 59-64% of the variance in national life expectancy at birth. There is no scientific justification for believing that alleged intelligence differences play any role in explaining international differences in health status. Measures of alleged national IQ scores are highly confounded with differences in literacy. Literacy is a key factor in the health of any community and policies designed to enhance the literacy of a population are expected to lead to significant improvements in health status.
Meppelink, Corine S; Smit, Edith G; Buurman, Bianca M; van Weert, Julia C M
It is often recommended that health information should be simplified for people with low health literacy. However, little is known about whether messages adapted to low health literacy audiences are also effective for people with high health literacy, or whether simple messages are counterproductive in this group. Using a two (illustrated vs. text-only) by two (nondifficult vs. difficult text) between-subjects design, we test whether older adults with low (n = 279) versus high health literacy (n = 280) respond differently to colorectal cancer screening messages. Results showed that both health literacy groups recalled information best when the text was nondifficult. Reduced text difficulty did not lead to negative attitudes or less intention to have screening among people with high health literacy. Benefits of illustrations, in terms of improved recall and attitudes, were only found in people with low health literacy who were exposed to difficult texts. This was not found for people with high health literacy. In terms of informed decisions, nondifficult and illustrated messages resulted in the best informed decisions in the low health literacy group, whereas the high health literacy group benefited from nondifficult text in general, regardless of illustrations. Our findings imply that materials adapted to lower health literacy groups can also be used for a more general audience, as they do not deter people with high health literacy.
Monkman, Helen; Griffith, Janessa; Kushniruk, Andre W
Heuristic evaluations have proven to be valuable for identifying usability issues in systems. Commonly used sets of heuritics exist; however, they may not always be the most suitable, given the specific goal of the analysis. One such example is seeking to evaluate the demands on eHealth literacy and usability of consumer health information systems. In this study, eight essential heuristics and three optional heuristics subsumed from the evidence on eHealth/health literacy and usability were tested for their utility in assessing a mobile blood pressure tracking application (app). This evaluation revealed a variety of ways the design of the app could both benefit and impede users with limited eHealth literacy. This study demonstrated the utility of a low-cost, single evaluation approach for identifying both eHealth literacy and usability issues based on existing evidence in the literature.
Widiyawati, W.; Fitriani, A.; Priyandoko, D.
This research aims to describe the high school student’s health literacy profile based on their knowledge, attitude, and behavior to health of respiration. This descriptive study involved 65 participants of senior high school students of Ciamis city. Research instruments for collecting data are test and questionnaires sheets. The data were analyzed using quantitative descriptive analysis. The results showed that student’s health literacy of respiration get mean 109.94, moderate category. Based on the above results, it can be concluded that student’s health literacy of respiration is enough because student’s health literacy are in the moderate category, but it needs to be improved by the classroom learning in accompanied by changing some of the lesser habits in maintaining respiratory health.
Nair, Satish Chandrasekhar; Satish, Karthyayani Priya; Sreedharan, Jayadevan; Ibrahim, Halah
Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restrict, health information access and utilization for those with low literacy. By employing expert panel, Delphi technique, focus group methodologies, and pre-testing using participants (N = 900) from the UAE and India, a survey construct to the Eastern-Middle Eastern cultures was developed. Reliability was assessed using Cronbach's α and validity using Factor analysis. Kiaser-Meyer-Olkin (KMO) sampling adequacy and Bartlett's tests were used to assess the strength of the relationship among the variables. Inclusion of non-health related items were found to be critical in the authentic assessment of health literacy in the Eastern and Middle Eastern population given the influence of social desirability. Thirty-two percentage of the original 19-item construct was eliminated by the focus group for reasons of relevance and impact for the local culture. Field pretesting participants from two countries, indicated overall construct reliability (Cronbach's α =0.85), validity and consistency (KMO value of 0.92 and Bartlett's test of sphericity was significant). The Eastern-Middle Eastern Adult Health Literacy (EMAHL13), screening instrument is brief, simple, a useful indicator of whether or not a patient can read. It assessespatients' ability to comprehend by distinguishing between health and non-health related items. The EMAHL13 will be a useful too for the reliable assessment of health literacy in countries, where culture plays a significant impact. This will be the first steptowards providing
Burgette, J M; Lee, J Y; Baker, A D; Vann, W F
The objectives of this study were to examine the pattern of association between dental utilization and oral health literacy (OHL). As part of the Carolina Oral Health Literacy Project, clients in the Women, Infants, and Children's Special Supplemental Nutrition Program completed a structured 30-min in-person interview conducted by 2 trained interviewers at 9 sites in 7 counties in North Carolina. Data were collected on clients' OHL, sociodemographics, dental utilization, self-efficacy, and dental knowledge. The outcome, OHL, was measured with a dental word recognition test (30-item Rapid Estimate of Adult Literacy in Dentistry). Descriptive and multiple linear regression methods were used to examine the distribution of OHL and its association with covariates. After adjusting for age, education, race, marital status, self-efficacy, and dental knowledge, multiple linear regression showed that dental utilization was not a significant predictor of OHL (P > 0.05). Under the conditions of this study, dental utilization was not a significant predictor of OHL. © International & American Associations for Dental Research 2015.
R. V. Rikard
Full Text Available Abstract Background In the United States, disparities in health literacy parallel disparities in health outcomes. Our research contributes to how diverse indicators of social inequalities (i.e., objective social class, relational social class, and social resources contribute to understanding disparities in health literacy. Methods We analyze data on respondents 18 years of age and older (N = 14,592 from the 2003 National Assessment of Adult Literacy (NAAL restricted access data set. A series of weighted Ordinary Least Squares (OLS regression models estimate the association between respondent’s demographic characteristics, socioeconomic status (SES, relational social class, social resources and an Item Response Theory (IRT based health literacy measure. Results Our findings are consistent with previous research on the social and SES determinants of health literacy. However, our findings reveal the importance of relational social status for understanding health literacy disparities in the United States. Objective indicators of social status are persistent and robust indicators of health literacy. Measures of relational social status such as civic engagement (i.e., voting, volunteering, and library use are associated with higher health literacy levels net of objective resources. Social resources including speaking English and marital status are associated with higher health literacy levels. Conclusions Relational indicators of social class are related to health literacy independent of objective social class indicators. Civic literacy (e.g., voting and volunteering are predictors of health literacy and offer opportunities for health intervention. Our findings support the notion that health literacy is a social construct and suggest the need to develop a theoretically driven conceptual definition of health literacy that includes a civic literacy component.
Larsen, Anne Konring; Holtermann, Andreas; Mortensen, Ole Steen
of the workplace as an arena for improving health literacy has developed emphasizing the organizational responsibility in facilitating and supporting that employees obtain basic knowledge and information needed to understand and take action on individual and occupational health concerns. The literature about...... workplace health literacy is very limited but points at the importance of educating employees to be able to access, appraise and apply health information and of organizing the infrastructure and communication in the organization. This study suggests a concrete operationalization of health literacy...... and effect of workplace health initiatives might be due to the fact that pain and the consequences of pain are affected by various individual, interpersonal and organizational factors in a complex interaction. Recent health literacy models pursue an integrated approach to understanding health behavior...
Suri, Venkata Ratnadeep; Majid, Shaheen; Chang, Yun-Ke; Foo, Schubert
The aim of this study is to investigate the relationship between five domain-specific skills of health literacy: Find Health Information (FHI), Appraise Health Information (AHI), Understand Health Information to act (UHI), Actively Manage One's Health (AMH), and E-health literacy (e-Heals), and health information seeking behaviors and three categories of health outcomes. A survey was implemented and data was collected from 1062 college going adults and analyzed using bivariate tests and multiple regression analysis. Among the five domain-specific Health Literacy skills, AHI and e-Heals were significantly associated with the use of traditional sources and the Internet for healthcare information respectively. Similarly and AMH and e-Heals were significantly associated with the use of traditional sources and the Internet for health lifestyle information respectively. Lastly AHI, AMH and e-Heals were significantly associated with the three categories of outcomes, and AFH was significantly associated with cognitive and instrumental outcomes, but not doctor-patient communication outcomes. Consumers' ability to use different health sources for both healthcare and health lifestyle information, and the three categories of health outcomes are associated with different domain-specific health literacy skills. Health literacy initiatives may be improved by focusing on clients to develop domain-specific skills that increase the likelihood of using health information sources and accrue benefits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Tubaishat, Ahmad; Habiballah, Laila
The Internet has become a major source of health related information. Nursing students, as future healthcare providers, should be skilled in locating, using and evaluating online health information. The main purpose of this study was to assess eHealth literacy among nursing students in Jordan, as well as to explore factors associated with eHealth literacy. A descriptive cross sectional survey was conducted in two universities in Jordan, one public and one private. A total of 541 students completed the eHealth literacy scale (eHEALS). Some additional personal and demographical variables were collected to explore their relation to eHealth literacy. Students have a moderate self-perceived level of eHealth literacy (M=3.62, SD=0.58). They are aware of the available online health resources and know how to search, locate, and use these resources. Yet, they lack skills to evaluate them and cannot differentiate between high and low quality resources. Factors that are related to eHealth literacy include type of university, type of student admission, academic level, students' internet skills, and their perception of the usefulness and importance of the internet. On the other hand, age, gender, grade point average (GPA), and frequency of internet use were found not to significantly affect eHealth literacy. This study represents a baseline reference for eHealth literacy in Jordan. Students have some of the necessary skills, while others still need to be improved. Nursing educators and administrators should incorporate eHealth literacy skills into the curriculum. Copyright © 2016 Elsevier Ltd. All rights reserved.
Marzieh Saeedi Koupai
Full Text Available Methods: the present study is descriptive-analytical with comparative type and the statistical population included 200 secondary female school students and their mothers who were randomly selected. The tool to collect data was a two-part researcher-made questionnaire the first part whereof involved demographic information and the second part includes 41 questions of health literacy about women’s health in 5 aspects of menstruation hygiene, nutrition, breast self-examination, body activity, iron deficiency anemia. Reliability and validity of the questionnaire were confirmed and the data were analyzed via SPSS22 software. Results: there was not observed any significant difference in three aspects of menstruation hygiene, nutrition and breast self-examination between mean scores of two female groups and their mothers according to Mann-Whitney instability test (p>0.05; however, there was a significant difference in the aspects of body activities and iron deficiency anomia (p<0.05. Conclusion: taking the results of the study, high school female students under study and their mothers have average healthy literacy level regarding women’s health. Therefore, considering the fact that the girls receive greatest education in the field of women’s hygiene from their mothers in the adolescence, the necessity of diagnosing limiters of health literacy in the society and specific attention to the mothers’ teaching and including curriculum of health literacy for female students are advised to promote health. Paper Type: Research Article.
Feranie, Selly; Efendi, Ridwan; Karim, Saeful; Sasmita, Dedi
The PISA results for Indonesian Students are lowest among Asian countries in the past two successive results. Therefore various Innovations in science learning process and its effectiveness enhancing student's science literacy is needed to enrich middle school science teachers. Literacy strategies have been implemented on health technologies theme learning to enhance Indonesian Junior high school Student's Physics literacy in three different health technologies e.g. Lasik surgery that associated with application of Light and Optics concepts, Ultra Sonographer (USG) associated with application of Sound wave concepts and Work out with stationary bike and walking associated with application of motion concepts. Science learning process involves at least teacher instruction, student learning and a science curriculum. We design two main part of literacy strategies in each theme based learning. First part is Integrated Reading Writing Task (IRWT) is given to the students before learning process, the second part is scientific investigation learning process design packed in Problem Based Learning. The first part is to enhance student's science knowledge and reading comprehension and the second part is to enhance student's science competencies. We design a transformation from complexity of physics language to Middle school physics language and from an expensive and complex science investigation to a local material and simply hands on activities. In this paper, we provide briefly how literacy strategies proposed by previous works is redesigned and applied in classroom science learning. Data were analysed using t- test. The increasing value of mean scores in each learning design (with a significance level of p = 0.01) shows that the implementation of this literacy strategy revealed a significant increase in students’ physics literacy achievement. Addition analysis of Avarage normalized gain show that each learning design is in medium-g courses effectiveness category
O'Hara, Jonathan; Hawkins, Melanie; Batterham, Roy; Dodson, Sarity; Osborne, Richard H; Beauchamp, Alison
The aim of this study was to develop a tool to support health workers' ability to identify patients' multidimensional health literacy strengths and challenges. The tool was intended to be suitable for administration in healthcare settings where health workers must identify health literacy priorities as the basis for person-centred care. Development was based on a qualitative co-design process that used the Health Literacy Questionnaire (HLQ) as a framework to generate questions. Health workers were recruited to participate in an online consultation, a workshop, and two rounds of pilot testing. Participating health workers identified and refined ten questions that target five areas of assessment: supportive professional relationships, supportive personal relationships, health information access and comprehension, current health behaviours, and health promotion barriers and support. Preliminary evidence suggests that application of the Conversational Health Literacy Assessment Tool (CHAT) can support health workers to better understand the health literacy challenges and supportive resources of their patients. As an integrated clinical process, the CHAT can supplement existing intake and assessment procedures across healthcare settings to give insight into patients' circumstances so that decisions about care can be tailored to be more appropriate and effective.
Luis Soares Luis
Full Text Available Background The development of a new food product aims to respond to consumer ́s concerns related to food and health promotion. Education plays a fundamental role in consumer’s behavior by providing tools that allows them to make informed decisions. Consumer’s empowerment is essential to the success of a health promotion strategy, also the knowledge of health literacy level is important to define a proper health policy. The aim of this study is to evaluate health literacy level and new foods consumption behavior (especially neophobic and neophilic behavior of the Lisbon area residents in Portugal. Methods A questionnaire, that includes the Portuguese version of the Newest Vital Sign, was applied to a stratified sample of 384 individuals (over 15 years old living in the Lisbon area in Portugal distributed accordingly to 2001 Census. Health literacy was evaluated by the Portuguese version of NVS, a tool by which a number of health-related information, in this case nutritional information written in a food label, is used to demonstrate one’s ability to use it to answer to questions. Data analysis was performed in SPSS®, version 19. Results Study results show that there is a close relationship between health literacy and general literacy. It is also clear that health literacy level is low for the majority of the participants and that this factor is relevant in new foods consumption, by positively affecting neophilia. Older individuals, with lower school years attendance and health literacy, are the main consumers with neophobic behavior. Higher health literacy is also directly associated with consumers concerns on how the product was manufactured and on environmental characteristics. There is no statistical association between gender and health literacy, but it is of relevance the fact that an association between health literacy and food neophilia is statistically significant. Conclusion Considering that new food products may improve health
Tsai, Hsiu-Min; Cheng, Ching-Yu; Chang, Shu-Chen; Yang, Yung-Mei; Wang, Hsiu-Hung
To understand the current status of health literacy and the relationship between health literacy and health-promoting behaviors among multiethnic groups of women in Taiwan. Convenience and snowball sampling methods were used to recruit study participants. Data were collected using a cross-sectional questionnaire survey. We recruited community female adults who lived in greater Taipei or Taoyuan areas (northern Taiwan) from January 1, 2010 through June 30, 2011. A total of 378 female participants were contacted, of which 351 consented to participate and 347 completed valid questionnaires for analysis. Health literacy was measured with the Taiwan Health Literacy Scale, and health-promoting behaviors were measured by the Chinese version of the Health-Promoting Lifestyle Profile. Participants had a moderate level of health literacy, and one third of them had inadequate health literacy. Participants with inadequate health literacy were more likely to be younger, not a high school graduate, and Vietnamese; to have a low monthly family income and no diagnosed diseases; to use a second language; and to regard TV/radio as the most useful source of health information. Health literacy alone could significantly predict health-promoting behaviors among the participants. Our findings confirmed that low health literacy is prevalent among underprivileged women in Taiwan. Health-related programs that are literacy sensitive and culturally appropriate are needed to teach and encourage health-promoting behaviors. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Elsborg, Lea; Krossdal, Fie; Kayser, Lars
Aims: It is important to address people’s health literacy when providing health care. Health professionals should be aware of, and have insight into, people’s health literacy when they provide health services. Health professionals need to be health literate themselves. We examined the level...
Fransen, M. P.; van Schaik, T. M.; Twickler, T. B.; Essink-Bot, M. L.
Health literacy measures for use in clinical-epidemiological research have all been developed outside Europe. In the absence of validated Dutch measures, we evaluated the cross-cultural applicability of the Rapid Estimate of Adult Literacy in Medicine (REALM), the Newest Vital Sign (NVS), the Set of
Paakkari, Leena; Kokko, Sami; Villberg, Jari; Paakkari, Olli; Tynjälä, Jorma
The aim of this research was to compare the levels of perceived health literacy among adolescents who do or do not participate in sports club activities. Organized sport club activities reach a high proportion of adolescents, and have the potential to contribute to the development of their health literacy. The cross-sectional data on health literacy among school children in Finland (aged 13 and 15, n=3852) were measured, as a part of the Health Behaviour in School-Aged Children (HBSC) study, using the Health Literacy for School-aged Children (HLSAC) instrument. Sports club participation and its association with health literacy were examined in relation to age, gender, family affluence, school achievement, and physical activity. The statistical analyses included cross-tabulation and the multilevel mixed-effects logistic regression analyses. Perceived health literacy was higher among adolescents who participated in sports club activities. This conclusion was valid for boys and girls, for both age groups, among those who were physically active 6-7 days a week, had at least moderate school achievement, and those who belonged to the middle or high affluence families. From the health literacy perspective, participation in sports club activities was especially beneficial for those having low or moderate school achievement level. The sports club setting may work towards equalizing health literacy differences related to school achievement. However, the clubs should ensure that access is available to as many adolescents as possible; by this means they may spread beneficial influences, supporting the development of health literacy among broader population groups.
McKee, Michael M.; Paasche-Orlow, Michael; Winters, Paul C.; Fiscella, Kevin; Zazove, Philip; Sen, Ananda; Pearson, Thomas
Communication and language barriers isolate Deaf American Sign Language (ASL) users from mass media, healthcare messages, and health care communication, which when coupled with social marginalization, places them at a high risk for inadequate health literacy. Our objectives were to translate, adapt, and develop an accessible health literacy instrument in ASL and to assess the prevalence and correlates of inadequate health literacy among Deaf ASL users and hearing English speakers using a cross-sectional design. A total of 405 participants (166 Deaf and 239 hearing) were enrolled in the study. The Newest Vital Sign was adapted, translated, and developed into an ASL version of the NVS (ASL-NVS). Forty-eight percent of Deaf participants had inadequate health literacy, and Deaf individuals were 6.9 times more likely than hearing participants to have inadequate health literacy. The new ASL-NVS, available on a self-administered computer platform, demonstrated good correlation with reading literacy. The prevalence of Deaf ASL users with inadequate health literacy is substantial, warranting further interventions and research. PMID:26513036
Full Text Available The main goal of this study was to identify the factors which are most associated with the progress in reading literacy assessed in the PISA survey. In the preliminary sample, students from ten schools (N=235 were retested two years after the 2009 PISA original study. There were measured intrinsic and extrinsic motivation, school self-efficacy, epistemological beliefs, metacognitive strategies, socio-economic status, enjoyment and preference for reading and motivation and self-regulation. The examined factors explain 27% of the variance in reading literacy progress. Factors that contribute most to this progress are school self-efficacy, proper use of metacognitive strategies and low extrinsic motivation. Socio-economic status explained a negligible amount of variance, while some effect of type of school on progress in reading literacy (η2=7% was observed. Achievement in reading literacy is correlated with school marks. Students who attend secondary schools are more likely to make progress in reading literacy than those who attend vocational schools. An attempt was made to formulate the implications for education policy based on this research.
Griebel, Lena; Enwald, Heidi; Gilstad, Heidi; Pohl, Anna-Lena; Moreland, Julia; Sedlmayr, Martin
The concept of electronic health (eHealth) literacy evolved from the social and information sciences and describes competencies necessary to use electronic health services. As it is a rather new topic, and as there is no current overview of the state of the art in research, it is not possible to identify research gaps. Therefore, the objective of this viewpoint article is to increase knowledge on the current state of the art of research in eHealth literacy and to identify gaps in scientific research which should be focused on by the research community in the future. The article provides a current viewpoint of the concept of eHealth literacy and related research. Gaps can be found in terms of a missing "gold standard" regarding both the definition and the measurement of eHealth literacy. Furthermore, there is a need for identifying the implications on eHealth developers, which evolve from the measurement of eHealth literacy in eHealth users. Finally, a stronger inclusion of health professionals, both in the evolving concept and in the measurement of eHealth literacy, is needed in the future.
Abstract Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.
Full Text Available Background & aim: Health literacy is the degree to which individuals can obtain, process, and understand the required basic health information and services to enhance and sustain good health status. Mothers with higher health literacy may have more physical activity than others in the postpartum period. This study sought to assess the effect of an educational program based on health literacy strategies on promoting physical activity in postpartum women. Methods: This quasi-experimental study conducted on 80 postpartum women who referred to healthcare centers of Mashhad, Iran, 2016, and randomly selected by multistage cluster sampling method. The subjects were placed in two groups of control and intervention (n=40 for each group. The intervention group received three 80-min theoretical and practical training sessions based on the health literacy strategies, while the control group received the routine care. Data was collected using Short Test of Functional Health Literacy in Adults (S-TOFHLA, Rapid Estimate of Adult Literacy in Medicine (REALM, and International Physical Activity Questionnaire (IPAQ before and eight weeks after training. Data analysis was performed using the chi-square, independent and paired t-tests with SPSS software version 16. Results: There was no significant difference between the levels of health literacy and physical activity among the groups before intervention; however, eight weeks after the educational intervention, the levels of both health literacy and physical activity significantly increased among the intervention group (P
Peerson, Anita; Saunders, Margo
'Health literacy' refers to accessing, understanding and using information to make health decisions. However, despite its introduction into the World Health Organization's Health Promotion Glossary, the term remains a confusing concept. We consider various definitions and measurements of health literacy in the international and Australian literature, and discuss the distinction between the broader concept of 'health literacy' (applicable to everyday life) and 'medical literacy' (related to individuals as patients within health care settings). We highlight the importance of health literacy in relation to the health promotion and preventive health agenda. Because health literacy involves knowledge, motivation and activation, it is a complex thing to measure and to influence. The development of health literacy policies will be facilitated by better evidence on the extent, patterns and impact of low health literacy, and what might be involved in improving it. However, the current lack of consensus of definitions and measurement of health literacy will first need to be overcome.
The papers II and III of this thesis are not available in Munin. Paper II: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl, J.: “The association between oral health literacy and alexithymia: Implications for patient-clinician communication”. (Manuscript). Published version with title “Exploring the association between oral health literacy and alexithymia” available in Community Dental Health 2015, 32(3):143 - 147. Paper III: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl...
Full Text Available The concept of eHealth literacy is beginning to be recognized as a being of key importance in the design and adoption of effective and efficient health information systems and applications targeted to lay people and patients. Indeed, many systems such as patient portals and personal health records have not been adopted due to a mismatch between the level of eHealth literacy demanded by a system and the level of eHealth literacy possessed by end users. The purpose of this paper is to present an overview of important concepts related to eHealth literacy, as well as how the notion of eHealth literacy can be applied to improve the design and adoption of consumer health information systems. This paper begins with describing the importance of eHealth literacy with respect to design of health applications for the general public paired with examples of consumer health information systems whose limited success and adoption has been attributed to the lack of consideration for eHealth literacy. This is followed by definitions of what eHealth literacy is and how it emerged from the related concept of health literacy. A model for conceptualizing the importance of aligning consumers’ eHealth literacy skills and the demands systems place on their skills is then described. Next, current tools for assessing consumers’ eHealth literacy levels are outlined, followed by an approach to systematically incorporating eHealth literacy in the deriving requirements for new systems is presented. Finally, a discussion of evolving approaches for incorporating eHealth literacy into usability engineering methods is presented.
Flynn, Priscilla; Acharya, Amit; Schwei, Kelsey; VanWormer, Jeffrey; Skrzypcak, Kaitlyn
This primary aim of this study was to assess communication techniques used with low oral health literacy patients by dental hygienists in rural Wisconsin dental clinics. A secondary aim was to determine the utility of the survey instrument used in this study. A mixed methods study consisting of a cross-sectional survey, immediately followed by focus groups, was conducted among dental hygienists in the Marshfield Clinic (Wisconsin) service area. The survey quantified the routine use of 18 communication techniques previously shown to be effective with low oral health literacy patients. Linear regression was used to analyze the association between routine use of each communication technique and several indicator variables, including geographic practice region, oral health literacy familiarity, communication skills training and demographic indicators. Qualitative analyses included code mapping to the 18 communication techniques identified in the survey, and generating new codes based on discussion content. On average, the 38 study participants routinely used 6.3 communication techniques. Dental hygienists who used an oral health literacy assessment tool reported using significantly more communication techniques compared to those who did not use an oral health literacy assessment tool. Focus group results differed from survey responses as few dental hygienists stated familiarity with the term "oral health literacy." Motivational interviewing techniques and using an integrated electronic medical-dental record were additional communication techniques identified as useful with low oral health literacy patients. Dental hygienists in this study routinely used approximately one-third of the communication techniques recommended for low oral health literacy patients supporting the need for training on this topic. Based on focus group results, the survey used in this study warrants modification and psychometric testing prior to further use. Copyright © 2016 The American Dental
Ganzer, Christine A; Insel, Kathleen C; Ritter, Leslie S
Stroke remains a major cause of mortality and disability among older adults. Although early treatment after stroke is known to reduce both mortality and disability, the first step in seeking early treatment is dependent on the rapid recognition of the signs of stroke. Recall of the signs of stroke may be dependent on factors that exist before the stroke itself. Although it is known that both working memory and health literacy decline with advancing age, these factors have not been thoroughly examined with respect to recall of the signs of stroke. Therefore, the purpose of the current study was to investigate associations between working memory, health literacy, and recall of the signs of stroke among older adults. Community dwelling older adults (≥65 years of age) were recruited from two senior centers. Fifty-six participants meeting inclusion criteria provided demographic and health information and were asked to read a public service brochure listing the five warning signs of stroke. Working memory was then assessed using the Wechsler Adult Intelligence Scale 3rd Edition Working Memory Index. Health literacy was assessed by the Short Test of Functional Health Literacy in Adults. Participants' recall of the five warning signs of stroke was evaluated. The mean age was 80.4 years. The mean number of the signs of stroke recalled was 2.9 ± 1.33. Working memory and health literacy were positively correlated with recall of the signs of stroke (r = .38, p recall. There was no statistically significant interaction between working memory and health literacy. Findings from this study indicate that working memory and health literacy were associated with successful recall of the warning signs of stroke in older adults. Further studies are needed to determine if programs that include cognitive and literacy assessments could identify older adults who need additional support to learn and recall the signs of stroke.
Full Text Available To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members.A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community.Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community" and the levels of health literacy (low, medium, high among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities.Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%. Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core
Catherine Santanello, PhD; Lakesha M Butler, PharmD, BCPS; Radhika Devraj, PhD
Objectives: 1) To describe the development of a health literacy video tailored for pharmacy students. 2) To compare the use of a health literacy video as an instructional method to a previously used health literacy instructional strategy by using both and: a) assessing pharmacy students' perceptions of their ability to communicate with low health literacy patients and b) assessing pharmacy students' perceptions of their overall understanding of the role of health literacy in a pharmacy settin...
Full Text Available There is growing recognition of the important role that eHealth Literacy strategies play in promoting mental health among youth populations. At the same time, youth engagement in mental health literacy initiatives is increasingly seen as a promising practice for improving health literacy and reducing stigma. The Health Literacy Team at BC Children’s Hospital uses a variety of strategies to engage youth in the development, implementation and dissemination of eMental Health Literacy resources. This paper reviews the evidence that supports the use of eHealth strategies for youth mental health promotion; describes the methods used by the Team to meaningfully engage youth in these processes; and evaluates them against three popular frameworks for youth participation and empowerment. The findings suggest that the Team is successfully offering opportunities for independent youth involvement, positively impacting project outcomes, and fostering youth empowerment. The Team could further contribute to the positive development of youth by creating more opportunities for youth-adult collaboration on eHealth Literacy initiatives.
Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li
Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p
Full Text Available Mental health literacy (MHL is considered a prerequisite for early recognition and intervention in mental disorders, and for this reason, it has become a focus of research over the past few decades. Assessing this construct is relevant for identifying knowledge gaps and erroneous beliefs concerning mental health issues, to inform the development of interventions aimed at promoting mental health literacy as well as the evaluation of these interventions. Recently, we developed a new self-reporting measure (MHLq for assessing mental health literacy in young people (12–14 years-old, meeting the need to assess MHL from a comprehensive perspective of the construct instead of focusing on a restricted number of mental disorders or specific dimensions (e.g., knowledge concerning specific disorders; stigma. The present study aimed to adapt the MHLq for the young adult population and to examine its psychometric properties, according to the following steps: (1 item adaptation, using a think aloud procedure (n = 5; (2 data collection (n = 356, aged between 18 and 25 years old; and (3 psychometric analyses (exploratory factor analysis and internal consistency analysis. The final version of the questionnaire included 29 items (total scale α = 0.84, organized by four dimensions: (1 knowledge of mental health problems (α = 0.74; (2 erroneous beliefs/stereotypes (α = 0.72; (3 help-seeking and first aid skills (α = 0.71; and (4 self-help strategies (α = 0.60. The results suggest that the MHLq-adult form is a practical, valid, and reliable screening tool for identifying gaps in knowledge, beliefs, and behavioral intentions related to mental health and mental disorders, planning promotion programs, and evaluating intervention effectiveness.
Taguchi, Atsuko; Murayama, Hiroshi; Murashima, Sachiyo
To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members). A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers. The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community") and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities. Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core health
Taguchi, Atsuko; Murayama, Hiroshi; Murashima, Sachiyo
Objectives To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members). Study Design A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers. Methods The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities (“healthy lifestyle,” “outreach to family,” “outreach to community”) and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers’ outreach activities. Results Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the
Levy, Helen; Janke, Alexander T; Langa, Kenneth M
Among the requirements for meaningful use of electronic medical records (EMRs) is that patients must be able to interact online with information from their records. However, many older Americans may be unprepared to do this, particularly those with low levels of health literacy. The purpose of the study was to quantify the relationship between health literacy and use of the Internet for obtaining health information among Americans aged 65 and older. We performed retrospective analysis of 2009 and 2010 data from the Health and Retirement Study, a longitudinal survey of a nationally representative sample of older Americans. Subjects were community-dwelling adults aged 65 years and older (824 individuals in the general population and 1,584 Internet users). Our analysis included measures of regular use of the Internet for any purpose and use of the Internet to obtain health or medical information; health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R) and self-reported confidence filling out medical forms. Only 9.7% of elderly individuals with low health literacy used the Internet to obtain health information, compared with 31.9% of those with adequate health literacy. This gradient persisted after controlling for sociodemographic characteristics, health status, and general cognitive ability. The gradient arose both because individuals with low health literacy were less likely to use the Internet at all (OR = 0.36 [95% CI 0.24 to 0.54]) and because, among those who did use the Internet, individuals with low health literacy were less likely to use it to get health or medical information (OR = 0.60 [95% CI 0.47 to 0.77]). Low health literacy is associated with significantly less use of the Internet for health information among Americans aged 65 and older. Web-based health interventions targeting older adults must address barriers to substantive use by individuals with low health literacy, or risk exacerbating the
van der Gaag, Marieke; van der Heide, Iris; Spreeuwenberg, Peter M M; Brabers, Anne E M; Rademakers, Jany J D J M
In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations between health literacy and health care use, and between ethnicity and health literacy have been studied separately, but, so far, have not been linked to each other. In the Netherlands, some expectations have been expressed with regard to supposed low health literacy of ethnic minority groups, however, no empirical study has been done so far. The objectives of this study are therefore to acquire insight into the level of health literacy of ethnic minorities in the Netherlands and to examine whether the relationship between ethnicity and health care use can be (partly) explained by health literacy. A questionnaire was sent to a sample of 2.116 members of the Dutch Health Care Consumer Panel (response rate 46%, 89 respondents of non-western origin). Health literacy was measured with the Health Literacy Questionnaire (HLQ) which covers nine different domains. The health literacy levels of ethnic minority groups were compared to the indigenous population. A negative binomial regression model was used to estimate the association between ethnicity and GP visits. To examine whether health literacy is an explaining factor in this association, health literacy and interaction terms of health literacy and ethnicity were added into the model. Differences in levels of health literacy were only found between the Turkish population and the indigenous Dutch population. This study also found an association between ethnicity and GP visits. Ethnic minorities visit their GP 33% more often than the indigenous population. Three domains of the HLQ (the ability to navigate the health care system, the ability to find information and to read and understand health information) partly explained the association
Full Text Available This is an exploratory case study aimed at investigating whether or not International English Language Testing Systems (IELTS scores correspond with literacy levels. During the 2011-2012 academic year, 20 first semester students in the English Literature Program in the Faculty of Language and Cultural Studies (Fakultas Bahasa dan Ilmu Budaya at Universitas Stikubank (UNISBANK were randomly selected to take the IELTS. Results were matched against predetermined criteria for literacy levels (Hammond, et al. 1992 in order to classify them into the appropriate levels of literacy. Findings indicate that all students (100 percent were at the performative level of literacy with respect to their overall IELTS scores. Only 25 percent of the students on the speaking subtest and 20 percent of the students on the reading subtest managed to test at the functional level. It is therefore recommended that action research be conducted in Central Java level to upgrade the level of literacy from the performative level up to the informative level. As well, similar research may be conducted with a multi-disciplinary approach employing a correlational study between IELTS band scores with literacy levels.
Wang, Weiwen; Sun, Ran; Mulvehill, Alice M; Gilson, Courtney C; Huang, Linda L
Patient care problems arise when health care consumers and professionals find health information on the Internet because that information is often inaccurate. To mitigate this problem, nurses can develop Web literacy and share that skill with health care consumers. This study evaluated a Web-literacy intervention for undergraduate nursing students to find reliable Web-based health information. A pre- and postsurvey queried undergraduate nursing students in an informatics course; the intervention comprised lecture, in-class practice, and assignments about health Web site evaluation tools. Data were analyzed using Wilcoxon and ANOVA signed-rank tests. Pre-intervention, 75.9% of participants reported using Web sites to obtain health information. Postintervention, 87.9% displayed confidence in using an evaluation tool. Both the ability to critique health Web sites (p = .005) and confidence in finding reliable Internet-based health information (p = .058) increased. Web-literacy education guides nursing students to find, evaluate, and use reliable Web sites, which improves their ability to deliver safer patient care. [J Nurs Educ. 2017;56(2):110-114.]. Copyright 2017, SLACK Incorporated.
Mcluckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia
Enhancement of mental health literacy for youth is a focus of increasing interest for mental health professionals and educators alike. Schools are an ideal site for addressing mental health literacy in young people. Currently, there is limited evidence regarding the impact of curriculum-based interventions within high school settings. We examined the effect of a high-school mental health curriculum (The Guide) in enhancing mental health literacy in Canadian schools. We conducted a secondary analysis on surveys of students who participated in a classroom mental health course taught by their usual teachers. Evaluation of students' mental health literacy (knowledge/attitudes) was completed before and after classroom implementation and at 2-month follow-up. We used paired-samples t-tests and Cohen's d value to determine the significance and impact of change. There were 265 students who completed all surveys. Students' knowledge significantly improved between pre- and post-tests (p mental health. This is the first study to demonstrate the positive impact of a curriculum-based mental health literacy program in a Canadian high school population.
Conclusions: The results suggest a significant relationship between the LH and BMI. It is found that, the better the LH, the more appropriate is the BMI. This evidence reinforces the importance of promoting literacy for health to the Portuguese population.
Bolanle A. Olaniran
Full Text Available We live in a digital world or digital era. Hence, People will argue that not only do information communication technologies (ICTs make e-health possible but rather that it is an innovation advance whose time has come. Notwithstanding, e-health while hoping to create well needed improvement in health care, it is rife with certain challenges which are not limited to e-health literacy. However, this paper looks specifically at e-health literacy. The paper, in particular overviews e-health while addressing the impacts of key contextual factors that impacts e-health and e-health literacy regarding the propensity to adopt and use e-health in LEDCs.
Literacy testing objects as co-actors in framing bilingual children´s literacy development Based on Latour´s theoretical perspective that human beings delegate roles and responsibility to artifacts, it becomes important to track and research the objects that circulate within and between “sites...... of human social interaction” (Latour, 2005). Latour argues that objects – e.g. a literacy testing instrument – play a central role through the meaning, human beings delegate to objects. In this way objects become co-actors in a network through the agency human actors delegate to them, and objects mediate...... categories and artifacts based on the local context. The second is termed “globalising connects” that brings local actors in line with bigger and remote networks. In order to understand the semiotic function of artifacts in a meaning making network an ethnographic oriented approach with a focus on actor...
Brega, A G; Thomas, J F; Henderson, W G; Batliner, T S; Quissell, D O; Braun, P A; Wilson, A; Bryant, L L; Nadeau, K J; Albino, J
Health literacy is 'the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions'. Although numerous studies show a link between health literacy and clinical outcomes, little research has examined the association of health literacy with oral health. No large-scale studies have assessed these relationships among American Indians, a population at risk for limited health literacy and oral health problems. This analysis was conducted as part of a clinical trial aimed at reducing dental decay among preschoolers in the Navajo Nation Head Start program. Using baseline data for 1016 parent-child dyads, we examined the association of parental health literacy with parents' oral health knowledge, attitudes, and behavior, as well as indicators of parental and pediatric oral health. More limited health literacy was associated with lower levels of oral health knowledge, more negative oral health attitudes, and lower levels of adherence to recommended oral health behavior. Parents with more limited health literacy also had significantly worse oral health status (OHS) and reported their children to have significantly worse oral health-related quality of life. These results highlight the importance of oral health promotion interventions that are sensitive to the needs of participants with limited health literacy. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please email: email@example.com.
Full Text Available Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008 and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452. Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points. There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001. The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001. The elderly with higher health literacy scores were significantly less likely to have risky behaviors
Baron-Epel, Orna; Levin-Zamir, Diane; Cohen, Vicki; Elhayany, Asher
The association between health literacy (HL) and health outcomes, including self-perceived health (SPH) has been well documented. Yet the complexity of this association is not yet completely clear. Drawing on the Health Literacy Scale (HLS) study in Israel, we examined the association between HL, Internal Health Locus of Control (IHLOC) and SPH among Jews and Arabs. A face-to-face survey was conducted among 242 Arabs and 358 Jews. The questionnaire measured SPH, IHLOC and two measures of HL: a European HLScale (HLS-EU-16) and the Hebrew/Arabic Health Literacy Test (H/AHLT), based on the Short Test Of Functional Health Literacy in Adults. Analysis included multivariable logistic regressions and bootstrapping to identify mediation effects. Among Jews, IHLOC seems to be a significant mediator between HL and SPH. IHLOC was strongly associated with SPH (OR = 6.13; CI = 3.2, 11.8), while HL was not significantly associated directly with SPH. Similar results were observed when using the H/AHLT as a measure of HL. Among Arabs a different pattern emerges; IHLOC was neither associated with SPH nor was it a mediator of the association between HL and SPH. The two measures of HL seem to have different associations with SPH among Arabs, as only H/AHLT was associated significantly with SPH, and not HLS-EU-16. Thus, those with higher levels of IHLOC assess their health as better than those with low IHLOC only among Jews, and not among Arabs. IHLOC seems to be a significant mediator between HL and SPH among some cultures. Among Arabs, only functional HL seems to be positively associated with SPH. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Chung, Min-Huey; Chen, Liang-Kung; Peng, Li-Ning; Chi, Mei-Ju
To screen health literacy among urban elderly in Taiwan, who cannot be evaluated easily using the current measurement tools because of the "face", which meant someone felt embarrassed if he did not know how to do something. A literature review was performed to define a framework for developing the health literacy screening tool. Two hundred elderly were recruited to test the validity and reliability for pilot study. One thousand and eighty two elderly who came from quota sampling in Taipei City by administrative areas and gender were interviewed face-to-face to gather health literacy performance by the developed health literacy screening tool and the short-form Mandarin Health Literacy Scale (s-MHLS). 10-items of health literacy screening tool by self-perception were developed. The mean score of screening tool among analysis sample was 42.3 (0-50) and s-MHLS was 9.5 (0-11). Pearson correlation coefficient was 0.441 (phealth knowledge had better health literacy performance in both measurements. This screening tool should be applied to screen health literacy of elderly came from baby boomer who usually have lower education levels than the general population in Chinese regions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background and objective: Health literacy is a key outcome measures of health education that should be in the context of broader health promotion. This study aims to predict the health literacy of students in Kermanshah University of Medical Sciences in 1395: the role of demographic variables was performed. Methods: A descriptive correlational study on 350 students of Kermanshah University of Medical Sciences was done. Sampling was random. Data collection was conducted through a questionnaire of health literacy Montazeri et al. Information collected through software SPSS 23 and using t-tests, ANOVA and Pearson correlation coefficient were analyzed. Results: The mean (SD total score of health literacy in students was 4.04 ± 0.43. T-test and ANOVA between health literacy by gender, age, profession, education level and location have a significant relationship. Pearson correlation coefficient between the components of health literacy in research samples showed high correlation was statistically significant (P <0.01. Conclusion: The importance and need for attention to students' health literacy for health promotion as an essential factor in the impact-transition seems to be. Paper Type: Research Article.
McNeil, Amy; Arena, Ross
In the last fifteen years, research on the link between health literacy (HL) and poor health outcomes has resulted in mixed results. Since 2004, concerted effort has been made to improve not only practitioner training, but also the HL of the United States population. And yet, to this day, only 12% of adults are considered health literate. Along with increased awareness of HL, creation of strategies and initiatives, such as shared decision, plain language, and decision aides, have improved patient-centered approaches to facilitating a person's ability to obtain and understand health information to the extent that they are able to affect a level of health autonomy; efforts have clearly fallen short given that during the same amount of time, the unhealthy living phenotype and chronic disease burden persists globally. In an effort to expand and leverage the work of shared decision making and communication models that include all forms of literacy (e.g., food, physical, emotional, financial, etc.) that make up the broad term of HL, we introduce the concept of harmonics as a framework to explore the bi-directional transaction between a patient and a practitioner with the goal of constructing meaning to assist in maintaining or improving one's health. Published by Elsevier Inc.
Karimi, Saeed; Keyvanara, Mahmoud; Hosseini, Mohsen; Jazi, Marzie Jafarian; Khorasani, Elahe
Today, much attention has been paid to the patient role as the central factor in the management of their own health. It is focused on the issue that the patient has a more critical role compared with the health-care provider in controlling the patient own health. 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. The objective of this study was to determine health literacy, health status, healthcare utilization and the relationship between them in 18 - 64 years old people in Isfahan. This study was a descriptive analytical survey, which was conducted on 300 subjects of 18-64 years old in Isfahan with Multi-stage sampling method proportional to selected sample size. For collecting the data, questionnaire adapted from CHAP (Consumer Assessment of Healthcare Providers and Systems) health literacy questionnaire was used. Health status was measured based on an assessment of the physical and mental health over the past 6 months by 5° Likert scale. Data analysis was performed by using SPSS 18, descriptive statistics, Chi-square test and multivariate analysis of variance. There was no significant correlation between health literacy, health status and healthcare utilization. Utilization was less in the urban area No. 6 of the city. In the bachelor's degree group, the health status was lower than the other groups in these cases: Older ages, married, women, large family size, undergraduates, and urban area No. 14. Due to the average prevalence of health literacy in 18-64 years old individuals in Isfahan and low- healthcare utilization, the followings are recommended: Necessity of more attention to the issue of health literacy, improving the physician-patient relationship and community awareness, whether through health promotion programs or media for the optimum use of available resources.
Kim, Henna; Xie, Bo
This study aimed to identify studies on online health service use by people with limited health literacy, as the findings could provide insights into how health literacy has been, and should be, addressed in the eHealth era. To identify the relevant literature published since 2010, we performed four rounds of selection-database selection, keyword search, screening of the titles and abstracts, and screening of full texts. This process produced a final of 74 publications. The themes addressed in the 74 publications fell into five categories: evaluation of health-related content, development and evaluation of eHealth services, development and evaluation of health literacy measurement tools, interventions to improve health literacy, and online health information seeking behavior. Barriers to access to and use of online health information can result from the readability of content and poor usability of eHealth services. We need new health literacy screening tools to identify skills for adequate use of eHealth services. Mobile apps hold great potential for eHealth and mHealth services tailored to people with low health literacy. Efforts should be made to make eHealth services easily accessible to low-literacy individuals and to enhance individual health literacy through educational programs. Copyright © 2017 Elsevier B.V. All rights reserved.
Santesmases-Masana, Rosalia; González-de Paz, Luis; Real, Jordi; Borràs-Santos, Alicia; Sisó-Almirall, Antoni; Navarro-Rubio, Maria Dolors
The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. A multicentre cross-sectional study. 10 Primary care centres from the metropolitan area of Barcelona. Patients diagnosed with heart failure. to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Primack, Brian A.; Bui, Thuy; Fertman, Carl I.
Objective It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. Methods In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. Results Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p marketing and health literacy can improve skills that improve medical students’ comfort with patients of diverse backgrounds. Practice implications Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers’ comfort with direct patient interaction. PMID:17418522
Meppelink, Corine S; van Weert, Julia C M; Haven, Carola J; Smit, Edith G
Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. The aim of this paper is to investigate what features of spoken health animations improve information recall and attitudes and whether there are differences between health literacy groups. We conducted an online experiment among 231 participants aged 55 years or older with either low or high health literacy. A 2 (spoken vs written text) x 2 (illustration vs animation) design was used. Participants were randomly exposed to one of the four experimental messages, all providing the same information on colorectal cancer screening. The results showed that, among people with low health literacy, spoken messages about colorectal cancer screening improved recall (P=.03) and attitudes (P=.02) compared to written messages. Animations alone did not improve recall, but when combined with spoken text, they significantly improved recall in this group (P=.02). When exposed to spoken animations, people with low health literacy recalled the same amount of information as their high health literate counterparts (P=.12), whereas in all other conditions people with high health literacy recalled more information compared to low health literate individuals. For people with low health literacy, positive attitudes mediated the relationship between spoken text and the intention to have a colorectal cancer screening (b=.12; 95% CI 0.02-0.25). We conclude that spoken animation is the best way to communicate complex health information to people with low health literacy. This format can even bridge the information processing gap between audiences with low and high health literacy as the recall differences between the two groups are eliminated. As animations do not negatively influence high health literate audiences, it is concluded that
van Weert, Julia CM; Haven, Carola J; Smit, Edith G
Background Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. Objective The aim of this paper is to investigate what features of spoken health animations improve information recall and attitudes and whether there are differences between health literacy groups. Methods We conducted an online experiment among 231 participants aged 55 years or older with either low or high health literacy. A 2 (spoken vs written text) x 2 (illustration vs animation) design was used. Participants were randomly exposed to one of the four experimental messages, all providing the same information on colorectal cancer screening. Results The results showed that, among people with low health literacy, spoken messages about colorectal cancer screening improved recall (P=.03) and attitudes (P=.02) compared to written messages. Animations alone did not improve recall, but when combined with spoken text, they significantly improved recall in this group (P=.02). When exposed to spoken animations, people with low health literacy recalled the same amount of information as their high health literate counterparts (P=.12), whereas in all other conditions people with high health literacy recalled more information compared to low health literate individuals. For people with low health literacy, positive attitudes mediated the relationship between spoken text and the intention to have a colorectal cancer screening (b=.12; 95% CI 0.02-0.25). Conclusions We conclude that spoken animation is the best way to communicate complex health information to people with low health literacy. This format can even bridge the information processing gap between audiences with low and high health literacy as the recall differences between the two groups are eliminated. As animations do not negatively influence high health
Collins, Sarah A; Currie, Leanne M; Bakken, Suzanne; Vawdrey, David K; Stone, Patricia W
To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms "health", "literacy", "computer-based," and "psychometrics". All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in seven different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Only English language health literacy assessment instruments were reviewed and analyzed. Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments' content and methodologies for computer-based health literacy screening and assessment. Copyright © 2012 Elsevier Inc. All rights reserved.
Jović-Vraneš, Aleksandra; Bjegović-Mikanović, Vesna; Marinković, Jelena; Vuković, Dejana
Improving health literacy skills is important for patient comprehension of health-related topics and their ability to attend to their medical problems. Promoting health literacy is a pivotal policy for maintaining and promoting health. The objective of the present study was to translate the Test of Functional Health Literacy in Adults (TOFHLA; long and short versions) into Serbian and evaluate the translated and cross-culturally adapted questionnaires in Serbian primary care patients. The translated TOFHLA questionnaires were administered to 120 patients. Additionally, a self-completed questionnaire was used. Both descriptive and inferential statistics were measured. The mean score for the TOFHLA was 73.49 (median, 78; SD = 17.94; range, 0-100) and the mean score for the Short Test of Functional Health Literacy in Adults (STOFHLA) was 29.28 (median, 32; SD = 6.16; range, 0-36). Sex, age, education, self-perceived health and presence of any chronic disease were associated with health literacy scores. The internal consistency (Cronbach's alpha) was 0.73 for the TOFHLA numeracy subset, 0.95 for reading comprehension, 0.94 for the TOFHLA and 0.90 for the STOFHLA. The Pearson correlation between the TOFHLA and STOFHLA was 0.89. The area under the curve of these two tests was 0.79 (95% CI, 0.602-0.817). The Serbian translated versions of the TOHFLA questionnaires offer valid measures of functional health literacy. There were no differences between the reliability and validity of the short and long TOFHLA forms. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Santana Arroyo, Sonia
Health professionals frequently do not possess the necessary information-seeking abilities to conduct an effective search in databases and Internet sources. Reference librarians may teach health professionals these information and technology skills through the Big6 information literacy model (Big6). This article aims to address this issue. It also…
Meppelink, C.S.; Smit, E.G.; Diviani, N.; van Weert, J.C.M.
The usefulness of the Internet as a health information source largely depends on the receiver’s health literacy. This study investigates the mechanisms through which health literacy affects information recall and website attitudes. Using 2 independent surveys addressing different Dutch health
Jeong, Seok Hee; Kim, Hyun Kyung
To identify the level of health literacy and barriers to information seeking and to explore the predictors of health literacy. A cross-sectional descriptive design was used. A total of 1000 Korean adults were recruited through proportional quota sampling. Health literacy, barriers to health information seeking, sociodemographics, and health-related characteristics were surveyed. Descriptive statistics and binary logistic regression were performed for data analysis. About 61% of participants were classified as inadequately health literate. "No health fairs/activities near home" was the most frequently reported barrier. Older age, lower education, living in the capital city, barriers regarding how to get information and access to expensive books and magazines were predictors of inadequate health literacy. Strategies for improving health literacy and reducing barriers to health information seeking should be designed. Education on how to access health-related information with easily accessible sources either free or inexpensive could be a way to help adults with limited health literacy. Health care professionals should assess clients' health literacy levels, particularly amongst those who are older or have less education. They should provide clients with information on how to access credible and readily available sources of health-related information, considering their health literacy level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Ghaddar, Suad F.; Valerio, Melissa A.; Garcia, Carolyn M.; Hansen, Lucy
Background: Little research has examined adolescent health literacy and its relationship with online health information sources. The purpose of this study is to explore health literacy among a predominantly Hispanic adolescent population and to investigate whether exposure to a credible source of online health information, MedlinePlus[R], is…
Weaver, Nancy L; Wray, Ricardo J; Zellin, Stacie; Gautam, Kanak; Jupka, Keri
Health care organizations, well positioned to address health literacy, are beginning to shift their systems and policies to support health literacy efforts. Organizations can identify barriers, emphasize and leverage their strengths, and initiate activities that promote health literacy-related practices. The current project employed an open-ended approach to conduct a needs assessment of rural federally qualified health center clinics. Using customized assessment tools, the collaborators were then able to determine priorities for changing organizational structures and policies in order to support continued health literacy efforts. Six domains of organizational health literacy were measured with three methods: environmental assessments, patient interviews, and key informant interviews with staff and providers. Subsequent strategic planning was conducted by collaborators from the academic and clinic teams and resulted in a focused, context-appropriate action plan. The needs assessment revealed several gaps in organizational health literacy practices, such as low awareness of health literacy within the organization and variation in perceived values of protocols, interstaff communication, and patient communication. Facilitators included high employee morale and patient satisfaction. The resulting targeted action plan considered the organization's culture as revealed in the interviews, informing a collaborative process well suited to improving organizational structures and systems to support health literacy best practices. The customized needs assessment contributed to an ongoing collaborative process to implement organizational changes that aided in addressing health literacy needs.
Weidmer, Beverly A; Brach, Cindy; Hays, Ron D
The complexity of health information often exceeds patients' skills to understand and use it. To develop survey items assessing how well healthcare providers communicate health information. Domains and items for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Item Set for Addressing Health Literacy were identified through an environmental scan and input from stakeholders. The draft item set was translated into Spanish and pretested in both English and Spanish. The revised item set was field tested with a randomly selected sample of adult patients from 2 sites using mail and telephonic data collection. Item-scale correlations, confirmatory factor analysis, and internal consistency reliability estimates were estimated to assess how well the survey items performed and identify composite measures. Finally, we regressed the CAHPS global rating of the provider item on the CAHPS core communication composite and the new health literacy composites. A total of 601 completed surveys were obtained (52% response rate). Two composite measures were identified: (1) Communication to Improve Health Literacy (16 items); and (2) How Well Providers Communicate About Medicines (6 items). These 2 composites were significantly uniquely associated with the global rating of the provider (communication to improve health literacy: PLiteracy composite accounted for 90% of the variance of the original 16-item composite. This study provides support for reliability and validity of the CAHPS Item Set for Addressing Health Literacy. These items can serve to assess whether healthcare providers have communicated effectively with their patients and as a tool for quality improvement.
This article discusses health literacy and cultural factors that have implications for the ethical practice of health education. It specifically focuses on recent data that speaks to the challenges in carrying out patient education from the perspective of comprehension and equitable distribution of health-related information across diverse cultures and communities. It discusses strategies for reducing the negative impact of low health literacy among diverse groups and the importance of acknowledging this pervasive problem in the context of ensuring equity in the optimal delivery of health promotion messages.
Robert T. Braun
Full Text Available Abstract Background Under the Affordable Care Act (ACA, millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy – a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy. Whether tobacco users choose enough coverage in the marketplaces given their expected health care needs and are able to access health care services effectively is fundamentally related to understanding health insurance. However, no studies to date have examined this important relationship. Methods Data were collected from 631 lower-income, minority, rural residents of Virginia. Health insurance literacy was assessed by asking four factual questions about the coverage options presented to them. Adjusted associations between tobacco use and health insurance literacy were tested using multivariate linear regression, controlling for numeracy, risk-taking, discount rates, health status, experiences with the health care system, and demographics. Results Nearly one third (31% of participants were current tobacco users, 80% were African American and 27% were uninsured. Average health insurance literacy across all participants was 2.0 (SD 1.1 out of a total possible score of 4. Current tobacco users had significantly lower HIL compared to non-users (−0.22, p < 0.05 after adjustment. Participants who were less educated, African American, and less numerate reported more difficulty understanding health insurance (p < 0.05 each. Conclusions Tobacco users face higher premiums for health coverage than non-users in the individual insurance marketplace. Our results suggest they may be
Until relatively recently, the concept of information literacy, and teaching the skills to enable it, was mainly a concern of academic libraries. Now, it is also seen to be of high importance within the context of health care libraries. Health care libraries and librarians can provide crucial support towards the implementation of evidence-based practice in patient care through both information literacy skills training and by conducting mediated searches on behalf of health care practitioners. This article reports the findings from an investigation conducted by Charlotte Kelham as part of her MA in Librarianship from the University of Sheffield. Her dissertation investigated how health care librarians understand the concept of information literacy, the implications of this for their role and their perceptions around how their role is valued. Charlotte graduated from Sheffield in 2013 and is currently job hunting. AM. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Journal.
Pati, Susmita; Feemster, Kristen A; Mohamad, Zeinab; Fiks, Alex; Grundmeier, Robert; Cnaan, Avital
To determine if maternal health literacy influences early infant immunization status. Longitudinal prospective cohort study of 506 Medicaid-eligible mother-infant dyads. Immunization status at age 3 and 7 months was assessed in relation to maternal health literacy measured at birth using the Test of Functional Health Literacy in Adults (short version). Multivariable logistic regression quantified the effect of maternal health literacy on immunization status adjusting for the relevant covariates. The cohort consists of primarily African-American (87%), single (87%) mothers (mean age 23.4 years). Health literacy was inadequate or marginal among 24% of mothers. Immunizations were up-to-date among 73% of infants at age 3 months and 43% at 7 months. Maternal health literacy was not significantly associated with immunization status at either 3 or 7 months. In multivariable analysis, compared to infants who had delayed immunizations at 3 months, infants with up-to-date immunizations at 3 months were 11.3 times (95%CI 6.0-21.3) more likely to be up-to-date at 7 months. The only strong predictors of up-to-date immunization status at 3 months were maternal education (high school graduate or beyond) and attending a hospital-affiliated clinic. Though maternal health literacy is not associated with immunization status in this cohort, later immunization status is most strongly predicted by immunization status at 3 months. These results further support the importance of intervening from an early age to ensure that infants are fully protected against vaccine preventable diseases.
Norman, Cameron D; Skinner, Harvey A
Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed.
Champlin, Sara; Mackert, Michael
Create a screening measure of health literacy for use with the Health Information National Trends Survey (HINTS). Participants completed a paper-based survey. Items from the survey were used to construct a health literacy screening measure. A population-based survey conducted in geographic areas of high and low minority frequency and in Central Appalachia. Two thousand nine hundred four English-speaking participants were included in this study: 66% white, 93% completed high school, mean age = 52.53 years (SD = 16.24). A health literacy screening measure was created using four items included in the HINTS survey. Scores could range from 0 (no questions affirmative/correct) to 4 (all questions answered affirmatively/correctly). Multiple regression analysis was used to determine whether demographic variables known to predict health literacy were indeed associated with the constructed health literacy screening measure. The weighted average health literacy score was 2.63 (SD = 1.00). Those who were nonwhite (p = .0005), were older (p literacy screening measure scores. This study highlights the need to assess health literacy in national surveys, but also serves as evidence that screening measures can be created within existing datasets to give researchers the ability to consider the impact of health literacy. © The Author(s) 2016.
Ana Larissa Gomes Machado
Full Text Available This study aimed to analyze nursing research regarding the instruments used to evaluate health literacy in elderly hypertensive patients. This is an integrative literature review done in the databases LILACS, PubMed, CINAHL, Scopus, and Cochrane, in June 2013. The articles, electronically available, were selected for full-text review by nurses, who assessed health literacy of elderly with hypertension. Eight studies were selected for analysis and four different instruments were used in the research. The instruments were developed according to a methodology and they were all designed to evaluate the abilities of elderly regarding reading, numeracy, pronunciation and recognition of some health-related words. The nursing research analyzed in this study revealed the gaps in care related to measures aimed to increase patient's involvement in decision-making. Also, the instruments used for measuring health literacy showed limitations, and there is no gold standard test.
Alice M. Noblin PhD, RHIA, CCS
Full Text Available Objective: Patient engagement in health care information technology (IT is required for government reimbursement programs. This research surveyed one older adult group to determine their willingness to use health information from a variety of sources. Health literacy was also measured using the Newest Vital Sign (NVS and eHealth Literacy Scale (eHEALS tools. Method: Regression models determined engagement in health care IT usage and impact of literacy levels based on survey data collected from the group. Results: Although most participants have adequate literacy, they are not more likely to use health care IT than those with limited literacy scores. Knowledge of how to use the Internet to answer questions about health was statistically associated with IT usage. Discussion: Health care IT usage is important for healthy aging. The ability of older adults to understand information provided to them can impact population health including medication usage and other important factors.
Noblin, Alice M; Rutherford, Ashley
Objective: Patient engagement in health care information technology (IT) is required for government reimbursement programs. This research surveyed one older adult group to determine their willingness to use health information from a variety of sources. Health literacy was also measured using the Newest Vital Sign (NVS) and eHealth Literacy Scale (eHEALS) tools. Method: Regression models determined engagement in health care IT usage and impact of literacy levels based on survey data collected from the group. Results: Although most participants have adequate literacy, they are not more likely to use health care IT than those with limited literacy scores. Knowledge of how to use the Internet to answer questions about health was statistically associated with IT usage. Discussion: Health care IT usage is important for healthy aging. The ability of older adults to understand information provided to them can impact population health including medication usage and other important factors.
Elsborg, Lea; Krossdal, Fie; Kayser, Lars
It is important to address people's health literacy when providing health care. Health professionals should be aware of, and have insight into, people's health literacy when they provide health services. Health professionals need to be health literate themselves. We examined the level of health literacy in students in Denmark attending one of four full university programmes related to health and investigated how their health literacy was associated with their sociodemographic background. The health literacy level of the students was measured using the multi-dimensional Health Literacy Questionnaire (HLQ) supplemented with sociodemographic questions. The questionnaire was administrated through the students' Facebook groups. The students were enrolled in courses on health informatics, medicine, molecular biomedicine or public health. Out of a total of 7663 students, 630 responded to the questionnaire. No sex difference was found although female students scored higher than male students in domain 4 (social support for health). Students attending the public health programme tended to score higher and those attending molecular biomedicine tended to score lower in the HLQ. There was a positive correlation between HLQ scores and the educational level of the students' parents. If one of their parents was employed in the health care sector, the HLQ score tended to be higher in domains 1 and 4. Students who had been hospitalized also tended to score higher in domains 1, 5 and 6. Students' health literacy relates to their personal background and educational path. This may be of importance when planning curricula and educational activities, including cross-disciplinary courses.
Cordasco, Kristina M; Asch, Steven M; Franco, Idalid; Mangione, Carol M
To evaluate the relationship between health literacy and age in chronically-ill inpatients at a safety-net hospital. We recruited 399 English- and Spanish-speaking inpatients being evaluated or treated for Congestive Heart Failure or Coronary Artery Disease at a large, urban safety-net teaching hospital in Southern California. Participants were interviewed to ascertain education, English comprehension, and in-home language use. Health literacy was assessed using The Test of Functional Health Literacy in Adults (TOFHLA). We compared by age (aged 65 or more, 51 to 64 years of age, and less than age 50) levels of health literacy, educational attainment, English comprehension, and language use. Prevalence of inadequate health literacy significantly increased with increasing age (87.2% in > or = 65, 48.9% for 51-64, and 26.3% in immigration status. Additionally, older patients were more likely to have never learned to read (34.9% in > or = 65, 6.5% for 51-64, and 1.5% in or = 65, 9.0% for 51-64, and 0.8% in or = 65, 43.5% for 51-64, and 35.8% in language at home (82.3% in > or = 65, 70.2% for 51-64, and 62.2% in < or = 50, p=0.015). To prepare to meet the chronic disease needs of a growing older patient population, and ameliorate the negative health effects of associated low literacy, safety-net hospital leaders and providers need to prioritize the development and implementation of low-literacy educational materials, programs, and services.
Lai, Hsiang-Ru; Wu, Der-Min; Lee, Pi-Hsia; Jhang, Yu-Siang
Background: Health education (HE) courses in schools are vital paths for improving teenagers' health literacy. HE and physical education (PE) teachers lead HE courses, and their teaching intentions and competency influence the effectiveness of the courses and the ability to promote students' health literacy. This study attempted to understand HE…
Vardell, Emily Johanna
The concept of health insurance literacy, which can be defined as "the extent to which consumers can make informed purchase and use decisions" (Kim, Braun, & Williams, 2013, p. 3), has only recently become a focus of health literacy research. Though employees have been making health insurance decisions for many years, the Affordable…
Full Text Available Background: Neglecting self-care behaviors is considered an important factor contributing to mortality among diabetic patients. According to Bandura’s Social-Cognitive Theory, there is a close relationship between individual performance and self-efficacy. Moreover, access to health-related information or health literacy can affect health status. Aim: To investigate the relationship between health literacy, self-efficacy, and self-care behaviors in diabetic patients. Method: This descriptive correlational study was conducted on 400 patients with diabetes referred to a diabetes clinic during 2015. The participants were selected through convenience sampling. The data collection tools included Short Test of Functional Health Literacy in Adults, Diabetes Management Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. To analyze the data, Pearson’s correlation coefficient, independent t-test, and one-way analysis of variance were run in SPSS, version 19. Results: The mean age of the participants was 55.1±10.1 years and 74.75% of them were male. The mean scores of self-care behaviors, health literacy, and self-efficacy were 61.94±14.35, 63.6±20.7, and 146.3±22.9, respectively. Moreover, the results of Pearson’s correlation coefficient showed a significant direct correlation between health literacy and self-efficacy (P=0.03, r=0.1, as well as health literacy and self-care behaviors (P=0.04, r=0.1. Furthermore, self-efficacy had a significant direct correlation with self-care behaviors (P
Collins, Sarah A.; Currie, Leanne M.; Bakken, Suzanne; Vawdrey, David K.; Stone, Patricia W.
Objective To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. Design The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms “health”, “literacy”, “computer-based,” and “psychometrics”. All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Results Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in 7 different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Limitations Only English language health literacy assessment instruments were reviewed and analyzed. Conclusions Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments’ content and methodologies for computer-based health literacy screening and assessment. PMID:22521719
Kim, Sun-Hee; Son, Youn-Jung
The Internet is a useful and accessible source for health-related information for modern healthcare consumers. Individuals with adequate eHealth literacy have an incentive to use the Internet to access health-related information, and they consider themselves capable of using Web-based knowledge for health. This cross-sectional study aimed to describe the relationship between eHealth literacy and health behaviors. A total of 230 adults aged 18 to 39 years and residing in South Korea participated in the study. The mean (SD) score for eHealth literacy was 25.52 (4.35) of a total possible score of 40. The main source of health information was the Internet. Using hierarchical linear regression, the results showed that eHealth literacy was the strongest predictor of health behaviors after adjusting for general characteristics. These findings indicate that eHealth literacy can be an important factor in promoting individual health behaviors. Further research on eHealth literacy and actual health behaviors including intention and self-reported health behaviors are required to explain the impact of eHealth literacy on overall health status.
Park, Hyejin; Cormier, Eileen; Gordon, Glenna; Baeg, Jung Hoon
The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.
Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh; Kahouei, Mehdi
Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Mean scores of the participants' attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects' demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy.
Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh
Background and aim Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. Methods This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Results Mean scores of the participants’ attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects’ demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy. PMID:29588815
Donovan-Kicken, Erin; Mackert, Michael; Guinn, Trey D; Tollison, Andrew C; Breckinridge, Barbara; Pont, Stephen J
Informed consent documents are designed to convey the risks of medical procedures to patients, yet they are often difficult to understand; this is especially true for individuals with limited health literacy. An important opportunity for advancing knowledge about health literacy and informed consent involves examining the theoretical pathways that help to explain how health literacy relates to information processing when patients read consent forms. In this study, we proposed and tested a model that positioned self-efficacy as a mediator of the association between health literacy and patients' comprehension and assessment of informed consent documentation. Findings from structured interviews with patients (n = 254) indicated that lower health literacy predicted lower self-efficacy, which predicted feeling less well informed and less prepared, being more confused about the procedure and its hazards, and wanting more information about risks. Incorporating awareness of self-efficacy into disclosure documents and consent conversations may be a useful means of prompting patients to ask questions that can help them make informed decisions about care.
Anderson, Lorin W.; Anderson, Jo Craig
Development of the mathematics functional literacy test (MFLT) is described, issues of predictive and content validity are discussed, and implications for educational policy are presented. Ten basic skill areas identified by the National Council of Supervisors of Mathematics were used as the basis for the development of the MFLT. (RL)
Ownby, Raymond L.; Waldrop-Valverde, Drenna; Taha, Jessica
Health literacy has emerged as an important factor related to health in older persons. The reason for the link between health literacy and health outcomes is not clear. Possible explanations include common relations among income, education, access to health care, health-promotion behaviors, frequency of reading, and perceptual impairments. In this…
Utami, Dina; Bickmore, Timothy W; Barry, Barbara; Paasche-Orlow, Michael K
Several web-based search engines have been developed to assist individuals to find clinical trials for which they may be interested in volunteering. However, these search engines may be difficult for individuals with low health and computer literacy to navigate. The authors present findings from a usability evaluation of clinical trial search tools with 41 participants across the health and computer literacy spectrum. The study consisted of 3 parts: (a) a usability study of an existing web-based clinical trial search tool; (b) a usability study of a keyword-based clinical trial search tool; and (c) an exploratory study investigating users' information needs when deciding among 2 or more candidate clinical trials. From the first 2 studies, the authors found that users with low health literacy have difficulty forming queries using keywords and have significantly more difficulty using a standard web-based clinical trial search tool compared with users with adequate health literacy. From the third study, the authors identified the search factors most important to individuals searching for clinical trials and how these varied by health literacy level.
Kim, Yong-Chan; Lim, Ji Young; Park, Keeho
This study aimed to examine whether social capital (bonding and bridging social capital) attenuate the effect of low functional health literacy on health information resources, efficacy, and behaviors. In-person interviews were conducted with 1,000 residents in Seoul, Korea, in 2011. The authors found that respondents' functional health literacy had positive effects on the scope of health information sources and health information self-efficacy but not health information-seeking intention. Respondents' social capital had positive effects on the scope of health information sources, health information efficacy, and health information-seeking intention. The authors found (a) a significant moderation effect of bridging social capital on the relation between health literacy and health information self-efficacy and (b) a moderation effect of bonding social capital on the relation between health literacy and health information-seeking intention.
Health literacy is widespread, but its potential is not recognized. By not recognizing health literacy, patients have the burden of coping with diabetes with renal complications without full knowledge of their responsibility to their health. The focus of the project was to assess participants with diabetes with low health literacy and low mean…
Rowlands, Gillian; Shaw, Adrienne; Jaswal, Sabrena; Smith, Sian; Harpham, Trudy
Health literacy, ‘the personal characteristics and social resources needed for individuals and communities to access, understand, appraise and use information and services to make decisions about health’, is key to improving peoples’ control over modifiable social determinants of health (SDH). This study listened to adult learners to understand their perspectives on gathering, understanding and using information for health. This qualitative project recruited participants from community skills courses to identify relevant ‘health information’ factors. Subsequently different learners put these together to develop a model of their ‘Journey to health’. Twenty-seven participants were recruited; twenty from community health literacy courses and seven from an adult basic literacy and numeracy course. Participants described health as a ‘journey’ starting from an individual's family, ethnicity and culture. Basic (functional) health literacy skills were needed to gather and understand information. More complex interactive health literacy skills were needed to evaluate the importance and relevance of information in context, and make health decisions. Critical health literacy skills could be used to adapt negative external factors that might inhibit health-promotion. Our model is an iterative linear one moving from ethnicity, community and culture, through lifestyle, to health, with learning revisited in the context of different sources of support. It builds on existing models by highlighting the importance of SDH in the translation of new health knowledge into healthy behaviours, and the importance of health literacy in enabling people to overcome barriers to health.
H. M. B. H. Denuwara
Full Text Available Abstract Background Health literacy refers to people's competencies to access, understand, judge and apply health information in healthcare, disease prevention and health promotion. This study aimed to describe the level of health literacy and the factors associated with it among school teachers in an Education Zone in Colombo, Sri Lanka. Methods A cross-sectional study among 520 teachers measured health literacy using the selfadministered, culturally adapted Sinhalese translation of Health Literacy Survey-European Union (HLS-EU. Health literacy assessment was based on self-reported competencies to access, understand, judge and apply health information in the domains of disease prevention, healthcare and health promotion. Based on a score, respondents were divided into four levels of health literacy as 'inadequate', 'problematic', 'sufficient' and 'excellent' as well as into two levels as 'limited' and 'adequate'. Factors associated with 'limited' health literacy was determined by using univariate analysis and assessing their associations using chi square test. Multivariate analysis was also done using multiple logistic regression to determine factors associated with limited health literacy controlled for confounding effects. A p value of 0.05 determined the significance. Results The response rate was 96.5%. Mean age was 43years (SD = +9.75, 81.7% (n = 410 were females and 66.1% (n = 332 were graduates. Only 3.6% (n = 18 taught the subject health while 18.3% (n = 92 taught science. 'Limited' health literacy was found in 32.5% (95% CI 28.4%–36.6% while 67.5% (95% CI 63.4%–71.6%, 61.2% (95% CI 56.9%-65.5% and 6.4% (95% CI 4.3%–8.5% showed 'adequate', 'sufficient' and 'excellent' levels, respectively. 'Problematic' and 'inadequate' health literacy were 31.5% (95% CI 27.4%-35.6% and 1% (95% CI 0.1%–1.9%. Univariate analysis showed not being a member of health club/welfare group (p = 0.002, having not done any special course on health (p = 0
Denuwara, H M B H; Gunawardena, Nalika Sepali
Health literacy refers to people's competencies to access, understand, judge and apply health information in healthcare, disease prevention and health promotion. This study aimed to describe the level of health literacy and the factors associated with it among school teachers in an Education Zone in Colombo, Sri Lanka. A cross-sectional study among 520 teachers measured health literacy using the selfadministered, culturally adapted Sinhalese translation of Health Literacy Survey-European Union (HLS-EU). Health literacy assessment was based on self-reported competencies to access, understand, judge and apply health information in the domains of disease prevention, healthcare and health promotion. Based on a score, respondents were divided into four levels of health literacy as 'inadequate', 'problematic', 'sufficient' and 'excellent' as well as into two levels as 'limited' and 'adequate'. Factors associated with 'limited' health literacy was determined by using univariate analysis and assessing their associations using chi square test. Multivariate analysis was also done using multiple logistic regression to determine factors associated with limited health literacy controlled for confounding effects. A p value of 0.05 determined the significance. The response rate was 96.5%. Mean age was 43years (SD = +9.75), 81.7% (n = 410) were females and 66.1% (n = 332) were graduates. Only 3.6% (n = 18) taught the subject health while 18.3% (n = 92) taught science. 'Limited' health literacy was found in 32.5% (95% CI 28.4%-36.6%) while 67.5% (95% CI 63.4%-71.6%), 61.2% (95% CI 56.9%-65.5%) and 6.4% (95% CI 4.3%-8.5%) showed 'adequate', 'sufficient' and 'excellent' levels, respectively. 'Problematic' and 'inadequate' health literacy were 31.5% (95% CI 27.4%-35.6%) and 1% (95% CI 0.1%-1.9%). Univariate analysis showed not being a member of health club/welfare group (p = 0.002), having not done any special course on health (p = 0.009), not getting an opportunity to participate
Tuyen Van Duong, RN, MSN, PhD
Conclusion: The comprehensive HL-SF12 was a valid and easy to use tool for assessing patients’ health literacy in the hospitals to facilitate healthcare providers in enhancing patients’ health literacy and healthcare qualities.
Satish Chandrasekhar Nair
Full Text Available Abstract Background Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restrict, health information access and utilization for those with low literacy. Methods By employing expert panel, Delphi technique, focus group methodologies, and pre-testing using participants (N = 900 from the UAE and India, a survey construct to the Eastern-Middle Eastern cultures was developed. Reliability was assessed using Cronbach’s α and validity using Factor analysis. Kiaser-Meyer-Olkin (KMO sampling adequacy and Bartlett’s tests were used to assess the strength of the relationship among the variables. Results Inclusion of non-health related items were found to be critical in the authentic assessment of health literacy in the Eastern and Middle Eastern population given the influence of social desirability. Thirty-two percentage of the original 19-item construct was eliminated by the focus group for reasons of relevance and impact for the local culture. Field pretesting participants from two countries, indicated overall construct reliability (Cronbach’s α =0.85, validity and consistency (KMO value of 0.92 and Bartlett’s test of sphericity was significant. Conclusion The Eastern-Middle Eastern Adult Health Literacy (EMAHL13, screening instrument is brief, simple, a useful indicator of whether or not a patient can read. It assessespatients’ ability to comprehend by distinguishing between health and non-health related items. The EMAHL13 will be a useful too for the reliable assessment of health literacy in countries, where culture plays a
Kostenius, Catrine; Bergmark, Ulrika
Purpose: The purpose of this paper is to explore Swedish children's positive experiences of health and well-being, and their thoughts on how health literacy can be promoted. Design/methodology/approach: Totally, 121 schoolchildren between the ages of 10 and 14 from three schools in two municipalities in the northern part of Sweden shared their…
Wang, Jen; Thombs, Brett D.; Schmid, Margareta R.
Abstract Background Growing recognition of the role of citizens and patients in health and health care has placed a spotlight on health literacy and patient education. Objective To identify specific competencies for health in definitions of health literacy and patient‐centred concepts and empirically test their dimensionality in the general population. Methods A thorough review of the literature on health literacy, self‐management, patient empowerment, patient education and shared decision making revealed considerable conceptual overlap as competencies for health and identified a corpus of 30 generic competencies for health. A questionnaire containing 127 items covering the 30 competencies was fielded as a telephone interview in German, French and Italian among 1255 respondents randomly selected from the resident population in Switzerland. Findings Analyses with the software MPlus to model items with mixed response categories showed that the items do not load onto a single factor. Multifactorial models with good fit could be erected for each of five dimensions defined a priori and their corresponding competencies: information and knowledge (four competencies, 17 items), general cognitive skills (four competencies, 17 items), social roles (two competencies, seven items), medical management (four competencies, 27 items) and healthy lifestyle (two competencies, six items). Multiple indicators and multiple causes models identified problematic differential item functioning for only six items belonging to two competencies. Conclusions The psychometric analyses of this instrument support broader conceptualization of health literacy not as a single competence but rather as a package of competencies for health. PMID:22390287
Wang, Jen; Thombs, Brett D; Schmid, Margareta R
Growing recognition of the role of citizens and patients in health and health care has placed a spotlight on health literacy and patient education. To identify specific competencies for health in definitions of health literacy and patient-centred concepts and empirically test their dimensionality in the general population. A thorough review of the literature on health literacy, self-management, patient empowerment, patient education and shared decision making revealed considerable conceptual overlap as competencies for health and identified a corpus of 30 generic competencies for health. A questionnaire containing 127 items covering the 30 competencies was fielded as a telephone interview in German, French and Italian among 1255 respondents randomly selected from the resident population in Switzerland. Analyses with the software MPlus to model items with mixed response categories showed that the items do not load onto a single factor. Multifactorial models with good fit could be erected for each of five dimensions defined a priori and their corresponding competencies: information and knowledge (four competencies, 17 items), general cognitive skills (four competencies, 17 items), social roles (two competencies, seven items), medical management (four competencies, 27 items) and healthy lifestyle (two competencies, six items). Multiple indicators and multiple causes models identified problematic differential item functioning for only six items belonging to two competencies. The psychometric analyses of this instrument support broader conceptualization of health literacy not as a single competence but rather as a package of competencies for health. © 2012 John Wiley & Sons Ltd.
Full Text Available Abstract Background The need for healthcare strengthening to enhance equity is critical, requiring systematic approaches that focus on those experiencing lesser access and outcomes. This project developed and tested the Ophelia (OPtimising HEalth LIteracy and Access approach for co-design of interventions to improve health literacy and equity of access. Eight principles guided this development: Outcomes focused; Equity driven, Needs diagnosis, Co-design, Driven by local wisdom, Sustainable, Responsive and Systematically applied. We report the application of the Ophelia process where proof-of-concept was defined as successful application of the principles. Methods Nine sites were briefed on the aims of the project around health literacy, co-design and quality improvement. The sites were rural/metropolitan, small/large hospitals, community health centres or municipalities. Each site identified their own priorities for improvement; collected health literacy data using the Health Literacy Questionnaire (HLQ within the identified priority groups; engaged staff in co-design workshops to generate ideas for improvement; developed program-logic models; and implemented their projects using Plan-Do-Study-Act (PDSA cycles. Evaluation included assessment of impacts on organisations, practitioners and service users, and whether the principles were applied. Results Sites undertook co-design workshops involving discussion of service user needs informed by HLQ (n = 813 and interview data. Sites generated between 21 and 78 intervention ideas and then planned their selected interventions through program-logic models. Sites successfully implemented interventions and refined them progressively with PDSA cycles. Interventions generally involved one of four pathways: development of clinician skills and resources for health literacy, engagement of community volunteers to disseminate health promotion messages, direct impact on consumers’ health literacy, and
Carroll, Lauren N; Smith, Sandra A; Thomson, Nicole R
The Parents as Teachers (PAT) Health Literacy Demonstration project assessed the impact of integrating data-driven reflective practices into the PAT home visitation model to promote maternal health literacy. PAT is a federally approved Maternal, Infant, Early Childhood Home Visiting program with the goal of promoting school readiness and healthy child development. This 2-year demonstration project used an open-cohort longitudinal design to promote parents' interactive and reflective skills, enhance health education, and provide direct assistance to personalize and act on information by integrating an empowerment paradigm into PAT's parent education model. Eight parent educators used the Life Skills Progression instrument to tailor the intervention to each of 103 parent-child dyads. Repeated-measures analysis of variance, paired t tests, and logistic regression combined with qualitative data demonstrated that mothers achieved overall significant improvements in health literacy, and that home visitors are important catalysts for these improvements. These findings support the use of an empowerment model of health education, skill building, and direct information support to enable parents to better manage personal and child health and health care. © 2014 Society for Public Health Education.
Cadman, Kathleen Paco
The concept of lay worker health literacy is created by concurrently analyzing and synthesizing two intersecting concepts, lay workers and health literacy. Articulation of this unique intersection is the result of implementing a simplified Wilson's Concept Analysis Procedure. This process incorporates the following components: a) selecting a concept, b) determining the aims/purposes of analysis, c) identifying all uses of the concept, d) determining defining attributes, e) identifying a model case, f) identifying borderline, related, contrary, and illegitimate cases, g) identifying antecedents and consequences, and h) defining empirical referents. Furthermore, as current literature provides no operational definition for lay worker health literacy, one is created to contribute cohesion to the concept. © 2017 Wiley Periodicals, Inc.
Park, Hyejin; Cormier, Eileen; Glenna, Gordon
The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that health care professionals can effectively address skills gaps in health consumers' ability to access and use high quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth literacy scale (eHEALS) was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high from low quality information was considerably less. The findings suggest the need for eHealth education and support to health consumers from health care professionals, in particular, how to access and evaluate the quality of health information.
Minal S Kale
Full Text Available Low health literacy is associated with low adherence to self-management in many chronic diseases. Additionally, health beliefs are thought to be determinants of self-management behaviors. In this study we sought to determine the association, if any, of health literacy and health beliefs among elderly individuals with COPD.We enrolled a cohort of patients with COPD from two academic urban settings in New York, NY and Chicago, IL. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Using the framework of the Self-Regulation Model, illness and medication beliefs were measured with the Brief Illness Perception Questionnaire (B-IPQ and Beliefs about Medications Questionnaire (BMQ. Unadjusted analyses, with corresponding Cohen's d effect sizes, and multiple logistic regression were used to assess the relationships between HL and illness and medication beliefs.We enrolled 235 participants, 29% of whom had low health literacy. Patients with low health literacy were more likely to belong to a racial minority group (p<0.001, not be married (p = 0.006, and to have lower income (p<0.001 or education (p<0.001. In unadjusted analyses, patients with low health literacy were less likely to believe they will always have COPD (p = 0.003, Cohen's d = 0.42, and were more likely to be concerned about their illness ((p = 0.04, Cohen's d = 0.17. In analyses adjusted for sociodemographic factors and other health beliefs, patients with low health literacy were less likely to believe that they will always have COPD (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.65-0.94. In addition, the association of low health literacy with expressed concern about medications remained significant (OR: 1.20, 95% CI: 1.05-1.37 though the association of low health literacy with belief in the necessity of medications was no longer significant (OR: 0.92, 95% CI: 0.82-1.04.In this cohort of urban individuals with COPD, low health literacy was
The purpose of this study was to develop a comprehensive health literacy assessment tool for young adult college students. Participants were 144 undergraduate students. Two hundred and twenty-nine questions were developed, which were based on concepts identified by the US Department of Health and Human Services, the World Health Organization, and health communication scholars. Four health education experts reviewed this pool of items and helped select 87 questions for testing. Students completed an online assessment consisting of these 87 questions in June and October of 2012. Item response theory and goodness-of-fit values were used to help eliminate nonperforming questions. Fifty-one questions were selected based on good item response theory discrimination parameter values. The instrument has 51 questions that look promising for measuring health literacy in college students, but needs additional testing with a larger student population to see how these questions continue to perform.
Hill, Sophie J; Sofra, Tanya A
Objective Health literacy is on the policy agenda. Accessible, high-quality health information is a major component of health literacy. Health information materials include print, electronic or other media-based information enabling people to understand health and make health-related decisions. The aim of the present study was to present the findings and recommended actions as they relate to health information of the Victorian Consultation on Health Literacy. Methods Notes and submissions from the 2014 Victorian Consultation workshops and submissions were analysed thematically and a report prepared with input from an advisory committee. Results Health information needs to improve and recommendations are grouped into two overarching themes. First, the quality of information needs to be increased and this can be done by developing a principle-based framework to inform updating guidance for information production, formulating standards to raise quality and improving the systems for delivering information to people. Second, there needs to be a focus on users of health information. Recommendation actions were for information that promoted active participation in health encounters, resources to encourage critical users of health information and increased availability of information tailored to population diversity. Conclusion A framework to improve health information would underpin the efforts to meet literacy needs in a more consistent way, improving standards and ultimately increasing the participation by consumers and carers in health decision making and self-management. What is known about the topic? Health information is a critical component of the concept of health literacy. Poorer health literacy is associated with poorer health outcomes across a range of measures. Improving access to and the use of quality sources of health information is an important strategy for meeting the health literacy needs of the population. In recent years, health services and
Diviani, N.; van den Putte, B.; Meppelink, C.S.; van Weert, J.C.M.
Objective To gain new insights into the relationship between health literacy and evaluation of online health information. Methods Using a mixed-methods approach, forty-four semi-structured interviews were conducted followed by a short questionnaire on health literacy and eHealth literacy.
Rowlands, Gillian; Dodson, Sarity; Leung, Angela; Levin-Zamir, Diane
Accessible and responsive health systems are critical to population health and human development. While progress has been made toward global health and development targets, significant inequities remain within and between countries. Expanding health inequities suggest a widespread and systemic neglect of vulnerable citizens, and a failure to enshrine within policies a responsibility to tailor care to the variable capabilities of citizens. Implementation of health and social policies that drive the design of accessible health systems, services, products and infrastructure represents the next frontier for health reform. Within this chapter we argue the need to consider health and health literacy across policy domains, to operationalize the intent to address inequities in health in meaningful and pragmatic ways, and to actively monitor progress and impact within the context of the Sustainable Development Goals (SDGs). We contend that viewing and developing policies and systems within a health literacy framework will assist in placing citizens and equity considerations at the center of development efforts. In this chapter, we explore the relationship between health literacy and equitable access to health care, and the role of health system and policy reform. We first explore international policies, health literacy, and the SDGs. We then explore national policies and the role that national and local services and systems play in building health literacy, and responding to the health literacy challenges of citizens. We discuss the World Health Organization's (WHO) Framework for Integrated People-Centered Health Services and the way in which health services are being encouraged to understand and respond to citizen health literacy needs. Each section of the chapter ends with a summary and a review of health literacy research and practice. Throughout, we illustrate our points through 'vignettes' from around the world.
Jang, Haeran; An, Ji-Young
Utilizing social network analysis, this study aimed to analyze the main keywords in the literature regarding the health literacy of and the use of online health information by aged persons over 65. Medical Subject Heading keywords were extracted from articles on the PubMed database of the National Library of Medicine. For health literacy, 110 articles out of 361 were initially extracted. Seventy-one keywords out of 1,021 were finally selected after removing repeated keywords and applying pruning. Regarding the use of online health information, 19 articles out of 26 were selected. One hundred forty-four keywords were initially extracted. After removing the repeated keywords, 74 keywords were finally selected. Health literacy was found to be strongly connected with 'Health knowledge, attitudes, practices' and 'Patient education as topic.' 'Computer literacy' had strong connections with 'Internet' and 'Attitude towards computers.' 'Computer literacy' was connected to 'Health literacy,' and was studied according to the parameters 'Attitude towards health' and 'Patient education as topic.' The use of online health information was strongly connected with 'Health knowledge, attitudes, practices,' 'Consumer health information,' 'Patient education as topic,' etc. In the network, 'Computer literacy' was connected with 'Health education,' 'Patient satisfaction,' 'Self-efficacy,' 'Attitude to computer,' etc. Research on older citizens' health literacy and their use of online health information was conducted together with study of computer literacy, patient education, attitude towards health, health education, patient satisfaction, etc. In particular, self-efficacy was noted as an important keyword. Further research should be conducted to identify the effective outcomes of self-efficacy in the area of interest.
Begoray, Deborah L.; Banister, Elizabeth M.; Wharf Higgins, Joan; Wilmot, Robin
The commercial media is an influential sociocultural force and transmitter of health information especially for adolescents. Instruction in critical media health literacy, a combination of concepts from critical health literacy and critical media literacy, is a potentially effective means of raising adolescents' awareness about commercial media…
Petrič, Gregor; Atanasova, Sara; Kamin, Tanja
Electronic health (eHealth) literacy is an important skill that allows patients to navigate intelligibly through the vast, often misleading Web-based world. Although eHealth literacy has been investigated in general and specific demographic populations, it has not yet been analyzed on users of online health communities (OHCs). Evidence shows that OHCs are important Web 2.0 applications for patients for managing their health, but at the same time, warnings have been expressed regarding the quality and relevance of shared information. No studies exist that investigate levels of eHealth literacy among users of OHCs and differences in eHealth literacy between different types of users. The study aimed to investigate eHealth literacy across different types of users of OHCs based on a revised and extended eHealth literacy scale (eHEALS). The study was based on a cross-sectional Web survey on a simple random sample of 15,000 registered users of the most popular general OHC in Slovenia. The final sample comprised 644 users of the studied OHC. An extended eHEALS (eHEALS-E) was tested with factor analytical procedures, whereas user types were identified with a hierarchical clustering algorithm. The research question was analyzed with analysis of variance (ANOVA) procedure and pairwise comparison tests. Factor analysis of the revised and extended eHEALS revealed six dimensions: awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information, and being smart on the Net. The factor solution demonstrates a good fit to the data (root mean square error of approximation [RMSEA]=.059). The most developed dimension of eHEALS-E is awareness of different Internet sources (mean=3.98, standard deviation [SD]=0.61), whereas the least developed is understanding information (mean=3.11, SD=0.75). Clustering resulted in four user types: active help-seekers (48.3%, 311/644), lurkers (31.8%, 205/644), core relational users (16
White, Richard O; Chakkalakal, Rosette J; Presley, Caroline A; Bian, Aihua; Schildcrout, Jonathan S; Wallston, Kenneth A; Barto, Shari; Kripalani, Sunil; Rothman, Russell
Patient-provider communication is modifiable and is linked to diabetes outcomes. The association of communication quality with medical mistrust is unknown. We examined these factors within the context of a low-literacy/numeracy-focused intervention to improve diabetes care, using baseline data from diverse patients enrolled in a randomized trial of a health communication intervention. Demographics, measures of health communication (Communication Assessment Tool [CAT], Interpersonal Processes of Care survey [IPC-18]), health literacy (Short Test of Functional Health Literacy in Adults), depression, medical mistrust, and glycemic control were ascertained. Adjusted proportional odds models were used to test the association of mistrust with patient-reported communication quality. The interaction effect of health literacy on mistrust and communication quality was also assessed. A total of 410 patients were analyzed. High levels of mistrust were observed. In multivariable modeling, patients with higher mistrust had lower adjusted odds of reporting a higher CAT score (adjusted odds ratio [AOR] = 0.67, 95% confidence interval [CI] [0.52, 0.86], p = .003) and higher scores on the Communication (AOR = 0.69, 95% CI [0.55, 0.88], p = .008), Decided Together (AOR = 0.74, 95% CI [0.59, 0.93], p = .02), and Interpersonal Style (AOR = 0.69, 95% CI [0.53, 0.90], p = .015) subscales of the IPC-18. We observed evidence of an interaction effect of health literacy for the association between mistrust and the Decided Together subscale of the IPC-18 such that patients with higher mistrust and lower literacy perceived worse communication relative to mistrustful patients with higher literacy. In conclusion, medical mistrust was associated with poorer communication with providers in this public health setting. Patients' health literacy level may vary the effect of mistrust on interactional aspects of communication. Providers should consider the impact of mistrust on communication
Knudsen, Astrid Karnøe; Kayser, Lars
The increasing use of digital services and technologies in health care calls for effective tools to evaluate the users’ eHealth literacy in order to better understand the users’ interaction with health technologies. We here present a systematic review of existing tools to measure eHealth literacy...... and for what these tools have been used to investigate. We identified eight tools, of which three of them are bases upon a conceptual model of eHealth literacy and the remaining five are dual tools, i.a. comprised of individual measures for health literacy and digital literacy. Of these eight tools, only one...... tool (The eHealth literacy Scale - eHEALS) was used in other studies than the one it was originally published in. eHEALS has primarily been used to establish eHealth literacy levels in different populations. Five of the studies have been conducted by examining eHealth literacy’s impact on health...
Jiang, Shaohai; Hong, Y Alicia
Thanks to rapid penetration of mobile tools, more and more cancer survivors have adopted mobile-based patient-provider communication (MBPPC). The relationship between MBPPC and patients' health outcomes, however, remains unclear; how health literacy and patient activation interact with such relationship is unexplored. Data were drawn from National Cancer Institute's Health Information National Trends Survey 4 Cycle 3. A sample of 459 cancer survivors were included in the analysis. Based on the 3-stage model of health promotion using interactive media, this study empirically tested a moderated mediation model. MBPPC (eg, patient use of email, text message, mobile app, and social media to communicate with providers) had no direct effect on cancer survivors' emotional health. Instead, health literacy completely mediated this path. Patient activation positively moderated the effect of health literacy on emotional health and further increased the indirect effect of MBPPC on emotional health. MBPPC alone does not directly result in better emotional health outcomes; health literacy is the key to realize its health benefits; patient activation significantly strengthens the effects of MBPPC. As we embrace the mHealth movement, innovative programs are needed to promote MBPPC, and improve health literacy and activation of cancer survivors, particularly in underserved communities, to reduce health disparities. Copyright © 2017 John Wiley & Sons, Ltd.
Kobayashi, Lindsay C; Wardle, Jane; von Wagner, Christian
Health literacy skills tend to decline during ageing, which is often attributed to age-related cognitive decline. Whether health literacy skills may be influenced by technological and social factors during ageing is unknown. We investigated whether internet use and social engagement protect against health literacy decline during ageing, independent of cognitive decline. We used prospective data from 4368 men and women aged ≥52 years in the English Longitudinal Study of Ageing from 2004 to 2011. Health literacy was measured at baseline (2004-2005) and at follow-up (2010-2011) using a reading comprehension test of a fictitious medicine label. The influences of consistent internet use and engagement in each of the civic, leisure and cultural activities on health literacy decline over the follow-up were estimated. After adjusting for cognitive decline and other covariates, consistent internet use (1379/4368; 32%) was protectively associated with health literacy decline (OR=0.77; 95% CI 0.60 to 0.99), as was consistent engagement in cultural activities (1715/4368; 39%; OR=0.73; 95% CI 0.56 to 0.93). As the number of activities engaged in increased, the likelihood of health literacy decline steadily decreased (ptrendcinema, art galleries, museums and the theatre), may help older adults to maintain health literacy during ageing. Support for older adults to maintain socially engaged lives and to access the internet should help promote the maintenance of functional literacy skills during ageing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Tran, T. Paul
Full Text Available BACKGROUND: Health literacy is an important predictor of healthcare outcomes, but research on this topic has largely been absent from the emergency medicine literature.OBJECTIVE: We measured the prevalence of health literacy in parents or guardians of pediatric patients seen in the emergency department (ED.METHODS: This was an observational study conducted in a Midwestern urban, university-based, tertiary, Level 1 trauma center ED with 33,000 visits/year. Using convenience sampling during a three-month period, English-speaking parents or guardians of pediatric patients (< 19 yrs. were asked to complete the short version of the Test of Functional Health Literacy for Adults (s-TOFHLA. Parents/guardians were excluded if they had uncorrected visual impairment, required an interpreter, had altered mental status, or if the patients they accompanied were the subjects of a medical or trauma activation.RESULTS: Of the 188 parents or guardians approached, six did not consent or withdrew, one was excluded, leaving 181 (96.3% in the study. Of these, 19 (10.5% had either "marginal" or "inadequate" health literacy, while 162 (89.5%, 95% CI: 84.1%, 93.6% had "adequate" health literacy.CONCLUSION: A large majority (89.5% of English-speaking parents or guardians of pediatric patients evaluated in the ED have adequate health literacy. This data may prompt ED professionals to adjust their communication styles in the evaluation of children. Future multi-center studies are needed to confirm the findings in this pilot study.
Helitzer, Deborah; Hollis, Christine; Sanders, Margaret; Roybal, Suzanne
Most health literacy assessments evaluate literacy skills including reading, writing; numeracy and interpretation of tables, graphs, diagrams and charts. Some assess understanding of health systems, and the ability to adequately apply one's skills to specific health-related tasks or demands in health situations. However, to achieve functional health literacy, the ability to "obtain, process, and understand basic health information and services needed to make appropriate health decisions," other health literacy dimensions should be assessed: a person's knowledge and attitudes about a health issue affects his or her ability to and interest in participating in his or her own care. In patient care settings, the abilities to listen, ask questions and check one's understanding are crucial to making appropriate decisions and carrying out instructions. Although literacy is a skill associated with educational attainment and therefore difficult to change in a short time, health education interventions can address health literacy domains such as knowledge, attitudes and oral communication skills. For this reason, an instrument that can assess these constructs is a valuable part of a health educator's toolbox. The authors describe the development and process and outcomes of testing a novel instrument targeted to assess HPV and cervical cancer health literacy competencies, TALKDOC, including its validation with the Health Activities Literacy Scale.
Davis, Deborah Winders; Jones, V Faye; Logsdon, M Cynthia; Ryan, Lesa; Wilkerson-McMahon, Mandie
Health literacy has been shown to predict health behaviors and outcomes above the effects of education or socioeconomic status. Much remains unknown about the health literacy of parents and the role it plays in children's health outcomes or in health disparities. The current study explored the health communication needs and health literacy indicators in a diverse sample of parents (n = 75) to identify potential areas for future interventions. The sample consisted of parents of children 18 to 36 months old who were visiting 3 different pediatric medical offices, 2 of which served low-income families and 1 located in an affluent suburb. When comparisons were made between 2 educational attainment groups, there were variations in indicators of health literacy and health communication needs. These data can be used to guide the development of interventions by primary care providers to improve parent education.
Kushalnagar, Poorna; Ryan, Claire; Smith, Scott; Kushalnagar, Raja
This study investigates the relationship between critical health literacy (CHL) and discussion of health information among college deaf students who use American Sign Language. CHL is crucial in making appropriate health-related decisions for oneself and aiding others in making good health-choices. Research on general youth population shows that frequent health-related discussions with both friends and family is associated with higher health literacy. However, for our sample of deaf college-aged students who might have had less access to communication at home, we hypothesize that health-related discussions with same-age peers may be more important for critical health literacy. We asked two questions to assess the frequency of health-related discussions with friends and families: "How often do you discuss health-related information with your friends" and "How often do you discuss your family medical history with your family?". Participants rated their experience on a scale from 1-5 (1=never, 5=always). To assess CHL, 38 deaf and 38 hearing participants were shown a short scenario that showed a woman confiding in her friend after finding a lump in her breast. Participants were then asked what the friend should say. Responses were scored by a team of 3 raters using a CHL rubric. As predicted, results showed a strong relationship between discussion of health-related information with friends and CHL in both deaf and hearing samples. Discussion with family was linked to CHL only for hearing participants, but not deaf participants in our study. These findings underscore the importance of socializing with health-literate, accessible peers to improve the health literacy and health outcomes of all deaf people. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Liechty, Janet M; Saltzman, Jaclyn A; Musaad, Salma M
The purpose of this study was to examine associations between parental health literacy and parent attitudes about weight control strategies for young children. Parental low health literacy has been associated with poor child health outcomes, yet little is known about its relationship to child weight control and weight-related health information-seeking preferences. Data were drawn from the STRONG Kids Study, a Midwest panel survey among parents of preschool aged children (n = 497). Parents endorsed an average of 4.3 (SD =2.8) weight loss strategies, 53% endorsed all three recommended weight loss strategies for children, and fewer than 1% of parents endorsed any unsafe strategies. Parents were most likely to seek child weight loss information from healthcare professionals but those with low (vs. adequate) health literacy were significantly less likely to use the Internet or books and more likely to use minister/clergy as sources. Poisson and logistic regressions showed that higher health literacy was associated with endorsement of more strategies overall, more recommended strategies, and greater odds of endorsing each specific recommended strategy for child weight control, after adjusting for parent age, education, race/ethnicity, income, marital status, weight concern, and child BMI percentile. Findings suggest that health literacy impacts parental views about child weight loss strategies and health information-seeking preferences. Pediatric weight loss advice to parents should include assessment of parent attitudes and prior knowledge about child weight control and facilitate parent access to reliable sources of evidence-informed child weight control information. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background People with low health literacy may not have the capacity to self-manage their health and prevent the development of chronic disease through lifestyle risk factor modification. The aim of this narrative synthesis is to determine the effectiveness of primary healthcare providers in developing health literacy of patients to make SNAPW (smoking, nutrition, alcohol, physical activity and weight lifestyle changes. Methods Studies were identified by searching Medline, Embase, Cochrane Library, CINAHL, Joanna Briggs Institute, Psychinfo, Web of Science, Scopus, APAIS, Australian Medical Index, Community of Science and Google Scholar from 1 January 1985 to 30 April 2009. Health literacy and related concepts are poorly indexed in the databases so a list of text words were developed and tested for use. Hand searches were also conducted of four key journals. Studies published in English and included males and females aged 18 years and over with at least one SNAPW risk factor for the development of a chronic disease. The interventions had to be implemented within primary health care, with an aim to influence the health literacy of patients to make SNAPW lifestyle changes. The studies had to report an outcome measure associated with health literacy (knowledge, skills, attitudes, self efficacy, stages of change, motivation and patient activation and SNAPW risk factor. The definition of health literacy in terms of functional, communicative and critical health literacy provided the guiding framework for the review. Results 52 papers were included that described interventions to address health literacy and lifestyle risk factor modification provided by different health professionals. Most of the studies (71%, 37/52 demonstrated an improvement in health literacy, in particular interventions of a moderate to high intensity. Non medical health care providers were effective in improving health literacy. However this was confounded by intensity of
Aleda M. H. Chen
Full Text Available 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.
Delanoë, Agathe; Lépine, Johanie; Leiva Portocarrero, Maria Esther; Robitaille, Hubert; Turcotte, Stéphane; Lévesque, Isabelle; Wilson, Brenda J; Giguère, Anik M C; Légaré, France
It has been suggested that health literacy may impact the use of decision aids (DAs) among patients facing difficult decisions. Embedded in the pilot test of a questionnaire, this study aimed to measure the association between health literacy and pregnant women's intention to use a DA to decide about prenatal screening. We recruited a convenience sample of 45 pregnant women in three clinical sites (family practice teaching unit, birthing center and obstetrical ambulatory care clinic). We asked participating women to complete a self-administered questionnaire assessing their intention to use a DA to decide about prenatal screening and assessed their health literacy levels using one subjective and two objective scales. Two of the three scales discriminated between levels of health literacy (three numeracy questions and three health literacy questions). We found a positive correlation between pregnant women's intention to use a DA and subjective health literacy (Spearman coefficient, Rho 0.32, P = 0.04) but not objective health literacy (Spearman coefficient, Rho 0.07, P = 0.65). Hence subjective health literacy may affect the intention to use a DA among pregnant women facing a decision about prenatal screening. Special attention should be given to pregnant women with lower health literacy levels to increase their intention to use a DA and ensure that every pregnant women can give informed and value-based consent to prenatal screening.
Manganello, Jennifer A; Falisi, Angela L; Roberts, Kristin J; Smith, Katherine C; McKenzie, Lara B
An understanding of preferred sources of injury information among parents is needed to develop best practices for information dissemination. Yet, almost no research examines injury information seeking for a national sample of mothers. A cross-sectional online survey was conducted in 2013 with 1081 mothers in the United States (U.S.) with at least one child literacy with the Morris Single-Item Screener (18% low), and eHealth literacy using the eHEALS (28% low). The internet was the most preferred source for injury information (76%), followed by health providers (44%), and family/friends (35%). Most mothers selected the internet as the first choice for information about bicycle helmets (65%) and car seats (63%). For poison prevention, preferences were mixed; 48% internet compared with 41% health providers. Mothers with low health literacy were more likely to have discussed injury prevention with their doctors ( P = 0.022) and searched for injury information ( P = 0.001), but less likely to report the internet as a top source ( P literacy were less likely to search for injury information ( P information ( P = 0.028). Findings suggest the internet is a common source of injury prevention information, but health providers remain a valuable resource for mothers, especially those with lower literacy skills. Despite widespread internet use, health providers should be sure to communicate injury prevention information to mothers, especially those at risk for low health literacy and eHealth literacy.
Meppelink, C.S.; van Weert, J.C.M.; Brosius, A.; Smit, E.G.
Objective To evaluate whether Dutch online health information (OHI) generally reflects message elements that support information processing and understanding among people with low health literacy. Methods We content-analyzed one hundred Dutch webpages about Ebola, fibromyalgia, ALS, losing weight,
Wharf Higgins, Joan; Begoray, Deborah; MacDonald, Marjorie
With the rising concern over chronic health conditions and their prevention and management, health literacy is emerging as an important public health issue. As with the development of other forms of literacy, the ability for students to be able to access, understand, evaluate and communicate health information is a skill best developed during their years of public schooling. Health education curricula offer one approach to develop health literacy, yet little is known about its influence on neither students nor their experiences within an educational context. In this article, we describe our experience applying a social ecological model to investigating the implementation of a health education curriculum in four high schools in British Columbia, Canada. We used the model to guide a conceptual understanding of health literacy, develop research questions, select data collection strategies, and interpret the findings. Reflections and recommendations for using the model are offered.
Kim, Hyunmin; Goldsmith, Joy V; Sengupta, Soham; Mahmood, Asos; Powell, M Paige; Bhatt, Jay; Chang, Cyril F; Bhuyan, Soumitra S
Health literacy is critical for cancer patients as they must understand complex procedures or treatment options. Caregivers' health literacy also plays a crucial role in caring for cancer patients. Low health literacy is associated with low adherence to medications, poor health status, and increased health care costs. There is a growing interest in the use of mobile health applications (apps) to improve health literacy. Mobile health apps can empower underserved cancer patients and their caregivers by providing features or functionalities to enhance interactive patient-provider communication and to understand medical information more readily. Despite the potentiality of improving health literacy through mobile health apps, there exist several related concerns: no equal access to mobile technology, no familiarity or knowledge of using mobile health apps, and privacy and security concerns. These elements should be taken into account for health policy making and mobile apps design and development. Importantly, mobile apps should be developed with the goal of achieving a high range of user access by considering all health literacy level and various cultural and linguistic needs.
Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn
In this protocol for a pilot study we seek to establish the feasibility of using a web-based survey to simultaneously supply healthcare organisations and agencies with feedback on a key aspect of the care experience they provide and increase the generic health decision literacy of the individuals...
Graf, Allyson Stella; Patrick, Julie Hicks
Purpose: Sexual education in adolescence may represent the only formal sexual information individuals ever receive. It is unclear whether this early educational experience is sufficient to promote lifelong sexual health literacy. The purpose of this paper is to examine the influence of the timing and source of sexual knowledge on current safe sex…
Bennett, Jarred S; Boyle, Patricia A; James, Bryan D; Bennett, David A
Recent research has begun to recognize the important influence of literacy levels and how they affect health and wellbeing, especially in older adults. Our study focuses on health and financial literacy, two domains of literacy which previous research has suggested may be significantly related to health and wellbeing. Our study examines the relation of health and financial literacy with health promoting behaviors and health status among community-based older persons. We conducted a cross-sectional study using data from the Rush Memory and Aging Project, a community-based cohort study of aging in northeastern Illinois. The study consisted of 556 older persons without dementia, each determined by a clinical evaluation. Health and financial literacy were measured using a series of questions designed to assess the ability to understand and process health and financial information, concepts, and numeracy; the two scores were averaged to yield a total literacy score. Health promoting behaviors, including engagement in cognitive, physical, and social activities, were assessed using self report measures. Indicators of heath status, including cognition (global cognition and five specific cognitive abilities), functional status (basic and instrumental activities of daily living, mobility disability), and mental health (depressive symptoms, loneliness) were assessed. In a series of regression models adjusted for age, sex, and education, higher total literacy scores were associated with more frequent participation in health promoting behaviors, including cognitive, physical and social activities (all p values literacy scores were associated with higher cognitive function, less disability, and better mental health (all p values Literacy remained associated with health promoting behaviors and health status in fully adjusted models that also controlled for income and the number of chronic medical conditions. Most of the findings were similar for health and financial literacy
Originally an editorial for "English in Education," this short article summarises key issues in the imposition of a separate test for grammar, punctuation and spelling. It illustrates the poor foundations, lack of clarity and distortion of curriculum which invalidate the test.
Sep 7, 2010 ... The English literacy level of primary health care patients in Tshwane .... It is therefore important to use appropriate literacy assessment tools to .... Participants were given the following instruction: ..... One of the disadvantages.
Zide, Mary; Caswell, Kaitlyn; Peterson, Ellen; Aberle, Denise R; Bui, Alex At; Arnold, Corey W
eHealth apps have the potential to meet the information needs of patient populations and improve health literacy rates. However, little work has been done to document perceived usability of portals and health literacy of specific topics. Our aim was to establish a baseline of lung cancer health literacy and perceived portal usability. A survey based on previously validated instruments was used to assess a baseline of patient portal usability and health literacy within the domain of lung cancer. The survey was distributed via Amazon's Mechanical Turk to 500 participants. Our results show differences in preferences and literacy by demographic cohorts, with a trend of chronically ill patients having a more positive reception of patient portals and a higher health literacy rate of lung cancer knowledge (Pportals and higher level of health literacy within the domain of lung cancer.
Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm
Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review
Dageforde, Leigh Anne; Petersen, Alec W.; Feurer, Irene D.; Cavanaugh, Kerri L.; Harms, Kelly A.; Ehrenfeld, Jesse M.; Moore, Derek E.
Background Health literacy (HL) may be a mediator for known socioeconomic and racial disparities in living kidney donation. Methods We evaluated the associations of patient and demographic characteristics with HL in living kidney donors (LD), living donor kidney transplant recipients (LDR), and deceased donor recipients (DDR) in a single center retrospective review of patients undergoing kidney donation or transplantation from September 2010 to July 2012. HL and demographic data were collected. HL was assessed via the Short Literacy Survey (SLS) comprising three self-reported screening questions scored using the 5-point Likert scale [low (3-8), moderate (9-14), high (15)]. Chi-square and logistic regression were used to test factors associated with lower HL. Results The sample included 360 adults (105 LD, 103 LDR, 152 DDR; 46±14 years; 70% white; 56% male; 14±3 years of education). HL scores were skewed (49% high, 41% moderate, 10% low). The distribution of HL categories differed significantly among groups (p=0.019). After controlling for age, race, gender, education and a race-education interaction term, DDR were more likely to have moderate or low HL than LDR (OR 1.911; 95%CI 1.096, 3.332; p=0.022) Conclusions Overall, living donors had high HL. The distribution of low, moderate and high HL differed significantly between LD, DDR and LDR. DDR had a higher likelihood of having low HL than LDR. Screening kidney transplant candidates and donors for lower HL may identify barriers to living donation. Future interventions addressing HL may be important to increase living donation and reduce disparities. PMID:24573114
Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa
Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure. PMID:25315595
Gele, Abdi A; Pettersen, Kjell Sverre; Torheim, Liv Elin; Kumar, Bernadette
Existing studies report a positive association between inadequate health literacy and immigrant's adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08-12.3) and socially less integrated (OR 8.17, CI 1.21-54.8) were independent predictors of an inadequate health literacy among Somali women. Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.
Abdi A. Gele
Full Text Available Abstract Background Existing studies report a positive association between inadequate health literacy and immigrant’s adverse health outcomes. Despite substantial research on this topic among immigrants, little is known about the level of health literacy among Somali women in Europe, and particularly in Norway. Methods A cross sectional study using respondent driven sampling was conducted in Oslo, Norway. A sample of 302 Somali women, 25 years and older, was interviewed using the short version of the European Health Literacy Questionnaire. Data was analysed using logistic regression. Results Findings revealed that 71 % of Somali women in Oslo lack the ability to obtain, understand and act upon health information and services, and to make appropriate health decisions. Being unemployed (OR 3.66, CI 1.08–12.3 and socially less integrated (OR 8.17, CI 1.21–54.8 were independent predictors of an inadequate health literacy among Somali women. Conclusions Enhanced health literacy will most likely increase the chance to better health outcomes for immigrants, thereby moving towards health equity in the Norwegian society. Therefore, policies and programs are required to focus and improve health literacy of immigrant communities.
Nair, Satish Chandrasekhar; Satish, Karthyayani Priya; Sreedharan, Jayadevan; Ibrahim, Halah
Abstract Background Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restr...
Dawkins-Moultin, Lenna; McDonald, Andrea; McKyer, Lisako
While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level.
Nowadays it is believed that a comprehensive approach towards one's health requires the development and subsequent mastering of health literacy. Although this term has no Polish equivalent, it applies to the ability of individuals to access, analyze and understand information necessary to make informed health decisions. In this publication it is suggested that 'biegłość zdrowotna' can be used as a corresponding Polish term. This publication is based on the review of the available literature (in Polish and in English) on health literacy. To illustrate the hypothetical level of health literacy among Polish employers and employees reports of the Chief Labour Inspectorate and individual items from the Second European Survey of Enterprises on New and Emerging Risks (ESENER-2) were used. The analysis proves that health literacy is a multidimensional concept which has been studied and investigated so far only in relation to chosen nosological units, but practically it does not appear in relation to occupational health. There are reasons to believe that in Poland the low level of health literacy among both employers and employees, lies at the forefront of a passive approach towards the safeguarding of workers health. The concept of health literacy needs further dissemination in Poland, whereas the main area of future research should be the design of the Polish tool for assessing health literacy. The national system of occupational health seems to offer a possible ground for implementing such a concept, especially bearing in mind that within the current system there are several entities and services, which have the legal mandate to undertake informative and advisory duties - exactly those, which help build and master health literacy skills. Med Pr 2016;67(5):681-689. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Rowlands, Gillian; Protheroe, Joanne; Winkley, John
skills in relation to these. DESIGN AND SETTING: An English observational study comparing health materials with national working-age population skills. METHOD: Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified......BACKGROUND: Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. AIM: To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population...... of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information....
Calvasina, Paola; Lawrence, Herenia P.; Hoffman-Goetz, Laurie; Norman, Cameron D.
Background Inadequate functional health literacy is a common problem in immigrant populations. The aim of this study was to investigate the association between oral (dental) health literacy (OHL) and participation in oral health care among Brazilian immigrants in Toronto, Ontario, Canada. Methods The study used a cross-sectional design and a convenience sample of 101 Brazilian immigrants selected through the snowball sampling technique. Data were analyzed using descriptive statistics and logi...
Rebecca K. Britt
Full Text Available eHealth literacy (eHEALS has yet to be examined with regard to need for cognition (NFC, as well as whether NFC moderates the relationship between eHealth literacy and seeking out online health information. Past research that has examined NFC as an interaction between whether interactivity on health web sites affected comprehension and attitudes, but no research to date has examined whether cognitive need interacts with eHEALS and subsequent information seeking behaviors. The present study tests eHEALS and its connection to need for cognition (NFC in the role of online health information seeking behaviors. Results showed that high eHEALS individuals were more likely to seek out online health information and were more likely to have higher NFC scores. NFC did not emerge as a moderator on the relationship between eHealth literacy and online health information seeking behaviors. Future directions are discussed, in particular, examining eHEALS as a construct of efficacy and further need to examine eHEALS with need for cognition in health communication research.
Zhang, Qinghua; Huang, Feifei; Liu, Zaoling; Zhang, Na; Mahapatra, Tanmay; Tang, Weiming; Lei, Yang; Dai, Yali; Tang, Songyuan; Zhang, Jingping
Considering the importance of health literacy (HL) for the maximum yield from the hypertension control programs, development of a reliable and valid instrument of hypertension-related HL is critical. This study aimed to translate and validate the High Blood Pressure-Health Literacy Scale (HBP-HLS) into Chinese (C-HBP-HLS) and evaluate its psychometric properties in Chinese context. Between June 2013 and January 2014, a cross-sectional study was conducted among recruited hypertensive patients belonging to the Han and Kazakh-Chinese communities in Urumqi, Xinjiang, China. A pilot sample (n = 242) was selected for the exploratory factor analysis of the translated and modified instrument. Another sample (n = 308) was recruited for the confirmatory factor analysis. C-HBP-HLS consisted of five dimensions (Print Health Literacy, Medication Label, Understanding Ability, Newest Vital Sign Test, and Avoiding Food Allergy) containing 15 items, accounting for 77.7% of the total variance. The 5-factor model demonstrated a good overall fit. The scale-level content validity index was 0.85. Cronbach's alpha of the overall scale was 0.78 and test-retest reliability was 0.96. Education level had a strong positive correlation with the scores for items Q1, Q2, and Q3(r = 0.481, 0.492, 0.475, respectively). Health Literacy scores among Kazakh patients were significantly lower than Han (7.13±7.90 vs. 30.10±13.42, Z = -14.573, P<0.001). C-HBP-HLS demonstrated suitable factor structure and robust psychometric properties for measuring health literacy level among hypertensive patients in China.
Park, Hyejin; Lee, Eunjoo
With the Internet being the preferred primary source for information seekers, 9 out of 10 Internet users report that they have looked online for health information in South Korea. Nurses as well as nursing students need to be knowledgeable about online health information resources and able to evaluate relevant information online in order to assist patients and patients' families' access. The purpose of the study was to assess eHealth literacy among undergraduate nursing students in South Korea. The specific aims were to: 1) identify the self-reported eHealth literacy levels, and 2) determine differences in levels of eHealth literacy between pre-nursing and nursing students. This study used a descriptive comparison design. One hundred and seventy-six undergraduate nursing students in South Korea participated. Participants were asked to complete the eHealth Literacy Scale. Collected data were analyzed using a descriptive statistical method and t-tests. Participants responded that the Internet is a useful or very useful tool in helping them make health-related decisions. Furthermore, participants felt that it is important to be able to access health resources on the Internet. The majority of the participants either agreed or strongly agreed that they felt comfortable using the Internet with awareness of what information is available and of their skill to find information. Only a few respondents agreed or strongly agreed that they had the ability to differentiate between a high quality and a low quality health resource on the Internet. Students enrolled in nursing scored higher means in all eHealth literacy items than students enrolled in pre-nursing. Six out of ten eHealth literacy items showed significant differences between two groups. Findings from this study provide fundamental data for education administrators and educators to begin supporting students with appropriate education programs to enhance their eHealth literacy. Copyright © 2014 Elsevier Ltd. All
Noblin, Alice M.; Wan, Thomas T. H.; Fottler, Myron
Health literacy is a concept that describes a patient's ability to understand materials provided by physicians or other providers. Several factors, including education level, income, and age, can influence health literacy. Research conducted at one medical practice in Florida indicated that in spite of the patients’ relatively low education level, the majority indicated a broad acceptance of personal health record (PHR) technology. The key variable explaining patient willingness to adopt a PHR was the patient's health literacy as measured by the eHealth Literacy Scale (eHEALS). Adoption and use rates may also depend on the availability of office staff for hands-on training as well as assistance with interpretation of medical information. It is hoped that technology barriers will disappear over time, and usefulness of the information will promote increased utilization of PHRs. Patient understanding of the information remains a challenge that must be overcome to realize the full potential of PHRs. PMID:23209454
Rasu, Rafia S; Bawa, Walter Agbor; Suminski, Richard; Snella, Kathleen; Warady, Bradley
Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL) on healthcare utilization and healthcare expenditure. Database analysis used Medical Expenditure Panel Survey (MEPS) from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs) were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL). HLS ranged from 0-500. Health literacy level (HLL) and categorized in 2 groups: Below basic or basic (HLS Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER) visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI). A P value of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA® 11.0 statistical software. The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%). Caucasian were the predominant racial ethnic group (83%) and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P healthcare utilization and expenditure. Individuals with below basic or basic HLL have greater healthcare
Shaw, Susan J; Huebner, Cristina; Armin, Julie; Orzech, Kathryn; Orzech, Katherine; Vivian, James
Cultural and language differences and socioeconomic status interact with and contribute to low health literacy, defined as the inability to understand or act on medical/therapeutic instructions. Health literacy is increasingly recognized as an important factor in patient compliance, cancer screening utilization, and chronic disease outcomes. Commendable efforts have been initiated by the American Medical Association and other organizations to address low health literacy among patients. Less work has been done, however, to place health literacy in the broader context of socioeconomic and cultural differences among patients and providers that hinder communication and compliance. This review examines cultural influences on health literacy, cancer screening and chronic disease outcomes. We argue that cultural beliefs around health and illness contribute to an individual's ability to understand and act on a health care provider's instructions. This paper proposes key aspects of the intersection between health literacy and culturally varying beliefs about health which merit further exploration.
Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro
In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth
Mayberry, Lindsay S; Kripalani, Sunil; Rothman, Russell L; Osborn, Chandra Y
Abstract Background: Patient web portals (PWPs) offer patients remote access to their medical record and communication with providers. Adults with health literacy limitations are less likely to access and use health information technology (HIT), including PWPs. In diabetes, PWP use has been associated with patient satisfaction, patient-provider communication, and glycemic control. Using mixed methods, we explored the relationships between health literacy, numeracy, and computer literacy and the usage of a PWP and HIT. Participants (N=61 adults with type 2 diabetes) attended focus groups and completed surveys, including measures of health literacy, numeracy, and computer anxiety (an indicator of computer literacy) and frequency of PWP and HIT use. Computer literacy was positively associated with health literacy (r=0.41, Pdigital divide" in diabetes by helping adults access a PWP or HIT for diabetes management.
Soto Mas, Francisco; Mein, Erika; Fuentes, Brenda; Thatcher, Barry; Balcázar, Héctor
Adult Hispanic immigrants are at a greater risk of experiencing the negative outcomes related to low health literacy, as they confront cultural and language barriers to the complex and predominately monolingual English-based U.S. health system. One approach that has the potential for simultaneously addressing the health, literacy, and language needs of Hispanics is the combination of health literacy and English as a second language (ESL) instruction. The purpose of the project was to evaluate the feasibility of using ESL instruction as a medium for improving health literacy among Hispanic immigrants. Objectives included the development, implementation, and evaluation of an interdisciplinary health literacy/ESL curriculum that integrates theories of health literacy and health behavior research and practice, sociocultural theories of literacy and communication, and adult learning principles. This article describes the curriculum development process and provides preliminary qualitative data on learners' experiences with the curriculum. Results indicate that the curriculum was attractive to participants and that they were highly satisfied with both the format and content. The curriculum described here represents one example of an audience-centered approach designed to meet the specific health and literacy needs of the Hispanic population on the U.S.-Mexico border. The combination of ESL and health literacy contributed to a perceived positive learning experience among participants. Interdisciplinary approaches to health literacy are recommended.
Smith, Sian K; Nutbeam, Don; McCaffery, Kirsten J
This article explores the concept and measurement of health literacy in the context of shared health decision-making. It draws upon a series of qualitative and quantitative studies undertaken in the development and evaluation of a bowel cancer screening decision aid for low literacy populations. The findings indicate that different types of health literacy (functional, interactive and critical) are required in decision-making and present a set of instruments to assess and discriminate between higher level health literacy skills required for engagement in decision-making. It concludes that greater sophistication in both the definition and measurement of health literacy in research is needed.
Full Text Available Background: Health literacy is an increasingly important public health concern. However, little is known about the health literacy of general public in China. The aim of this study was to evaluate the prevalence of low health literacy and demographic associations in Shanghai, China. Methods: This study was a community-based cross-sectional health survey utilizing a multi-stage random sampling design. The sample consisted of 1360 individuals aged 15–69 years with the total community-dwelling Chinese as the sample frame. Health literacy was measured by a questionnaire developed on the basis of a national health literacy manual released by the Chinese Ministry of Health. Multiple logistic regression models were used to identify whether common socio-demographic features were associated with health literacy level. Results: The prevalence of low health literacy was 84.49% (95% CI, 82.56% to 86.41%. The prevalence of low health literacy was negatively associated with the level of education, occupation, and annual household income, but was not associated with gender, age, or the presence of non-communicable chronic disease. Conclusions: Simplifying health services, enhancing health education, and promoting interventions to improve health literacy in high-risk populations should be considered as part of the strategies in the making of health policy in China.
Green, Jamie A; Mor, Maria K; Shields, Anne Marie; Sevick, Mary Ann; Arnold, Robert M; Palevsky, Paul M; Fine, Michael J; Weisbord, Steven D
Although limited health literacy is common in hemodialysis patients, its effects on clinical outcomes are not well understood. Observational study. 260 maintenance hemodialysis patients enrolled in a randomized clinical trial of symptom management strategies from January 2009 through April 2011. Limited health literacy. Dialysis adherence (missed and abbreviated treatments) and health resource utilization (emergency department visits and end-stage renal disease [ESRD]-related hospitalizations). We assessed health literacy using the Rapid Estimate of Adult Literacy in Medicine (REALM) and used negative binomial regression to analyze the independent associations of limited health literacy with dialysis adherence and health resource utilization over 12-24 months. 41 of 260 (16%) patients showed limited health literacy (REALM score, ≤60). There were 1,152 missed treatments, 5,127 abbreviated treatments, 552 emergency department visits, and 463 ESRD-related hospitalizations. Limited health literacy was associated independently with an increased incidence of missed dialysis treatments (missed, 0.6% vs 0.3%; adjusted incidence rate ratio [IRR], 2.14; 95% CI, 1.10-4.17), emergency department visits (annual visits, 1.7 vs 1.0; adjusted IRR, 1.37; 95% CI, 1.01-1.86), and hospitalizations related to ESRD (annual hospitalizations, 0.9 vs 0.5; adjusted IRR, 1.55; 95% CI, 1.03-2.34). Generalizability and potential for residual confounding. Patients receiving maintenance hemodialysis who have limited health literacy are more likely to miss dialysis treatments, use emergency care, and be hospitalized related to their kidney disease. These findings have important clinical practice and cost implications. Copyright © 2013 National Kidney Foundation, Inc. All rights reserved.
Gaag, M. van der; Heide, I. van der; Spreeuwenberg, P.; Brabers, A.E.M.; Rademakers, J.J.D.J.M.
Background: In the Netherlands, ethnic minority populations visit their general practitioner (GP) more often than the indigenous population. An explanation for this association is lacking. Recently, health literacy is suggested as a possible explaining mechanism. Internationally, associations
Tsubakita, Takashi; Kawazoe, Nobuo; Kasano, Eri
Health literacy predicts health outcomes. Despite concerns surrounding the health of Japanese young adults, to date there has been no objective assessment of health literacy in this population. This study aimed to develop a Functional Health Literacy Scale for Young Adults (funHLS-YA) based on item response theory. Each item in the scale requires participants to choose the most relevant term from 3 choices in relation to a target item, thus assessing objective rather than perceived health literacy. The 20-item scale was administered to 1816 university students and 1751 responded. Cronbach's α coefficient was .73. Difficulty and discrimination parameters of each item were estimated, resulting in the exclusion of 1 item. Some items showed different difficulty parameters for male and female participants, reflecting that some aspects of health literacy may differ by gender. The current 19-item version of funHLS-YA can reliably assess the objective health literacy of Japanese young adults.
Olesen, Kasper; F. Reynheim, Anne Louise; Joensen, Lene
Aim Self-management of diabetes is influenced by a range of factors including the ability to access, understand, appraise, and use of health information in everyday life, which can collectively be called health literacy. We investigated associations between nine domains of health literacy and HbA1c...... of nine health literacy domains. This association remained significant after adjusting for educational attainment. Among the domains, ‘Actively managing my health’ had the strongest impact on HbA1c. This was in turn predicted by ‘Appraising health information’, ‘Having sufficient information to manage...... level in people with type 1 diabetes. Methods A cross-sectional study was conducted with 1399 people with type 1 diabetes attending a Danish specialist diabetes clinic. Health literacy was assessed using the nine-domain Health Literacy Questionnaire. The association between health literacy and HbA1c...
The process of navigating through the modern American health care system is becoming progressively challenging. The range of tasks being asked of patients in the digital age is vast and complex and includes completing intricate insurance applications, signing complex consent forms, and translating medical data and prescription medication directions. Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely offered by medical providers. Mounting evidence now supports a growing awareness that general health literacy is the greatest individual factor affecting a person's health status. Copyright © 2015 Elsevier Inc. All rights reserved.
Lincoln, Alisa; Paasche-Orlow, Michael K; Cheng, Debbie M; Lloyd-Travaglini, Christine; Caruso, Christine; Saitz, Richard; Samet, Jeffrey H
Health literacy has been linked to health status in a variety of chronic diseases. However, evidence for a relationship between health literacy and mental health outcomes is sparse. We hypothesized that low literacy would be associated with higher addiction severity, higher levels of depressive symptoms, and worse mental health functioning compared with those with higher literacy in adults with alcohol and drug dependence. The association of literacy with multiple mental health outcomes was assessed using multivariable analyses. Measurement instruments included the Rapid Estimate of Adult Literacy in Medicine (REALM), the Center for Epidemiologic Studies-Depression (CES-D) scale, the Mental Component Summary scale of the Short Form Health Survey, and the Addiction Severity Index for drug and alcohol addiction. Subjects included 380 adults recruited during detoxification treatment and followed prospectively at 6-month intervals for 2 years. Based on the REALM, subjects were classified as having either low ( or = 9th grade) literacy levels. In longitudinal analyses, low literacy was associated with more depressive symptoms. The adjusted mean difference in CES-D scores between low and high literacy levels was 4 (Pmental health-related quality of life or addiction severity. In people with alcohol and drug dependence, low literacy is associated with worse depressive symptoms. The mechanisms underlying the relationship between literacy and mental health outcomes should be explored to inform future intervention efforts.
Alberti, Traci L; Morris, Nancy J
An increasing number of Americans are using urgent care (UC) clinics due to: improved health insurance coverage, the need to decrease cost, primary care offices with limited appointment availability, and a desire for convenient care. Patients are treated by providers they may not know for episodic illness or injuries while in pain or not feeling well. Treatment instructions and follow-up directions are provided quickly. To examine health literacy in the adult UC population and identify patient characteristics associated with health literacy risk. As part of a larger cross-sectional study, UC patients seen between October 2013 and January 2014 completed a demographic questionnaire and the Newest Vital Sign. Descriptive, nonparametric analyses, and a multinomial logistic regression were done to assess health literacy, associated and predictive factors. A total of 57.5% of 285 participants had adequate health literacy. The likelihood of limited health literacy was associated with increased age (p literacy is common in a suburban UC setting, increasing the risk that consumers may not understand vital health information. Clear provider communication and confirmation of comprehension of discharge instructions for self-management is essential to optimize outcomes for UC patients. ©2017 American Association of Nurse Practitioners.
Manganello, Jennifer; Gerstner, Gena; Pergolino, Kristen; Graham, Yvonne; Falisi, Angela; Strogatz, David
An understanding of the association of health literacy with patterns related to access and usage of digital technologies and preferences for sources of health information is necessary for public health agencies and organizations to appropriately target channels for health information dissemination. A cross-sectional telephone survey was conducted in New York State. Health literacy was assessed using the Morris Single-Item Screener, a self-report question. A weighted analysis was conducted utilizing Stata/SE. The final sample size of New York State residents used for analysis was 1350. In general, self-report health literacy did not predict digital technology use (ie, Internet and smartphone use, text messaging) but was associated with certain digital activities. People with low self-report health literacy were less likely to use search engines (P = .026) but more likely to get health information from social networking sites (P = .002) and use health-related phone apps (P = .046). With respect to health information seeking, those with lower self-report health literacy reported greater difficulty with their most recent search for health information. Furthermore, they were more likely to prefer text messages (P = .013) and radio (P = .022), 2 text-limited communication channels, to receive health information than those with higher self-report health literacy. While self-report health literacy does not appear to influence access to and use of digital technologies, there is a strong association with experiences searching for health information and preferences for health information sources. Public health agencies and organizations should consider the needs and preferences of people with low health literacy when determining channels for health information dissemination. They should also consider implementing interventions to develop health information-seeking skills in populations they serve and prepare information and materials that are easily accessible and
Full Text Available Abstract Background Health literacy is an increasingly important topic in both the policy and research agendas of many countries. During the recent 36th Annual Meeting of the North American Primary Care Research Group, the authors led an audio-taped 3-hour forum, "Studying Health Literacy: Developing an International Collaboration," where the current state of health literacy (HL in the United States (US and United Kingdom (UK was presented and attendees were encouraged to debate a future research agenda. Discussion of Forum Themes The debate centred around three distinct themes, including: (1 refining HL definitions and conceptual models, (2 HL measurement and assessment tools, and (3 developing a collaborative international research agenda. The attendees agreed that future research should be theoretically grounded and conceptual models employed in studies should be explicit to allow for international comparisons to be drawn. Summary and Authors Reflections The importance of HL research and its possible contribution to health disparities is becoming increasingly recognised internationally. International collaborations and comparative studies could illuminate some of the possible determinants of disparities, and also possibly provide a vehicle to examine other research questions of interest.
Health insurance literacy is an emerging concept in the health education and health promotion field. The passage of the Affordable Care Act highlighted the link between health insurance and health outcomes. However, the law does not specifically address how the public should be educated on choosing an appropriate health insurance plan. Research shows adults, regardless of previous health insurance status, are likely confused and uncertain about their selection. The University of Maryland Extension developed and created health insurance Smart Choice Health Insurance™ to reduce confusion and increase confidence and capability to make this decision. Andragogy, an adult learning theory, was used to guide the development of the program and help ensure best practices are used to achieve desired outcomes. Using the six principles of andragogy, the team incorporated reality-based case studies, allowed adults time to practice, and emphasized choice making and many other elements to create an atmosphere conducive to adult learning. Results from Smart Choice indicate the program is successful in reducing confusion and increasing confidence. Furthermore, feedback from participants and trained educators indicates that adults were engaged in the program and found the materials useful. Based on program success, creation of new health insurance literacy programs grounded in adult education principles is under way.
Blizniuk, Anastasiya; Ueno, Masayuki; Furukawa, Sayaka; Kawaguchi, Yoko
Oral health literacy has become a popular research area in the last decade; however, to date no health literacy instruments in the Russian language exist. The objectives of this study were to develop a Russian version of the Oral Health Literacy Instrument (OHLI) and to examine its reliability and validity. A convenience sample of patients who visited the dental division of the district hospital in Belarus was used in the study. The OHLI, created originally in English, was modified to adapt it to characteristics of routine dental services in Belarus and then translated into Russian, followed by back-translation. Participants completed a self-administered socio-demographic questionnaire, an oral health knowledge test and the Russian version of the OHLI (R-OHLI). Bivariate and multivariate statistical analyses, including multiple regression modeling, were performed to examine reliability and validity of the R-OHLI. Participants were 281 adult patients aged from 18 to 60 years, with a mean age of 33.1 ± 12.2; 64.1% of them were women. Cronbach's alpha values for the two sections (reading comprehension and numeracy) and the total R-OHLI were 0.853, 0.815 and 0.895, respectively. The mean total R-OHLI score was 77.2 ± 14.5; the mean reading comprehension and numeracy scores were 39.5 ± 7.5 and 37.8 ± 8.8, respectively. The R-OHLI was significantly correlated to the oral health knowledge test. Pearson's correlation coefficients between the oral health knowledge test and the reading comprehension, numeracy and total R-OHLI were 0.401, 0.258, and 0.363, respectively (p literacy instrument for Russian-speaking people.
McTavish, Sarah; Moore, Spencer; Harper, Sam; Lynch, John
The United Nations Millennium Development Goals have identified improving women's access to maternal health care as a key target in reducing maternal mortality in sub-Saharan Africa (sSA). Although individual factors such as income and urban residence can affect maternal health care use, little is known about national-level factors associated with use. Yet, such knowledge may highlight the importance of global and national policies in improving use. This study examines the importance of national female literacy on women's maternal health care use in continental sSA. Data that come from the 2002-2003 World Health Survey. Multilevel logistic regression was used to examine the association between national female literacy and individual's non-use of maternal health care, while adjusting for individual-level factors and national economic development. Analyses also assessed effect modification of the association between income and non-use by female literacy. Effect modification was evaluated with the likelihood ratio test (G(2)). We found that within countries, individual age, education, urban residence and household income were associated with lack of maternal health care. National female literacy modified the association of household income with lack of maternal health care use. The strength of the association between income and lack of maternal health care was weaker in countries with higher female literacy. We conclude therefore that higher national levels of female literacy may reduce income-related inequalities in use through a range of possible mechanisms, including women's increased labour participation and higher status in society. National policies that are able to address female literacy and women's status in sub-Saharan Africa may help reduce income-related inequalities in maternal health care use. Copyright © 2010 Elsevier Ltd. All rights reserved.
van der Vaart, Rosalie; Drossaert, Constance
Background: With the digitization of health care and the wide availability of Web-based applications, a broad set of skills is essential to properly use such facilities; these skills are called digital health literacy or eHealth literacy. Current instruments to measure digital health literacy focus
Robinson, Cendrine; Seaman, Elizabeth L; Montgomery, LaTrice; Winfrey, Adia
African-American children and adolescents experience an undue burden of disease for many health outcomes compared to their White peers. More research needs to be completed for this priority population to improve their health outcomes and ameliorate health disparities. Integrating hip hop music or hip hop dance into interventions may help engage African-American youth in health interventions and improve their health outcomes. We conducted a review of the literature to characterize hip hop interventions and determine their potential to improve health. We searched Web of Science, Scopus, PsycINFO, and EMBASE to identify studies that assessed hip hop interventions. To be included, studies had to (1) be focused on a psychosocial or physical health intervention that included hip hop and (2) present quantitative data assessing intervention outcomes. Twenty-three articles were identified as meeting all inclusion criteria and were coded by two reviewers. Articles were assessed with regards to sample characteristics, study design, analysis, intervention components, and results. Hip hop interventions have been developed to improve health literacy, health behavior, and mental health. The interventions were primarily targeted to African-American and Latino children and adolescents. Many of the health literacy and mental health studies used non-experimental study designs. Among the 12 (of 14) health behavior studies that used experimental designs, the association between hip hop interventions and positive health outcomes was inconsistent. The number of experimental hip hop intervention studies is limited. Future research is required to determine if hip hop interventions can promote health.
Nouri, Sarah S; Rudd, Rima E
Oral communication between health care providers and patients--the "oral exchange"--greatly impacts patient health outcomes; however, only recently have health literacy inquiries been incorporated into this field. This review examines the intersection between oral and aural literacy and the oral exchange. A systematic literature search was carried out. Papers published in English since 2003 that specifically examine oral/aural literacy and oral patient-provider communication were included. The search yielded 999 articles, 12 of which were included in this review. Three tools have been developed to measure either patient or provider oral/aural literacy. There is a discrepancy between patient and provider oral/aural literacy levels, and high literacy demand is associated with reduced patient learning. Low patient oral/aural literacy is associated with poor health outcomes. Two interventions have been developed to reduce literacy demand. This review demonstrates the critical role of oral and aural literacy in the oral exchange, the importance of reducing literacy demand, and the need for future research in this field. Recommendations include the use of plain language and teach-back by providers, as well as incorporation of awareness of oral and aural literacy into community programs and health care provider education and training. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Paige, Samantha R; Krieger, Janice L; Stellefson, Michael L
Disparities in online health information accessibility are partially due to varying levels of eHealth literacy and perceived trust. This study examined the relationship between eHealth literacy and perceived trust in online health communication channels and sources among diverse sociodemographic groups. A stratified sample of Black/African Americans (n = 402) and Caucasians (n = 409) completed a Web-based survey that measured eHealth literacy and perceived trustworthiness of online health communication channels and information sources. eHealth literacy positively predicted perceived trust in online health communication channels and sources, but disparities existed by sociodemographic factors. Segmenting audiences according to eHealth literacy level provides a detailed understanding of how perceived trust in discrete online health communication channels and information sources varies among diverse audiences. Black/African Americans with low eHealth literacy had high perceived trust in YouTube and Twitter, whereas Black/African Americans with high eHealth literacy had high perceived trust in online government and religious organizations. Older adults with low eHealth literacy had high perceived trust in Facebook but low perceived trust in online support groups. Researchers and practitioners should consider the sociodemographics and eHealth literacy level of an intended audience when tailoring information through trustworthy online health communication channels and information sources.
Rowlands, Gillian; Protheroe, Joanne; Winkley, John; Richardson, Marty; Seed, Paul T; Rudd, Rima
Low health literacy is associated with poorer health and higher mortality. Complex health materials are a barrier to health. To assess the literacy and numeracy skills required to understand and use commonly used English health information materials, and to describe population skills in relation to these. An English observational study comparing health materials with national working-age population skills. Health materials were sampled using a health literacy framework. Competency thresholds to understand and use the materials were identified. The proportion of the population above and below these thresholds, and the sociodemographic variables associated with a greater risk of being below the thresholds, were described. Sixty-four health materials were sampled. Two competency thresholds were identified: text (literacy) only, and text + numeracy; 2515/5795 participants (43%) were below the text-only threshold, while 2905/4767 (61%) were below the text + numeracy threshold. Univariable analyses of social determinants of health showed that those groups more at risk of socioeconomic deprivation had higher odds of being below the health literacy competency threshold than those at lower risk of deprivation. Multivariable analysis resulted in some variables becoming non-significant or reduced in effect. Levels of low health literacy mirror those found in other industrialised countries, with a mismatch between the complexity of health materials and the skills of the English adult working-age population. Those most in need of health information have the least access to it. Efficacious strategies are building population skills, improving health professionals' communication, and improving written health information. © British Journal of General Practice 2015.
Mackert, Michael; Mabry-Flynn, Amanda; Champlin, Sara; Donovan, Erin E; Pounders, Kathrynn
Approximately one-half of American adults exhibit low health literacy and thus struggle to find and use health information. Low health literacy is associated with negative outcomes including overall poorer health. Health information technology (HIT) makes health information available directly to patients through electronic tools including patient portals, wearable technology, and mobile apps. The direct availability of this information to patients, however, may be complicated by misunderstanding of HIT privacy and information sharing. The purpose of this study was to determine whether health literacy is associated with patients' use of four types of HIT tools: fitness and nutrition apps, activity trackers, and patient portals. Additionally, we sought to explore whether health literacy is associated with patients' perceived ease of use and usefulness of these HIT tools, as well as patients' perceptions of privacy offered by HIT tools and trust in government, media, technology companies, and health care. This study is the first wide-scale investigation of these interrelated concepts. Participants were 4974 American adults (n=2102, 42.26% male, n=3146, 63.25% white, average age 43.5, SD 16.7 years). Participants completed the Newest Vital Sign measure of health literacy and indicated their actual use of HIT tools, as well as the perceived ease of use and usefulness of these applications. Participants also answered questions regarding information privacy and institutional trust, as well as demographic items. Cross-tabulation analysis indicated that adequate versus less than adequate health literacy was significantly associated with use of fitness apps (P=.02), nutrition apps (Pliteracy was significantly associated with greater perceived ease of use and perceived usefulness across all HIT tools after controlling for demographics. Regarding privacy perceptions of HIT and institutional trust, patients with greater health literacy often demonstrated decreased privacy
Mahoney, Stephen T; Tawfik-Sexton, Dahlia; Strassle, Paula D; Farrell, Timothy M; Duke, Meredith C
Hospital readmissions following bariatric surgery are high and it is necessary to identify modifiable risk factors to minimize this postoperative cost. We hypothesize that lower levels of education and health literacy are associated with increased risks of nonadherence, thus leading to increased emergency department (ED) visits and preventable readmissions postoperatively. Bariatric surgery patients presenting between October 2015 and December 2016 were administered a preoperative questionnaire that measured education level and the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) health literacy test. The rates of postoperative ED visits and readmissions were across education levels (≤12th grade versus >12th grade) and health literacy scores (≤8th grade versus high school level). A composite "hospital visit" outcome was also assessed. Ninety-five patients were enrolled; 23 had ≤12th grade level education and 7 scored ≤8th grade on the REALM-SF. Patients with ≤12th grade education were significantly more likely to have a hospital visit after surgery, compared with patients with >12th grade education (incidence rate ratio [IRR] 3.06, P = .008). No significant difference in ED visits, readmission, or hospital visits was seen when stratified by REALM-SF health literacy score. Lower level of education was associated with more than threefold increased risk of postoperative ED visits and readmission in our center's bariatric surgery patients. A patient's education level is a low-cost means to identify patients who are at risk for postoperative hospital visits, and who may benefit from enhanced educational efforts or more intensive postoperative follow-up.
Bonneville, Luc; Bouchard, Louise
Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey. PMID:29569968
Farmanova, Elina; Bonneville, Luc; Bouchard, Louise
Organizational health literacy is described as an organization-wide effort to transform organization and delivery of care and services to make it easier for people to navigate, understand, and use information and services to take care of their health. Several health literacy guides have been developed to assist healthcare organizations with this effort, but their content has not been systematically reviewed to understand the scope and practical implications of this transformation. The objective of this study was to review (1) theories and frameworks that inform the concept of organizational health literacy, (2) the attributes of organizational health literacy as described in the guides, (3) the evidence for the effectiveness of the guides, and (4) the barriers and facilitators to implementing organizational health literacy. Drawing on a metanarrative review method, 48 publications were reviewed, of which 15 dealt with the theories and operational frameworks, 20 presented health literacy guides, and 13 addressed guided implementation of organizational health literacy. Seven theories and 9 operational frameworks have been identified. Six health literacy dimensions and 9 quality-improvement characteristics were reviewed for each health literacy guide. Evidence about the effectiveness of health literacy guides is limited at this time, but experiences with the guides were positive. Thirteen key barriers (conceived also as facilitators) were identified. Further development of organizational health literacy requires a strong and a clear connection between its vision and operationalization as an implementation strategy to patient-centered care. For many organizations, becoming health literate will require multiple, simultaneous, and radical changes. Organizational health literacy has to make sense from clinical and financial perspectives in order for organizations to embark on such transformative journey.
Meppelink, Corine S.; van Weert, Julia C. M.; Haven, Carola J.; Smit, Edith G.
Background: Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. Objective: The aim of this paper
Meppelink, C.S.; van Weert, J.C.M.; Haven, C.J.; Smit, E.G.
Background: Processing Web-based health information can be difficult, especially for people with low health literacy. Presenting health information in an audiovisual format, such as animation, is expected to improve understanding among low health literate audiences. Objective: The aim of this paper
Tennant, Bethany; Stellefson, Michael; Dodd, Virginia; Chaney, Beth; Chaney, Don; Paige, Samantha; Alber, Julia
Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t217.60=-2.98, P=.003. Younger age (b=-0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R(2) =.17, R(2)adj =.14, F9,229=5.277, Pinformation (OR 2.63, Wald= 8.09, df=1, P=.004). Finally, more education predicted greater use of Web 2.0 for health
Perrenoud, Beatrice; Velonaki, Venetia-Sofia; Bodenmann, Patrick; Ramelet, Anne-Sylvie
designed to reduce the effects of limited health literacy in general. Some of the outcomes of the included studies were comprehension and behavioral intent, outcomes which could be strongly related to the informed consent process. Without making any distinction of the studies referring to the informed consent process, they conclude that several health literacy interventions, for example, adding video to narrative, could improve an individual's comprehension. Schenker et al. conducted a systematic review on the interventions to improve patient comprehension of medical and surgical procedures, including articles published until 2008. One of their conclusions was that, in most studies, while particular attention is needed for interventions provided to patients with limited literacy, the literacy of the patients was not addressed or assessed.Since then, many articles on health literacy and informed consent have been published. According to a recent review on best practices and new models of health literacy for informed consent, which includes papers published from 2004 to 2014, over half of the collected articles were published since 2010. This review, which is limited to literature within the US and its territories, and does not focus on the evaluation of the recommended practices in the literature, concludes that different tactics for simplifying written documents and clarifying verbal exchanges, and the use of multimedia formats and computerized exchanges might ameliorate constraints to health literate communications required for informed consent.Studies have evaluated the effectiveness of health literacy interventions which aim to improve the informed consent process. Improvement of the informed consent process may refer not only to the patients' comprehension but also, for example, to the recall of the information provided, to their intention to ask for clarifications, or to their satisfaction with the procedure. Interventions described and tested in the literature focus
Lauritzen, Dorthe Furstrand; Kayser, Lars
In a world with rising focus on the use of eHealth, the match between the competences of the individual and the demands of eHealth systems becomes increasingly important, thus making assessment of eHealth literacy as a measure of user competences a vital element. We propose the eHealth Literacy...
BACKGROUND: Limited health literacy among adults is one of the many barriers to better oral health outcomes. It is not uncommon to find people who consider understanding oral health information a challenge. Therefore, the present study assessed oral health literacy among clients visiting Gian Sagar Dental College and ...
Mantwill, Sarah; Schulz, Peter J
To compare functional health literacy (HL) levels in three immigrant groups to those of the German- and Italian-speaking non-immigrant population in Switzerland. Moreover, to investigate whether language-independent, respectively language-dependent, functional HL and variables of acculturation were associated with self-reported health status among immigrants. Language-independent HL was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) in the respective native languages. Language-dependent HL was measured using Brief Health Literacy Screeners (BHLS) asking about participants' confidence in understanding medical information in the language of the host country. Measures of acculturation included length of stay and age when taking residency in Switzerland. In particular Albanian- and Portuguese-speaking immigrants had lower levels of functional HL. In unadjusted analysis "age when taking residency in Switzerland" was associated with the BHLS. Adjusted analysis showed that the BHLS were significantly associated with self-reported health among all immigrant groups (p≤0.01). Functional HL that is dependent on understanding of medical information in the language of the new host country is a better predictor for self-reported health status among immigrants than language-independent HL. In the clinical setting limited functional HL might be a significant obstacle to successful disease treatment and prevention in immigrants. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
I løbet at de seneste 10 år har literacy-begrebet for alvor vundet indpas som et etableret begreb i den nordiske forsknings- og uddannelsesverden, ikke mindst inden for læse-/skriveområdet. Der er dog langt fra konsensus om den præcise betydning af begrebet, og af samme grund hersker der en udbredt...... forvirring om hvorledes det skal forstås. Man kan på den baggrund stille spørgsmålet om hvorvidt literacy overhovedet er et brugbart og produktivt begreb i en nordisk kontekst. Når man i PISA-undersøgelserne giver læseområdet den pleonastiske betegnelse reading literacy, kunne det give anledning til...... at tvivle på at det er tilfældet. Med afsæt i forskellige begrebs- og forskningsmæssige perspektiver diskuteres i oplægget literacy-begrebets berettigelse, og i forlængelse heraf præsenteres et bud på en trifokal optik som teoretisk blik på literacy i undervisningskontekster. Eksempler fra forskellige...
Friis, Karina; Lasgaard, Mathias; Rowlands, Gill
behavior (smoking, physical inactivity, poor diet) and obesity. The study included respondents ages 25 years or older drawn from a large population-based survey conducted in 2013 (N = 29,473). Two scales from the Health Literacy Questionnaire were used: (a) Understanding health information well enough...... to know what to do and (b) Ability to actively engage with health care providers. Multiple mediation analyses were conducted using the Karlson-Holm-Breen method. The study showed that health literacy in general and the ability to understand health information in particular mediated the relationship......Individuals with a lower education level frequently have unhealthier behaviors than individuals with a higher education level, but the pathway is not fully understood. The aim of this study was to investigate whether health literacy mediates the association between educational attainment and health...
Rajan, Keertichandra; Kennedy, Jonathan; King, Lawrence
Standard policy prescriptions for improving public health in less developed countries (LDCs) prioritise raising average income levels over redistributive policies since it is widely accepted that 'wealthier is healthier'. It is argued that income inequality becomes a significant predictor of public health only after the 'epidemiological transition'. This paper tests this theory in India, where rising income levels have not been matched by improvements in public health. We use state-, district-, and individual-level data to investigate the relationship between infant and under-five mortality, and average income, poverty, income inequality, and literacy. Our analysis shows that at both state- and district-level public health is negatively associated with average income and positively associated with poverty. But, at both levels, controlling for poverty and literacy renders average income statistically insignificant. At state-level, only literacy remains a significant and negative predictor. At the less aggregated district-level, both poverty and literacy predict public health but literacy has a stronger effect than poverty. Inequality does not predict public health at state- or district-levels. At the individual-level, however, it is a strong predictor of self-reported ailment, even after we control for district average income, individual income, and individual education. Our analysis suggests that wealthier is indeed healthier in India - but only to the extent that high average incomes reflect low poverty and high literacy. Furthermore, inequality has a strong effect on self-reported health. Standard policy prescriptions, then, need revision: first, alleviating poverty may be more effective than raising average income levels; second, non-income goods like literacy may make an important contribution to public health; and third, policy should be based on a broader understanding of societal well-being and the factors that promote it. Copyright © 2013 Elsevier Ltd. All
Jessup, Rebecca L.; Osborne, Richard H.; Beauchamp, Alison; Bourne, Allison; Buchbinder, Rachelle
Background Health literacy refers to an individual’s ability to find, understand and use health information in order to promote and maintain health. An individual’s health literacy may also be influenced by the way health care organisations deliver care. The aim of this study was to investigate the influence of hospital service type (public versus private) on individual health literacy. Methods Two cross-sectional surveys were conducted using the Health Literacy Questionnaire (HLQ), a multi-d...
Diviani, Nicola; van den Putte, Bas; Meppelink, Corine S; van Weert, Julia C M
To gain new insights into the relationship between health literacy and evaluation of online health information. Using a mixed-methods approach, forty-four semi-structured interviews were conducted followed by a short questionnaire on health literacy and eHealth literacy. Qualitative and quantitative data were merged to explore differences and similarities among respondents with different health literacy levels. Thematic analysis showed that most respondents did not question the quality of online health information and relied on evaluation criteria not recognized by existing web quality guidelines. Individuals with low health literacy, despite presenting higher eHealth literacy scores, appeared to use less established criteria and to rely more heavily on non-established ones compared to those with high health literacy. Disparities in evaluation ability among people with different health literacy might be related to differences in awareness of the issue and to the use of different evaluation criteria. Future research should quantitatively investigate the interplay between health literacy, use of established and non-established criteria, and ability to evaluate online health information. Communication and patient education efforts should aim to raise awareness on online health information quality and to promote use of established evaluation criteria, especially among low health literate citizens. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Ku, Ya-Lie; Sheu, Sheila; Kuo, Shih-Ming
Information literacy, essential to evidences-based nursing, can promote nurses' capability for life-long learning. Nursing education should strive to employ information literacy education in nursing curricula to improve information literacy abilities among nursing students. This study explored the effectiveness of information literacy education by comparing information literacy skills among a group of RN-BSN (Registered Nurse to Bachelors of Science in Nursing) students who received information literacy education with a group that did not. This quasi-experimental study was conducted during a women's health issues course taught between March and June 2004. Content was presented to the 32 RN-BSN students enrolled in this course, which also taught skills on searching and screening, integrating, analyzing, applying, and presenting information. At the beginning and end of the program, 75 RN-BSN student self-evaluated on a 10 point Likert scale their attained skills in searching and screening, integrating, analyzing, applying, and presenting information. Results identified no significant differences between the experimental (n = 32) and control groups (n = 43) in terms of age, marital status, job title, work unit, years of work experience, and information literacy skills as measured at the beginning of the semester. At the end of the semester during which content was taught, the information literacy of the experimental group in all categories, with the exception of information presentation, was significantly improved as compared to that of the control group. Results were especially significant in terms of integrating, analyzing, and applying skill categories. It is hoped that in the future nursing students will apply enhanced information literacy to address and resolve patients' health problems in clinical settings.
Jorm Anthony F; Christensen Helen; Griffiths Kathleen M
Abstract Background Although there have been many population studies of mental health literacy, little is known about the mental health literacy of people who reside in rural areas. This study sought to determine the impact of remoteness on public knowledge of depression and schizophrenia. Methods The mental health literacy of residents of major cities, inner regional, and outer-remote (including outer regional, remote, and very remote) regions were compared using data from a 2003–04 Australi...
Magnani, Jared W; Schlusser, Courtney L; Kimani, Everlyne; Rollman, Bruce L; Paasche-Orlow, Michael K; Bickmore, Timothy W
Atrial fibrillation (AF) is a highly prevalent heart rhythm condition that has significant associated morbidity and requires chronic treatment. Mobile health (mHealth) technologies have the potential to enhance multiple aspects of AF care, including education, monitoring of symptoms, and encouraging and tracking medication adherence. We have previously implemented and tested relational agents to improve outcomes in chronic disease and sought to develop a smartphone-based relational agent for improving patient-centered outcomes in AF. The objective of this study was to pilot a smartphone-based relational agent as preparation for a randomized clinical trial, the Atrial Fibrillation Health Literacy Information Technology Trial (AF-LITT). We developed the relational agent for use by a smartphone consistent with our prior approaches. We programmed the relational agent as a computer-animated agent to simulate a face-to-face conversation and to serve as a health counselor or coach specific to AF. Relational agent's dialogue content, informed by a review of literature, focused on patient-centered domains and qualitative interviews with patients with AF, encompassed AF education, common symptoms, adherence challenges, and patient activation. We established that the content was accessible to individuals with limited health or computer literacy. Relational agent content coordinated with use of the smartphone AliveCor Kardia heart rate and rhythm monitor. Participants (N=31) were recruited as a convenience cohort from ambulatory clinical sites and instructed to use the relational agent and Kardia for 30 days. We collected demographic, social, and clinical characteristics and conducted baseline and 30-day assessments of health-related quality of life (HRQoL) with the Atrial Fibrillation Effect on Quality of life (AFEQT) measure; self-reported medication adherence with the Morisky 8-item Medication Adherence Scale (MMAS-8); and patient activation with the Patient Activation
Walsh, Louisa; Hemsley, Bronwyn; Allan, Meredith; Adams, Natalie; Balandin, Susan; Georgiou, Andrew; Higgins, Isabel; McCarthy, Shaun; Hill, Sophie
My Health Record is Australia's electronic personal health record system, which was introduced in July 2012. As of August 2017, approximately 21 percent of Australia's total population was registered to use My Health Record. Internationally, usability issues have been shown to negatively influence the uptake and use of electronic health record systems, and this scenario may particularly affect people who have low e-health literacy. It is likely that usability issues are negatively affecting the uptake and use of My Health Record in Australia. To identify potential e-health literacy-related usability issues within My Health Record through a heuristic evaluation method. Between September 14 and October 12, 2016, three of the authors conducted a heuristic evaluation of the two consumer-facing components of My Health Record-the information website and the electronic health record itself. These two components were evaluated against two sets of heuristics-the Health Literacy Online checklist and the Monkman Heuristics. The Health Literacy Online checklist and Monkman Heuristics are evidence-based checklists of web design elements with a focus on design for audiences with low health literacy. During this heuristic evaluation, the investigators individually navigated through the consumer-facing components of My Health Record, recording instances where the My Health Record did not conform to the checklist criteria. After the individual evaluations were completed, the investigators conferred and aggregated their results. From this process, a list of usability violations was constructed. When evaluated against the Health Literacy Online Checklist, the information website demonstrated violations in 12 of 35 criteria, and the electronic health record demonstrated violations in 16 of 35 criteria. When evaluated against the Monkman Heuristics, the information website demonstrated violations in 7 of 11 criteria, and the electronic health record demonstrated violations in 9 of 11
Connie V. Chan
Full Text Available Background: Consumer eHealth tools play an increasingly important role in engaging patients as participants in managing their health and seeking health information. However, there is a documented gap between the skill and knowledge demands of eHealth systems and user competencies to benefit from these tools. Objective: This research aims to reveal the knowledge- and skill-related barriers to effective use of eHealth tools. Methods: We used a micro-analytic framework for characterizing the different cognitive dimensions of eHealth literacy to classify task demands and barriers that 20 participants experienced while performing online information-seeking and decision-making tasks. Results: Participants ranged widely in their task performance across all 6 tasks as measured by task scores and types of barriers encountered. The highest performing participant experienced only 14 barriers whereas the lowest scoring one experienced 153. A more detailed analysis of two tasks revealed that the highest number of incorrect answers and experienced barriers were caused by tasks requiring: (a Media literacy and Science literacy at high cognitive complexity levels and (b a combination of Numeracy and Information literacy at different cognitive complexity levels. Conclusions: Applying this type of analysis enabled us to characterize task demands by literacy type and by cognitive complexity. Mapping barriers to literacy types provided insight into the interaction between users and eHealth tasks. Although the gap between eHealth tools, users’ skills, and knowledge can be difficult to bridge, an understanding of the cognitive complexity and literacy demands can serve to reduce the gap between designer and consumer.
Health education is largely informed by psychological theories and practices that pursue reductionist views of people learning. However, critical attention is moving to understand health in ways that reconsider relationships to context and the forms of life within which everyday living takes place. This shift is apparent in theoretical…
Islam, Md Mohaimenul; Touray, Musa; Yang, Hsuan-Chia; Poly, Tahmina Nasrin; Nguyen, Phung-Anh; Li, Yu-Chuan Jack; Syed Abdul, Shabbir
Web 2.0 has become a leading health communication platform and will continue to attract young users; therefore, the objective of this study was to understand the impact of Web 2.0 on health information seeking behavior among university students in Bangladesh. A random sample of adults (n = 199, mean 23.75 years, SD 2.87) participated in a cross-sectional, a survey that included the eHealth literacy scale (eHEALS) assessed use of Web 2.0 for health information. Collected data were analyzed using a descriptive statistical method and t-tests. Finally logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and use of Web 2.0 for seeking and sharing health information. Almost 74% of older Web 2.0 users (147/199, 73.9%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Current study support that current Web-based health information seeking and sharing behaviors influence health-related decision making.
Garbers, Samantha; Chiasson, Mary Ann
The objective of this study was to examine the association between inadequate functional health literacy in Spanish among low-income Latinas aged 40 and older and cervical cancer screening knowledge and behavior. Spanish-speaking Latinas aged 40-78 of various nationalities (n = 205) participated in a study that included a survey on cervical cancer knowledge and behavior administered in Spanish and the Spanish version of the Test of Functional Health Literacy in Adults. Compared to those with adequate and marginal health literacy, women with inadequate functional health literacy in Spanish were significantly less likely to have ever had a Papanicolaou (Pap) test (odds ratio, 0.12; 95% confidence interval [CI], 0.04-0.37) or in the last three years (odds ratio, 0.35; 95% CI, 0.18-0.68) and were significantly more likely to have had their last Pap test at a local public hospital (odds ratio, 2.43; 95% CI, 1.18-4.97). Even when controlling for other factors, women with inadequate health literacy were 16.7 times less likely (adjusted odds ratio, 0.06; 95% CI, 0.01-0.55) to have ever had a Pap test. Almost half of the population we studied will have difficulty interpreting written medical materials, even in Spanish. When developing efforts to reach women who have not been screened, programs and service providers need to be aware that the women most in need of information about screening may be more likely to be unable to read any written materials provided to them, regardless of the language or level of simplicity of the materials. Programs and strategies need to be implemented to increase screening prevalence and to minimize the identified gaps in regular screening for Latinas who have low health literacy.
Estacio, Emee Vida; Nathan, Lavinia; Protheroe, Joanne
Parents play a vital role in promoting children's health. The parental health literacy skills are important since the decisions they make can have an impact on other family members' health and well-being. Using an assets-based approach, this project aimed to explore the skills parents use to communicate health messages with their children and how they manage their family's health. Six adult parents of children aged 0-16 years old took part in this photovoice study. The thematic analysis suggests that tapping into the creativity of parents through the gamification of health messages and encouraging children's independence are effective ways to promote healthy behaviors. Trusting their instincts and developing good relationships with healthcare providers were also seen as important. However, there is still a need to improve confidence and skills, particularly on how to critically appraise information, especially in this digital age where sources of information are vast and conflicting messages could arise.
Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa
Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…
Brey, Rebecca A.; Clark, Susan E.; Wantz, Molly S.
The second National Health Education Standard states the importance of student demonstration of the ability to access valid health information and services. The teaching technique presented in this article provides an opportunity for children and adolescents to develop their health literacy and advocacy skills by contributing to a class resource…
Jamieson Lisa M
Full Text Available Abstract Objectives To determine oral health literacy (REALD-30 and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. Results REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. Conclusions REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.
Hirvonen, Noora; Ek, Stefan; Niemelä, Raimo; Korpelainen, Raija; Huotari, Maija-Leena
Introduction: Everyday health information literacy refers to the competencies needed to find relevant information, evaluate its reliability, and use it to make decisions concerning health in everyday life. More evidence is needed of the determinants of health information literacy to better understand how it is acquired and through which mechanisms…
Yang, Shu-Ching; Luo, Yi-Fang; Chiang, Chia-Hsun
eHealth literacy is gaining importance for maintaining and promoting health. Studies have found that individuals with high eHealth literacy are more likely to adopt healthy eating, exercise, and sleep behaviors. In addition, previous studies have shown that various individual factors (eg, frequency of seeking information on health issues, degree of health concern, frequency of eating organic food, and students' college major) are associated with eHealth literacy and health-promoting lifestyles. Nevertheless, few studies have explored the associations among individual factors, eHealth literacy, and health-promoting lifestyles among college students. Moreover, there is a lack of studies that focus on eHealth literacy as a predictor of psychological health behaviors. To examine the associations among various individual factors, eHealth literacy, and health-promoting lifestyles. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. The Health-promoting Lifestyle Scale is a 23-item instrument developed to measure college students' self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management. A nationally representative sample of 556 valid college students in Taiwan was surveyed. A questionnaire was administered to gather the respondents' background information, including the frequency of seeking information on health issues, the frequency of eating organic food, the degree of health concern, and the students' major. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health-promoting lifestyles. The study found that factors such as medical majors (t 550 =2.47-7.55, PeHealth literacy. Moreover, critical eHealth literacy positively predicted all 6 health-promoting lifestyle dimensions (t 547 =2.66-7.28, PeHealth literacy, and had a positive health
Indonesia, Pakistan, Brazil and Chile) found the median prevalence rate of ..... aspects of well-being of their patients.39 Programs aimed at integrating mental health ... tural beliefs and formulate their inclusion in an appropriate referral system.
Zotti, Paola; Cocchi, Simone; Polesel, Jerry; Cipolat Mis, Chiara; Bragatto, Donato; Cavuto, Silvio; Conficconi, Alice; Costanzo, Carla; De Giorgi, Melissa; Drace, Christina A; Fiorini, Federica; Gangeri, Laura; Lisi, Andrea; Martino, Rosalba; Mosconi, Paola; Paradiso, Angelo; Ravaioli, Valentina; Truccolo, Ivana; De Paoli, Paolo
The aim of this study was to assess the psychometric characteristics of four Health Literacy (HL) measurement tools, viz. Newest Vital Sign (NVS), Short Test of Functional Health Literacy in Adults (STOFHLA), Single Item Literacy Screener (SILS) and Single question on Self-rated Reading Ability (SrRA) among Italian oncology patients. The original version of the tools were translated from the English language into Italian using a standard forward-backward procedure and according to internationally recognized good practices. Their internal consistency (reliability) and validity (construct, convergent and discriminative) were tested in a sample of 245 consecutive cancer patients recruited from seven Italian health care centers. The internal consistency of the STOFHLA-I was Chronbach's α=0.96 and that of NVS-I was α=0.74. The STOFHLA-I, NVS-I, SILS-I and SrRA-I scores were in a good relative correlation and in all tools the discriminative known-group validity was confirmed. The reliability and validity values were similar to those obtained from other cultural context studies. The psychometric characteristics of the Italian version of NVS, STHOFLA, SILS and SrRA were found to be good, with satisfactory reliability and validity. This indicates that they could be used as a screening tool in Italian patients. Moreover, the use of the same cross-cultural tools, validated in different languages, is essential for implementing multicenter studies to measure and compare the functional HL levels across countries.
Full Text Available Aim: The aim of this study was to find out how the health literacy of primiparae in the first six months of motherhood is examined. The following research questions were raised: What methods are used to examine maternal health literacy? What aspects of maternal health literacy are investigated? Do the results prove any link between maternal health literacy and child health? Design: Review. Methods: The search for primary research studies was based on a combination of the following keywords: health literacy, mother*, maternity*, information, and knowledge in the Scopus and Web of Science databases. Exclusion criteria: not a primary study, does not concern research on primiparae of children under six months, unrelated to health literacy research or obtaining of information and acquiring of knowledge, not available in full-text, or clear research methodology description not available. The data were processed using thematic analysis based on the sorting method. Results: 31 studies were found, 17 of which were analysed. The majority of studies used quantitative methods of research with standardized tools. The key categories of health literacy related to obtaining, understanding and use of health information. No direct correlation was clearly demonstrated between level of maternal health literacy and child health. Conclusion: The trend in terms of the focus and goals of professional studies, regardless of cultural or national context, is a shift away from examining the way information is acquired to how it is understood by mothers.
Poureslami, Iraj; Nimmon, Laura; Rootman, Irving; Fitzgerald, Mark J
Understanding the nature and impact of health literacy is a priority in health promotion and chronic disease prevention and treatment. Health literacy comprises the application of a broad set of skills to access, comprehend, evaluate, communicate and act on health information for improved health and well-being. A complex concept, it involves multiple participants and is enacted across a wide variety of contexts. Health literacy's complexity has given rise to challenges achieving a standard definition and developing means to measure all its dimensions. In May 2013, a group of health literacy experts, clinicians and policymakers convened at an Expert Roundtable to review the current state of health literacy research and practice, and make recommendations about refining its definition, expanding its measurement and integrating best practices into chronic disease management. The four-day knowledge exchange concluded that the successful integration of health literacy into policy and practice depends on the development of a more substantial evidence base. A review of the successes and gaps in health literacy research, education and interventions culminated in the identification of key priorities to further the health literacy agenda. The workshop was funded by the UBC Peter Wall Institute for Advanced Studies, Vancouver. © The Author 2016. Published by Oxford University Press.
Demian, Maryam N; Shapiro, R Jean; Thornton, Wendy Loken
There is a high prevalence of non-adherence to immunosuppressants in kidney transplant recipients. Although limited health literacy is common in kidney recipients and is linked to adverse outcomes in other medical populations, its effect on medication adherence in kidney transplant recipients remains poorly understood. The objective was to investigate the effect of lower health literacy on immunosuppressant adherence. Kidney recipients who were at least 6 months post-transplant and outpatients of Vancouver General Hospital in B.C., Canada were recruited through invitation letters. A total of 96 recipients completed the Health Literacy Questionnaire, which provides a multifactorial profile of self-reported health literacy and the Transplant Effects Questionnaire-Adherence subscale measuring self-reported immunosuppressant adherence. Hierarchical linear regression was used to analyze the association between health literacy and adherence after controlling for identified risk factors of non-adherence. Our sample was on average 53 years old, 56% male and 9 years post-transplant. Kidney recipients reported low levels of health literacy on scales measuring active health management and critical appraisal of information and 75% reported non-perfect adherence. Worse adherence was associated with poorer overall health literacy (Δ R 2 = 0.08, P = 0.004) and lower scores on six of nine of the health literacy factors. Poorer health literacy is associated with lower immunosuppressant adherence in adult kidney transplant recipients suggesting the importance of considering a recipient's level of health literacy in research and clinical contexts. Medication adherence interventions can target the six factors of health literacy identified as being risk factors for lower medication adherence.
Rodríguez, Sally Ann; Roter, Debra L; Castillo-Salgado, Carlos; Hooker, Gillian W; Erby, Lori H
Literacy deficits and underutilization of medical services have been linked to health disparities among minorities, and this appears especially relevant for the Latino population. Given the increasing importance of genetics, assessment of genetic health literacy may direct future efforts to better serve this vulnerable population. The current study was designed to contribute to this area by translating and validating a Spanish-language genetic health literacy measure. This was a cross-sectional study involving an interviewer-administered questionnaire. Eligible individuals were Latinos between the ages of 18 and 75 residing in Maryland, who self-reported Spanish as their primary language, recruited through convenience sampling. The genetic health literacy measure components were adapted from existing English-language measures [Erby, Roter, Larson, & Cho's (2008) Rapid Estimate of Adult Literacy in Genetics (REAL-G) and Hooker et al.'s (2014) Genetic Literacy and Comprehension]. An existing Spanish-language general health literacy measure was used to establish preliminary concurrent validity [Lee, Bender, Ruiz, & Cho's (2006) SAHLSA]. 116 individuals completed the assessment. The Spanish-language REAL-G (REAL-G-Sp) was found to correlate well with the SAHLSA (Pearson's r = .77, p validity with an existing health literacy measure in the Latino population residing in Maryland. Significant proportions of this population are predicted to have limitations in genetic health literacy, even when information is provided in Spanish.
van Schaik, T M; Jørstad, H T; Twickler, T B; Peters, R J G; Tijssen, J P G; Essink-Bot, M L; Fransen, M P
To explore the association between health literacy and the risk of cardiovascular disease (CVD), and to assess the differential effects by health literacy level of a nurse-coordinated secondary prevention program (NCPP) in patients with coronary artery disease (CAD). Data were collected in two medical centres participating in the RESPONSE trial (Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists). CVD risk profiles were assessed at baseline and 12-month follow-up using the Systematic Coronary Risk Evaluation (SCORE). Health literacy was assessed by the short Rapid Estimate of Adult Literacy in Medicine (REALM-D) and the Newest Vital Sign (NVS-D); self-reported health literacy was evaluated by the Set of Brief Screening Questions (SBSQ-D). Among 201 CAD patients, 18% exhibited reading difficulties, 52% had difficulty understanding and applying written information, and 5% scored low on self-reported health literacy. Patients with low NVS-D scores had a higher CVD risk [mean SCORE 5.2 (SD 4.8) versus 3.3 (SD 4.1), p literacy levels without significant differences. Inadequate health literacy is prevalent in CAD patients in the Netherlands, and is associated with less favourable CVD risk profiles. Where many other forms of CVD prevention fail, nurse-coordinated care seems to be effective among patients with inadequate health literacy.
Jordan, Susanne; Hoebel, Jens
In today's information society, health literacy (HL) is considered important for health maintenance and disease management. In this context, dealing with health information is fundamental and requires different cognitive and social skills. The aim of this study was to investigate the distribution of HL levels in the adult population of Germany, and to identify associations with health behaviours and health status. The analyses were based on data from the German Health Update (GEDA) study, a cross-sectional survey of the German-speaking adult population of Germany, which was conducted from October 2013 to June 2014. Health literacy was assessed with the short form of the European Health Literacy Questionnaire (HLS EU-Q16), along with questions about socio-demographics, health behaviours, and health status. The HLS-EU-Q16 index could be calculated for 4845 respondents. According to the criteria of the HLS-EU-Q16, more than half of the adults had "adequate" HL (55.8 %). Every third person (31.9 %) had "problematic" and almost every eighth person (12.3 %) had "inadequate" HL. We found significant differences in HL by educational level, but no differences in HL by sex and age group. Certain health behaviours were positively associated with health literacy. A low HL level was associated with poorer physical and mental health. The results point to a need for action to improve HL in the adult population. The strengthening of health literacy should not solely aim at the promotion of individual skills, but also give high priority to the development of health-literate settings.
Neter, Efrat; Brainin, Esther
eHealth literacy is defined as the ability of people to use emerging information and communications technologies to improve or enable health and health care. The goal of this study was to explore whether literacy disparities are diminished or enhanced in the search for health information on the Internet. The study focused on (1) traditional digital divide variables, such as sociodemographic characteristics, digital access, and digital literacy, (2) information search processes, and (3) the outcomes of Internet use for health information purposes. We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286). We measured eHealth literacy; Internet access; digital literacy; sociodemographic factors; perceived health; presence of chronic diseases; as well as health information sources, content, search strategies, and evaluation criteria used by consumers. Respondents who were highly eHealth literate tended to be younger and more educated than their less eHealth-literate counterparts. They were also more active consumers of all types of information on the Internet, used more search strategies, and scrutinized information more carefully than did the less eHealth-literate respondents. Finally, respondents who were highly eHealth literate gained more positive outcomes from the information search in terms of cognitive, instrumental (self-management of health care needs, health behaviors, and better use of health insurance), and interpersonal (interacting with their physician) gains. The present study documented differences between respondents high and low in eHealth literacy in terms of background attributes, information consumption, and outcomes of the information search. The association of eHealth literacy with background attributes indicates that the Internet reinforces existing social differences. The more comprehensive and sophisticated use of the Internet and the subsequent increased
Geboers, Bas; de Winter, Andrea F.; Spoorenberg, Sophie L. W.; Wynia, Klaske; Reijneveld, Sijmen A.
Low health literacy is an important predictor of poor health outcomes and well-being among older adults. A reason may be that low health literacy decreases older adults' self-management abilities. We therefore assessed the association between health literacy and self-management abilities among
Geboers, Bas; de Winter, Andrea F.; Spoorenberg, Sophie L. W.; Wynia, Klaske; Reijneveld, Sijmen A.
Low health literacy is an important predictor of poor health outcomes and well-being among older adults. A reason may be that low health literacy decreases older adults' self-management abilities. We therefore assessed the association between health literacy and self-management abilities among
Toçi, Ervin; Burazeri, Genc; Sørensen, Kristine; Kamberi, Haxhi; Brand, Helmut
Public health practice has come to increasing recognition of health promotion and the central role of knowledge, attitude, beliefs and practices in achieving health promotion. Health literacy (HL) is an under-explored topic in South Eastern European countries. There are no HL reports from Albania to date. The aim of this study was to assess the concurrent validity of the European Health Literacy Survey Questionnaire (HLS-EU-Q) and the Test of Functional Health Literacy in Adults (TOFHLA) in a population-based sample of adults in Albania. A cross-sectional study was conducted in 2013 in Tirana, Albania, including 239 individuals aged ≥ 18 years (61% women; 87% response). A structured interviewer-administered questionnaire was applied twice (test and retest procedure after 2 weeks) including HLS-EU-Q and TOFHLA instruments. The internal consistency was high for both instruments (Cronbach's alpha for the test procedure was 0.92 for TOFHLA and 0.98 for HLS-EU-Q). Both tools exhibited a high stability over time (Spearman's rho: 0.88 for TOFHLA and 0.87 for HLS-EU). Mean values of both instruments were similar in men and women (mean score for TOFHLA: 76.0 vs. 76.5, P = 0.83; mean score for HLS-EU-Q: 32.2 vs. 32.6, P = 0.63). For both instruments, higher HL scores were significantly associated with younger age, higher educational and economic level and lower body mass index. Our study provides valuable novel evidence on concurrent validation of two major HL instruments in a South Eastern European population-based sample. Future studies should be conducted in order to confirm and expand our findings. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Cotton, Sue M; Wright, Annemarie; Harris, Meredith G; Jorm, Anthony F; McGorry, Patrick D
To determine the effects of gender on mental health literacy in young people between 12 and 25 years of age. Computer-Assisted Telephone Interviewing was employed to conduct a cross-sectional structured interview focusing on young people's awareness of depression and psychosis. The sample comprised 1207 young Australians (539 males and 668 females) between the ages of 12-25 recruited from two metropolitan and two regional areas within Victoria. Six hundred and six respondents were presented a depression vignette and 601 were presented a psychosis vignette. Female respondents (60.7%) were significantly more likely to correctly identify depression in the vignette as compared to male respondents (34.5%). No significant gender differences were noted for the psychosis vignette. Males were less significantly likely to endorse seeing a doctor or psychologist/counsellor for the treatment of psychosis. Males were also significantly more likely than females to endorse alcohol as a way of dealing with depression and antibiotics as useful for dealing with psychosis. Gender differences in mental health literacy are striking. Males showed significantly lower recognition of symptoms associated with mental illness and were more likely endorse the use alcohol to deal with mental health problems. Such factors may contribute to the delays in help seeking seen in young males. Further research is needed to delineate how these gender differences in young people may obstruct help seeking, early intervention and other aspects of mental health service delivery.
Mein, Erika; Fuentes, Brenda; Soto Más, Francisco; Muro, Andrés
The increasing digitization of information and communication has undoubtedly impacted the ways in which people in the United States access and interpret health information. Although the traditional emphasis of health literacy research has been the comprehension of health-related texts such as patient information forms, prescriptions, and medicine labels, the increased use of electronic means to locate health information requires more critical engagement with texts beyond basic comprehension. In accessing electronic health information, patients need to be able to navigate the vast amount of online health information and to interpret and synthesize health information across multiple sources (i.e. websites) while also evaluating the credibility of these sources. Recent health literacy research has examined the increased role of the media literacy in influencing health behaviors (Bergsma & Carney, 2008) and the role of increased access to computers (Salovey et al., 2009), but little (if any) research to date has provided recommendations for best practices related to meeting the health literacy demands required by digitization. This article attempts to fill this gap by exploring the use of the internet as a key source of health information and by looking at best practices in teaching digital health literacy. It describes the development of a digital literacy component within a community-based health literacy/ESL curriculum funded by the National Institutes of Health and implemented on the US-Mexico border.
Damman, Olga C; Bogaerts, Nina M M; van Dongen, Diana; Timmermans, Danielle R M
To identify the barriers from the perspective of consumers with low health literacy in using risk information as provided in cardiometabolic risk assessments. A qualitative thematic approach using cognitive interviews was employed. We performed interviews with 23 people with low health literacy/health numeracy, who were recruited through (1) several organisations and snowball sampling and (2) an online access panel. Participants completed the risk test of the Dutch national cardiometabolic risk assessment and viewed the personalized information about their risk. They were asked to answer probing questions about different parts of the information. The qualitative data were analysed by identifying main themes related to barriers in using the information, using a descriptive thematic approach. The four main themes identified were as follows: (1) People did not fully accept the risk message, partly because numerical information had ambiguous meaning; (2) people lacked an adequate framework for understanding their risk; (3) the purpose and setting of the risk assessment was unclear; and (4) current information tells nothing new: A need for more specific risk information. The main barriers were that the current presentation seemed to provoke undervaluation of the risk number and that texts throughout the test, for example about cardiometabolic diseases, did not match people's existing knowledge, failing to provide an adequate framework for understanding cardiometabolic risk. Our findings have implications for the design of disease risk information, for example that alternative forms of communication should be explored that provide more intuitive meaning of the risk in terms of good versus bad. What is already known on this subject? Online disease risk assessments have become widely available internationally. People with low SES and health literacy tend to participate less in health screening. Risk information is difficult to understand, yet little research has been
Alfrey, Laura; Brown, Trent D.
The concept of "health literacy" is becoming increasingly prominent internationally, and it has been identified as one of the five key propositions that underpin the forthcoming Australian Curriculum: Health and Physical Education (ACHPE). The ACHPE is one of few national curricula to explicitly refer to health literacy, identifying it…
Nie, Xueqiong; Li, Yinghua; Li, Li; Huang, Xianggang
To understand the status and its influencing factors of health information literacy among urban and suburban residents in China, and to explore the method for improving the health information literacy. From March to May in 2013, residents aged 18-60 years in six provinces in China were investigated with Questionnaire of Health Literacy of Diabetes Mellitus of the Public in China about self-reported health information literacy. The results of the survey were standardized by the 6th national census data. Logistic regression analysis was used to explore influencing factors of health information literacy. A total of 4 416 residents were surveyed, and 4 282 (97.0%) valid questionnaires were collected. After weight adjustments, 30.1% of the residents aged 18-60 years had adequate health information literacy in China, and the 95%CI of the rate was 28.5% - 31.6%. Totally, 70.8% of the residents ever actively searched for health information, 43.7% of the residents could easily retrieve the health information, 49.1% of the residents could easily understand the health information, 41.8% of the residents could confidently differentiate the quality of the health information and 51.1% of the residents ever searched health information on the internet. The results of multi-logistic regression showed that the rural residents, the males, those with lower levels of education, those with poor health had a lower health information literacy. The most trusted health information source was from doctors, and the trust rate reached 97.0%, followed by family members, friends or colleagues. The residents trusted the interpersonal communication more than the mass media and the new media. The level of health information literacy of the residents was generally low in China. To improve the health information literacy, high-quality health information services should be delivered to the residents, and the health education on the internet provided by the medical professionals should also be explored.
Baisunova, G; Turdaliyeva, B; Tulebayev, K; Zagulova, D
Aim of the study was to explore the relationships between health literacy (HL) and financial wellbeing in residents of Almaty oblast (region). The survey was conducted among 826 residents of Almaty region aged 18 y.o. Over 56.5% were female residents. To estimate health literacy, self assessed health, financial wellbeing and attitude towards health /work -questionnaire HLS-EU-Q was used. The results confirmed a significant relationship between financial wellbeing, health literacy and health outcomes residents of Almaty region. Relationships between HL and self- assessed health and attitudes towards health /work balance were observed only in respondents with low financial deprivation index, in respondents with low financial wellbeing (high financial deprivation index) no such relationships were observed. Higher financial deprivation index and lower health literacy were observed in respondents for whom work meant more than health. Lower financial deprivation index and higher health literacy were in those respondents for whom health meant more than work. Improvement of HL and motivation for healthy behavior are important challenges for public health. To answer them population's financial wellbeing improvement alone is not enough, as complex change of consumer behavior in healthcare system is needed. HL enhancing in disadvantaged population groups should inform about possibilities of free healthcare services, medications and about the structure of public healthcare service.
Eklund Karlsson, Leena; Crondahl, Kristine
Statens offentliga utredningar har föreslagit en strategi där målet var att stänga välfärdsgapet mellan romer och andra grupper. Detta påstås dock att skulle ta minst en generation, eller 20 år och är en satsning på landsbasis. I detta kapitel beskrivs ett projekt med samma målsättning, fastän på...... romers health literacy vilket fungerade som en katalysator för empowerment....
Asselin, Marlene; Moayeri, Maryam
Competency in the new literacies of the Internet is essential for participating in contemporary society. Researchers studying these new literacies are recognizing the limitations of traditional methodological tools and adapting new technologies and new media for use in research. This paper reports our exploration of usability testing software to…
Emtekaer Haesum, Lisa Korsbakke; Ehlers, Lars; Hejlesen, Ole K.
Objective: To conduct a systematic review of the literature describing the interaction between the use of telehomecare technology and level of health literacy among chronic patients. The aim of the review was both to explore whether and how level of health literacy affects the ability to use telehomecare technology and, additionally, whether and…
Brabers, A.E.M.; Rademakers, J.J.D.J.M.; Groenewegen, P.P.; Dijk, L. van; Jong, J.D. de
Patients vary in their preferences towards involvement in medical decision-making. Previous research, however, gives no clear explanation for this observed variation in their involvement. One possible explanation might be health literacy. Health literacy refers to personal characteristics and social
Heide, I. van der; Heijmans, M.; Schuit, A.J.; Uiters, E.; Rademakers, J.
Introduction: In chronic care, patients are expected to exert a certain degree of control over the care for their condition, for instance by fulfilling care tasks in their home environment. Health literacy is considered relevant in this regard, especially critical health literacy. The aim of this
Boyle, Joseph; Speroff, Theodore; Worley, Katherine; Cao, Aize; Goggins, Kathryn; Dittus, Robert S; Kripalani, Sunil
To examine the association of health literacy with the number and type of transitional care needs (TCN) among patients being discharged to home. A cross-sectional analysis of patients admitted to an academic medical center. Nurses administered the Brief Health Literacy Screen and documented TCNs along 10 domains: caregiver support, transportation, healthcare utilization, high-risk medical comorbidities, medication management, medical devices, functional status, mental health comorbidities, communication, and financial resources. Among the 384 patients analyzed, 113 (29%) had inadequate health literacy. Patients with inadequate health literacy had needs in more TCN domains (mean = 5.29 vs 4.36; P literacy were significantly more likely to have TCNs in 7 out of the 10 domains. In multivariate analyses, inadequate health literacy remained significantly associated with inadequate caregiver support (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.37-4.99) and transportation barriers (OR, 1.69; 95% CI, 1.04-2.76). Among hospitalized patients, inadequate health literacy is prevalent and independently associated with other needs that place patients at a higher risk of adverse outcomes, such as hospital readmission. Screening for inadequate health literacy and associated needs may enable hospitals to address these barriers and improve postdischarge outcomes. © 2017 Society of Hospital Medicine
Scull, Tracy Marie; Malik, Christina V.; Kupersmidt, Janis Beth
As states are moving toward comprehensive sexual health education, educators require engaging and effective curricula. This pre-post study (N = 64) examined the feasibility of a comprehensive, media literacy education program for influencing adolescents' sexual health and media literacy outcomes. After the program, participants were more likely to…
Paschal, Angelia M; Mitchell, Qshequilla P; Wilroy, Jereme D; Hawley, Suzanne R; Mitchell, Jermaine B
The relationship between parent health literacy and adherence to treatment in children with epilepsy has not been fully explored. The purpose of this study was to determine whether parent health literacy and other variables predicted factors associated with adherence, such as missed medication doses, missed medical appointments, and seizure frequency, in children with epilepsy between 1 and 12 years old. It was hypothesized that parents with adequate parent health literacy would report fewer missed doses, missed appointments, and seizure occurrences. Using a nonexperimental, cross-sectional study design, interviews were conducted with 146 parents and guardians of children with epilepsy who resided in rural communities. Univariate analyses, including ANOVA, and multiple linear regressions were conducted. Results indicated that parent health literacy was the strongest predictor of two of the adherence-related factors. Higher health literacy scores were associated with fewer missed medication doses and seizure occurrences. However, health literacy was not associated with missed medical appointments. Among other study variables, higher household income was also predictive of fewer missed doses. The study findings suggest that inadequate health literacy among parents may serve as an independent risk factor for adherence-related outcomes among children with epilepsy. Further research, as well as effective, targeted parent health literacy strategies used to improve epilepsy management and care in children, is recommended. Copyright © 2015 Elsevier Inc. All rights reserved.
Tepe, Rodger; Tepe, Chabha
To develop and psychometrically evaluate an information literacy (IL) self-efficacy survey and an IL knowledge test. In this test-retest reliability study, a 25-item IL self-efficacy survey and a 50-item IL knowledge test were developed and administered to a convenience sample of 53 chiropractic students. Item analyses were performed on all questions. The IL self-efficacy survey demonstrated good reliability (test-retest correlation = 0.81) and good/very good internal consistency (mean κ = .56 and Cronbach's α = .92). A total of 25 questions with the best item analysis characteristics were chosen from the 50-item IL knowledge test, resulting in a 25-item IL knowledge test that demonstrated good reliability (test-retest correlation = 0.87), very good internal consistency (mean κ = .69, KR20 = 0.85), and good item discrimination (mean point-biserial = 0.48). This study resulted in the development of three instruments: a 25-item IL self-efficacy survey, a 50-item IL knowledge test, and a 25-item IL knowledge test. The information literacy self-efficacy survey and the 25-item version of the information literacy knowledge test have shown preliminary evidence of adequate reliability and validity to justify continuing study with these instruments.
Chu, Cheng-I; Tseng, Chia-Chih Alex
There is a lack of research examining patient-perceived empathy and its effect on low-literacy patients' understanding of health information. This study investigated the moderating effect of patient-perceived empathy on the relationship between health literacy and understanding of preoperative information. During a 2-month period, a total of 144 patients took a survey that included the Chinese-edition Rapid Estimate of Adult Literacy in Medicine, the Barrett-Lennard Relationship Inventory and the Preoperative Information Understanding Scale. Hierarchical multiple regression analysis provided a test of moderator effects. All Cronbach's alphas exceeded 0.6, with REALM at 0.91, BLRI at 0.67, and PIUS at 0.77.The finding that the interaction term was significant suggests perceived empathy is a relevant factor when considering the relationship between health literacy and the understanding of information by patients. The relationship between the health literacy and understanding of information was stronger and positive among patients who perceived greater empathy from their physicians. Our study demonstrates that a focus on improving physician-patient empathy skills could be beneficial in helping to overcome the negative consequences associated with limited health-literacy capabilities. Healthcare providers who wish to improve the understanding of information by low health-literacy patients should first identify components of their empathic communication mechanisms, and then try to refine these skills to better serve their patients.
Kim, Y S; Lee, H Y; Lee, M H; Simms, T; Park, B H
WHAT IS KNOWN ON THE SUBJECT?: Mental health literacy is a fairly new concept, first introduced in 1997. It refers to what people know and believe about mental health disorders. People's knowledge and beliefs help them to recognize, manage and prevent mental disorders. Generally, older adults have lower health literacy compared to young and middle-aged adults. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: This is the first study on the mental health literacy of Korean older adults. This study looks beyond peoples' ability to recognize mental health disorders and their opinions about them. It identifies factors that are associated with mental health literacy (level of education and social support, the number of people in one's social circles and how individuals rate their health). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Older adults might get more out of mental health literacy programmes in group or social settings. Programmes that use older adult peer educators/supporters, such as the "older people's champions" of the Healthy Passport programme in England, might make the programmes more effective. Mental health campaigns, such as Australia's beyondblue, might increase mental health literacy of older adults. Introduction Korea is experiencing rapid population ageing, spurring an increased need for mental health services for the elderly. Approximately one-third of Korean older adults experience depressive symptoms, and Korea has the highest elder suicide rate among 34 developed nations. Mental health literacy is an important component of promoting mental health, yet studies on the concept have been conducted in few countries. Aim This study examines the level of mental health literacy among Korean older adults and identifies factors associated with their mental health literacy. Method A cross-sectional survey was conducted with 596 community-dwelling Korean adults aged 65 and older. Andersen's Behavioral Model of Health Services Use framed the study. Results Overall
Health communication is an essential health promotion strategy to convert scientific findings into actionable, empowering information for the public. Health communication interventions have shown positive outcomes, but many efforts have been disappointing. A key weakness is that expert-designed health communication is often overly generic and not adequately aligned with the abilities, preferences and life situations of specific audiences. The emergence of the field of health literacy is providing powerful theoretical guidance and practice strategies. Health literacy, in concert with other determinants of health, has greatly advanced understanding of factors that facilitate or hinder health promotion at individual, organizational and community settings. However, health literacy models are incomplete and interventions have shown only modest success to date. A challenge is to move beyond the current focus on individual comprehension and address deeper factors of motivation, self-efficacy and empowerment, as well as socio-environmental influences, and their impact to improve health outcomes and reduce health disparities. Integrating participatory design theory and methods drawn from social sciences and design sciences can significantly improve health literacy models and interventions. Likewise, researchers and practitioners using participatory design can greatly benefit from incorporating health literacy principles into their efforts. Such interventions at multiple levels are showing positive health outcomes and reduction of health disparities, but this approach is complex and not yet widespread. This chapter focuses on research findings about health literacy and participatory design to improve health promotion, and practical guidance and case examples for researchers, practitioners and policymakers.
Guo, Shuaijun; Davis, Elise; Yu, Xiaoming; Naccarella, Lucio; Armstrong, Rebecca; Abel, Thomas; Browne, Geoffrey; Shi, Yanqin
Health literacy is an increasingly important topic in the global context. In mainland China, health literacy measures mainly focus on health knowledge and practices or on the functional domain for adolescents. However, little is known about interactive and critical domains. This study aimed to adopt a skills-based and three-domain (functional, interactive and critical) instrument to measure health literacy in Chinese adolescents and to examine the status and determinants of each domain. Using a systematic review, the eight-item Health Literacy Assessment Tool (HLAT-8) was selected and translated from English to Chinese (c-HLAT-8). Following the translation process, a cross-sectional study was conducted in four secondary schools in Beijing, China. A total of 650 students in Years 7-9 were recruited to complete a self-administered questionnaire that assessed socio-demographics, self-efficacy, social support, school environment, community environment and health literacy. Results showed that the c-HLAT-8 had satisfactory reliability (Cronbach's α = 0.79; intra-class correlation coefficient = 0.72) and strong validity (translation validity index (TVI) ≥0.95; χ 2 / df = 3.388, p students had an average score of 26.37 (±5.89) for the c-HLAT-8. When the determinants of each domain of health literacy were examined, social support was the strongest predictor of interactive and critical health literacy. On the contrary, self-efficacy and school environment played more dominant roles in predicting functional health literacy. The c-HLAT-8 was demonstrated to be a reliable, valid and feasible instrument for measuring functional, interactive and critical health literacy among Chinese students. The current findings indicate that increasing self-efficacy, social support and creating supportive environments are important for promoting health literacy in secondary school settings in China.
Villaire, Michael; Gonzalez, Diana Peña; Johnson, Kirby L
This chapter discusses the need for innovative health literacy solutions to combat extensive chronic disease prevalence and costs. The authors explore the intersection of chronic disease management and health literacy. They provide specific examples of successful health literacy interventions for managing several highly prevalent chronic diseases. This is followed by suggestions on pairing research and practice to support effective disease management programs. In addition, the authors discuss strategies for collection and dissemination of knowledge gained from collaborations between researchers and practitioners. They identify current challenges specific to disseminating information from the health literacy field and offer potential solutions. The chapter concludes with a brief look at future directions and organizational opportunities to integrate health literacy practices to address the need for effective chronic disease management.
Goto, Aya; Lai, Alden Yuanhong; Rudd, Rima E
Public health nurses (PHNs) are community residents' access points to health information and services in Japan. After the Fukushima nuclear accident, they were challenged to communicate radiation-related health information to best meet community needs. We previously developed and evaluated the outcome of a single-site health literacy training program to augment PHNs' ability to improve community residents' access to written health information. This paper presents an evaluation of an identical training program using data combined from multiple sites, and further included proximal and distal evaluations to document the impact of health literacy training in a post-disaster setting. A total of 64 participants, primarily experienced PHNs, attended one of three multi-session health literacy workshops conducted in multiple sites across Fukushima. Quantitative and qualitative data on PHNs' training satisfaction, self-evaluation of achievements regarding training goals, and application of learned skills were collected and analyzed. Each workshop consisted of two 2-hour sessions introducing health literacy and assessment tools and developing skills to improve written materials, followed by a one-month follow-up assessment on PHNs' application of the gained skills in the field. Post-training evaluations on the appropriateness and usefulness of the workshop were highly positive. At the end of the one-month follow-up, 45% of participants had gained confidence in assessing and revising written materials and had applied the skills they had gained to develop and communicate health information in various settings and modes. This increase in confidence was associated with further application of the learned skills at the municipal level. However, participants reported difficulties in explaining risks, and the need to learn more about plain language to be able to paraphrase professional terms. This paper highlighs the positive outcomes of health literacy training among PHNs. Practical
McKenna, Verna B; Sixsmith, Jane; Barry, Margaret M
Conceptualizing health literacy as a relational concept, which involves how individuals interact with complex health and social systems, requires a greater understanding of the context of people's health experiences. To describe individuals' experiences of accessing, understanding, appraising and applying health information; explore the barriers and facilitators to using these skills; and to describe the experience of information exchange in health consultations. A longitudinal qualitative methodology with thematic analysis of interviews was used. Health literacy levels were assessed using the HLS-EU-47-Item Questionnaire. Findings are presented from the first round of data collection. Twenty-six participants purposefully selected from a CVD risk reduction programme at three separate time points. Four key themes identified: using health literacy capacities for managing health; psychological and structural factors that impact on these capacities; and the relationship quality with the health-care provider (HCP). Although limited health literacy was prevalent across the sample (65%), all individuals were very proactive in attempting to utilize health literacy skills. Findings emphasize the importance of contextual factors such as the quality of communication with the health-care provider, perceptions of control, attitudes to family medical history, navigating structural barriers and being supported in managing treatment and medication side-effects. Findings are relevant for health-care providers in order to enhance the patient-provider relationship and to ensure optimum health outcomes for all individuals regardless of health literacy levels. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.
Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa
Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance...
Geboers, Bas; de Winter, Andrea F; Spoorenberg, Sophie L W; Wynia, Klaske; Reijneveld, Sijmen A
Low health literacy is an important predictor of poor health outcomes and well-being among older adults. A reason may be that low health literacy decreases older adults' self-management abilities. We therefore assessed the association between health literacy and self-management abilities among adults aged 75 and older, and the impact of demographic factors, socioeconomic factors, and health status on this association. We used data of 1052 older adults, gathered for a previously conducted randomized controlled trial on Embrace, an integrated elderly care model. These data pertained to health literacy, self-management abilities, demographic background, socioeconomic situation, and health status. Health literacy was measured by the validated three-item Brief Health Literacy Screening instrument. Self-management abilities were measured by the validated Self-Management Ability Scale (SMAS-30). After adjustment for confounders, self-management abilities were poorer in older adults with low health literacy (β = .34, p older adults than in low-educated older adults. Sex, age, living situation, income, presence of chronic illness, and mental health status did not moderate the association between health literacy and self-management abilities. Low health literacy is associated with poor self-management abilities in a wide range of older adults. Early recognition of low health literacy among adults of 75 years and older and interventions to improve health literacy might be very beneficial for older adults.
Ownby, Raymond L; Acevedo, Amarilis; Waldrop-Valverde, Drenna; Jacobs, Robin J; Caballero, Joshua; Davenport, Rosemary; Homs, Ana-Maria; Czaja, Sara J; Loewenstein, David
Current measures of health literacy have been criticized on a number of grounds, including use of a limited range of content, development on small and atypical patient groups, and poor psychometric characteristics. In this paper, we report the development and preliminary validation of a new computer-administered and -scored health literacy measure addressing these limitations. Items in the measure reflect a wide range of content related to health promotion and maintenance as well as care for diseases. The development process has focused on creating a measure that will be useful in both Spanish and English, while not requiring substantial time for clinician training and individual administration and scoring. The items incorporate several formats, including questions based on brief videos, which allow for the assessment of listening comprehension and the skills related to obtaining information on the Internet. In this paper, we report the interim analyses detailing the initial development and pilot testing of the items (phase 1 of the project) in groups of Spanish and English speakers. We then describe phase 2, which included a second round of testing of the items, in new groups of Spanish and English speakers, and evaluation of the new measure's reliability and validity in relation to other measures. Data are presented that show that four scales (general health literacy, numeracy, conceptual knowledge, and listening comprehension), developed through a process of item and factor analyses, have significant relations to existing measures of health literacy.
Full Text Available Background and objective: Outbreak of influenza A/H1N1 become serious concern. Student in academic institutions can play effective role in prevention and control of influenza. Here paramedical faculty student health literacy toward Influenza was assessed. Methods: A cross sectional-descriptive study was conducted among 139 students in Medical Records, Physiotherapy, Radiology, Health Information Technology, Speech Therapy and Optometry discipline at paramedical faculty of Mashhad medical university in 2016. A pandemic influenza questionnaire was translated and edited. Demographic characteristics of student, level of knowledge and perception toward influenza and perception toward government and media were collected. Results: More than half of student correctly identified influenza symptoms as fever 95/1%, body ache 51/2%, cough 46/3% and headaches 43/9%.person to person transmission and contact with infected objects were recognized by 87/8% and 68/3% of student as a mode of transmission. Students Covering identified nose and mouth 87/8%, hand washing with soap and water 80/5% and throwing tissues in rubbish bin as precutions.48/6% of student believed that influenza is not fatal; despite 88/9% of student perceived influenza as serious disease. In Government and media assessment, 39% of student agreed health department and other health authorities had a good control plan, 51/4% of student agreed with transparency of necessary intervention during flu outbreak. Conclusion: This study shows that paramedical faculty student has appropriate influenza health literacy. Delivering more information about mode of transmission, high risk group and precaution intervention and playing more effective role by media is recommended. Paper Type: Research Article.
Background “Mental health for everyone” is a school program for mental health literacy and prevention aimed at secondary schools (13–15 yrs). The main aim was to investigate whether mental health literacy, could be improved by a 3-days universal education programme by: a) improving naming of symptom profiles of mental disorder, b) reducing prejudiced beliefs, and c) improving knowledge about where to seek help for mental health problems. A secondary aim was to investigate whether adolescent sex and age influenced the above mentioned variables. A third aim was to investigate whether prejudiced beliefs influenced knowledge about available help. Method This non-randomized cluster controlled trial included 1070 adolescents (53.9% boys, M age14 yrs) from three schools in a Norwegian town. One school (n = 520) received the intervention, and two schools (n = 550) formed the control group. Pre-test and follow-up were three months apart. Linear mixed models and generalized estimating equations models were employed for analysis. Results Mental health literacy improved contingent on the intervention, and there was a shift towards suggesting primary health care as a place to seek help. Those with more prejudiced beleifs did not suggest places to seek help for mental health problems. Generally, girls and older adolescents recognized symptom profiles better and had lower levels of prejudiced beliefs. Conclusions A low cost general school program may improve mental health literacy in adolescents. Gender specific programs and attention to the age and maturity of the students should be considered when mental health literacy programmes are designed and tried out. Prejudice should be addressed before imparting information about mental health issues. PMID:24053381
Patel, Amit; Bakina, Daria; Kirk, Jim; von Lutcken, Scott; Donnelly, Tom; Stone, William; Ashley-Collins, Heather; Tibbals, Karen; Ricker, Lynn; Adler, Jeffrey; Ewing, John; Blechman, Michelle; Fox, Sherry; Leopold, Will; Ryan, Daniel; Wray, Donna; Turkoz, Heather
Counseling patients with written materials relies equally on patients' health literacy to understand their disease and its treatment, and the written materials' effectiveness communicating clearly in accessible and actionable ways. Only about 12% of the US population is adequately health literate. To explore the impact of reducing the health literacy demands of written patient health information. 805 patients were screened for health literacy, and recruited for balanced cohorts of adequate and low literacy, and high and normal blood pressure. Half of each patient cohort received either standard or "health literacy-friendly" drug summaries (i.e. Patient Package Inserts, or PPIs or "leaflets") along with a standardized health literacy assessment scale. The literacy-friendly drug summary improved comprehension of drug-related information overall from 50% to 71% correct responses. Adequate literacy patients improved from 58% correct to 90%, while lower literacy patients improved from 42% to 52% correct in response to the health literacy-friendly PPIs. Health literacy demands require special attention in developing and using written drug summary materials. Additionally, pharmacists should be provided additional information and counseling support materials to facilitate communications with low health literacy level patients. Copyright © 2018 Elsevier Inc. All rights reserved.
Cosic, Filip; Porter, Tabitha; Norsworthy, Cameron; Price, Rohan; Bedi, Harvinder
Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. Results In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including
This book supports trainee teachers in the Lifelong Learning Sector in the assessment of their literacy knowledge. A self-audit section is included to help trainees understand their level of competence and confidence in literacy and will help them identify any gaps in their knowledge and skills. This is followed by exercises and activities to support and enhance learning. The book covers all the content of the LLUK standards for the minimum core for literacy. Coverage and assessment of the minimum core have to be embedded in all Certificate and Diploma courses leading to QTLS and ATLS status.
Kim, Su Hyun; Utz, Sonja
Low health literacy has been recognized as a potential barrier to obtaining knowledge and maintaining self-care in older people. However, little is known about information-seeking preference in relation to health literacy among older people. The aim of the present study was to understand the influence of health literacy on the information-seeking preference of older people. A total of 129 community-residing Korean older people completed a survey in 2016. The findings revealed that health literacy was a significant predictor of information-seeking preference in older people after controlling for demographic and illness variables. Our study highlights the important need to incorporate strategies to increase the desire for information seeking in older people, in addition to adopting communication strategies that address low health literacy. © 2018 John Wiley & Sons Australia, Ltd.
Hayat, Tsahi Zack; Brainin, Esther; Neter, Efrat
eHealth literacy is defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply knowledge gained to addressing or solving a health problem. Previous research has shown high reliance on both online and face-to-face interpersonal sources when sharing and receiving health information. In this paper, we examine these interpersonal sources and their interplay with respondents' eHealth literacy and perceived health outcomes. Specifically, we look at how the relationship between eHealth literacy and health outcomes is moderated by (1) finding help while performing online activities, (2) finding others with similar health concerns online, and (3) the importance of finding others with similar health concerns for people from ethnic minorities, specifically Palestinian citizens of Israel versus Israeli Jews. We used a nationally representative random-digit dial telephone household survey of an Israeli adult population (age ≥21 years, N=819). The collected data were analyzed using two regression models. The first examined how the correlation between eHealth literacy and perceived outcomes was moderated by the availability of help. The second examined how the correlation between eHealth literacy and perceived outcomes was moderated by finding others with similar health concerns and by ethnicity. Respondents with low eHealth literacy who were able to recruit help when performing online activities demonstrated higher perceived health outcomes compared to similar respondents who did not find help. Respondents with low eHealth literacy, who were able to find others with similar health concerns (online), demonstrated higher perceived health outcomes when compared to similar respondents who did not find others with similar health concerns. Finally, finding similar others online was more helpful in enhancing health outcomes for ethnic minorities; Palestinian citizens of Israel gained more health benefits by finding similar
Smith, Samuel G; Jackson, Sarah E; Kobayashi, Lindsay C; Steptoe, Andrew
To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Champlin, Sara; Mackert, Michael; Glowacki, Elizabeth M; Donovan, Erin E
While many health literacy assessments exist, this area of research lacks an instrument that isolates and reflects the four components driving this concept (abilities to find, understand, use, and communicate about health information). The purpose of this study was to determine what abilities comprise the first component, how a patient finds health information. Low ( n = 13) and adequate ( n = 14) health literacy patients, and health professionals ( n = 10) described their experiences when looking for health information and the skills they employed to complete these tasks. Major skills/themes elicited included knowing when to search, credibility assessments, finding text and numerical information, interpersonal seeking, technology and online search, and spatial navigation. Findings from this study suggest that each of the dimensions included in the definition of health literacy warrants specific attention and assessment. Given identification of the skills comprising each dimension, interventions targeting deficits across health literacy dimensions could be developed to improve patient health.
Helitzer, Deborah; Hollis, Christine; Cotner, Jane; Oestreicher, Nancy
Health literacy requires reading and writing skills as well as knowledge of health topics and health systems. Materials written at high reading levels with ambiguous, technical, or dense text, often place great comprehension demands on consumers with lower literacy skills. This study developed and used an instrument to analyze cervical cancer prevention materials for readability, comprehensibility, suitability, and message design. The Suitability Assessment of Materials (SAM) was amended for ease of use, inclusivity, and objectivity with the encouragement of the original developers. Other novel contributions were specifically related to "comprehensibility" (CAM). The resulting SAM + CAM was used to score 69 materials for content, literacy demand, numeric literacy, graphics, layout/typography, and learning stimulation variables. Expert reviewers provided content validation. Inter-rater reliability was "substantial" (kappa = .77). The mean reading level of materials was 11th grade. Most materials (68%) scored as "adequate" for comprehensibility, suitability, and message design; health education brochures scored better than other materials. Only one-fifth were ranked "superior" for ease of use and comprehensibility. Most written materials have a readability level that is too high and require improvement in ease of use and comprehensibility for the majority of readers.
Jorm, Anthony F.
For major physical diseases, it is widely accepted that members of the public will benefit by knowing what actions they can take for prevention, early intervention, and treatment. However, this type of public knowledge about mental disorders ("mental health literacy") has received much less attention. There is evidence from surveys in several…
Sentell, Tetine; Baker, Kay Kromer; Onaka, Alvin; Braun, Kathryn
Health literacy is understudied in Asian Americans/Pacific Islanders (AA/PI). We used a population-based sample in Hawai'i to consider if low health literacy is associated with poor health outcomes in Japanese, Filipino, Native Hawaiians, and other AA/PI groups compared with Whites. In data weighted and adjusted for population undercounts and complex survey design, low health literacy varied significantly by group, from 23.9% among Filipinos, 20.6% in Other AA/PI, 16.0% in Japanese, 15.9% in Native Hawaiians, and 13.2% in Whites (χ(2) (4) = 52.22; p culture, and health outcomes.
Hemsley, Bronwyn; Rollo, Megan; Georgiou, Andrew; Balandin, Susan; Hill, Sophie
To integrate the findings of research on electronic personal health records (e-PHRs) for an understanding of their health literacy demands on both patients and providers. We sought peer-reviewed primary research in English addressing the health literacy demands of e-PHRs that are online and allow patients any degree of control or input to the record. A synthesis of three theoretical models was used to frame the analysis of 24 studies. e-PHRs pose a wide range of health literacy demands on both patients and health service providers. Patient participation in e-PHRs relies not only on their level of education and computer literacy, and attitudes to sharing health information, but also upon their executive function, verbal expression, and understanding of spoken and written language. The multiple health literacy demands of e-PHRs must be considered when implementing population-wide initiatives for storing and sharing health information using these systems. The health literacy demands of e-PHRs are high and could potentially exclude many patients unless strategies are adopted to support their use of these systems. Developing strategies for all patients to meet or reduce the high health literacy demands of e-PHRs will be important in population-wide implementation. Copyright © 2017 Elsevier B.V. All rights reserved.
Heijmans, M.; Waverijn, G.; Rademakers, J.; Vaart, R. van der; Rijken, M.
Objective: To provide insight into the level of health literacy among chronic disease patients in the Netherlands, to identify subgroups with low literacy and to examine the associations between health literacy and self-management. Methods: Self-report questionnaires were sent to a nationwide sample
Webb, Gwendalyn L.; Williams, Cori J.
Australian Aboriginal children, in general, lag behind their mainstream peers in measures of literacy. This article discusses some of the complex and interconnected factors that impact Aboriginal children's early language and literacy development. Poor health and historically negative socio-political factors are known influences on Aboriginal…
Taylor, Dominic M; Fraser, Simon; Dudley, Chris; Oniscu, Gabriel C; Tomson, Charles; Ravanan, Rommel; Roderick, Paul
Limited health literacy affects 25% of people with chronic kidney disease (CKD), and may reduce self-management skills resulting in poorer clinical outcomes. By disproportionately affecting people with low socio-economic status and non-white ethnicity, limited health literacy may promote health inequity. We performed a systematic review of quantitative studies of health literacy and clinical outcomes among adults with CKD. A total of 29 studies (13 articles; 16 conference abstracts) were included. One included non-USA patients. Of the 29 studies, 5 were cohort studies and 24 were cross-sectional. In all, 18 300 patients were studied: 4367 non-dialysis CKD; 13 202 dialysis; 390 transplant; 341 unspecified. Median study size was 127 [interquartile range (IQR) 92-238)], but 480 (IQR 260-2392) for cohort studies. Median proportion of non-white participants was 48% (IQR 17-70%). Six health literacy measures were used. Outcomes included patient attributes, care processes, clinical/laboratory parameters and 'hard' clinical outcomes. Limited health literacy was significantly, independently associated with hospitalizations, emergency department use, missed dialysis sessions, cardiovascular events and mortality (in cohort studies). Study quality was high (1 study), moderate (3 studies) and poor (25 studies), limited by sampling methods, variable adjustment for confounders and reduced methodological detail given in conference abstracts. There is limited robust evidence of the causal effects of health literacy on patient outcomes in CKD. Available evidence suggests associations with adverse clinical events, increased healthcare use and mortality. Prospective studies are required to determine the causal effects of health literacy on outcomes in CKD patients, and examine the relationships between socio-economic status, comorbidity, health literacy and CKD outcomes. Intervention development and evaluation will determine whether health literacy is a modifiable determinant of
Santos, Maricel G; Handley, Margaret A; Omark, Karin; Schillinger, Dean
A reliance on the conceptualization of health literacy as functional skill has limited researchers' views of the adult English-as-a-second-language (ESL) context as a site for health literacy interventions. To explore the contributions of alternative views of literacy as social practice to health literacy research, the authors examined teacher survey data and learner outcomes data collected as part of a multiyear collaboration involving the California Diabetes Program, university researchers, and adult ESL teachers. The survey results (n=144 teachers) indicated that ESL teachers frequently model effective pedagogical practices that mediate social interaction around health content, the basis for acquiring new literacy skills and practices. In the classroom pilot (n=116 learners), the majority of learners reported they had learned about diabetes risk factors and prevention strategies, which affirmed existing healthy behaviors or prompted revision of unhealthy ones. About two thirds of the learners reported sharing preventive health content with members of out-of-school social networks. This study represents a first step in research efforts to account more fully for the mechanisms by which social interaction and social support facilitate health literacy outcomes in ESL contexts, which should complement what is already known about the development of health literacy as functional skill.
McCormack, Lauren; Thomas, Veronica; Lewis, Megan A; Rudd, Rima
This article posits four principal objectives related to the overarching goal of broadening the conceptualization of health literacy. We propose a social ecological approach to health literacy and patient engagement by illustrating how this multilevel approach offers an array of strategic options for interventions. A social ecological approach supports a broader understanding of health literacy that aligns with increased patient engagement. The ecological model highlights the importance of context, demonstrates how health literacy and patient engagement are inextricably connected, and gives rise to strategies to enhance them both. We illustrate the five multilevel intervention strategies for addressing low health literacy and promoting patient engagement: accumulation, amplification, facilitation, cascade, and convergence strategies. In addition, we provide a theoretical foundation to facilitate the development of interventions to enhance health literacy and ultimately increase patient engagement. The practice implications of adopting a broader social ecological perspective to address low health literacy shifts the field from thinking about individual educational interventions to how individual interventions may be augmented or supported by interventions at additional levels of influence. The potential benefit of adopting a multilevel intervention approach is that combining interventions could produce synergies that are greater than interventions that only utilize one level of influence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Bennett Jarred S
Full Text Available Abstract Background Recent research has begun to recognize the important influence of literacy levels and how they affect health and wellbeing, especially in older adults. Our study focuses on health and financial literacy, two domains of literacy which previous research has suggested may be significantly related to health and wellbeing. Our study examines the relation of health and financial literacy with health promoting behaviors and health status among community-based older persons. Methods We conducted a cross-sectional study using data from the Rush Memory and Aging Project, a community-based cohort study of aging in northeastern Illinois. The study consisted of 556 older persons without dementia, each determined by a clinical evaluation. Health and financial literacy were measured using a series of questions designed to assess the ability to understand and process health and financial information, concepts, and numeracy; the two scores were averaged to yield a total literacy score. Health promoting behaviors, including engagement in cognitive, physical, and social activities, were assessed using self report measures. Indicators of heath status, including cognition (global cognition and five specific cognitive abilities, functional status (basic and instrumental activities of daily living, mobility disability, and mental health (depressive symptoms, loneliness were assessed. Results In a series of regression models adjusted for age, sex, and education, higher total literacy scores were associated with more frequent participation in health promoting behaviors, including cognitive, physical and social activities (all p values Conclusions Health and financial literacy are associated with more frequent engagement in health promoting behaviors and better health status in older persons without dementia.
Tseng, Hsu-Min; Liao, Shu-Fen; Wen, Yu-Ping; Chuang, Yuh-Jue
Health literacy has been recognized as a key construct associated with clinical outcomes; however, few studies have explored the mechanism underlying the association. The transtheoretical model (TTM) has long been considered a useful conceptualization in the process of intentional behavior change. Stages of change lies at the heart of the TTM as studies of change have found that people move through a series of stages when modifying behavior. This study focuses on the role of knowledge and stages of change (SOC) as serial mediators linking health literacy to glycemic control. In this cross-sectional survey, a total of 232 patients with type 2 diabetes participated in this study. Participants completed questionnaires for assessing health literacy, readiness to consume healthy foods, and a dietary knowledge test specific to diabetes. Low health literacy was significantly associated with worse glycemic control. Statistical evaluation supported the serial mediation model, in which knowledge and SOC formed a serial mediation chain that accounted for the indirect effect of health literacy on glycemic control. In other words, dietary knowledge significantly motivated participants to move into the later stages of behavior change, which in turn improved the outcome of glycemic control. The results indicate that the ordering of mediators in the pathway between health literacy and health outcome may be complex, help explain the conflicting results of the past, and form a basis for the development of interventions promoting self-management of diabetes through glycemic control. Copyright © 2016. Published by Elsevier Ltd.
Whitney, Wanda; Keselman, Alla; Humphreys, Betsy
The field of librarianship has a history of involvement in patient education, general literacy and information literacy efforts. This history and prominent placement in communities make libraries and librarians an excellent resource in advancing health literacy practice and research. This chapter provides an overview of health literacy and health information literacy efforts in US libraries over the past two decades. The chapter begins with the description of the role of the US National Library of Medicine in developing resources, programs, and partnerships serving health information needs of the public. It then overviews special training programs for increasing librarians' expertise with health information and health literacy support. The narrative also presents different models of health information outreach programs in diverse communities, focusing on serving special populations that may suffer from health disparities. The second half of the chapter describes libraries' and librarians' health information response to continuously evolving contexts, mediums, and requirements. One subsection describes librarians' outreach effort with cutting-edge technologies, such as virtual worlds and gaming. Another focuses on supporting patients' information needs in clinical settings. Two more describe how libraries meet patrons' health information needs in the context of disaster preparedness and health insurance market place sign-up. While presenting the information, to the extent possible, the chapter draws upon research and ev