Health literacy refers to how well a person can get the health information and services that they need, and ... adults in the United States have low health literacy. It affects their ability to make health decisions. ...
Goodman, Melody S; Griffey, Richard T; Carpenter, Christopher R; Blanchard, Melvin; Kaphingst, Kimberly A
Existing health literacy assessments developed for research purposes have constraints that limit their utility for clinical practice, including time requirements and administration protocols. The Brief Health Literacy Screen (BHLS) consists of 3 self-administered Single-Item Literacy Screener (SILS) questions and obviates these clinical barriers. We assessed whether the addition of SILS items or the BHLS to patient demographics readily available in ambulatory clinical settings reaching underserved patients improves the ability to identify limited health literacy. We analyzed data from 2 cross-sectional convenience samples of patients from an urban academic emergency department (n = 425) and a primary care clinic (n = 486) in St. Louis, Missouri. Across samples, health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine-Revised (REALM-R), Newest Vital Sign (NVS), and the BHLS. Our analytic sample consisted of 911 adult patients, who were primarily female (62%), black (66%), and had at least a high school education (82%); 456 were randomly assigned to the estimation sample and 455 to the validation sample. The analysis showed that the best REALM-R estimation model contained age, sex, education, race, and 1 SILS item (difficulty understanding written information). In validation analysis this model had a sensitivity of 62%, specificity of 81%, a positive likelihood ratio (LR(+)) of 3.26, and a negative likelihood ratio (LR(-)) of 0.47; there was a 28% misclassification rate. The best NVS estimation model contained the BHLS, age, sex, education and race; this model had a sensitivity of 77%, specificity of 72%, LR(+) of 2.75, LR(-) of 0.32, and a misclassification rate of 25%. Findings suggest that the BHLS and SILS items improve the ability to identify patients with limited health literacy compared with demographic predictors alone. However, despite being easier to administer in clinical settings, subjective estimates of health literacy have
Cesnaviciene, Jurate; Ustilaite, Stase; Kalinkeviciene, Ausra
Seeking to successfully act in the 21st century, a person should have a relatively big spectrum of abilities and competences; in other words, s/he should develop literacy in a number of spheres. Health literacy is essential for a person’s daily capability to manage own health and the quality of life, which is dependent on it. It is significant for the social and economic development of the society. The purpose of the research was to identify the relationships between subjective health literac...
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.
Alsomali, Hana J; Vines, David L; Stein, Brian D; Becker, Ellen A
Improper inhaler use results in decreased drug deposition in the lungs. The impact of health literacy and poor vision on the patient's ability to learn inhaler technique by reading instructions has not been confirmed. This study evaluated the effectiveness of learning inhaler technique from written instructions and the impact of health literacy for patients diagnosed with COPD who used a dry powder inhaler (DPI). This pilot study recruited subjects diagnosed with COPD. A trained assessor scored subjects' inhaler technique before and after reading the appropriate American College of Chest Physicians handouts. Peak inspiratory flows (PIFs) were measured using an InCheck Dial. Health literacy was measured by the S-TOFHLA (Short Test of Functional Health Literacy in Adults), and visual acuity was measured by a Snellen chart. Associations between health literacy and visual acuity and changes in subjects' inhaler technique scores were assessed by Spearman's rho. Inhaler technique change scores were assessed by the Wilcoxon signed-rank test at P = .05. Of the 24 participants enrolled, 63% were female, mean age was 65.6 y, and 83% were Global Initiative for Chronic Obstructive Lung Disease air-flow limitation 2 or 3. Wilcoxon scores were significant for improved total scores for both the Diskus and HandiHaler, with medians improving from 6.5 to 7.0 (interquartile range 6.0-7.8) (P = .047) and from 6.0 to 7.5 (interquartile range 7.0-9.0) (P = .002), respectively. The minimum required PIF was achieved by 93.8% of the Diskus and 94.4% of the HandiHaler groups. There were no associations detected between the handout intervention (Diskus and HandiHaler) and health literacy level and vision. The educational handouts for DPIs helped participants already using a DPI to improve their inhaler technique. Stable participants diagnosed with COPD are able to generate appropriate PIFs to properly use DPIs. Neither vision nor health literacy was associated with the inability to learn
... Submit What's this? Submit Button What is Health Literacy? Recommend on Facebook Tweet Share Compartir Low Resolution ... and services to make appropriate health decisions. Health Literacy Capacity and Skills Capacity is the potential a ...
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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
Diehl, Sandra J.
Building health literacy skills among adult learners has the potential to contribute to efforts to eliminate health disparities and improve health outcomes. Adults with limited literacy skills are more likely to be underserved by health services and at risk for poorer health. Recognition of the need for stronger health literacy skills and a desire…
This paper reports an analysis of the concept of health literacy in order to clarify its meaning, reduce ambiguities associated with references to it, and promote consistency in using the concept in nursing dialogue and research. Health literacy is a relatively new concept in health promotion research. Only within the last decade have researchers identified the problems associated with health literacy, the role it plays in an individual's ability to comprehend health and self-care information, and its relationship to health outcomes. Clarifying the concept is essential so that nurses develop an awareness of the phenomenon and its relationship to the outcomes of their communication and health education efforts. The method used for this concept analysis was that of Walker and Avant (1995). Health literacy empowers people to act appropriately in new and changing health-related circumstances through the use of advanced cognitive and social skills. The defining attributes of health literacy are reading and numeracy skills, comprehension, the capacity to use information in health care decision-making, and successful functioning as a healthcare consumer. Antecedents of health literacy are literacy and a health-related experience. Consequences of health literacy include improved self-reported health status, lower health care costs, increased health knowledge, shorter hospitalizations, and less frequent use of health care services. Empirical referents of the concept are the Test of Functional Health Literacy in Adults and the health literacy component of the National Assessment of Adult Literacy. An analysis of the concept of health literacy enhances nurses' ability to assess more accurately their clients' levels of health literacy, thus identifying those at risk for misunderstanding health care instructions, shame associated with inadequate reading skills, and inability to adhere to health care recommendations.
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.
Kim, Su Hyun
The aim of the study was to investigate the relationships of health literacy to chronic medical conditions and the functional health status among community-dwelling Korean older adults. In the literature, limited health literacy has been reported to have adverse effect on health outcomes. However, the link between health literacy to health status among Korean older adults needs to be clarified. A cross-sectional survey. A cross-sectional survey of 103 community-dwelling Korean older adults was conducted from June 2007-September 2007. Health literacy was measured using the Korean Functional Health Literacy test and functional health status was measured using the subscales of the Medical Outcomes Study 12-item Short-Form Health Survey. Individuals with a low health literacy had significantly higher rates of arthritis and hypertension. After adjusting for age, education and income, older individuals with low health literacy had higher limitations in activity and lower subjective health. In a model adjusting for age and income only, older individuals with low health literacy were more likely to report lower levels of physical function and subjective health and higher levels of limitations in activity and pain. Among community-dwelling Korean older adults, limited health literacy is associated independently with higher rates of chronic medical conditions and lower subjective health status. Nurses are key to providing health education to older adults. The understanding of the relationship of health literacy to health status is essential to develop communication and health education efforts for older adults in nursing practice.
Crondahl, Kristine; Eklund Karlsson, Leena
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...... 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....
Husson, O.; Mols, F.; Fransen, M.P.; Poll-Franse, L.V. van de; Ezendam, N.P.
BACKGROUND: The objectives of the study were to examine the prevalence of health literacy (HL) among colorectal cancer (CRC) survivors and the relation between HL and health behaviors and to explore whether or not HL and health behaviors are independently associated with health-related quality of
... of Public Health. 87(6): 1027-1030. 11 Baker DW, Parker RM, Williams MV, Clark WS. 1998. Health literacy and the risk of hospital admission. Journal of General Internal Medicine. 13(12): 791-798. ...
Squiers, Linda; Peinado, Susana; Berkman, Nancy; Boudewyns, Vanessa; McCormack, Lauren
Although there are a variety of models and frameworks that describe factors that are associated with health literacy skills, few illustrate the full pathway from development and moderators of health literacy skills, their application, and the outcomes that result all in one framework or model. This article introduces the Health Literacy Skills conceptual framework that does encompass this full continuum. To develop the framework, the authors reviewed and built upon existing health literacy frameworks. The Health Literacy Skills framework hypothesizes the relations between health literacy and health-related outcomes and depicts how health literacy functions at the level of the individual. The framework also reflects how factors external to the individual (e.g., family, setting, community, culture, and media) influence the constructs and relations represented in the framework. The framework is organized into 4 primary components: (a) factors that influence the development and use of health literacy skills; (b) health-related stimuli; (c) health literacy skills needed to comprehend the stimulus and perform the task; and (d) mediators between health literacy and health outcomes. Previous theoretical frameworks lend support to the proposed causal pathways it illustrates. The authors hope this conceptual framework can serve as a springboard for further discussion and advancement in operationalizing this complex construct. The Health Literacy Skills framework could also be used to guide the development of interventions to improve health literacy. Future research should be conducted to fully test the relations in the framework.
Full Text Available Objective: All currently available definitions of health literacy may be considered quite general. Given the complex nature of the patient-pharmacy encounter and the varying tasks required to properly and successfully consume or administer medication or to adhere to a pharmaceutical care regimen, these available definitions may describe inadequately a patient’s health literacy for the purpose of pharmacotherapy and pharmacist intervention. Therefore, the objective of this research was to conceptualize the Pharmacotherapy Literacy construct.Methods: Licensed pharmacists (n=2,368 were mailed a questionnaire providing them with the Healthy People 2010 definition of health literacy and asked, “Given this definition, how would you define Pharmacotherapy Literacy?” A total of 420 usable surveys were returned of which 176 (42% included responses to the open-ended question concerning pharmacotherapy literacy. Responses were reviewed independently and collectively by the authors. Common themes were identified, compared and discussed until consensus was reached. An initial definition was formulated and distributed to six doctoral-trained academicians and practicing pharmacists who were asked to offer their opinions of the definition as well as suggestions for its improvement. The definition was modified and subjected to further review from 15 additional doctoral-trained academicians and practicing pharmacists who provided feedback concerning its improvement.Results: Based on the recommendations received from the academicians and pharmacists, the following, definition was formulated by the authors: Pharmacotherapy Literacy – An individual’s capacity to obtain, evaluate, calculate, and comprehend basic information about pharmacotherapy and pharmacy related services necessary to make appropriate medication-related decisions, regardless of the mode of content delivery (e.g. written, oral, visual images and symbols.Conclusions: As the ever
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
Khajouei, Reza; Salehi, Fatemeh
We examined the health lit- eracy status of high school students in Kerman, Iran. This descriptive cross-sectional study was conducted at high schools in Kerman. Data concerning 3 dimensions of health literacy (health knowledge, health skills and health be- haviors) were collected from 312 students using an adapted version of a valid and reliable questionnaire developed by the Ministry of Health of China. Data analysis was performed by descriptive statistics and chi-square analysis using SPSS version 22. The average age of the students was 16 ± 3 years and 50% (N = 156) of them were girls. Twenty-nine percent of students gained a health literacy score between 37 and 47 (adequate). A statistically significant relationship was found between health literacy and type of school (p health literacy requiring serious interventions by authorities and policy-makers. Incorporating subjects such as mental health, prevention of addiction, and puberty and sexual health into educational curricula can improve Iranian students' health literacy.
Klecun, Ela; Lichtner, Valentina; Cornford, Tony
This paper explores notions of e-Literacy (otherwise IT literacy or digital literacy) in health care. It proposes a multi-dimensional definition of e-Literacy in health care and provides suggestions for policy makers and managers as to how e-Literacy might be accounted for in their decisions.
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 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.
Dickens, Carolyn; Lambert, Bruce L; Cromwell, Terese; Piano, Mariann R
Patient education and effective communication are core elements of the nursing profession; therefore, awareness of a patient's health literacy is integral to patient care, safety, education, and counseling. Several past studies have suggested that health care providers overestimate their patient's health literacy. In this study, the authors compare inpatient nurses' estimate of their patient's health literacy to the patient's health literacy using Newest Vital Sign as the health literacy measurement. A total of 65 patients and 30 nurses were enrolled in this trial. The results demonstrate that nurses incorrectly identify patients with low health literacy. In addition, overestimates outnumber underestimates 6 to 1. The results reinforce previous evidence that health care providers overestimate a patient's health literacy. The overestimation of a patient's health literacy by nursing personnel may contribute to the widespread problem of poor health outcomes and hospital readmission rates.
Håkansson Lindqvist, Marcia J.P.
This thesis on school literacy focuses on how students employ different texts within classroom contexts. Based on a methodological, analytical, and theoretical foundation in New Literacy Studies (NLS), it explores how different texts are integrated into a variety of literacy practices across various subjects. The overarching aim of the thesis is to explore prominent literacy practices within a school context, among students in their final year of upper secondary school in Norway. I also discu...
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.
McIntyre, Sue; Dale, Helen; Gabler, Carol
Health literacy, the ability to obtain and understand information and services to make good health decisions, has received much attention recently. Literacy is a stronger predictor of health status than age, income, race, ethnicity, employment status, or educational level. Inadequate health literacy costs the United States an estimated $100-$236…
Lindgren, Kurt; Sølling, Ina Koldkjær; Carøe, Per
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...... 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...
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.
Levinsen, Karin; Sørensen, Birgitte Holm
It is generally agreed that learners need to acquire digital literacy in order to be able to act as citizens, employees and entrepreneurs in an increasingly digitalized environment. It is also generally agreed that the educational system has to be responsible for educating towards digital literacy....... However, there is no shared conception of the scope and meaning of digital literacy. The overall picture shows two main approaches: The first aims at digital literacy in the sense of Buildung (general education) while the second addresses a wide range of specific skills and competences: From basic...... computer skills over multimodal analysis to social conventions for behavior in online environments. Consequently designs for teaching and learning that aim at learners acquiring digital literacy and the related learning objectives appear as weak defined. According to the Danish Ministry of Education Shared...
Literacy is increasingly being thought of as a social practice with its use and understandings being context dependent. As an essential element within and of education, literacy offers possibilities for engaging in everyday life. Health literacy has emerged as a means to develop health-promoting practices that has meaning in social contexts. Reflecting biomedical interests, the focus of health literacy is predominately constructed as a neutral and technical process that has specific meaning a...
Adult literacy is inextricably linked with adults' understanding of educational and informational materials concerning their health. Approximately 90 million American adults are functionally illiterate or have only marginal reading skills. This article describe the impact of poor literacy skills on patient health and the scope of the challenges to health literacy. The author also describes simple steps which dentists can undertake to identify patients with poor literacy skills and methods which may help improve educational programs for those patients.
Calderón, José L; Shaheen, Magda; Hays, Ron D; Fleming, Erik S; Norris, Keith C; Baker, Richard S
To produce a Spanish/English animated video about diabetes; to qualitatively assess cultural and linguistic appropriateness; and to test effectiveness at improving diabetes health literacy among Latino/Hispanics. Participatory research and animation production methods guided development of the video. Cultural appropriateness was assessed through focused discussion group methods. A prospective randomized controlled trial tested the effectiveness of the Spanish version at improving diabetes health literacy, compared to "easy to read" diabetes information from the National Institute of Diabetes and Digestive and Kidney Diseases. Functional health literacy was measured by the Short Test of Functional Health Literacy in Adults. Diabetes health literacy was measured by the Diabetes Health Literacy Survey (DHLS). No significant differences were recorded between experimental (n = 118) and control groups (n = 122) at baseline on demographic characteristics, Short Test of Functional Health Literacy in Adults score, or DHLS score. Fifty-eight percent of the study participants had inadequate functional health literacy. Mean DHLS score for all participants and those having adequate functional health literacy were 0.55 and 0.54, respectively (inadequate diabetes health literacy). When adjusting for baseline DHLS score, sex, age, and insurance status, DHLS scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, P = .03). Interaction between experimental group and health literacy level was significant (F = 6.37, df = 2, P = .002), but the experimental effect was significant only for participants with inadequate health literacy (P = .009). The positive effect on DHLS scores suggests that animation has great potential for improving diabetes health literacy among Latinos having limited functional health literacy. A study is needed that targets participants with inadequate health literacy and that uses the
Pomerantz, Karyn L.; Muhammad, Abdul-Ali; Downey, Stacey; Kind, Terry
This article describes a community-based health information partnership to address health literacy and health information inequalities in marginalized communities. Public health, medical, literacy, and library practitioners promote health literacy through outreach, training, and professional development activities in community settings. They create learning environments for people to develop the necessary knowledge and skills to better understand health information and health policy so they can make decisions concerning personal and community health. Outreach activities focus on visits to neighborhood health centers, health fairs, health exhibits at union meetings and conferences; training programs involve hands-on, peer-led computer classes for people living with HIV and for the general public; and professional development programs connect librarians, health providers, public health workers, and literacy teachers in joint planning and learning. Several learners currently participate in and lead community health education programs and HIV advocacy. The coalition's strength develops from strongly shared objectives, an absence of territoriality, and a core active leadership group. PMID:18544664
Fairbrother, Hannah; Curtis, Penny; Goyder, Elizabeth
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.
Health literacy has been redefined in recent years to move beyond an individual's own communication skills to include the skills of persons working within health care organizations, including librarians. Provision of consumer health services and resources, while a long-standing practice in hospital libraries, has also been redefined. As definitions of health literacy have evolved, so too have hospital librarian services as they embrace their role within health literacy. Many hospital medical and consumer health librarians have developed programs, services, and collaborations to further health literacy awareness, education, and initiatives for consumers, health care professionals, and their parent organizations.
S?rensen, Kristine; Pelikan, J?rgen M.; R?thlin, 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
Background: 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. Methods: The European health literacy survey (HLS-EU) was conducted i...
Martin, Laurie T; Ruder, Teague; Escarce, José J; Ghosh-Dastidar, Bonnie; Sherman, Daniel; Elliott, Marc; Bird, Chloe E; Fremont, Allen; Gasper, Charles; Culbert, Arthur; Lurie, Nicole
Low health literacy (LHL) remains a formidable barrier to improving health care quality and outcomes. Given the lack of precision of single demographic characteristics to predict health literacy, and the administrative burden and inability of existing health literacy measures to estimate health literacy at a population level, LHL is largely unaddressed in public health and clinical practice. To help overcome these limitations, we developed two models to estimate health literacy. We analyzed data from the 2003 National Assessment of Adult Literacy (NAAL), using linear regression to predict mean health literacy scores and probit regression to predict the probability of an individual having 'above basic' proficiency. Predictors included gender, age, race/ethnicity, educational attainment, poverty status, marital status, language spoken in the home, metropolitan statistical area (MSA) and length of time in U.S. All variables except MSA were statistically significant, with lower educational attainment being the strongest predictor. Our linear regression model and the probit model accounted for about 30% and 21% of the variance in health literacy scores, respectively, nearly twice as much as the variance accounted for by either education or poverty alone. Multivariable models permit a more accurate estimation of health literacy than single predictors. Further, such models can be applied to readily available administrative or census data to produce estimates of average health literacy and identify communities that would benefit most from appropriate, targeted interventions in the clinical setting to address poor quality care and outcomes related to LHL.
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.
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
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…
Bruselius-Jensen, Maria; Bonde, Ane Høstgaard; Christensen, Julie Hellesøe
in Copenhagen, Denmark, during the autumn and winter of 2013–2014. Participants numbered 281 pupils and nine teachers. Method: We used Nutbeam’s conceptualisation of health literacy as a theoretical framework to assess which levels of health literacy the programme would promote; we assessed these using data...... school pupils develop health literacy related to physical activity. It discusses curriculum-integrated health education’s contribution to promoting health literacy. Design: Qualitative classroom observation. Setting: IMOVE was implemented in 12 school classes (grades 5–7) in four public schools...
Schaeffer, Doris; Berens, Eva-Maria; Vogt, Dominique
Persons with low health literacy have difficulty dealing with the health care system and understanding health-related information. Studies from multiple countries have shown that low health literacy negatively affects health, health-related and illness-related behavior, and the utilization of health care resources. The data available till now on health literacy in Germany have been sparse. The goal of this study is to acquire representative data on the health literacy of the German population. In a cross-sectional study, we collected data from a representative group of 2000 persons over age 15 in Germany by means of computer-assisted personal interviews (CAPI) that were based on the long version of the questionnaire used in the European Health Literacy Survey (HLS-EU-Q47). Sociodemographic data were also collected. The respondents were a representative sample of the German population. 54.3% of them were found to have limited health literacy. Multiple logistic regression revealed associations of limited health literacy with advanced age (odds ratio [OR] 1.83, 95% confidence interval [CI] [1.36; 2.48]), an immigrant background (OR 1.87 [1.27; 2.75]), low self-assessed social status (OR 5.25 [3.57; 7.72]), and low functional literacy (OR 1.94 [1.49; 2.52]). The low health literacy of many Germans can impair communication between doctors and patients and exacerbate existing problems in health policy. In the future, greater effort will have to be made to foster health literacy, make health-related information for patients easier to understand, and intensify research in the field of health literacy.
Akbarinejad, Farideh; Soleymani, Mohammad Reza; Shahrzadi, Leila
Background: 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. Materials and Methods: 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. Results: 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. Conclusion: 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. PMID:28546982
Palumbo, Rocco; Annarumma, Carmela; Adinolfi, Paola; Musella, Marco; Piscopo, Gabriella
Inadequate health literacy, namely the problematic individual's ability to navigate the health care system, has been depicted as a silent epidemic affecting a large part of the world population. Inadequate health literacy has been variously found to be a predictor of patient disengagement, inappropriateness of care, increased health care costs, and higher mortality rates. However, to date the evidence on the prevalence of limited health literacy is heterogeneous; moreover, studies dealing with this topic show a pronounced geographical concentration. To contribute in filling these gaps, this paper investigates health literacy skills in Italy. Drawing on the European Health Literacy Survey (HLS-EU), a tool to measure self-perceived levels of health literacy was administered to a representative sample of Italian citizens. A stepwise regression analysis allowed to shed light on the determinants and consequences of limited health literacy. Findings suggested that inadequate health literacy is a prevailing problem in Italy, even though it has been overlooked by both policy makers and health care practitioners. Financial deprivation was found to be a significant predictor of inadequate health literacy. Low health literate patients reported higher hospitalization rates and greater use of health services. As compared with the European Countries, Italy showed some peculiarities in terms of health literacy levels and socio-demographic determinants of health literacy, which provide with intriguing insights for policy making. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
... 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 ...
What Jorm's definition of mental health literacy fails to specify (although perhaps ... This is a non-systematic review of published articles on mental health literacy in the general population and among primary healthcare workers, in .... includes basic reading and numerical skills in health care settings, such as being able to ...
Taylor, Dominic M; Bradley, John A; Bradley, Clare; Draper, Heather; Johnson, Rachel; Metcalfe, Wendy; Oniscu, Gabriel; Robb, Matthew; Tomson, Charles; Watson, Chris; Ravanan, Rommel; Roderick, Paul
Limited health literacy may reduce the ability of patients with advanced kidney disease to understand their disease and treatment and take part in shared decision making. In dialysis and transplant patients, limited health literacy has been associated with low socioeconomic status, comorbidity, and mortality. Here, we investigated the prevalence and associations of limited health literacy using data from the United Kingdom-wide Access to Transplantation and Transplant Outcome Measures (ATTOM) program. Incident dialysis, incident transplant, and transplant wait-listed patients ages 18 to 75 were recruited from 2011 to 2013 and data were collected from patient questionnaires and case notes. A score >2 in the Single-Item Literacy Screener was used to define limited health literacy. Univariate and multivariate analyses were performed to identify patient factors associated with limited health literacy. We studied 6842 patients, 2621 were incident dialysis, 1959 were wait-listed, and 2262 were incident transplant. Limited health literacy prevalence was 20%, 15%, and 12% in each group, respectively. Limited health literacy was independently associated with low socioeconomic status, poor English fluency, and comorbidity. However, transplant wait-listing, preemptive transplantation, and live-donor transplantation were associated with increasing health literacy. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.
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.
Koay, Kelvin; Schofield, Penelope; Jefford, Michael
Health literacy refers to one's ability to obtain, process and understand health information and services to enable sound health decision-making. This is an area of increasing importance due to the complexity of the health system, especially in the cancer setting. A certain level of health literacy is required for patients to fully understand health information and services to make sound decisions about their health care, including decisions about screening and treatment. Previous research has suggested that a significant proportion of the population may have limited health literacy. Suboptimal health literacy is an independent risk factor for poor health outcomes, including increased risk of hospitalization. Cancer patients with poor health literacy may have misconceptions about their disease and ineffective communication with their health professionals, leading to unnecessary interventions, under-treatment or poor adherence to their treatment plans. In addition, cancer patients who have a poor understanding of their disease may experience greater anxiety and be more dissatisfied with their care. Various strategies have been suggested to assist cancer patients with low health literacy. However, more work needs to be done to support all cancer patients with varying levels of health literacy, thus enhancing health experiences and health outcomes. © 2012 Blackwell Publishing Asia Pty Ltd.
Bacon, Opal; Vandenberg, Amy; May, Meghan E
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. 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. 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. 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. 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.
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
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.
Varekojis, Sarah M.; Miller, Larry; Schiller, M. Rosita; Stein, David
Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the…
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.
Jukkala, Angela; Deupree, Joy P; Graham, Shannon
Health care providers' awareness and knowledge of the impact that limited health literacy has on the health care system and the individual patient was measured. In addition, the usefulness of the Limited Literacy Impact Measure (LLIM) was examined. Two hundred forty providers and students attending a university-sponsored presentation on health literacy were invited to participate. Participants were most knowledgeable about the impact on patients and less knowledgeable about the impact on the health care system. Health care provider knowledge and awareness of limited health literacy continues to be a challenge. Educational programs developed for providers and patients are needed to address the health literacy crisis. Improving health literacy will improve health outcomes while reducing the use of unnecessary health care services.
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
Becerra, Benjamin J; Arias, Devin; Becerra, Monideepa B
Low health literacy is a significant barrier to healthcare access and service utilization; however, there are few studies that have evaluated the factors associated with having low health literacy, especially among immigrant minority populations. This exploratory study aimed to assess the key determinants of low health literacy among immigrant Hispanic adults in California using the California Health Interview Survey, the largest population-based state health survey in the United States. Analysis accounted for complex survey design, allowing generalizations to the entire state of California. Low health literacy was associated with living in poverty (OR = 1.63), lacking consistent health insurance (OR = 1.40), and limited English language proficiency (OR = 3.22), while women were less likely than men (OR = 0.59) to report low health literacy. The results of this study demonstrate that language proficiency, in addition to other key sociodemographic variables, can significantly posit limitations to health literacy. Future efforts should address providing linguistically competent health literacy interventions in order to improve associated health outcomes.
Sanders, Kalina; Schnepel, Loretta; Smotherman, Carmen; Livingood, William; Dodani, Sunita; Antonios, Nader; Lukens-Bull, Katryne; Balls-Berry, Joyce; Johnson, Yvonne; Miller, Terri; Hodges, Wayne; Falk, Diane; Wood, David; Silliman, Scott
Inadequate health literacy is a pervasive problem with major implications for reduced health status and health disparities. Despite the role of focused education in both primary and secondary prevention of stroke, the effect of health literacy on stroke education retention has not been reported. We examined the relationship of health literacy to the retention of knowledge after recommended stroke education. This prospective cross-sectional study was conducted at an urban safety-net hospital. Study subjects were patients older than 18 admitted to the hospital stroke unit with a diagnosis of acute ischemic stroke who were able to provide informed consent to participate (N = 100). Health literacy levels were measured by using the short form of Test of Functional Health Literacy in Adults. Patient education was provided to patients at an inpatient stroke unit by using standardized protocols, in compliance with Joint Commission specifications. The education outcomes for poststroke care education, knowledge retention, was assessed for each subject. The effect of health literacy on the Stroke Patient Education Retention scores was assessed by using univariate and multivariate analyses. Of the 100 participating patients, 59% had inadequate to marginal health literacy. Stroke patients who had marginal health literacy (mean score, 7.45; standard deviation [SD], 1.9) or adequate health literacy (mean score, 7.31; SD, 1.76) had statistically higher education outcome scores than those identified as having inadequate health literacy (mean score, 5.58; SD, 2.06). Results from multivariate analysis indicated that adequate health literacy was most predictive of education outcome retention. This study demonstrated a clear relationship between health literacy and stroke education outcomes. Studies are needed to better understand the relationship of health literacy to key educational outcomes for primary or secondary prevention of stroke and to refine stroke education for literacy
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
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
Di Girolamo, Amalia; Harrison, Glenn W.; Lau, Morten
We characterize the literacy of an individual in a domain by their elicited subjective belief distribution over the possible responses to a question posed in that domain. By eliciting the distribution, rather than just the answers to true/false or multiple choice questions, we can directly measur...
Hernandez, Lyla M
.... Health literacy can be difficult to assess, however, as it is not only a measure of individuals' understanding of health information at various points in time but also a measure of how well various...
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...
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
Full Text Available 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 draw on. The paper presents findings from a study of forty five literacy and ESOL (English for Speakers of Other Languages students’ health-related reading and writing practices in the north-west of England. I suggest that health literacy needs to be understood as a situated social practice and that it is a shared resource frequently achieved collectively by groups of people, for example families. I conclude with some reflections on the implications of my research for adult education practice.
Demographic changes in California require a multicultural paradigm shift in oral health care. The shift encompasses attention to health literacy in all forms of communication: signage, oral and written communication, consent forms, postop instructions, and patient education materials. California dentists may find it necessary to adapt their practices to reflect community demographics and health literacy needs. This article provides a toolbox of recommendations to address these needs.
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...
Estacio, Emee Vida
The concept of health literacy is evolving. The re-emergence of Freireian-inspired health literacy projects moves the conceptualisation of health literacy from merely the ability to apply functional literacy skills in a health-care context to a wider ability to exert control over the determinants of health. This article presents an example of a community-based project that adopts an empowerment education model in health literacy. Based within a small indigenous community in the Philippines, participants were engaged in critical reflection to gain a better understanding of how health is conceptualised within their socio-economic and political environment and its implications for practice, power relations and subjective experiences. The article concludes with the assertion that although developing health literacy skills is important, we must never lose sight of unbalanced power relations and unfair structures that hinder positive social change.
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.
Hersh, Lauren; Salzman, Brooke; Snyderman, Danielle
Health literacy includes a set of skills needed to make appropriate health decisions and successfully navigate the health care system. These skills include reading, writing, numeracy, communication, and, increasingly, the use of electronic technology. National data indicate that more than one-third of U.S. adults have limited health literacy, which contributes to poor health outcomes and affects patient safety, and health care access and quality. Although there are a number of tools that screen for limited health literacy, they are primarily used for research. Routinely screening patients for health literacy has not been shown to improve outcomes and is not recommended. Instead, multiple professional organizations recommend using universal health literacy precautions to provide understandable and accessible information to all patients, regardless of their literacy or education levels. This includes avoiding medical jargon, breaking down information or instructions into small concrete steps, limiting the focus of a visit to three key points or tasks, and assessing for comprehension. Additionally, printed information should be written at or below a fifth- to sixth-grade reading level. Visual aids, graphs, or pictures can enhance patient understanding, as can more concrete presentation of numerical information.
Sykes, Susie; Wills, Jane; Rowlands, Gillian; Popple, Keith
Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part of this concept when it was first introduced in the literature
Full Text Available Abstract Background Interest in and debates around health literacy have grown over the last two decades and key to the discussions has been the distinction made between basic functional health literacy, communicative/interactive health literacy and critical health literacy. Of these, critical health literacy is the least well developed and differing interpretations of its constituents and relevance exist. The aim of this study is to rigorously analyse the concept of critical health literacy in order to offer some clarity of definition upon which appropriate theory, well grounded practice and potential measurement tools can be based. Method The study uses a theoretical and colloquial evolutionary concept analysis method to systematically identify the features associated with this concept. A unique characteristic of this method is that it practically combines an analysis of the literature with in depth interviews undertaken with practitioners and policy makers who have an interest in the field. The study also analyses how the concept is understood across the contexts of time, place, discipline and use by health professionals, policy makers and academics. Results Findings revealed a distinct set of characteristics of advanced personal skills, health knowledge, information skills, effective interaction between service providers and users, informed decision making and empowerment including political action as key features of critical health literacy. The potential consequences of critical health literacy identified are in improving health outcomes, creating more effective use of health services and reducing inequalities in health thus demonstrating the relevance of this concept to public health and health promotion. Conclusions While critical health literacy is shown to be a unique concept, there remain significant contextual variations in understanding particularly between academics, practitioners and policy makers. Key attributes presented as part
French, Melissa; Hernandez, Lyla M
Organizational Change to Improve Health Literacy is the summary of a workshop convened in April 2013 by the Institute of Medicine Board on Population Health and Public Health Practice Roundtable on Health Literacy...
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.
Keim-Malpass, Jessica; Doede, Aubrey; Kennedy, Christine; Showalter, Shayna L
Health literacy is recognized as an integral component of high-quality health care. However, health literacy has been understudied in the context of cancer care delivery and surgical decision making. The goal of this article is to outline a process for implementation of a health literacy screening assessment within the routine practices of an academic breast surgical oncology clinic. The self-reported health literacy assessment is feasible, particularly with integration of the health literacy screen in the electronic health record. The authors' estimated clinic prevalence of low health literacy was 22%, which has numerous implications for communication and shared decision-making processes. .
Cosic, Filip; Kimmel, Lara; Edwards, Elton
This study aimed to determine the level of health literacy in a postoperative orthopaedic trauma population and to evaluate the efficacy of a simple predischarge discussion strategy, targeted at improving health literacy. A pre-post intervention study was conducted from April 2014 to January 2015. Academic Level 1 trauma center. One hundred ninety consecutive orthopaedic trauma patients with operatively managed lower limb fractures were recruited. All eligible participants agreed to participate. The first ninety-nine patients received usual care (UC). The following 91 patients received a structured predischarge discussion, including x-rays, written and verbal information, from the orthopaedic staff (DG). Patients were then randomized into health literacy evaluation before first outpatient review or after first outpatient review. The primary outcome measure was a questionnaire determining health literacy. Ninety-six (97%) of the UC patients and 87 (96%) of the discussion patients (DG) completed the interview. UC preoutpatient (n = 46) demonstrated a mean score of 4.67 of a maximum 8. UC postoutpatient (n = 50) demonstrated a mean score of 5.42. DG preoutpatient (n = 47) demonstrated a mean score of 6.70. DG postoutpatient (n = 40) demonstrated a mean score of 7.08. Australian orthopaedic trauma patients demonstrate poor health literacy, with this not showing improvement after their first outpatient follow-up visit. The use of a time efficient, structured predischarge discussion improved patient health literacy. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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
Background: 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. Methods: 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. Results: 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. Discussion: 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. PMID:25843827
Health Literacy is defined as the ability to understand, obtain and appraise health information in order to make appropriate decisions that can promote health. Low health literacy means lacking the ability to understand, obtain and appraise health information successfully and making decisions become difficult. The aim of the study was to address how low health literacy can have negative impact on health of older individual and also to suggest ways to deliver and create more accessible ...
Zahnd, Whitney E.; Scaife, Steven L.; Francis, Mark L.
Objective: To determine whether health literacy is lower in rural populations. Method: We analyzed health, prose, document, and quantitative literacy from the National Assessment of Adult Literacy study. Metropolitan Statistical Area designated participants as rural or urban. Results: Rural populations had lower literacy levels for all literacy…
von Wagner, Christian; Steptoe, Andrew; Wolf, Michael S.; Wardle, Jane
The association between performance on health literacy measures and health outcomes is well established. The next step is to understand the processes through which health literacy affects health. This review introduces a framework drawing on ideas from health psychology and proposing that associations between health literacy and health outcomes…
Mantwill, Sarah; Schulz, Peter J
Health literacy tests in the Chinese-speaking parts of the world have been mainly developed in traditional Chinese to be used in Hong Kong or Taiwan. So far no validated tool in simplified Chinese to assess functional health literacy in Mainland China has been developed. The aim of the study was to validate the simplified Chinese version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The traditional Chinese version was translated into simplified Chinese and 150 interviews in an outpatient department of a public hospital in Mainland China were conducted. Predictive validity was assessed by known predictors for health literacy and convergent validity by three health literacy screening questions. The Cronbach's α for the reading comprehension part was 0.94 and 0.90 for the numeracy items. Participants with lower education and men had significantly lower levels of health literacy. The reading comprehension part was significantly correlated with two of the health literacy screening questions. Our results indicate that the simplified Chinese version of the S-TOFHLA is a reliable measure of health literacy to be used in Mainland China. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Wolf, Michael S; Wilson, Elizabeth A H; Rapp, David N; Waite, Katherine R; Bocchini, Mary V; Davis, Terry C; Rudd, Rima E
The relationship between literacy and health outcomes are well documented in adult medicine, yet specific causal pathways are not entirely clear. Despite an incomplete understanding of the problem, numerous interventions have already been implemented with variable success. Many of those who proposed earlier strategies assumed the problem to originate from reading difficulties only. Given the timely need for more effective interventions, it is of increasing importance to reconsider the meaning of health literacy to advance our conceptual understanding of the problem and how best to respond. One potentially effective approach might involve recognizing the known associations between a larger set of cognitive and psychosocial abilities with functional literacy skills. Here we review the current health literacy definition and literature and draw on relevant research from the fields of education, cognitive science, and psychology. In this framework, a research agenda is proposed that considers an individual's "health-learning capacity," which refers to the broad constellation of cognitive and psychosocial skills from which patients or family members must draw to effectively promote, protect, and manage their own or a child's health. This new, related concept will lead, ideally, to more effective ways of thinking about health literacy interventions, including the design of health-education materials, instructional strategies, and the delivery of health care services to support patients and families across the life span.
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
Hernandez, Lyla; French, Melissa; Parker, Ruth
In 2004 the Institute of Medicine (IOM) report, Health Literacy: A Prescription to End Confusion, highlighted that "efforts to improve quality, to reduce costs, and to reduce disparities cannot succeed without efforts to improve health literacy" . The IOM report emphasized that poor health literacy is a major challenge for individuals who need to find, understand, and use information to make informed decisions for health. Following the publication of the 2004 report and in response to rising interest in health literacy in the U.S., the IOM established the Roundtable on Health Literacy. Roundtables convene a broad array of stakeholders from foundations, health plans, associations, government, private companies, and patient and consumer groups to discuss challenges and provide a forum for exchange of knowledge and expertise. The Roundtable does not make recommendations, rather its mission is to inform, inspire, and activate diverse U.S. (and potentially international) stakeholders. The Roundtable's activities support the development, implementation, and sharing of evidence-based health literacy practices and policies. The Roundtable's goal is to improve the health and well-being of Americans as well as persons in other nations. Since its inception, the Roundtable has explored ways in which health literacy relates to a diverse array of topics from medications to oral health to public health to health equity and more. In particular the Roundtable has served to highlight the issues central to the alignment of system demands and complexities with individual skills and abilities. Roundtable workshops and discussions, no matter the specific topic, maintain a focus on identifying and illuminating evidence-based health literacy approaches that foster high-quality, patient centered care. The work of the Roundtable has been used throughout the United States and globally to foster health literate organizations and approaches to improving patient-centered care and the health
Hadden, Kristie B
This pilot project assessed the effectiveness of training health professionals in (1) readability assessment of written health materials, (2) plain language editing, and (3) formatting materials so they are easy to understand and use. Over six semesters, five students participated in the project. Students were trained to assess document readability, confirm and interpret readability results and "stamp" the documents with results. Students then edited documents under supervision, via revised documents were re-assessed for readability and approved. Training was assessed through readability score comparison and exit interviews with students. Most original readability scores were 10th grade to college level. After editing, the average reading level of 73% was 6th grade or better. Students and supervisor rated skill levels as "proficient" at the end of the semester. To address the gap between document reading level and patients' reading ability, health documents should be assessed and edited for plain language. Working with patient documents from various health fields, our program effectively trained health professions students in these skills. Training health professions students in readability assessment and plain language editing can reduce literacy demands on patients and address the need for professionals with these skills. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Bruselius-Jensen, Maria; Bonde, Ane Høstgaard; Christensen, Julie Hellesøe
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 school pupils develop health literacy…
Cutilli, Carolyn Crane; Schaefer, Cynthia T
The geriatric population has the highest rate of low health literacy when compared with other age groups. To maximize health outcomes with this group, healthcare providers have an obligation to recognize individuals with potential for low health literacy and educate these patients in a manner that ensures understanding. Research and clinical experience have demonstrated several interventions that are useful in providing effective health education including the use of the teach-back technique, multimedia material including visual aids, simple and clear language, support persons, and experiences. The cases presented in this article emphasize awareness of individuals at risk for low health literacy and interventions that are effective in helping patients understand how to care for themselves.
Muir, Kelly W; Ventura, Alice; Stinnett, Sandra S; Enfiedjian, Abraham; Allingham, R Rand; Lee, Paul P
To test an educational intervention targeted to health literacy level with the goal of improving glaucoma medication adherence. One hundred and twenty-seven veterans with glaucoma were randomized to glaucoma education or standard care. The intervention included a video scripted at a 4th, 7th, or 10th grade level, depending on the subject's literacy level. After six months, the number of days without glaucoma medicine (DWM) according to pharmacy records for the intervention and control groups was compared. The number of DWM in the six months following enrollment was similar for control and intervention groups (intervention, n=67, DWM=63 ± 198; standard care, n=60, DWM=65 ± 198; p=0.708). For each subgroup of literacy (adequate, marginal, inadequate), subjects in the intervention group experienced less mean DWM than subjects in the control group and the effect size (ES) increased as literacy decreased: adequate literacy, ES 0.069; marginal, ES 0.183, inadequate, ES 0.363. Decreasing health literacy skills were associated with decreasing self-reported satisfaction with care (slope=0.017, SE=0.005, p=0.002). Patients with decreased health literacy skills may benefit from educational efforts tailored to address their health literacy level and learning style. Providers should consider health literacy skills when engaging in glaucoma education. Published by Elsevier Ireland Ltd.
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...
Adams, Robert J; Stocks, Nigel P; Wilson, David H; Hill, Catherine L; Gravier, Susan; Kickbusch, Ilona; Beilby, Justin J
Health literacy is the ability to understand and interpret the meaning of health information in written, spoken or digital form and how this motivates people to embrace or disregard actions relating to health. This article aims to describe the concept of health literacy, its importance and its applications in the general practice setting. Australia trails behind other western countries in practical applications of health literacy. Health literacy underpins the efficiency of consultations, health promotion efforts, and self management programs. Recognition of the health literacy status of individuals allows use of appropriate communication tools. This can save time and effort and improve patient satisfaction and health outcomes.
Garcia, Cesar H.; Espinoza, Sara E.; Lichtenstein, Michael; Hazuda, Helen P.
Knowing health literacy levels of older patients and their caregivers is important because caregivers assist patients in the administration of medications, manage daily health care tasks, and help make health services utilization decisions. The authors examined the association of health literacy levels between older Hispanic patients and their caregivers among 174 patient-caregiver dyads enrolled from 3 community clinics and 28 senior centers in San Antonio, Texas. Health literacy was measured using English and Spanish versions of the Short-Test of Functional Health Literacy Assessment and categorized as “low” or “adequate.” The largest dyad category (41%) consisted of a caregiver with adequate health literacy and patient with low health literacy. Among the dyads with the same health literacy levels, 28% had adequate health literacy and 24% had low health literacy. It is notable that 7% of dyads consisted of a caregiver with low health literacy and a patient with adequate health literacy. Low health literacy is a concern not only for older Hispanic patients but also for their caregivers. To provide optimal care, clinicians must ensure that information is given to both patients and their caregivers in clear effective ways as it may significantly affect patient health outcomes. PMID:24093360
Clausen, Whitney; Watanabe-Galloway, Shinobu; Bill Baerentzen, M; Britigan, Denise H
People diagnosed with a mental illness are at higher risk of developing preventable chronic diseases; thus, health literacy improvements may have great potential to impact health outcomes for this typically underserved population. However, there is a dearth of research on health literacy of persons with severe mental illness. The purpose of this research was to investigate aspects of health literacy and identify factors associated with low literacy among adults with severe mental illness using three literacy assessment tools. Seventy-one adults with serious mental illness were assessed and a high proportion had limited literacy levels: 42% with the Single Item Literacy Screener, 50% with the Rapid Estimate of Adult Literacy in Medicine-Short Form, and 67% with the Newest Vital Sign. Findings suggest that individuals with certain mental illnesses and lower functioning may have more difficulty understanding health information and have limited numerical literacy.
Hewitt, Maria Elizabeth
.... According to Health Literacy: A Prescription to End Confusion (IOM, 2004), nearly half of all American adults--90 million people--have inadequate health literacy to navigate the healthcare system...
McKee, Michael M.; Paasche-Orlow, Michael
Inadequate health literacy and limited English proficiency are associated with poor health care access and outcomes. Despite what appears to be an interaction phenomenon—whereby the rate of inadequate health literacy is particularly high among limited English proficiency populations—researchers in health literacy and limited English proficiency rarely collaborate. As a result, few health literacy instruments and interventions have been developed or validated for smaller linguistic populations...
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.
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.
Birru, Mehret S
African Americans with low incomes and low literacy levels disproportionately suffer poor health outcomes from many preventable diseases. Low functional literacy and low health literacy impede millions of Americans from successfully accessing health information. These problems are compounded for African Americans by cultural insensitivity in health materials. The Internet could become a useful tool for providing accessible health information to low-literacy and low-income African Americans. Optimal health Web sites should include text written at low reading levels and appropriate cultural references. More research is needed to determine how African Americans with low literacy skills access, evaluate, prioritize, and value health information on the Internet. PMID:15471752
Roberts, Michelle; Callahan, Lizz; O'Leary, Catina
Social media - websites and other online tools called social networks - serve as a tool to connect people and organizations around topics of common interest. Social media platforms offer tremendous opportunity to engage quickly and sometimes in depth with many and diverse stakeholders as people have the ability to communicate back-and-forth from anywhere in the world. As increasing numbers of people receive their news and health information online, it is important to ensure content delivered through online resources is accessible to diverse target audiences. This chapter discusses a mid-sized health literacy nonprofit organizations' social media philosophy and tactics during the past 10 years, as both social media and health literacy strategies evolved continuously. The integration of social media in health literacy program content depends on the use with best evidence health literacy strategies, such as the use of plain language techniques. Strategy and technical considerations for the implementation and integration of social media within a health literate health communications model are discussed.
Full Text Available As attention to health literacy grows as an area for policy intervention, policy discourse continues to draw on skills deficit and patient compliance, buttressed by the dominant political discourse of individual responsibility. But for patients, the health domain is interwoven with linguistic challenges, significant affective issues, underlying cultural dimensions, political and economic exigencies, variable access to resources, and cognitive and situated complexity. From these perspectives, this article reports on findings of an ongoing study of health literacy demands in the Midlands region of the North Island of New Zealand, an area of high ethnic and socio-economic diversity. The study focuses on patients with diabetes and cardiovascular disease - two chronic areas strongly associated with ‘failure to care’ and identifed as having reached epidemic proportions. It analyses work to date: health professionals’ conceptions of and responses to perceived patients’ health literacy needs, and health information documents for patients. Implications of the study support the need for improvement in language and literacy skills among patients, but also the recognition of complexity and a collective responsibility for effective health communication.
Guzys, Diana; Kenny, Amanda; Dickson-Swift, Virginia; Threlkeld, Guinever
Defining health literacy from a public health perspective places greater emphasis on the knowledge and skills required to prevent disease and for promoting health in everyday life. Addressing health literacy at the community level provides great potential for improving health knowledge, skills and behaviours resulting in better health outcomes. Yet there is a notable absence of discussion in the literature of what a health literate population looks like, or how this is best assessed. The emphasis in assessing health literacy has predominantly focused on the functional health literacy of individuals in clinical settings. This review examines currently available health literacy assessment tools to identify how well suited they are in addressing health literacy beyond clinical care settings and beyond the individual. Although public health literature appears to place greater emphasis on conceptualizing critical health literacy, the focus continues to remain on assessing individuals, rather than on health literacy within the context of families, communities and population groups. When a population approach is adopted, an aggregate of individual health literacy assessment is generally used. Aggregation of individual health literacy fails to capture the dynamic and often synergistic relationships within communities, and fails to reflect societal influences on health knowledge, beliefs and behaviours. We hypothesise that a different assessment framework is required to adequately address the complexities of community health literacy. We assert that a public health approach, founded on health promotion theories provides a useful scaffold to assess the critical health literacy of population groups. It is proposed that inclusion of community members in the research process is a necessary requirement to coproduce such an appropriate assessment framework. We contend that health literacy assessment and potential interventions need to shift to promoting the knowledge and skills
Koster, E.S.; Schmidt, Alain; Philbert, D.; van de Garde, E.M.W.; Bouvy, M.L.
Aim Patients with limited health literacy have poorer surgical outcomes. However, current studies assessing the prevalence of limited health literacy in patients expecting surgery are small scale. We aimed to provide insight into the health literacy level of patients undergoing planned surgery.
May 20, 2011 ... danger signs during pregnancy. Key words: Literacy, Health Literacy, Maternal health ... maternal health literacy, which is a skill to diagnose the dangerous symptoms of the pregnancy period, the method of a ... mother's milk have been more than the other group. Ikeako, Onah, and Ilobachie (2006) in their ...
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: firstname.lastname@example.org.
Bitzer, Eva Maria; Spörhase, U
Medical rehabilitation in Germany has a long tradition. It is covered by the statutory sickness funds and pension schemes, and is aimed at the prevention of work disability and need for nursing care due to chronic conditions. Chronically ill but health-literate patients - patients capable of making good health-related decisions, or of participating strongly in this decision making - have better health outcomes. To enhance health literacy and participation, medical rehabilitation relies heavily on patient education. This article describes health literacy from the perspective of educational research, outlines the basics of learning principles, and draws conclusions for developing patient education programmes in medical rehabilitation. Implementing a constructivist learning paradigm promotes changes within the trainer team and within the rehabilitation institution - turning it into a health-literate health care organisation. Health literacy in medical rehabilitation is aimed at neither turning the patient into a physician nor replacing evidence-based recommendations through subjective preferences. Medical rehabilitation reaches patients best by using modern health education programmes based on findings from education research, theoretically founded and directed towards building competencies. Furthermore, an educationally qualified training team and a rehabilitation institution are essential in enabling formal and informal learning processes.
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.
Garcia-Retamero, Rocio; Cokely, Edward T; Ghazal, Saima; Joeris, Alexander
Visual aids tend to help diverse and vulnerable individuals understand risk communications, as long as these individuals have a basic understanding of graphs (i.e., graph literacy). Tests of objective graph literacy (OGL) can effectively identify individuals with limited skills, highlighting vulnerabilities and facilitating custom-tailored risk communication. However, the administration of these tests can be time-consuming and may evoke negative emotional reactions (e.g., anxiety). To evaluate a brief and easy-to-use assessment of subjective graph literacy (SGL) (i.e., self-reported ability to process and use graphically presented information) and to estimate the robustness and validity of the SGL scale and compare it with the leading OGL scale in diverse samples from different cultures. Demographically diverse residents (n = 470) of the United States, young adults (n = 172) and patients (n = 175) from Spain, and surgeons (n = 175) from 48 countries. A focus group and 4 studies for instrument development and initial validation (study 1), reliability and convergent and discriminant validity evaluation (study 2), and predictive validity estimation (studies 3 and 4). Psychometric properties of the scale. In about 1 minute, the SGL scale provides a reliable, robust, and valid assessment of skills and risk communication preferences and evokes fewer negative emotional reactions than the OGL scale. The SGL scale can be suitable for use in clinical research and may be useful as a communication aid in clinical practice. Theoretical mechanisms involved in SGL, emerging applications, limitations, and open questions are discussed. © The Author(s) 2016.
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.
These picture stories help English as a Second Language teachers address topics affecting their students' health and wellbeing. They are useful for beginner and low-literacy students, offering a safe, impromptu way to discuss difficult topics, ask questions, and obtain information. As the stories are about cartoon characters, students are not…
Bridges, Susan M; Parthasarathy, Divya S; Au, Terry K F; Wong, Hai Ming; Yiu, Cynthia K Y; McGrath, Colman P
This paper describes the development of a new literacy assessment instrument, the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P). Its relationship to literacy theory is analyzed to establish content and face validity. Implications for construct validity are examined by analyzing cognitive demand to determine how "comprehension" is measured. Key influences from literacy assessment were identified to analyze item development. Cognitive demand was analyzed using an established taxonomy. The HKOHLAT-P focuses on the functional domain of health literacy assessment. Items had strong content and face validity reflecting established principles from modern literacy theory. Inclusion of new text types signified relevant developments in the area of new literacies. Analysis of cognitive demand indicated that this instrument assesses the "comprehension" domain, specifically the areas of factual and procedural knowledge, with some assessment of conceptual knowledge. Metacognitive knowledge was not assessed. Comprehension tasks assessing patient health literacy predominantly examine functional health literacy at the lower levels of comprehension. Item development is influenced by the fields of situated and authentic literacy. Inclusion of content regarding multiliteracies is suggested for further research. Development of functional health literacy assessment instruments requires careful consideration of the clinical context in determining construct validity. © 2013 American Association of Public Health Dentistry.
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 ...
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.
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.
Ownby, Raymond L; Acevedo, Amarilis; Waldrop-Valverde, Drenna; Jacobs, Robin J; Caballero, Joshua
Health literacy has been recognized as an important factor in patients' health status and outcomes, but the relative contribution of demographic variables, cognitive abilities, academic skills, and health knowledge to performance on tests of health literacy has not been as extensively explored. The purpose of this paper is to propose a model of health literacy as a composite of cognitive abilities, academic skills, and health knowledge (ASK model) and test its relation to measures of health literacy in a model that first takes demographic variables into account. A battery of cognitive, academic achievement, health knowledge and health literacy measures was administered to 359 Spanish- and English-speaking community-dwelling volunteers. The relations of health literacy tests to the model were evaluated using regression models. Each health literacy test was related to elements of the model but variability existed across measures. Analyses partially support the ASK model defining health literacy as a composite of abilities, skills, and knowledge, although the relations of commonly used health literacy measures to each element of the model varied widely. Results suggest that clinicians and researchers should be aware of the abilities and skills assessed by health literacy measures when choosing a measure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Borzekowski, Dina L G
The theoretical approaches of Paulo Freire, Jean Piaget, and Lev Vygotsky frame the consideration of children and health literacy. This article includes a general discussion of literacy from the Freirian perspective. A definition of health literacy is then presented; first, the established meaning is introduced, but then a Freirian extension is proposed. Next, the theories of cognitive development by Piaget and Vygotsky are discussed, and examples related to children's health literacy are given. Finally, there is a discussion of why it is important to encourage and enable health literacy among children and adolescents.
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…
Health literacy research and scholarship has largely overlooked the experiences of people with intellectual disabilities (ID), though growing concern about the health inequalities they face has increasingly given rise to health promotion interventions for this group. However, these interventions reference a rather limited vision of health literacy…
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…
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 (Pliteracy 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.
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.
Ratzan, Scott; Apfel, Franklin
Noncommunicable disease (NCD) health literacy is a person's ability to access, understand and use information to prevent, treat and manage chronic illness. Poor health literacy is shown to be associated with riskier behaviour, poor health choices and poorer health. Hospitals can play an important role in enhancing people's NCD health literacy all the way along a patient's "NCD journey" from prevention to management by aligning their communications to the health literacy capacities of their users. The authors suggest training providers to communicate more effectively with patients, making their systems easier to navigate, simplifying written materials, incorporating the use of technology and mobile-health, and using individual and system level scorecards and checklists.
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
Birru, Mehret S; Monaco, Valerie M; Charles, Lonelyss; Drew, Hadiya; Njie, Valerie; Bierria, Timothy; Detlefsen, Ellen; Steinman, Richard A
Adults with low literacy may encounter informational obstacles on the Internet when searching for health information, in part because most health Web sites require at least a high-school reading proficiency for optimal access. The purpose of this study was to 1) determine how low-literacy adults independently access and evaluate health information on the Internet, 2) identify challenges and areas of proficiency in the Internet-searching skills of low-literacy adults. Subjects (n=8) were enrolled in a reading assistance program at Bidwell Training Center in Pittsburgh, PA, and read at a 3rd to 8th grade level. Subjects conducted self-directed Internet searches for designated health topics while utilizing a think-aloud protocol. Subjects' keystrokes and comments were recorded using Camtasia Studio screen-capture software. The search terms used to find health information, the amount of time spent on each Web site, the number of Web sites accessed, the reading level of Web sites accessed, and the responses of subjects to questionnaires were assessed. Subjects collectively answered 8 out of 24 questions correctly. Seven out of 8 subjects selected "sponsored sites"-paid Web advertisements-over search engine-generated links when answering health questions. On average, subjects accessed health Web sites written at or above a 10th grade reading level. Standard methodologies used for measuring health literacy and for promoting subjects to verbalize responses to Web-site form and content had limited utility in this population. This study demonstrates that Web health information requires a reading level that prohibits optimal access by some low-literacy adults. These results highlight the low-literacy adult population as a potential audience for Web health information, and indicate some areas of difficulty that these individuals face when using the Internet and health Web sites to find information on specific health topics.
Cummings, Carol A.; Obel-Omia, Carolyn
Across the world, development of health literacy skills with elementary school students improves health outcomes, reduces health risks, and increases academic success. As elementary school classroom teachers are often responsible for delivering the health curriculum to their students, this article examines ways to integrate health literacy with…
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
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…
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.
Older adults with low health literacy can improve their health if they learn to self-manage their well-being and improve their physical activity and their dietary pattern. One of the major challenges in health care is the problem of low health literacy. Especially older adults often have low health literacy, which can harm their health. It is difficult to improve older adults’ health literacy itself. It is therefore important to gain insight into the underlying mechanisms: how does health lit...
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.
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. PMID:24093354
Federman, Alex D.; Sano, Mary; Wolf, Michael S.; Siu, Albert L.; Halm, Ethan A.
Objectives Specific cognitive abilities may explain the association of health literacy with health status. We studied the relationship between health literacy and memory and verbal fluency in older adults. Design Cross-sectional cohort. Setting Twenty senior centers and apartment buildings in New York City, NY. Participants Independently living, English and Spanish-speaking adults ages 60 and older (n=414). Measurements Health literacy was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The associations of S-TOFHLA scores with immediate and delayed recall (Wechsler Memory Scale II), verbal fluency (Animal Naming), and global cognitive function (Mini Mental Status Exam, MMSE), were modeled with multivariable logistic and linear regression. Results Health literacy was inadequate in 24.3%. Impairment of immediate recall occurred in 20.4%; delayed recall, 15.0%; verbal fluency, 9.9%; and MMSE, 17.4%. Abnormal cognitive function was strongly associated with inadequate health literacy: immediate recall (AOR 3.44, 95% CI 1.71 to 6.94, pMemory and verbal fluency are strongly associated with health literacy, independently of education and health status, even among those with subtle cognitive dysfunction. Reducing the cognitive burden of health information might mitigate the detrimental effects of limited health literacy in older adults. Research that examines the impact of materials tailored to older adults' cognitive limitations on health literacy and health outcomes is needed. PMID:19515101
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.
Caplan, Liron; Wolfe, Frederick; Michaud, Kaleb; Quinzanos, Itziar; Hirsh, Joel M
Studies linking health literacy to outcomes in rheumatoid arthritis (RA) have been underpowered and have not adequately accounted for confounders. We examined the association of health literacy with functional status in 6,052 subjects participating in a prospective observational study, controlling for numerous important covariates. Using linear regression, we analyzed the cross-sectional association of health literacy, as measured by 2 validated single-item literacy screening questions (SILS1 and SILS2), and functional status, assessed by the Health Assessment Questionnaire (HAQ) disability index. Subjects reported demographics, comorbidities, social support, educational attainment, visual problems, and memory problems, as well as use of prednisone, disease-modifying antirheumatic drugs, and biologic agents. Each SILS measure was forced into the final model. Low health literacy was present in 7.0% and 4.3% of subjects (per SILS1 and SILS2, respectively). When controlling for all covariates, low health literacy was associated with a 0.376-point greater HAQ score, compared to subjects with adequate health literacy (95% confidence interval 0.306, 0.447; P literacy was also associated with poorer self-reported adherence to RA medications. Visual and memory problems were associated with worse functional status. Health literacy was more strongly associated with functional status than prednisone use, smoking history, and biologic agent use, and independent of educational attainment. Health literacy may play an important role in understanding functional status in RA patients. Single-item questions amenable to use in the clinical setting may identify subjects with low health literacy, who are at risk for poor RA outcomes. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
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…
Park, Aesoon; Eckert, Tanya L.; Zaso, Michelle J.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Kate B.; Ewart, Craig K.; Carey, Michael P.
Background: Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures,…
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.
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.
Kuo Ken N
Full Text Available Abstract Background Low health literacy is considered a worldwide health threat. The purpose of this study is to assess the prevalence and socio-demographic covariates of low health literacy in Taiwanese adults and to investigate the relationships between health literacy and health status and health care utilization. Methods A national survey of 1493 adults was conducted in 2008. Health literacy was measured using the Mandarin Health Literacy Scale. Health status was measured based on self-rated physical and mental health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations. Results Approximately thirty percent of adults were found to have low (inadequate or marginal health literacy. They tended to be older, have fewer years of schooling, lower household income, and reside in less populated areas. Inadequate health literacy was associated with poorer mental health (OR, 0.57; 95% CI, 0.35-0.91. No association was found between health literacy and health care utilization even after adjusting for other covariates. Conclusions Low (inadequate and marginal health literacy is prevalent in Taiwan. High prevalence of low health literacy is not necessarily indicative of the need for interventions. Systematic efforts to evaluate the impact of low health literacy on health outcomes in other countries would help to illuminate features of health care delivery and financing systems that may mitigate the adverse health effects of low health literacy.
The review also reveals that improving the mental health literacy among primary health care professionals is imperative. Poor mental health literacy can be an obstacle to providing treatment for those in need, and is of particular concern in low and middle-income countries where mental health services are already scarce.
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...... 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....
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.
Seurer, Andrea C; Vogt, H Bruce
Health literacy is defined in the U.S. Department of Health and Human Services initiative Healthy People 2010 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." It is estimated that 48.8 million Americans are functionally illiterate, making health literacy a major obstacle for providing health care. Although communicating with physicians is a small component of the tasks that are incorporated in a definition of health literacy, it remains the most important aspect of this concept contributing to personal health. Primary care clinics within the Sioux Falls area were provided with both English and Spanish patient education brochures on communicating with physicians. A survey was then distributed to determine how low health literacy was affecting physician practices and what they were doing to remove the obstacles that health literacy presented. Physicians were asked to evaluate the multiple skills and competencies required by patients to access health care services and resources they use to assist patients. A total of 77 surveys were distributed. Twenty-two (28.6 percent) were returned. Of the physicians who returned the survey, the majority (77 percent) thought that low health literacy is a moderate obstacle in their practices. Several physicians stated that their offices had at least one method in place to assist those with low health literacy, but none of them were using a formal test of health literacy. Only six physicians could name a community resource to assist patients with low health literacy. Low health literacy is an unavoidable barrier to effective patient care for physicians across the country. If the full spectrum definition of health literacy is understood by physicians and carefully considered in the context of their own practices, it is likely they would come to the realization that health literacy is a greater obstacle to
Naccarella, Lucio; Murphy, Bernice
Health literacy courses for health professionals have emerged in response to health professionals' perceived lack of understanding of health literacy issues, and their failure to routinely adopt health literacy practices. Since 2013 in Victoria, Australia, the Centre for Culture, Ethnicity and Health has delivered an annual health literacy demonstration training course that it developed. Course development and delivery partners included HealthWest Partnership and cohealth. The courses are designed to develop the health literacy knowledge, skills and organisational capacity of the health and community services sector in the western metropolitan region of Melbourne. This study presents key learnings from evaluation data from three health literacy courses using Wenger's professional educational learning design framework. The framework has three educational learning architecture components (engagement, imagination and alignment) and four educational learning architecture dimensions (participation, emergent, local/global, identification). Participatory realist evaluation approaches and qualitative methods were used. The evaluations revealed that the health literacy courses are developing leadership in health literacy, building partnerships among course participants, developing health literacy workforce knowledge and skills, developing ways to use and apply health literacy resources and are serving as a catalyst for building organisational infrastructure. Although the courses were not explicitly developed or implemented using Wenger's educational learning design pedagogic features, the course structure (i.e. facilitation role of course coordinators, providing safe learning environments, encouraging small group work amongst participants, requiring participants to conduct mini-projects and sponsor organisation buy-in) provided opportunities for engagement, imagination and alignment. Wenger's educational learning design framework can inform the design of future key
Wood, Jennifer; Gillis, Doris E
Recognition of health literacy as a serious problem in Canada calls for all health practitioners to rethink how they provide health information. This qualitative research study explored how Canadian dietitians understand the multifaceted concept of health literacy and, if and how, they apply it in their practice. Nine dietetic or nutrition practitioners from different practice settings were purposely selected through an environmental scan of health literacy interventions, professional networks, and interviewee snowballing. Qualitative data were collected using conversational-style personal interviews and thematically analyzed through an iterative process of constant comparison. All participants recognized value in addressing health literacy in their practice with many barriers and enablers to its application identified. Participants referred to difficulties in communicating nutrition information to people with low levels of functional literacy, reflective of a deficit approach to health literacy. However, practices consistent with the more empowering concepts of interactive and critical health literacy, reflective of an asset-based approach, were also described. This research provides a preliminary picture of how dietitians engage with health literacy in various settings in Canada and suggests implications for developing strengths-based health literacy approaches to dietetic practice.
Tuti N Mohd-Dom
Full Text Available Objective: This study aimed to determine the level of oral health literacy and behavior among health sciences. Methods: The method used descriptive cross-sectional survey involving 609 students from Faculty of Medicine, Dentistry, Pharmacy and Allied Health Sciences in the Universiti Kebangsaan Malaysia. Oral health literacy level and behaviour was assessed with a validated and pretested self-administered questionnaire using the Newest Vital Sign (NVS tool and modified Oral Health Adult Literacy Questionnaire (OHL-AQ. Results: A total of 509 participants involved in the study (83.6%. The overall mean oral health literacy score was 10.27 (95% CI 7.92, 12.62, which found dental students showing statistically significant higher scores (mean=11.36, 95% CI 9.70, 13.02 compared to medical (mean=10.72, 95% CI 8.67, 12.77, allied health sciences (mean=9.89, 95% CI 7.34, 12.44 and pharmacy (mean=9.55, 95% CI 7.23, 11.87. Almost all respondents are non-smokers (99.8% and non-drinkers (97.2%. Only 19.1% pay regular dental visits every 6-12 months while 51.1% visit dentist only when they have dental pain. Conclusion: There appears to be a positive relationship between oral health literacy and oral health behavior. Health science university students should be provided substantial dental health education in their curriculum as they show good potential as strategic partners in oral health.DOI: 10.14693/jdi.v22i2.404
Archambault, Isabelle; Eccles, Jacquelynne S.; Vida, Mina N.
Because literacy skills are critical for most academic subject matters, researchers have become increasingly interested in understanding children's motivation in this domain as a way to increase academic success. In this study, we extend previous work by looking at the heterogeneity of children's motivational changes in literacy across Grades…
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.
Singleton, Kate; Krause, Elizabeth M S
Nurses today are providing care, education, and case management to an increasingly diverse patient population that is challenged with a triad of cultural, linguistic, and health literacy barriers. For these patients, culture and language set the context for the acquisition and application of health literacy skills. Yet the nursing literature offers minimal help in integrating cultural and linguistic considerations into nursing efforts to address patient health literacy. Nurses are in an ideal position to facilitate the interconnections between patient culture, language, and health literacy in order to improve health outcomes for culturally diverse patients. In this article the authors begin by describing key terms that serve as background for the ensuing discussion explaining how culture and language need to be considered in any interaction designed to address health literacy for culturally diverse patients. The authors then discuss the interrelationships between health literacy, culture, and language. Next relevant cultural constructs are introduced as additional background. This is followed by a description of how literacy skills are affected by culture and language, a note about culturally diverse, native-born patients, and a presentation of case examples illustrating how culture and language barriers are seen in patients' healthcare experiences. The authors conclude by offering recommendations for promoting health literacy in the presence of cultural and language barriers and noting the need for nursing interventions that fully integrate health literacy, culture, and language.
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.
Morony, Suzanne; Lamph, Emma; Muscat, Danielle; Nutbeam, Don; Dhillon, Haryana M; Shepherd, Heather; Smith, Sian; Khan, Aisha; Osborne, Julie; Meshreky, Wedyan; Luxford, Karen; Hayen, Andrew; McCaffery, Kirsten J
Adults with low literacy are less empowered to take care of their health, have poorer health outcomes and higher healthcare costs. We facilitated partnerships between adult literacy teachers and community health providers to deliver a health literacy training program in adult basic education classrooms. Following course completion we interviewed 19 adult education teachers (15 delivering the health literacy program; 4 delivering standard literacy classes) and four community health providers (CHPs) about their experiences, and analysed transcripts using Framework analysis. Written feedback from eight teachers on specific course content was added to the Framework. Health literacy teachers reported a noticeable improvement in their student's health behaviours, confidence, vocabulary to communicate about health, understanding of the health system and language, literacy and numeracy skills. CHP participation was perceived by teachers and CHPs as very successful, with teachers and CHPs reporting they complemented each other's skills. The logistics of coordinating CHPs within the constraints of the adult education setting was a significant obstacle to CHP participation. This study adds to existing evidence that health is an engaging topic for adult learners, and health literacy can be successfully implemented in an adult basic learning curriculum to empower learners to better manage their health. Health workers can deliver targeted health messages in this environment, and introduce local health services. Investment in adult literacy programs teaching health content has potential both to meet the goals of adult language and literacy programs and deliver health benefit in vulnerable populations. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
The term 'health literacy' usually refers to the comprehension by patients of prescriptions and other health documents presented to them. Literacy among health staff has received less attention, in spite of the impact it may have on effective treatment, especially in multilingual situations such as Zambia where much official ...
In recognition of the fact that literacy has multiple benefits by impacting on infant mortality rate, fertility rate, appropriate utilization of health services, and other behaviour related to health, the female functional literacy in health project (FFLH) was implemented in selected communities in Nigeria. This study reports the findings ...
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 ...
van der Heide, Iris; Rademakers, Jany; Schipper, Maarten; Droomers, Mariël; Sørensen, Kristine; Uiters, Ellen
Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify socio-economic
Federman, Alex D; Sano, Mary; Wolf, Michael S; Siu, Albert L; Halm, Ethan A
To study the relationship between health literacy and memory and verbal fluency in older adults. Cross-sectional cohort. Twenty senior centers and apartment buildings in New York, New York. Independently living, English- and Spanish-speaking adults aged 60 and older (N=414). Health literacy was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The associations between S-TOFHLA scores and immediate and delayed recall (Wechsler Memory Scale II), verbal fluency (Animal Naming), and global cognitive function (Mini-Mental State Examination, MMSE) were modeled using multivariable logistic and linear regression. Health literacy was inadequate in 24.3% of participants. Impairment of immediate recall occurred in 20.4%; delayed recall, 15.0%; verbal fluency, 9.9%; and MMSE, 17.4%. Abnormal cognitive function was strongly associated with inadequate health literacy: immediate recall (adjusted odds ratio (AOR)=3.44, 95% confidence interval (CI)=1.71-6.94, PMemory and verbal fluency are strongly associated with health literacy, independently of education and health status, even in those with subtle cognitive dysfunction. Reducing the cognitive burden of health information might mitigate the detrimental effects of limited health literacy in older adults. Research that examines the effect of materials modified to older adults' cognitive limitations on health literacy and health outcomes is needed.
Jamieson Lisa M; Parker Eleanor J
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 mode...
Sistani, M M Naghibi; Yazdani, R; Virtanen, J; Pakdaman, A; Murtomaa, H
To assess oral health literacy level and oral health information of Iranian adults in Tehran, and to determine the factors related to oral health literacy. A cross-sectional population study. A random sample of 1,031 adults in Tehran, Iran. Oral health literacy was measured using an oral health adult literacy questionnaire (OHL-AQ). Variation in use of information sources by socio-economic and demographic background was estimated by odds ratios. A multiple linear regression model served to determine predictor factors of OHL-AQ scores controlling for characteristics of the subjects and number of information sources. The mean OHL-AQ score was 10.5 (sd 3.0). Women (p information were dentists (52.6%), and TV/Radio (49.5%). According to the regression model, females (p = 0.001), high educational level (p information sources (two sources p = 0.01, three sources or more p = 0.002) were the main predictor factors of OHL-AQ scores. The average oral health literacy level of Iranian adults was low. Disseminating evidence-based oral health care information from multiple sources including TV/radio, dentists, and other health professionals in different settings should improve public oral health literacy.
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.
Lee, Hee Yun; Lee, Jiwoo; Kim, Nam Keol
The role of gender in determining the level of health literacy in Korean adults is unclear. This study aimed to investigate the level of health literacy in Korean adults and identify factors associated with health literacy by gender. This study employed a cross-sectional survey design with a convenient sample of 585 community-dwelling Korean adults age19 years and older. Health literacy was measured by using eight items selected from Chew et al.'s 16-question self-reported health literacy measure. In accordance with Andersen's health behavior model, predisposing, enabling, and need factors were included in the multiple regression model. Women indicated a higher level of health literacy than men in understanding medical forms, directions on medication bottles, and written information offered by health care providers. Additionally, for Korean women, a higher level of health literacy was associated with attaining a higher education level and having a consistent place to receive care. Unmarried men and men who had higher self-rated health reported a higher level of health literacy compared with their counterparts. Lower level of depression and higher monthly income were significantly linked to a higher level of health literacy in both men and women. This study has established the importance of gender differences in health literacy and suggests gender-specific intervention may be warranted to reduce the existing gap in health literacy in both Korean men and women. Future research should replicate this study to confirm whether or not our finding is an international phenomenon. © The Author(s) 2014.
Full Text Available This paper seeks to explore health literacies with a focus on public libraries and their patrons. The authors’ aim is to extract major themes, challenges, and recommendations for further research and collaboration between health professionals and information professionals in promoting health literacy skills to the public. Major issues will be discussed on the subjects of public service, education, and collaboration between health specialists and information specialists. A major focus of the paper is Canadian health literacy issues, as well as Canadian health information dissemination. Time constraints and budget cuts in the health care system have caused a major strain on health professionals. Within the system, there is a shortage of doctors, nurses, and time devoted to health literacy. As a result, patients often seek answers to their health concerns on their own and supplement their understanding of individual health issues by searching for information via the Internet. While consumers often seek answers to their health questions online, the lack of quality control on the Internet is problematic. Public librarians should therefore turn their attention to promoting and providing reliable online information. Meeting the needs of any group can be a challenge for information professionals in public libraries, especially when it comes to health literacy. Public libraries tend to be one of the first places of contact for general public inquiries on infectious diseases and emerging illnesses. Public librarians play an important role in their communities in all aspects of information research and therefore should be advocates for promoting proper health information.
Okan, Orkan; Lopes, Ester; Bollweg, Torsten Michael; Bröder, Janine; Messer, Melanie; Bruland, Dirk; Bond, Emma; Carvalho, Graça S; Sørensen, Kristine; Saboga-Nunes, Luis; Levin-Zamir, Diane; Sahrai, Diana; Bittlingmayer, Uwe H; Pelikan, Jürgen M; Thomas, Malcolm; Bauer, Ullrich; Pinheiro, Paulo
Health literacy is an important health promotion concern and recently children and adolescents have been the focus of increased academic attention. To assess the health literacy of this population, researchers have been focussing on developing instruments to measure their health literacy. Compared to the wider availability of instruments for adults, only a few tools are known for younger age groups. The objective of this study is to systematically review the field of generic child and adolescent health literacy measurement instruments that are currently available. A systematic literature search was undertaken in five databases (PubMed, CINAHL, PsycNET, ERIC, and FIS) on articles published between January 1990 and July 2015, addressing children and adolescents ≤18 years old. Eligible articles were analysed, data was extracted, and synthesised according to review objectives. Fifteen generic health literacy measurement instruments for children and adolescents were identified. All, except two, are self-administered instruments. Seven are objective measures (performance-based tests), seven are subjective measures (self-reporting), and one uses a mixed-method measurement. Most instruments applied a broad and multidimensional understanding of health literacy. The instruments were developed in eight different countries, with most tools originating in the United States (n = 6). Among the instruments, 31 different components related to health literacy were identified. Accordingly, the studies exhibit a variety of implicit or explicit conceptual and operational definitions, and most instruments have been used in schools and other educational contexts. While the youngest age group studied was 7-year-old children within a parent-child study, there is only one instrument specifically designed for primary school children and none for early years. Despite the reported paucity of health literacy research involving children and adolescents, an unexpected number of health
Komenaka, Ian K; Nodora, Jesse N; Machado, Lorenzo; Hsu, Chiu-Hsieh; Klemens, Anne E; Martinez, Maria Elena; Bouton, Marcia E; Wilhelmson, Krista L; Weiss, Barry D
Individuals with limited health literacy have barriers to patient-physician communication. Problems in communication are known to contribute to malpractice litigation. Concern exists, however, about the feasibility and patient acceptance of a health literacy assessment. This study was performed to determine the feasibility of health literacy assessment in surgical practice and its effect on patient satisfaction. Every patient seen in a Breast Surgery Clinic during a 2-year period was asked to undergo a health literacy assessment with the Newest Vital Sign (NVS) as part of the routine history and physical examination. During the year before routine NVS assessments and during the 2-year study period, all patients were asked to rate their "overall satisfaction with clinic visit" on a 5-point scale. A total of 2,026 of 2,097 patients (96.6%) seen during the study were eligible for the health literacy assessment. Of those, no patients refused assessment, and only one patient was missed. Therefore, 2,025 of 2,026 eligible patients (99.9%) underwent the assessment. The average time for NVS assessment was 2:02 minutes. Only 19% of patients had adequate health literacy. Patient satisfaction ratings were slightly greater during the first year of the health literacy assessment (3.8 vs 3.7, P = .049) compared with the year prior to health literacy assessment and greater during the second year of health literacy assessment (4.1 vs 3.7, P < .0001). Routine health literacy assessment is feasible in surgical practice and results in no decrease in patient satisfaction. In fact, satisfaction was greater during the years when health literacy assessments were performed. Copyright © 2014 Mosby, Inc. All rights reserved.
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
Full Text Available Abstract Background The community's knowledge and beliefs about mental health problems, their risk factors, treatments and sources of help may vary as a function of age. Methods Data were taken from an epidemiological survey conducted during 2003–2004 with a national clustered sample of Australian adults aged 18 years and over. Following the presentation of a vignette describing depression (n = 1001 or schizophrenia (n = 997, respondents were asked a series of questions relating to their knowledge and recognition of the disorder, beliefs about the helpfulness of treating professionals and medical, psychological and lifestyle treatments, and likely causes. Results Participant age was coded into five categories and cross-tabulated with mental health literacy variables. Comparisons between age groups revealed that although older adults (70+ years were poorer than younger age groups at correctly recognising depression and schizophrenia, young adults (18–24 years were more likely to misidentify schizophrenia as depression. Differences were also observed between younger and older age groups in terms of beliefs about the helpfulness of certain treating professionals and medical and lifestyle treatments for depression and schizophrenia, and older respondents were more likely to believe that schizophrenia could be caused by character weakness. Conclusion Differences in mental health literacy across the adult lifespan suggest that more specific, age appropriate messages about mental health are required for younger and older age groups. The tendency for young adults to 'over-identify' depression signals the need for awareness campaigns to focus on differentiation between mental disorders.
Fernández-Gutiérrez, M; Bas-Sarmiento, P; Albar-Marín, M J; Paloma-Castro, O; Romero-Sánchez, J M
Health literacy is considered a social health determinant that influences improvement in health, patient empowerment and reduction in inequalities. There is a lack of health literacy interventions for vulnerable social groups (i.e. immigrants), and nurses have shown little familiarity with the concept. This study aimed to identify and analyse whether interventions directed at immigrant populations improve the functional (basic reading, writing and arithmetic skills), interactive (social and cognitive skills) and critical (advanced cognitive and social skills in critically analyzing information and making informed decisions) dimensions of health literacy, taking into account the role played by nursing in these interventions. A systematic review of four databases including PubMed, PsycINFO, the Cochrane Library and ERIC was conducted to identify relevant articles published between 2000 and 2015. Thirty-four articles met the inclusion criteria, and nine articles used a validated instrument. Few specific health literacy interventions for immigrant populations were found. The main findings of the studies showed positive changes in functional health literacy. However, the interventions were less effective in improving interactive and critical health literacy. Several of the findings of this review were based on studies that had their own limitations. The assessment of the articles was not blinded, and the review was restricted to articles written in Spanish and English. The interventions studied were reported as being effective in improving health literacy in immigrants, particularly the functional aspects. Regarding the role played by nursing, this review observed little involvement. It is important for educational strategies to include health literacy dimensions. The concept of health literacy should be included as a Nursing Outcomes Classification and in its subsequent validation taxonomy. To promote community health, health literacy must be a prioritized objective of
Morgan, Erin E; Iudicello, Jennifer E; Cattie, Jordan E; Blackstone, Kaitlin; Grant, Igor; Woods, Steven Paul
This study sought to determine the effects of HIV-associated neurocognitive disorders (HAND) on health literacy, which encompasses the ability to access, understand, appraise, and apply health-related information. Participants included 56 HIV seropositive individuals, 24 of whom met Frascati criteria for HAND, and 24 seronegative subjects who were comparable on age, education, ethnicity, and oral word reading. Each participant was administered a brief battery of well-validated measures of health literacy, including the Expanded Numeracy Scale (ENS), Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy in Medicine (REALM), and Brief Health Literacy Screen (BHLS). Results revealed significant omnibus differences on the ENS and NVS, which were driven by poorer performance in the HAND group. There were no significant differences on the REALM or the BHLS by HAND status. Among individuals with HAND, lower scores on the NVS were associated with greater severity of neurocognitive dysfunction (e.g., working memory and verbal fluency) and self-reported dependence in activities of daily living. These preliminary findings suggest that HAND hinders both fundamental (i.e., basic knowledge, such as numeracy) and critical (i.e., comprehension and application of healthcare information) health literacy capacities, and therefore may be an important factor in the prevalence of health illiteracy. Health literacy-focused intervention may play an important role in the treatment and health trajectories among persons living with HIV infection.
Sand-Jecklin, Kari; Coyle, Sue
Although health literacy limitations are common among patient populations, no efficient yet comprehensive health literacy assessment tool is available to nurses for use in busy health care settings. This study presents beginning evidence for the validity and reliability of a new health literacy assessment tool, the Brief Health Literacy Screen (BHLS). One hundred patients attending four primary care clinics completed the BHLS and the Test of Functional Health Literacy in Adults (TOFHLA) short form and answered questions about the health literacy tools. Findings indicated significant correlations between BHLS and shortened version of the TOFHLA (S-TOFHLA) scores, with higher correlations between BHLS items addressing written health literacy and the S-TOFHLA. Comparative discrimination findings were significant at BHLS cut point of 18 and S-TOFHLA cut point less than 23. Patients rated the BHLS significantly less difficult to complete than the S-TOFHLA. Results of preliminary testing indicate the BHLS is a potentially efficient, effective, and patient-friendly screening tool for health literacy. © The Author(s) 2013.
Mitty, Ethel; Flores, Sandi
Functional illiteracy is an inability to read sufficient to function in society. In the high-tech, information-dependent environment of postindustrial society, being illiterate is being at risk. Health literacy is the ability to access, understand, and use basic information about health conditions and services that is necessary to make informed decisions. Older adults (>/=65 years of age) have lower health literacy than all other age groups. Limited health literacy is associated with greater use of emergency department visits, increased rates of hospitalization, and failure to take important diagnostic tests. To maintain independence and self-determination, assisted living (AL) residents need to be able to understand a new or changed diagnosis, as well as oral and written instructions, especially with regard to their medication management. This article discusses health literacy, "plain language," and assessment and interventions to maintain health literacy.
Wångdahl, Josefin; Lytsy, Per; Mårtensson, Lena; Westerling, Ragnar
Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden. A cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participants in 16 strategically selected language schools for immigrants responded to a questionnaire. Health literacy was measured using the Swedish Functional Health Literacy Scale and the HLS-EU-Q16 questionnaire. Uni- and multivariate statistical methods were used to investigate group differences. The majority of the participating refugees had inadequate or limited functional health literacy and comprehensive health literacy. About 60% of them had inadequate functional health literacy and 27% had inadequate comprehensive health literacy. Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy. Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy. The majority of refugees in the language schools had limited or poor health literacy. Health literacy should be taken into consideration in contexts and in activities addressing migrants. More research is needed to better understand health literacy among refugees and to develop strategies and methods to increase health literacy and make life easier for those with low health literacy.
The problems of illiteracy in health contexts have been well documented in the literature and include such serious repercussions as medication non-compliance and failure to seek medical help during the course of an illness. The Rapid Estimate of Adult Literacy in Medicine (REALM) is a standardised health literacy test ...
Peralta, Louisa; Rowling, Louise; Samdal, Oddrun; Hipkins, Rose; Dudley, Dean
Background: Health literacy research for adolescents and young people has been growing in importance. However, conceptualisation has been largely limited to concepts of adult health literacy in healthcare and disease prevention settings. The challenge for the future lies in developing a coherent concept that combines adolescent development,…
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…
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.
Kim, Eun Jin; Kim, Su Hyun
This study evaluated the effect of a simplified informed consent form for clinical trials on the understanding and efficacy of informed consent information across health literacy levels. A total of 150 participants were randomly assigned to one of two groups and provided with either standard or simplified consent forms for a cancer clinical trial. The features of the simplified informed consent form included plain language, short sentences, diagrams, pictures, and bullet points. Levels of objective and subjective understanding were significantly higher in participants provided with simplified informed consent forms relative to those provided with standard informed consent forms. The interaction effects between type of consent form and health literacy level on objective and subjective understanding were nonsignificant. Simplified informed consent was effective in enhancing participant's subjective and objective understanding regardless of health literacy. © The Author(s) 2015.
Chervin, Cara; Clift, Joseph; Woods, Lakeesha; Krause, Elizabeth; Lee, Kien
Incorporating health literacy in adult education instruction is a promising approach to increasing the health equity of people who face racial/ethnic health disparities. Six adult education centers throughout a small Northeast state received 1-year Health Literacy Project grants from a local foundation to increase their capacity to teach health literacy through Study Circles. The evaluation of the project assessed changes in adult learners' skills needed to navigate health systems, manage chronic diseases, and engage in preventive behavior; learners' self-efficacy; and how the education centers increased their capacity to teach health literacy skills to adult learners of color. Quantitative and qualitative data indicated that students' knowledge about health issues and self-efficacy increased significantly as a result of the health literacy instruction. All six centers improved their capacity to teach health literacy. By the end of the Health Literacy Project, almost three quarters of classes included health literacy instruction. Almost half of the Study Circle teachers continued to attend professional development activities for health literacy and share their knowledge with other teachers. Each center also developed partnerships with health care providers and created an infrastructure to continue to teach health literacy. Implications of the identified strengths and challenges on future efforts to increase health literacy and equity are considered.
Tam, Amy; Yue, Olivia; Atchison, Kathryn A; Richards, Jessica K; Holtzman, Jennifer S
The aim of this pilot study was to assess adult patients' ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school's general dental clinic during 2012-13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects' oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults' oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients' ability to navigate and understand health information, regardless of their health literacy.
Keller, Darcie L; Wright, Julie; Pace, Heather A
To examine the relationship between low health literacy and disease state control and between low health literacy medication adherence in the primary care setting. The following databases were searched for relevant articles from date of inception to April 2008: The Cochrane Database of Systematic Reviews, Cumulative Index to Nursing & Allied Health Literature, EMBASE, Education Resources Information Center, PsycINFO, International Pharmaceutical Abstracts, and Iowa Drug Information Service. MEDLINE was searched from 1966 to April 2008. Key words included literacy, health literacy, health education, educational status, disease outcomes, health outcomes, adherence, medication adherence, and patient compliance. Additional articles were identified by reviewing reference sections of retrieved articles. Studies using a validated measure of health literacy and performing statistical analysis to evaluate the relationship between health literacy and disease state control or medication adherence were evaluated. Eleven evaluations, including 10 discrete studies, met eligibility criteria. Six studies evaluated the relationship between health literacy and disease state control, 3 evaluated health literacy and medication adherence, and 1 study evaluated health literacy and both outcomes. A quality rating of poor, fair, or good was assigned to each study based on the study question, population, outcome measures, statistical analysis, and results. Eight studies had good quality, 1 was fair, and 2 were poor. Two high-quality studies demonstrated statistically significant relationships with health literacy, 1 with disease state control and 1 with medication adherence. Limitations of the other studies included inadequate sample size, underrepresentation of patients with low health literacy, use of less objective outcome measures, and insufficient statistical analysis. There may be a relationship between health literacy and disease state control and health literacy and medication
Braden O Neill
Full Text Available With the increasing recognition of health literacy as a worldwide research priority, the development and refinement of indices to measure the construct is an important area of inquiry. Furthermore, the proliferation of online resources and research means that there is a growing need for self-administered instruments. We undertook a systematic overview to identify all published self-administered health literacy assessment indices to report their content and considerations associated with their administration. A primary aim of this study was to assist those seeking to employ a self-reported health literacy index to select one that has been developed and validated for an appropriate context, as well as with desired administration characteristics. Systematic searches were carried out in four electronic databases, and studies were included if they reported the development and/or validation of a novel health literacy assessment measure. Data were systematically extracted on key characteristics of the instruments: breadth of construct ("generic" vs. "content- or context- specific" health literacy, whether it was an original instrument or a derivative, country of origin, administration characteristics, age of target population (adult vs. pediatric, and evidence for validity. 35 articles met the inclusion criteria. There were 27 original instruments (27/35; 77.1% and 8 derivative instruments (8/35; 22.9%. 22 indices measured "general" health literacy (22/35; 62.9% while the remainder measured condition- or context- specific health literacy (13/35; 37.1%. Most health literacy measures were developed in the United States (22/35; 62.9%, and about half had adequate face, content, and construct validity (16/35; 45.7%. Given the number of measures available for many specific conditions and contexts, and that several have acceptable validity, our findings suggest that the research agenda should shift towards the investigation and elaboration of health literacy
Heerman, William J; Perrin, Eliana M; Yin, H Shonna; Sanders, Lee M; Eden, Svetlana K; Shintani, Ayumi; Coyne-Beasley, Tamera; Bronaugh, Andrea B; Barkin, Shari L; Rothman, Russell L
Unintentional injury is a leading cause of infant mortality. To examine the role of caregiver health literacy in infant injury prevention behaviors. A cross-sectional analysis of data collected in 2010-2012 from a randomized trial at four pediatric clinics was performed in 2012-2013. Caregiver health literacy was assessed with the Short Test of Functional Health Literacy in Adults. Caregiver-reported adherence to American Academy of Pediatrics-recommended injury prevention behaviors was assessed across seven domains: (1) car seat position; (2) car seat use; (3) sleeping safety; (4) fire safety; (5) hot water safety; (6) fall prevention; and (7) firearm safety. Data were analyzed from 844 English- and Spanish-speaking caregivers of 2-month-old children. Many caregivers were non-adherent with injury prevention guidelines, regardless of health literacy. Notably, 42.6% inappropriately placed their children in the prone position to sleep, and 88.6% did not have their hot water heater set caregivers were categorized as having low health literacy. Low caregiver health literacy, compared to adequate health literacy, was significantly associated with increased odds of caregiver non-adherence with recommended behaviors for car seat position (AOR=3.4, 95% CI=1.6, 7.1) and fire safety (AOR=2.0, 95% CI=1.02, 4.1) recommendations. Caregivers with low health literacy were less likely to be non-adherent to fall prevention recommendations (AOR=0.5, 95% CI=0.2, 0.9). Non-adherence to injury prevention guidelines was common. Low caregiver health literacy was significantly associated with some injury prevention behaviors. Future interventions should consider the role of health literacy in promoting injury prevention. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
O′Neill, Braden; Gonçalves, Daniela; Ricci-Cabello, Ignacio; Ziebland, Sue; Valderas, Jose
With the increasing recognition of health literacy as a worldwide research priority, the development and refinement of indices to measure the construct is an important area of inquiry. Furthermore, the proliferation of online resources and research means that there is a growing need for self-administered instruments. We undertook a systematic overview to identify all published self-administered health literacy assessment indices to report their content and considerations associated with their administration. A primary aim of this study was to assist those seeking to employ a self-reported health literacy index to select one that has been developed and validated for an appropriate context, as well as with desired administration characteristics. Systematic searches were carried out in four electronic databases, and studies were included if they reported the development and/or validation of a novel health literacy assessment measure. Data were systematically extracted on key characteristics of the instruments: breadth of construct (“generic” vs. “content- or context- specific” health literacy), whether it was an original instrument or a derivative, country of origin, administration characteristics, age of target population (adult vs. pediatric), and evidence for validity. 35 articles met the inclusion criteria. There were 27 original instruments (27/35; 77.1%) and 8 derivative instruments (8/35; 22.9%). 22 indices measured “general” health literacy (22/35; 62.9%) while the remainder measured condition- or context- specific health literacy (13/35; 37.1%). Most health literacy measures were developed in the United States (22/35; 62.9%), and about half had adequate face, content, and construct validity (16/35; 45.7%). Given the number of measures available for many specific conditions and contexts, and that several have acceptable validity, our findings suggest that the research agenda should shift towards the investigation and elaboration of health literacy
McKee, Michael M; Paasche-Orlow, Michael K
Inadequate health literacy and limited English proficiency are associated with poor health care access and outcomes. Despite what appears to be an interaction phenomenon--whereby the rate of inadequate health literacy is particularly high among limited English proficiency populations--researchers in health literacy and limited English proficiency rarely collaborate. As a result, few health literacy instruments and interventions have been developed or validated for smaller linguistic populations. Interventions to improve health outcomes for people with low health literacy and limited English proficiency show great potential to alleviate many of the health disparities currently experienced by some of the most disenfranchised individuals in our health care system, those from smaller linguistic minority groups, including Deaf American Sign Language users. It is critical for health literacy and limited English proficiency researchers to work together to understand how culture, language, literacy, education, and disabilities influence health disparities and health outcomes. It is important to ensure that research is collaborative and inclusive in order to broaden the reach of future interventions to smaller linguistic minority populations.
Though there has been a considerable expansion of interest in the health literacy concept worldwide, there has also been criticism that this concept has been poorly defined, that it stretches the idea of "literacy" to an indefensible extent and more specifically, that it adds little to the existing concerns and intervention approaches of the better established discipline of health promotion. This paper takes as a starting point the expanded model of health literacy advanced by Nutbeam (2000) and addresses these concerns by interrogating the concept of "critical health literacy" in order to draw conclusions about its utility for advancing the health of individuals and communities. The constituent domains of critical health literacy are identified; namely information appraisal, understanding the social determinants of health, and collective action, and as far as possible each are clearly delineated, with links to related concepts made explicit. The paper concludes that an appreciation of work undertaken in a range of different disciplines, such as media studies, medical sociology, and evidence-based medicine can enhance our understanding of the critical health literacy construct and help us understand its usefulness as a social asset which helps individuals towards a critical engagement with health information. There is some evidence that aspects of critical health literacy have indeed been found to be a resource for better health outcomes, but more research is needed in this area, both to develop quantitative and qualitative approaches to evaluating health literacy skills, and to offer convincing evidence that investment in programmes designed to enhance critical health literacy are worthwhile. Copyright © 2011 Elsevier Ltd. All rights reserved.
Ownby, Raymond L; Acevedo, Amarilis; Goodman, Kenneth; Caballero, Joshua; Waldrop-Valverde, Drenna
Informed consent for participation in studies with human subjects is a critically important aspect of clinical research, but research has shown that many potential subjects do not understand information relevant to their participation. A better understanding of factors related to participant understanding of study-related information is thus important. As part of a study to develop a new measure of health literacy, participants viewed a 50 second video in their preferred language (Spanish or English) of a clinician presenting informed consent information. They then responded to six questions about it. In progressively more complicated regression models, we evaluated the relation of demographic variables, general cognitive ability, and health literacy to participants' recall of the information. In a model that only included demographic variables, Spanish language, black race and older age were associated with poorer performance. In a model that included the effects of general cognitive ability and health literacy as well as demographics, education and health literacy were related to performance. Informed consent interventions that take potential research subjects' levels of health literacy into account may result in better understanding of research-related information that can inform their decision to participate.
Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S
To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. 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 participants completed structured, in-person interviews administered by trained research assistants. 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. 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. 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. © Health Research and Educational Trust.
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...
Ghaddar, Suad F; Valerio, Melissa A; Garcia, Carolyn M; Hansen, Lucy
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(®), is associated with higher levels of health literacy. An online survey was administered to a cross-sectional random sample of high school students in South Texas. Self-reported sociodemographic characteristics and data on health-information-seeking behavior and exposure to MedlinePlus(®) were collected. Health literacy was assessed by eHEALS and the Newest Vital Sign (NVS). Linear and binary logistic regressions were completed. Of the 261 students who completed the survey, 56% had heard of MedlinePlus(®), 52% had adequate levels of health literacy as measured by NVS, and the mean eHEALS score was 30.6 (possible range 8-40). Health literacy was positively associated with self-efficacy and seeking health information online. Exposure to MedlinePlus(®) was associated with higher eHealth literacy scores (p literacy (odds ratio: 2.1; 95% CI: 1.1, 4.1). Exposure to a credible source of online health information is associated with higher levels of health literacy. The incorporation of a credible online health information resource into school health education curricula is a promising approach for promoting health literacy. © 2011, American School Health Association.
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
Rikard, R V; Thompson, Maxine S; McKinney, Julie; Beauchamp, Alison
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. 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. 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. 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.
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
Belcastro, Philip A.; Ramsaroop-Hansen, Hardaye
Background: Health literacy evolved from a standard of English language proficiency designed to promote patient compliance into an inferential for promoting positive health decision-making and health outcomes. In turn, the United States relegated health literacy as a national strategy to improve personal health and health care outcomes as well as…
McKee, Michael M; Paasche-Orlow, Michael K; 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, health care 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 (ASL-NVS). We found that 48% 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.
Kiechle, Eric S; Hnat, Andrew T; Norman, Kenneth E; Viera, Anthony J; DeWalt, Darren A; Brice, Jane H
Measuring health literacy efficiently yet accurately is of interest both clinically and in research. The authors examined 6 brief health literacy measures and compared their categorization of patient health literacy levels and their comparative associations with patients' health status. The authors assessed 400 emergency department patients with the Short Test of Functional Health Literacy in Adults, the Newest Vital Sign, Single Item Literacy Screen, brief screening questions, Rapid Estimate of Adult Literacy in Medicine-Revised, and the Medical Term Recognition Test. The authors analyzed data using Spearman's correlation coefficients and ran separate logistic regressions for each instrument for patient self-reported health status. Tests differed in the proportion of patients' skills classified as adequate, but all instruments were significantly correlated; instruments targeting similar skills were more strongly correlated. Scoring poorly on any instrument was significantly associated with worse health status after adjusting for age, sex and race, with a score in the combined inadequate/marginal category on the Short Test of Functional Health Literacy in Adults carrying the largest risk (OR = 2.94, 95% CI [1.23, 7.05]). Future research will need to further elaborate instrument differences in predicting different outcomes.
Bakker, Caitlin J; Koffel, Jonathan B; Theis-Mahon, Nicole R
Health literacy-the ability to obtain, process, and understand basic health information-is a major determinant of an individual's overall health and health care utilization. In this project, the authors examined predictors of health literacy levels, including numeracy and graphic literacy, among an adult population in the Upper Midwest. The research was conducted at the Minnesota State Fair. Three previously validated scales were used to assess health literacy: Newest Vital Sign, the General Health Numeracy Test, and questions from Galesic and Garcia-Retamero's Graph Literacy Scale. Demographic information-such as age, educational attainment, zip code, and other potential predictors and modifiers-was collected. Multivariate linear regression was conducted to examine the independent effects of educational attainment, race, ethnicity, gender, and rural or urban location on overall health literacy and scores on each of the individual instruments. A total of 353 Upper Midwest residents completed the survey, with the majority being white, college-educated, and from an urban area. Having a graduate or professional degree or being under the age of 21 were associated with increased health literacy scores, while having a high school diploma or some high school education, being Asian American, or being American Indian/Alaska Native were associated with lower health literacy scores. Advanced health literacy skills, including the ability to calculate and compare information, were problematic even in well-educated populations. Understanding numerical and graphical information was found to be particularly difficult, and more research is needed to understand these deficits and how best to address them.
Larsen, Anne Konring; Holtermann, Andreas; Mortensen, Ole Steen
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...... and have been suggested as a suitable framework for addressing individual, organizational and interpersonal factors concomitantly. Therefore, the aim of the trial is to examine the effectiveness of an intervention to improve health literacy (building knowledge, competences and structures for communication...... 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...
Full Text Available Background: Health literacy is defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health. This study was conducted to determine health literacy levels and the associated factors among patients attending the outpatient departments of a tertiary care hospital in Delhi. Methods: A hospital-based cross-sectional study was carried out in a tertiary care teaching hospital in Delhi over a period of four months. A total of 150 patients were included in the study. Fifty patients from the Diabetes Clinic, 50 patients from the Hypertension Clinic, and 50 patients with anemia from the Antenatal Outpatient Department (OPD were selected using a convenience sampling method. Data was analyzed using Epi Info software. Statistical analysis was conducted with the chi-square test and the Fisher’s exact test. P values less than 0.05 were considered significant. Results: Out of 50 diabetic subjects, 37 (74% understood the information about their blood sugar levels as explained to them by the doctor. Similar results were found among hypertensive subjects as well. Furthermore, education status was significantly associated with health literacy. In terms of understanding the regimen of medications, significant association was seen with age, sex, and education. Conclusion: Education status, age, and gender are important determinants of health literacy. Our results support that innovative strategies of communication should be used to improve health literacy among patients.
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.
Hester, Eva Jackson; Stevens-Ratchford, Regena
Purpose: This article reviews concepts of health literacy and discusses the role of speech-language pathologists in improving the health literacy of individuals with and without communication disorders. Method: A literature review was completed of health literacy definitions, concepts, and health literacy assessment and intervention studies with…
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.
Full Text Available This paper describes a literacy program delivered at the Kirketon Road Centre (KRC, a primary health centre located in Kings Cross, Sydney. KRC was established to meet the health needs of ‘at risk’ young people, sex workers, and people who inject drugs. The literacy program was initiated from within an Aboriginal health group at KRC, following a request from clients in the group. A teacher from Tranby Aboriginal College delivered the literacy program one afternoon every fortnight over a period of approximately one year. This paper is based on recorded and transcribed ‘reflection’ discussions undertaken over several months between the literacy teacher, a KRC counsellor and the researcher immediately following the literacy sessions. Of particular interest is the nature of the literacy program and its pedagogical approach which is based largely on the delivery of popularly themed worksheet exercises. These activities represent in some ways an approach to adult literacy education that we term ‘autonomous’, that is, as a single set of skills generalisable to other life contexts. This pedagogical approach, however, needs to be understood in relation to the social capital outcomes of the course which take into account the complex and varying relationships and networks of the client group. The real value of the course can be seen largely in terms of the social capital outcomes for individual participants.
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
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.
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. PMID:22276600
Koster, E S; Schmidt, A; Philbert, D; van de Garde, E M W; Bouvy, M L
Patients with limited health literacy have poorer surgical outcomes. However, current studies assessing the prevalence of limited health literacy in patients expecting surgery are small scale. We aimed to provide insight into the health literacy level of patients undergoing planned surgery. Patients aged ≥18 years visiting the preoperative screening department were approached in the waiting area and invited to participate in a brief interview including the Functional Communicative Critical Health Literacy (FCCHL). In total, 225 patients (84.9% response) were studied. Based on the FCCHL, 37.3% of the patients were classified as having limited health literacy. The mean score in the critical domain (2.7 ± 0.9) was lower than scores in the functional (3.3 ± 0.6) and communicative (3.3 ± 0.6) domains. More than one third of the patients admitted to the hospital for surgery had limited health literacy. Healthcare professionals should be aware of the different health literacy levels and tailor their information provision strategies accordingly.
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 literacy or knowledge scores were associated with several interactive and critical health literacy skills (all ps higher functional health literacy (all ps higher cardiovascular health knowledge scores (all ps 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.
Conclusion: Our findings indicate that oral health literacy is associated with differences in oral health behaviors and clinical oral health status. An understanding of participants’ oral health literacy levels is crucial for designing effective health educational materials and creating intervention programs to promote oral health.
Altin, Sibel Vildan; Finke, Isabelle; Kautz-Freimuth, Sibylle; Stock, Stephanie
Health literacy (HL) is seen as an increasingly relevant issue for global public health and requires a reliable and comprehensive operationalization. By now, there is limited evidence on how the development of tools measuring HL proceeded in recent years and if scholars considered existing methodological guidance when developing an instrument. We performed a systematic review of generic measurement tools developed to assess HL by searching PubMed, ERIC, CINAHL and Web of Knowledge (2009 forward). Two reviewers independently reviewed abstracts/ full text articles for inclusion according to predefined criteria. Additionally we conducted a reporting quality appraisal according to the survey reporting guideline SURGE. We identified 17 articles reporting on the development and validation of 17 instruments measuring health literacy. More than two thirds of all instruments are based on a multidimensional construct of health literacy. Moreover, there is a trend towards a mixed measurement (self-report and direct test) of health literacy with 41% of instruments applying it, though results strongly indicate a weakness of coherence between the underlying constructs measured. Overall, almost every third instrument is based on assessment formats modeled on already existing functional literacy screeners such as the REALM or the TOFHLA and 30% of the included articles do not report on significant reporting features specified in the SURGE guideline. Scholars recently developing instruments that measure health literacy mainly comply with recommendations of the academic circle by applying multidimensional constructs and mixing up measurement approaches to capture health literacy comprehensively. Nonetheless, there is still a dependence on assessment formats, rooted in functional literacy measurement contradicting the widespread call for new instruments. All things considered, there is no clear "consensus" on HL measurement but a convergence to more comprehensive tools. Giving
Intarakamhang, Ungsinun; Intarakamhang, Patrawut
WHO focuses on developing health literacy (HL) referring to cognitive and social skills. Our objectives were to develop a scale for evaluating the HL level of Thai childhood overweight, and develop a path model of health behavior (HB) for preventing obesity. A cross-sectional study. This research used a mixed method. Overall, 2,000 school students were aged 9 to 14 yr collected by stratified random sampling from all parts of Thailand in 2014. Data were analyzed by CFA, LISREL. Reliability of HL and HB scale ranged 0.62 to 0.82 and factor loading ranged 0.33 to 0.80, the subjects had low level of HL (60.0%) and fair level of HB (58.4%), and the path model of HB, could be influenced by HL from three paths. Path 1 started from the health knowledge and understanding that directly influenced the eating behavior (effect sized - β was 0.13, Pliteracy, and making appropriate health-related decision β=0.07, 0.98, and 0.05, respectively. Path 3 the accessing the information and services that influenced communicating for added skills, media literacy, and making appropriate health-related decision β=0.63, 0.93, 0.98, and 0.05. Finally, basic level of HL measured from health knowledge and understanding and accessing the information and services that influenced HB through interactive, and critical level β= 0.76, 0.97, and 0.55, respectively. HL Scale for Thai childhood overweight should be implemented as a screening tool developing HL by the public policy for health promotion.
Sarangarm, Dusadee; Ernst, Amy; Horner, Rachel; Crum, Ashley; Weiss, Steven J; Zemkova, Yana; King, Kisa
The primary aim of this study was to determine whether emergency department (ED) length of stay (LOS) or primary language was related to the degree of health literacy of patients. Adult English-speaking and Spanish-speaking patients were recruited for the study. Participants completed the Newest Vital Sign (NVS) tool (English and Spanish versions), a 6-question validated scale. Patients with NVS scores of 0 to 3 were considered to be at risk for limited health literacy, whereas those with adequate health literacy were defined as scoring a 4 to 6. After completion of their ED visit, a retrospective chart review was performed to identify the patient's ED LOS (time from registration to time of disposition) and ED disposition. In addition, 2 single-item questions were compared with the NVS for validity. Participants included 250 English-speaking and 257 Spanish-speaking subjects. Per the NVS, 71% (359 of 507) of all patients had limited health literacy. By language group, significantly more Spanish-speaking than English-speaking patients had limited health literacy (93% vs 48%, diff 45%, 95% confidence interval 37-51). There was no significant difference in LOS between the limited health literacy group and adequate health literacy group (medians 440 vs 461 min). The 2 single-item questions had fair validity in comparison to the NVS scale (κ 0.2-0.3). There was a significant difference in health literacy based on language, with 93% of all Spanish-speaking patients in our sample having limited health literacy. We found no significant difference in ED LOS between patients with limited health and adequate health literacy in an academic urban ED setting.
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
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 the values and concerns of the social work profession. Despite the extensive knowledge and skills that social workers can bring to bear to assist patients with low health literacy, the concept of health literacy is underused in social work scholarship.This gap reflects missed opportunities for social workers to contribute their expertise to the evolving field of health literacy and to strategically align their work with organizational and national priorities.To address this gap, this article provides an overview of health literacy, its relevance to social work, and its representation in disciplinary literature; and it outlines opportunities for health social workers to systematically incorporate health literacy concepts and tools into their practices with patients and families. Implications for a social work research and practice agenda in health literacy are discussed.
Hashimoto, Hidemi; Yanagisawa, Satoko
Japanese-Brazilians were the third largest immigrant group in Japan in 2011. Their health issues have caused concern, as their limited language made them vulnerable by hindering access to health services. Upon considering child health, mothers' health literacy (HL) is very important. This study aimed to develop a health literacy scale among Brazilian mothers (HLSBM) in Japan. Questionnaires in Portuguese were distributed to 1474 mothers from December 2011 to March 2012. Among 698 collected, 558 questionnaires were analyzed. We prepared 29 candidate items for HLSBM based on Nutbeam's concept of functional, interactive and critical literacy. The dimensional structure was determined statistically using confirmatory factor analysis. Validity was also analyzed by Pearson's correlation with Ishikawa's scale and Kendall's coefficient of concordance among researchers. Cronbach's α coefficients were calculated to examine internal consistency. The confirmatory factor analysis revealed a two-factor model (five items for basic literacy and five items for critical literacy) with sufficient goodness of fit (GFI 969, AGFI 945, NFI 959, CFI 972, RMSEA 060). The internal consistency values of the total score, basic and critical literacy sub-scales were 0.819, 0.889 and 0.667, respectively. Kendall's coefficient of concordance showed good agreement of researchers (p literacy and 0.472 for critical literacy. The HLSBM consisting of two factors was confirmed to be valid and reliable. The HLSBM must be useful for understanding this vulnerable group's health literacy and its associated factors. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Older adults with low health literacy can improve their health if they learn to self-manage their well-being and improve their physical activity and their dietary pattern. One of the major challenges in health care is the problem of low health literacy. Especially older adults often have low health
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.
Tse, Carrie Kw; Bridges, Susan M; Srinivasan, Divya Parthasarathy; Cheng, Brenda Ss
.... 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...
Bickmore, Timothy W; Pfeifer, Laura M; Paasche-Orlow, Michael K
Patients are commonly presented with complex documents that they have difficulty understanding. The objective of this study was to design and evaluate an animated computer agent to explain research consent forms to potential research participants. Subjects were invited to participate in a simulated consent process for a study involving a genetic repository. Explanation of the research consent form by the computer agent was compared to explanation by a human and a self-study condition in a randomized trial. Responses were compared according to level of health literacy. Participants were most satisfied with the consent process and most likely to sign the consent form when it was explained by the computer agent, regardless of health literacy level. Participants with adequate health literacy demonstrated the highest level of comprehension with the computer agent-based explanation compared to the other two conditions. However, participants with limited health literacy showed poor comprehension levels in all three conditions. Participants with limited health literacy reported several reasons, such as lack of time constraints, ability to re-ask questions, and lack of bias, for preferring the computer agent-based explanation over a human-based one. Animated computer agents can perform as well as or better than humans in the administration of informed consent. Animated computer agents represent a viable method for explaining health documents to patients.
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.
Jackson, Richard D; Eckert, George J
The purpose of this investigation was to gather data concerning the level of health literacy in adults who frequently volunteer for our clinical research programs. A convenience sample of 99 adults was recruited from our database of subjects taking part in an ongoing series of investigations. Health literacy was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Additional demographic and socioeconomic data were collected by means of a questionnaire. The results indicated that 13 percent of the cohort of subjects scored in the "inadequate" or "marginal" categories as described by the criteria of the S-TOFHLA. Inadequate or marginal health literacy was associated with race, gender, and age. Unfortunately, the sample size was too small to determine the interaction of these variables. Dental faculty conducting clinical research investigations should be cognizant of the fact that a portion of adults, especially older adults, may have difficulty reading written instructions, informational letters of consent, prescriptions, and other documents. Researchers should make every effort to ensure that information provided in text form is provided in a manner that is easily understandable to the reader. Technical terminology and jargon should be avoided or if used, it should be explained in plain, simple language. If a potential subject is having difficulty, the investigator is obligated to take the additional time to educate the potential subject using alternative methods.
Suka, Machi; Taniuchi, Asako; Igarashi, Suguru; Yanagisawa, Hiroyuki; Ishizuka, Bunpei
This study proposed a method for assessing menopause-specific health literacy (knowledge and beliefs about menopausal symptoms which aid their recognition, assessment, and management) using a vignette methodology. A cross-sectional web-based survey was conducted in September 2015 among Japanese women aged 30-59 years. Of 1236 women surveyed, 1196 eligible participants who were not under treatment for menopausal symptoms were included. Participants were presented with a vignette describing a woman with menopausal symptoms and were then asked a series of questions to assess their recognition of menopausal symptoms, attitude, subjective norm, perceived behavior control, availability, and intention to seek medical care if they themselves had the problems described in the vignette. The majority (87%) of participants correctly labelled the vignette as menopausal symptoms and 60% expressed an intention to seek medical care if they had the symptoms presented. Logistic regression showed that attitude, subjective norm, and perceived behavior control were significant predictors of the intention to seek medical care. A structural equation model depicting these relationships with intention to seek medical care revealed acceptable fit indices: goodness of fit index (GFI)=0.948, adjusted goodness of fit index (AGFI)=0.913, comparative fit index (CFI)=0.883, and root mean square error of approximation (RMSEA)=0.089. Subjective norm had the greatest direct effect on intention to seek medical care. The assessment of menopause-specific health literacy may be useful for understanding why women hesitate to seek medical care for menopausal symptoms and for developing interventions to improve the coping behaviors of women with menopausal symptoms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
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.
Steptoe, Andrew; Deaton, Angus; Stone, Arthur A
Subjective wellbeing and health are closely linked to age. Three aspects of subjective wellbeing can be distinguished-evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, anger, stress, and pain), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in the specialty of psychological wellbeing, and present new analyses about the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, a continuing survey in more than 160 countries, shows a U-shaped relation between evaluative wellbeing and age in high-income, English speaking countries, with the lowest levels of wellbeing in ages 45-54 years. But this pattern is not universal. For example, respondents from the former Soviet Union and eastern Europe show a large progressive reduction in wellbeing with age, respondents from Latin America also shows decreased wellbeing with age, whereas wellbeing in sub-Saharan Africa shows little change with age. The relation between physical health and subjective wellbeing is bidirectional. Older people with illnesses such as coronary heart disease, arthritis, and chronic lung disease show both increased levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing might also have a protective role in health maintenance. In an analysis of the English Longitudinal Study of Ageing, we identify that eudemonic wellbeing is associated with increased survival; 29·3% of people in the lowest wellbeing quartile died during the average follow-up period of 8·5 years compared with 9·3% of those in the highest quartile. Associations were independent of age, sex, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of elderly people is an important objective for both economic and health policy. Present psychological and economic theories do not adequately account for the variations in patterns
Liao, Li-Ling; Liu, Chieh-Hsing; Cheng, Chi-Chia; Chang, Tzu-Chau
Health literacy is related to health inequality, health behaviors, and health status. Globally, health literacy has primarily focused on adults and has been based on the medical model. It is necessary to understand children's life experiences as they relate to health; thus, this study attempted to evaluate and describe the health literacy abilities of sixth-graders in Taiwan. Interviews were conducted with 10 teachers and 11 caregivers, and focus groups were conducted with 32 children. Health literacy abilities corresponding to real-life situations were identified from life skills and the Taiwanese Curriculum Guidelines for health education. Three expert meetings were held to redefine children's health literacy using a health promotion perspective and confirmed indicators. An operational definition of three aspects of children's health literacy and 25 abilities was proposed: 11 functional health literacy abilities (e.g. understands the connection between personal health care behaviors and health); seven interactive health literacy abilities (e.g. obtains and understands information from various channels); and seven critical health literacy abilities (e.g. analyzes the relationship between personal needs and diet choices for a balanced diet). These indicators cover 10 health education categories. These findings highlight the importance of understanding Taiwanese children's health literacy, and the urgency of developing an appropriate measurement tool. The definition and indicators in this study were identified using a child-centered approach focusing on children's real-life experiences. The result serves as a solid basis for the development of the Taiwan Children's Health Literacy Scale, and provides information for the decision-making sector on health education.
Kutcher, S; Gilberds, H.; Morgan, C.; Greene, R.; Hamwaka, K.; Perkins, K.
Background. Mental health literacy is foundational for mental health promotion, prevention, stigma reduction and care. Integrated school mental health literacy interventions may offer an effective and sustainable approach to enhancing mental health literacy for educators and students globally. Methods. Through a Grand Challenges Canada funded initiative called ?An Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania?, we culturally adapted a previously demons...
De Caro, Walter; Caranzetti, Maria Vittoria; Capriati, Ilaria; Alicastro, Marco Gregorio; Angelini, Sara; Dionisi, Sara; Marucci, Anna Rita; Lancia, Loreto; Sansoni, Julita
Individuals and population's health is influenced by environmental, social economical and cultural aspects which in turn connect individuals to society. In order to decide autonomously, independently and consciously individuals should have several competences. The aim of this study is to identify, analyse and emphasise health literacy concept relevance per se,its relationship with nursing through a narrative revision focused on: Health literacy definition recognition and analysis; evaluation of connection between nursing and health literacy. A narrative review was carried out through PUBMED and CINHAL, using 'health literacy' and nursing related terms, in English or Italian between 2010 and 2015. Results show that 'health literacy' is fully appraised, while attention paid by nurses on the topic is poor due both to a lack of awareness of its relevance on individuals' health and of appraisal. Twenty-height definition emerged from the revision; concepts expressed by scholars are mainly focused on very few individuals' abilities and competences applied to the health context (reading, writing, calculation, comprehension, listening and so on). According to the results it is difficult to define health literacy due to its multidimensional nature. Notwithstanding the above an attempt to develop a unique new definition of health literacy has been carried out although its multidimensional nature and its strong connection to several variables constantly under development. Nevertheless it is imperative that educational modules would be developed and stably integrated in health care education, at the same time a strong effort is due from professional and policy makers to provide population of the necessary tools in order to improve their health.
Komenaka, Ian K; Nodora, Jesse N; Hsu, Chiu-Hsieh; Martinez, Maria Elena; Gandhi, Sonal G; Bouton, Marcia E; Klemens, Anne E; Wikholm, Lauren I; Weiss, Barry D
To investigate the relationship of health literacy and screening mammography. All patients seen at a breast clinic underwent prospective assessment of health literacy from January 2010 to April 2013. All women at least 40 years of age were included. Men and women diagnosed with breast cancer before age 40 years were excluded. Routine health literacy assessment was performed using the Newest Vital Sign. Demographic data were also collected. Medical records were reviewed to determine if patients had undergone screening mammography: women aged 40-49 years were considered to have undergone screening if they had another mammogram within 2 years. Women 50 years or older were considered to have undergone screening mammography if they had another mammogram within 1 year. A total of 1,664 consecutive patients aged 40 years or older were seen. No patient declined the health literacy assessment. Only 516 (31%) patients had undergone screening mammography. Logistic regression analysis that included ethnicity, language, education, smoking status, insurance status, employment, income, and family history found that only three factors were associated with not obtaining a mammogram: low health literacy (odds ratio [OR] 0.27, 95% confidence interval [CI] 0.19-0.37; P<.001), smoking (OR 0.64, 95% CI 0.47-0.85; P=.002), and being uninsured (OR 0.66, 95% CI 0.51-0.85; P=.001). Of all the sociodemographic variables examined, health literacy had the strongest relationship with use of screening mammography.
Kumar, Disha; Sanders, Lee; Perrin, Eliana M.; Lokker, Nicole; Patterson, Baron; Gunn, Veronica; Finkle, Joanne; Franco, Vivian; Choi, Leena; Rothman, Russell L.
Objective To assess parental health literacy and numeracy skills in understanding instructions for caring for young children, and to develop and validate a new parental health literacy scale, the Parental Health Literacy Activities Test (PHLAT). Methods Caregivers of infants (age 9th-grade numeracy skills. Mean score on the PHLAT was 68% (SD 18); for example, only 47% of caregivers could correctly describe how to mix infant formula from concentrate, and only 69% could interpret a digital thermometer to determine if an infant had a fever. Higher performance on the PHLAT was significantly correlated (p<0.001) with education, literacy skill, and numeracy level (r=0.29, 0.38, and 0.55 respectively). Caregivers with higher PHLAT scores were also more likely to interpret age recommendations for cold medications correctly (OR 1.6, 95% CI 1.02, 2.6). Internal reliability on the PHLAT was good (KR-20=0.76). The PHLAT-10 also demonstrated good validity and reliability. Conclusions Many parents do not understand common health information required to care for their infants. The PHLAT, and PHLAT-10 have good reliability and validity and may be useful tools for identifying parents who need better communication of health-related instructions. PMID:20674532
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
Lindsey, Martha Ann
Health literacy involves basic reading and numeracy, which allow a person to function as a health care consumer, by reading, understanding, evaluating and using information in health documents. For thirty years, the gap between the reading level of most of the public, eighth grade, and the reading level of most written health information, above…
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.
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.
Furstrand, Dorthe; 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 Assessment toolkit, eHLA, evaluating the user by seven scales: computer familiarity, confidence, incentive and performance as well as functional health literacy, health literacy self-assessment and health literacy performance, as a first step toward development of technology that accommodates the literacy level of the user.
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...... Assessment toolkit, eHLA, evaluating the user by seven scales: computer familiarity, confidence, incentive and performance as well as functional health literacy, health literacy self-assessment and health literacy performance, as a first step toward development of technology that accommodates the literacy...
Puente-Maestu, Luis; Calle, Myriam; Rodríguez-Hermosa, Juan Luis; Campuzano, Anna; de Miguel Díez, Javier; Álvarez-Sala, Jose Luis; Puente-Andues, Luis; Pérez-Gutiérrez, Maria Joselín; Lee, Shoou-Yih D
There is little information worldwide about the impact of health literacy (HL) on clinical outcomes of COPD. Our aim was to quantify inadequate HL in Spain, as measured by the Short Assessment of Health Literacy for Spanish Adults questionnaire, and to examine the associations between HL and both COPD outcomes and health status. 296 COPD patients of 68(SD = 9) years and a FEV1%predicted of 53%(SD = 18%) were enrolled and followed-up for one year. 59% showed "inadequate" HL. Individuals with inadequate HL were older (70[SD = 9] vs 65[SD = 8] years; p disease, as measured by the low HL-COPD questionnaire, (6.9[SD = 2.3] vs 7.5[SD = 1.9]; p prevalent among COPD patients and it is related to health status and relevant clinical outcomes of the disease. HL needs to be considered when planning the care for COPD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.
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…
Rikard, R. V.; Thompson, Maxine S.; McKinney, Julie; Beauchamp, Alison
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 wei...
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.
Rudd, Rima E.; Anderson, Jennie E.
The "health literacy environment" of a healthcare facility represents the expectations, preferences, and skills of those providing health information and services. Some of these demands are in the form of physical aspects of the hospital or health center, such as signs and postings. At the same time, access to and navigation of health services…
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.
Full Text Available Background and Objectives: Health Literacy has been defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. People with inadequate health literacy have poorer health status. Thus, the aim of this study was to determine the status of health literacy and its relationship with general health status, use of health services and preventive behaviors. Materials and Methods: This descriptive-analytical study was conducted on 400 individuals aged 18to 65 years in Balochestan, Iran. Multi-stage cluster sampling was used. Data were collected using Health Literacy for Iranian Adults (HELIA questionnaires. Data analyses were conducted using Kruskal-Wallis and Mann-Whitney, using SPSS (version 18. Results: The mean age of the studied population was 9.29± 28.7years. Only %32 of adults were found to have adequate health literacy. Inadequate health literacy was more common in older people, ones with fewer years of schooling or lower household income, and females. The health literacy level was associated with outpatient visits, screening, and health status. Individuals with higher levels of health literacy had performed screening more than others. conclusions: Due to the low health literacy level in the target population, educational interventions are needed to develop health literacy skills in the community.
Chen, Aleda M H; Noureldin, Marwa; Plake, Kimberly S
The average American adult reads at the 8th grade level while most written health information materials, including medication guides, are written at the 12th grade level. To assist students with health literacy-sensitive communication, pharmacy schools should incorporate educational activities addressing health literacy competencies. The objectives of this study were to evaluate the impact of a health literacy assignment on student pharmacists' perceptions of: 1) learning about health literacy; 2) ability to write health literacy level-appropriate patient education material; and 3) the use of these skills in future pharmacy practice. Third professional year student pharmacists were asked to rewrite a patient medication information sheet at the 5th grade reading level, altering it from the 12th grade level. Following assignment completion, students responded to a 4-item open-ended questionnaire on what they learned from the activity, what information components were the most difficult to rewrite and reason for the difficulty, key strategies to accomplish the assignment, and their perception of the impact this assignment had on their future practice. Content analysis of the reflections was performed using QSR NVivo to identify themes grounded in the students' responses. Reflections were completed in 2009 (n = 159) and 2010 (n = 144), for a total of 303 completed reflections. Predominant themes included greater understanding about the challenges, importance, and methods of health literacy level-appropriate communication and greater awareness of the role of pharmacists in presenting information clearly to patients. Students indicated the activity increased their understanding of the complexity of patient information, the educational needs of patients, and the importance of providing information that is understandable. Student pharmacists learned methods of effective communication with patients and should be better prepared to communicate in a health literacy
Nutbeam, Don; McGill, Bronwyn; Premkumar, Pav
Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Sorensen, K.; van den Broucke, S.; Fullam, J.; Doyle, G.; Pelikan, J.; Slonska, Z.; Brand, H.
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
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.
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.
Alokozai, Aaron; Bernstein, David N; Sheikholeslami, Nicole; Uhler, Lauren; Ring, David; Kamal, Robin N
Patients with limited health literacy may have less knowledge and fewer resources for efficient access and navigation of the health care system. We tested the null hypothesis that there is no correlation between health literacy and total time spent seeking hand surgery care. New patients visiting a hand surgery clinic at a suburban academic medical center were asked to complete a questionnaire to determine demographics, total time spent seeking hand surgery care, and outcomes. A total of 112 patients were included in this study. We found health literacy levels did not correlate with total time seeking hand surgery care or from booking an appointment to being evaluated in clinic. In this suburban academic medical center, patients with low health literacy do not spend more time seeking hand surgery care and do have longer delays between seeking and receiving care. The finding that-at least in this setting-health literacy does not impact patient time seeking hand care suggests that resources to improve health disparities can be focused elsewhere in the care continuum.
Suka, Machi; Odajima, Takeshi; Okamoto, Masako; Sumitani, Masahiko; Igarashi, Ataru; Ishikawa, Hirono; Kusama, Makiko; Yamamoto, Michiko; Nakayama, Takeo; Sugimori, Hiroki
To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people. A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status. The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health. HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan. In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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
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…
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.
Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna
Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
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.
Smith, Sian K; Zhu, Yunyun; Dhillon, Haryana M; Milross, Chris G; Taylor, Jennifer; Halkett, Georgia; Zilliacus, Elvira
Health literacy plays a key role in a patient's ability to use health information and services, and can affect health outcomes. This study aimed to explore radiation therapists' perspectives on how they support people with lower health literacy who are undergoing radiotherapy. Semi-structured interviews were conducted with 25 radiation therapists working in radiation oncology departments in New South Wales, Australia. The four key themes were (1) the process of identifying a patient with low health literacy, (2) the perceived consequences of low health literacy, (3) managing and responding to the needs of different health literacy groups and (4) recommendations to address low health literacy in radiotherapy. Radiation therapists appeared to make an informal, intuitive judgment about a patient's health literacy, using a variety of verbal and non-verbal cues as well as impromptu conversations with the multi-disciplinary team. Patients perceived to have lower health literacy were described as having greater difficulties assimilating knowledge and engaging in self-care. Although participants reported communicating to patients at a basic level initially, they subsequently tailored their communication to match a patient's health literacy. Strategies reported to communicate to low health literacy groups ranged from using lay language with minimal medical terminology, using visual aids (photos), using analogies, reiterating information and asking family members with higher literacy to attend consultations. A more structured approach to supporting patients with low health literacy and integrating health literacy training in radiation oncology departments may help to minimise the adverse outcomes typically experienced by this population.
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
Belcastro, Philip A; Ramsaroop-Hansen, Hardaye
Health literacy evolved from a standard of English language proficiency designed to promote patient compliance into an inferential for promoting positive health decision-making and health outcomes. In turn, the United States relegated health literacy as a national strategy to improve personal health and health care outcomes as well as reduce national health care expenditures. We reviewed the literature to assess the empirical research about health literacy and health behavior and health status outcomes. There is a paucity of empirical research supporting health literacy's capacity to improve personal health behavior or health outcomes. We submit that the process of acquiring scientifically valid health knowledge partnered with the skills for informed health decision-making as well as motivation to foster positive health behaviors and health outcomes is that of health education, and not that inferred by health literacy competency. We recommend that comprehensive school health education serve as the standard for advancing personal health and health outcomes. We recommend that elementary, secondary, and higher education institutions be charged with the objective to provide comprehensive school health education intervention to advance personal health, community health, and concomitantly moderate national health care expenditures. © 2017, American School Health Association.
Grønbaek, M; Mortensen, E L; Mygind, K
To examine the association between intake of different types of alcoholic beverages and self reported subjective health.......To examine the association between intake of different types of alcoholic beverages and self reported subjective health....
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
Erica D. Spangenberg
Full Text Available In this article I report on research intended to characterise and compare the thinking styles of Grade 10 learners studying Mathematics and those studying Mathematical Literacy in eight schools in the Gauteng West district in South Africa, so as to develop guidelines as to what contributes to their subject choice of either Mathematics or Mathematical Literacy in Grade 10. Both a qualitative and a quantitative design were used with three data collection methods, namely document analysis, interviews and questionnaires. Sixteen teachers participated in one-to-one interviews and 1046 Grade 10 learners completed questionnaires. The findings indicated the characteristics of learners selecting Mathematics and those selecting Mathematical Literacy as a subject and identified differences between the thinking styles of these learners. Both learners and teachers should be more aware of thinking styles in order that the learners are able to make the right subject choice. This article adds to research on the transition of Mathematics learners in the General Education and Training band to Mathematics and Mathematical Literacy in the Further Education and Training band in South Africa.
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.
Wehmeyer, Meggan M. H.; Corwin, Caleb L.; Guthmiller, Janet M.; Lee, Jessica Y.
Objective The objective of this study was to describe oral health literacy (OHL) among periodontal patients and to examine its association with periodontal health status. Methods This cross-sectional study included new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinic. Sociodemographic and dental history information were collected. OHL was measured using a dental word recognition instrument, Rapid Estimate of Adult Literacy-30 (REALD-30). Clinical periodontal examinations were completed. Results One hundred and twenty-eight participants enrolled and 121 completed all study examinations and instruments. Despite a high level of education among participants in our study, low levels of OHL were found in one-third (33 percent) of the study population. Thirty-one percent had moderate OHL (score of 22–25), 37 percent had high OHL (score ≥ 26). The mean REALD-30 score was 23. Fifty-three percent of participants had severe periodontitis, 29 percent had moderate periodontitis, and 18 percent had mild or no periodontitis. Bivariate analysis showed a significant association between OHL and periodontal status (P Periodontology Clinics. PMID:23121152
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.
Cha, EunEeok; Kim, Kevin H; Lerner, Hannah M; Dawkins, Colleen R; Bello, Morenike K; Umpierrez, Guillermo; Dunbar, Sandra B
To examine relationships among health literacy, self-efficacy, food label use, and dietary quality in young adults aged 18-29. Health literacy, self-efficacy, food label use, and dietary quality were assessed. Participants were categorized into low, medium and high health literacy groups based on Newest Vital Sign score. Self-efficacy and health literacy were predictors of food label use, which positively predicted dietary quality. The low health literacy group had significantly lower use of food labels than the high health literacy group. However, there was no significant difference between medium and high health literacy groups. Strategies to enhance health literacy, self-efficacy and food label use should be developed to improve dietary quality and health outcomes.
Scott, Sheryl A
This study's aim was to determine the prevalence of health literacy education in nursing programs. Health literacy content and teaching strategies were also explored. Over 75 million Americans have low health literacy, a problem that can cause negative health outcomes. Knowledge about health literacy is important for nurses; yet, the extent to which the topic is included within nursing curricula is unknown. An online survey was distributed to 150 nursing programs to obtain information about health literacy education in the curricula. Fifty-seven programs responded, with the majority reporting that health literacy is taught in their curricula. The impact of low health literacy and the importance of plain language were noted as common topics. The majority of participants reported inclusion of health literacy in their curricula using various teaching strategies. However, a low response rate prevents generalized conclusions.
Huber, Jeffrey T.; Shapiro, Robert M., II; Gillaspy, Mary L.
The health literacy movement has been socially constructed over time. Unlike the consumer health information movement, which developed with broad public support, the health literacy movement has been fashioned primarily from the top down, initiated by policy makers and imposed on targeted populations. Interest in the health literacy movement has…
Results: The Health literacy statistics report of the Institute of Medicine (IOM) 2004) shows that nearly half the United States of America population has difficulty understanding and using health information. Conclusion: Low health literacy incurs significant costs to society, investing in health literacy will improve population ...
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.
Harvard-Hinchberger, Patricia Ann
New and improved teaching strategies are required to engage students in meaningful coursework to enhance critical thinking, problem-solving, and decision-making. Advanced practice nurses are responsible for producing creative and realistic health promotion and disease prevention proposals, which have the potential for implementation as part of a course requirement. Unfortunately, these proposals often lack the sophistication and critical literacy necessary to effectively communicate the student's knowledge and understanding of their ideas. Infusing critical thinking and critical literacy into all curricula is one of the stated goals of the university-wide "Enhancing Critical Literacy Project." This learning-centered program serves as the platform for this article and the early adoption of selected student assessment techniques. Concepts presented as part of a critical literacy enhancement seminar provides the theoretical underpinning of this approach and is designed to encourage student innovation through creative writing. A detailed description of the various strategies and their implementation are discussed.
Canyon Ranch Institute and Health Literacy Media are a 501(c)3 non-profit public charity working to improve health based on the best evidence-based practices of health literacy and integrative health. As an organization, we offer a spectrum of health literacy work extending from plain language services to intensive community-based interventions. (See www.canyoranchinstitute.org & www.healthliteracy.media) In this chapter, we discuss the methodologies and outcomes of two of those community-based interventions - the Canyon Ranch Institute Life Enhancement Program and our Theater for Health program. Perhaps uniquely, an underpinning approach to both efforts is based on the increasing body of evidence of health literacy as a social determinant of health. Therefore, our research and evaluation of these programs captures not only changes in knowledge, attitudes, and beliefs but explicitly includes changes in informed behavior change and objective health outcomes as well. Our work makes it clear - that if you engage people in a health literate approach to informed behavior change (and respect their knowledge of their own lives and context) you can help people help themselves to better health. Further, from the perspective of health as a right and a resource for living, we find people who advance their health use this resource to continually better their own and their family's lives as well as the communities where they live. Hopefully, the examples provided in this chapter provide a sense of direction and motivation to others to fully explore the potential of health literacy to improve health and well-being, increase satisfaction with life, and produce health outcomes at a lower cost.
Muscat, Danielle M; Smith, Sian; Dhillon, Haryana M; Morony, Suzanne; Davis, Esther L; Luxford, Karen; Shepherd, Heather L; Hayen, Andrew; Comings, John; Nutbeam, Don; McCaffery, Kirsten
Adult education institutions have been identified as potential settings to improve health literacy and address the health inequalities that stem from limited health literacy. However, few health literacy interventions have been tested in this setting. Feasibility study for an RCT of the UK Skilled for Health Program adapted for implementation in Australian adult education settings. Implementation at two sites with mixed methods evaluation to examine feasibility, test for change in participants' health literacy and pilot test health literacy measures. Twenty-two socially disadvantaged adults with low literacy participated in the program and received 80-90 hours of health literacy instruction. The program received institutional support from Australia's largest provider of vocational education and training and was feasible to implement (100 % participation; >90 % completion; high teacher satisfaction). Quantitative results showed improvements in participants' health literacy skills and confidence, with no change on a generic measure of health literacy. Qualitative analysis identified positive student and teacher engagement with course content and self-reported improvements in health knowledge, attitudes, and communication with healthcare professionals. Positive feasibility results support a larger RCT of the health literacy program. However, there is a need to identify better, multi-dimensional measures of health literacy in order to be able to quantify change in a larger trial. This feasibility study represents the first step in providing the high quality evidence needed to understand the way in which health literacy can be improved and health inequalities reduced through Australian adult education programs.
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.
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.
Jimenez, Manuel E; Barg, Frances K; Guevara, James P; Gerdes, Marsha; Fiks, Alexander G
To compare parents' experience with the early intervention (EI) referral process based on health literacy level. We interviewed 44 parents of children referred to EI by their pediatricians. Parents completed the Newest Vital Sign (NVS) health literacy assessment. We analyzed transcripts using modified grounded theory and compared themes based on health literacy. Forty parents completed the NVS. Twenty-eight (70%) had adequate health literacy. Four primary themes differed between parents based on health literacy level. Parents with low health literacy commonly reported that: (1) they lacked continuity with a single pediatrician, (2) they had difficulty contacting EI, (3) they were confused about EI or the referral process (4) their pediatricians did not explain EI and written materials were not helpful. Parents with low health literacy commonly reported difficulty with EI referrals including contact problems and confusion. Strategies that accommodate parents with low health literacy level may improve referral success.
Rosario, Carrie; Modeste, Naomi; Dos Santos, Hildemar; Handysides, Daniel; Gamboa-Maldonado, Thelma; Boyd, Kendal
Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students' health literacy. During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18-24 were recruited from enrollment lists at two urban universities in the Southeastern United States. Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled. Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p literacy. Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students' health literacy.
Vogt, Dominique; Schaeffer, Doris; Messer, Melanie; Berens, Eva-Maria; Hurrelmann, Klaus
Health literacy is especially important for older people to maintain or enhance remaining health resources and self-management skills. The aim of the study was to determine the level of health literacy and the association between health literacy, demographic and socio-economic factors in German older adults aged 65 years and above stratified by age group. Health literacy was assessed via computer-assisted personal interviews using HLS-EU-Q47 on a representative sample of the German-speaking population. Descriptive statistics, bivariate analyses and logistic regression modelling stratified by age group were conducted to assess health literacy of 475 respondents aged 65 years and above. Overall, 66.3% of all respondents aged 65 years and above had limited health literacy. Limited health literacy was especially prevalent among respondents above 76 years of age (80.6%). Limited health literacy was associated with financial deprivation (OR: 3.05; 95% CI: 1.99-4.67) and limited functional health literacy (OR: 2.16; 95% CI: 1.29-3.61). Financial deprivation was strongest predictor for limited health literacy in the total sample and stratified by age group. Limited health literacy is a frequent phenomenon in German adults aged 65 years and above. Research on health literacy in old age and the role in health disparities is urgently needed. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
This study examined the empirical impact of parental education on child health. Using Cameroon household consumption survey data collected by the government statistics office in 2001 and a range of econometric methods, the existence of prominent spillover effects linking parental literacy to better child health ...
Kutcher, Stan; Wei, Yifeng; Morgan, Catherine
Objectives: The transition from high school to college or university is an important time to enhance mental health literacy for young people. This study evaluated the second edition of a resource entitled "Transitions," a comprehensive life-skills resource with embedded mental health information available in book, e-book and iPhone app…
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
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.
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.
McInnes, Nicholas; Haglund, Bo J A
Accessibility is one of six quality criteria articulated by the European Commission in its code of conduct for health websites. Readability plays an integral part in determining a website's accessibility. Health information that is hard to read may remain inaccessible to people with low health literacy. This study aimed to calculate the readability of websites on various causes of disease. The names of 22 health conditions were entered into five search engines, and the readability of the first 10 results for each search were evaluated using Gunning FOG, SMOG, Flesch-Kincaid and Flesch Reading Ease tests (n=352). Readability was stratified and assessed by search term, search term complexity, top-level domain and paragraph position. The mean reading grade was 12.30, and the mean FRE was 46.08, scores considered 'difficult'. Websites on certain topics were found to be even harder to read than average. Where conditions had multiple names, searching for the simplest one led to the most readable results. Websites with .gov and .nhs TLDs were the most readable while .edu sites were the least. Within texts, a trend of increasing difficulty was found with concluding paragraphs being the hardest to read. It was also found that some of the most frequent search results (such as Wikipedia pages) were amongst the hardest to read. Health professionals, with the help of public and specialised libraries, need to create and direct patients towards high-quality, plain language health information in multiple languages.
Full Text Available Background 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. Methods 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 <226 and above basic (HLS ≥226. 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 Pvalue 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. Results 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 < .05. The extrapolated national
Scheckel, Martha; Emery, Nicole; Nosek, Catherine
To describe undergraduate nursing students' experiences of learning and providing patient education. To teach nursing students principles and practices of patient education, nurse educators design instructional strategies using educational and clinical practice guidelines, research and theories. This means teachers' approaches to teaching patient education are derived from evidence and support the evidence-based teaching movement. Despite their efforts, research shows that students lack knowledge and skills needed for proficiency in providing patient education. However, this research does not explicate students' experiences of learning and providing patient education, which can inform teachers of ways to structure approaches to teaching students this nursing practice. The philosophical background for this study was interpretive phenomenology. Eight undergraduate nursing students in their final semester of a baccalaureate nursing programme were interviewed using face-to-face, unstructured interviews. Data were collected using unstructured interviews and analysed using hermeneutics. Common meanings from the analysis of data shows that a primary practice of students' learning and providing patient education is addressing health literacy. Three sub-themes: (1) respecting languages: learning persistence (2) helping patients understand: learning to teach and (3) promoting engagement: learning sensitivity, exemplify how students are addressing health literacy. Contrary to literature on students' lack of proficiency in providing patient education, the findings of this study reveal extraordinary competencies students already have in addressing health literacy. The results of this study show the paramount need for teachers to design instructional strategies that deepen students' extant knowledge and skills in health literacy prior to graduation from nursing programmes. Using the findings of this study, teachers will gain novel approaches to teaching patient education that
Shohet, Linda; Renaud, Lise
From a holistic perspective, health literacy is a requirement for the well-being of entire populations. It moves beyond the focus on individuals to consider the role of organizations and systems. This perspective offers a context for discussing best practices in health literacy, and implications for research and policy development. This paper offers an overview of the best practices that were presented at the Second Canadian Conference on Literacy and Health. It discusses clear writing in some detail because it was emphasized at the conference. It also considers practices that were addressed less emphatically, such as oral communication between patients and health care professionals, training for health care professionals, non-written means of communication (such as video), and building capacity through action-research. The paper critiques some practices. It also notes the lack of research on the links between health literacy and oral understanding, on the impact of verbal and non-written interventions, and on the effectiveness of these practices on the health outcomes of the population. It briefly discusses policy issues and suggests some future directions.
Health Literacy Online: A Guide to Writing and Designing Easy-to-Use Health Web Sites is a practical and well-written resource for public health and health communication professionals and web designers. This guide builds on the principles of web usability and adds to existing best practices by providing research-based strategies for writing and designing health websites especially for users with limited literacy and health literacy skills. This guide synthesizes years of lessons learned from Office of Disease Prevention and Health Promotion's original research with hundreds of web users, experience with revising the healthfinder.gov, as well as strategies supported by the Research-Based Web Design and Usability Guidelines (Usability.gov). In the United States, roughly one third of adults have limited literacy skills, yet far more (as many as 90%) have limited health literacy skills, meaning they have trouble understanding complex health information. This how-to guide is timely and developed with the aim of creating easy-to-use health websites to reach as many web users as possible, especially those with limited literacy and health literacy skills.
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…
Quenzel, Gudrun; Schaeffer, D; Messer, M; Vogt, D
Health literacy is known to influence health. Findings on the unequal distribution of health literacy among less well-educated young people are presented. The influence of socio-demographic factors and the consequences of a low level of health literacy with regard to health-related behaviour are discussed. Data from a survey on the health literacy of young people with a lower level of education, older people and migrants (n = 1,000) were used. Health literacy was measured using the instruments of the European Health Literacy Survey (HLS-EU-Q47). The results demonstrate a lower level of health literacy among young people with less education and especially among young migrants. Explanations for a lower level of health literacy among young people with less well-educated young people were parents' educational background and parents' wealth. Migration-related factors had no influence on young people. Further correlations between health literacy and health behaviour were explored. It is concluded that health literacy is linked to health behaviour and that unequal distributions of health literacy among young people may increase health inequalities.
Neter, Efrat; Brainin, Esther
eHealth literacy is defined as the use of emerging information and communications technology to improve or enable health and health care. The study examined whether literacy disparities are diminished or enhanced in the search for health information on the Internet.We used a countrywide representative random-digital-dial telephone household survey of the Israeli adult population (18 years and older, N = 4286).Respondents who were highly eHealth literate tended to be younger and more educated ...
Li, Chun Yu; Lee, Ogcheol; Shin, Gi Soo; Li, Xian Wen
This descriptive study was done to identify the relationship between health literacy and health status and to provide basic data for developing nursing interventions for Korean-Chinese elders living in Yanbian, China. For data collection, intentional sampling of 300 elders was used. The questionnaire was composed of 5 items based on "Ministry of Health, the People's Republic of China (2008)" to measure health literacy, 33 health status items from the "Korean Health Status Measure for Elderly People" developed by Shin (2002), revised for use in China, and 9 general characteristics. Data were analyzed using SPSS Win 13.0 program. Total level of health literacy was relatively high (68.7%). Elders had high scores for taking medicines according to doctor's instruction, but lower ones for full comprehension through communication with doctors. Health status was high for emotional, physical, and social function in that order. There were significant differences between general characteristics and health status for gender, age, marital status, education, family, smoking, and alcohol consumption in that order. Results of multiple regression analysis for factors influencing health status showed that self-report health level was the most influential, followed by health literacy, age, gender. Health literacy is the main factor affecting health promotion among minority elders indicating a need to develop health promotion programs for elders who have low health literacy.
Rosenbaum, Andrew J; Uhl, Richard L; Rankin, E Anthony; Mulligan, Michael T
The Institute of Medicine considers limited health literacy a "silent epidemic," as approximately half of Americans lack the competencies necessary for making informed decisions regarding their health. Limited health literacy substantially impedes the effective dissemination and comprehension of relevant health information, and also complicates communication, compromises care, and leads to worse patient outcomes. Poor health, early death, and worse control of chronic conditions have also been associated with limited health literacy. Unfortunately, physicians often struggle to identify those with limited health literacy, which can have adverse effects on the physician-patient relationship. In this article, we discuss the meaning of health literacy,the risk factors for and consequences of limited health literacy, orthopaedic-specific implications and investigations, and the strategies orthopaedic surgeons can utilize to improve health literacy and communication. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.
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 (P<.001), activity trackers (P<.001), and patient portals (P<.001). Additionally, greater health literacy 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
Martins, Maria Auxiliadora Parreiras; Costa, Josiane Moreira; Mambrini, Juliana Vaz de Melo; Ribeiro, Antonio Luiz Pinho; Benjamin, Emelia J; Brant, Luisa Campos Caldeira; Paasche-Orlow, Michael K; Magnani, Jared W
Health literacy has been related to health-related conditions and health outcomes. Studies examining the association of health literacy and anticoagulation have had variable results. We sought to investigate the relations of health literacy and percentage of time in therapeutic range (TTR) in a vulnerable Brazilian cohort at two hospital-based anticoagulation clinics. We measured health literacy with the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) in 2015-2016. We identified the demographic and clinical characteristics associated with health literacy and related health literacy to TTR. We enrolled 422 adults prescribed chronic warfarin therapy in our observational study (median age 62.1 years; 58.8% women; monthly income $200.00). The prevalence of inadequate health literacy (score 0-14 points) was 72.3% with a median score of 12 (quartiles, Q1=10; Q3=15) on the SAHLPA-18. The median TTR was 66.1%. In the multivariable logistic analysis, cognitive impairment and assistance with taking warfarin were associated with inadequate health literacy. Prosthetic heart valves and more school years were associated with adequate health literacy. Our analyses showed no significant relation between health literacy and TTR, analysing health literacy as a categorical (adjusted OR 1.05; 95% CI 0.65 to 1.70) or continuous variable (Spearman's coefficient 0.02; p=0.70). Inadequate health literacy was highly prevalent in this impoverished Brazilian cohort receiving anticoagulation with warfarin. However, we did not identify an association between health literacy and TTR. Future investigations may consider the systemic factors that contribute towards successful anticoagulation outcomes for vulnerable patient cohorts with inadequate health literacy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kamberi, Haxhi; Hysa, Bajram; Toçi, Ervin; Jerliu, Naim; Qirjako, Gentiana; Burazeri, Genc
Adequate functional health literacy is considered as a basic prerequisite for a proper health-seeking behavior of adult individuals. Our aim was to assess the levels and socioeconomic correlates of functional health literacy among adult primary care users in transitional Kosovo. A cross-sectional study was conducted in Kosovo in November 2012-February 2013 including a representative sample of 1035 primary health care users aged > or = 18 years (60% females; overall mean age: 44.3 +/- 16.9 years; overall response rate: 86%). The cross-culturally adapted long version of TOFHLA test (an instrument assessing reading comprehension and numerical abilities) was used to assess functional health literacy among study participants. TOFHLA scores range between 0-100 with higher scores implying better functional health literacy. The analysis of variance (ANOVA) was used to assess the association of functional health literacy with demographic and socioeconomic characteristics. Mean score of the functional health literacy was significantly higher among younger participants, in men, in highly educated individuals and participants with better self-reported income level. Our findings indicate that vulnerable socioeconomic individuals exhibit lower functional health literacy levels in post-war Kosovo. Health care professionals and particularly policy makers in Kosovo must be aware of the excess risk among the low socioeconomic groups and should tailor intervention programs accordingly.
Haun, Jolie; Luther, Stephen; Dodd, Virginia; Donaldson, Patricia
National priorities and recent federal initiatives have brought health literacy to the forefront in providing safe accessible care. Having valid and reliable health literacy measures is a critical factor in meeting patients' health literacy needs. In this study, the authors examined variation across three brief health literacy instruments in categorizing health literacy levels and identifying associated factors. The authors screened 378 veterans using the short form of the Test of Functional Health Literacy in Adults; the Rapid Estimate of Adult Literacy in Medicine; and a 4-Item Brief Health Literacy Screening Tool (known as the BRIEF). They analyzed data using prevalence estimates, Pearson product moment correlations, and logistic regression. When categorizing individuals' health literacy, agreement among instruments was present for 37% of the sample. There were consistencies; however, categorization and estimated risk factors varied by instrument. Depending on instrument, increased age, low education, minority status, and self-reported poor reading level were associated with low health literacy. Findings suggest that these instruments measure health literacy differently and are likely conceptually different. As the use of health literacy screening gains momentum, alignment between instrument and intended purpose is essential; in some cases, multiple instruments may be appropriate. When selecting an instrument, one should consider style of administration, purpose for measure, and availability of time and resources.
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: email@example.com.
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.
Elsborg, Lea; Krossdal, Fie; Kayser, Lars
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...
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,
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.
Smith, Samuel G.; Curtis, Laura M.; Wardle, Jane; von Wagner, Christian; Wolf, Michael S.
Objective 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. Methods 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. Results The relationship between health literacy and patient activation was weak, but significant (r = 0.11, pliteracy was associated with worse physical health (β = 0.13, pliteracy 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. PMID:24023942
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.
Giuse, Nunzia B; Koonce, Taneya Y; Storrow, Alan B; Kusnoor, Sheila V; Ye, Fei
Limited patient understanding of hypertension contributes to poor health outcomes. In 2 sequential randomized studies, the authors determined the impact of administering information tailored to health literacy level alone or in combination with preferred learning style on patients' understanding of hypertension. Patients with high blood pressure were recruited in an academic emergency department. In Experiment 1 (N = 85), the control group received only the routine discharge instructions; the intervention group received discharge instructions combined with information consistent with their health literacy level as determined by the Short Test of Functional Health Literacy. In Experiment 2 (N = 87), the information provided to the intervention group was tailored to both health literacy and learning style, as indicated by the VARK™ Questionnaire. To measure learning, the authors compared scores on a hypertension assessment administered during the emergency department visit and 2 weeks after discharge. Participants who received materials tailored to both health literacy level and learning style preference showed greater gains in knowledge than did those receiving information customized for health literacy level only. This study demonstrates that personalizing health information to learning style preferences and literacy level improves patient understanding of hypertension.
Kutcher, S; Gilberds, H; Morgan, C; Greene, R; Hamwaka, K; Perkins, K
Mental health literacy is foundational for mental health promotion, prevention, stigma reduction and care. Integrated school mental health literacy interventions may offer an effective and sustainable approach to enhancing mental health literacy for educators and students globally. Through a Grand Challenges Canada funded initiative called 'An Integrated Approach to Addressing the Issue of Youth Depression in Malawi and Tanzania', we culturally adapted a previously demonstrated effective Canadian school mental health curriculum resource (the Guide) for use in Malawi, the African Guide: Malawi version (AGMv), and evaluated its impact on enhancing mental health literacy for educators (teachers and youth club leaders) in 35 schools and 15 out-of-school youth clubs in the central region of Malawi. The pre- and post-test study designs were used to assess mental health literacy - knowledge and attitudes - of 218 educators before and immediately following completion of a 3-day training programme on the use of the AGMv. Results demonstrated a highly significant and substantial improvement in knowledge (p mental health literacy in study participants. There were no significant differences in outcomes related to sex or location. These positive results suggest that an approach that integrates mental health literacy into the existing school curriculum may be an effective, significant and sustainable method of enhancing mental health literacy for educators in Malawi. If these results are further found to be sustained over time, and demonstrated to be effective when extended to students, then this model may be a useful and widely applicable method for improving mental health literacy among both educators and students across Africa.
Gilmara Holanda da Cunha
Full Text Available ABSTRACT Objective: to analyze knowledge produced by research about health literacy for adult with HIV/Aids. Method: an integrative literature review, using six databases, was conducted between January and April of 2014. The descriptors aids and Health Literacy were used, in Portuguese, English and Spanish. A total of 130 articles were found and 14 were selected. Three categories were identified: educational technologies and health literacy for HIV/Aids; assessment of health literacy of patients with HIV/Aids; and health literacy and adherence to antiretroviral therapy. Results: analysis of health literacy, socioeconomic status and educational level of people living with HIV/ Aids was essential for implementation of educational strategies that increased adherence to health guidance. Conclusion: this study showed the importance of health literacy for working with people living with HIV/Aids, especially considering individuals who did not possess the minimum necessary for survival, which makes it relevant and encourages further research on the topic.
Apolinario, Daniel; Mansur, Leticia L; Carthery-Goulart, Maria T; Brucki, Sonia M D; Nitrini, Ricardo
The purpose of this study was to explore the relationship between health literacy and specific cognitive abilities in hospital users. A neuropsychological battery was administered and the Short Test of Functional Health Literacy in Adults was used to classify individuals as having adequate or limited functional health literacy. Of the 322 participants, 102 (31.7%) presented limited health literacy. Even after adjusting for demographics, years of education, and quality of education, health literacy was strongly associated with measures of cognitive performance, but the strength of association was variable across different cognitive abilities. © The Author(s) 2014.
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.
Yamashita, Takashi; Brown, J Scott
Growing empirical evidence supports the generally positive relationship between education, health literacy and health outcomes. However, little is known about cohort in this relationship. This study examined the role of cohort defined by 10-year age period in the association between educational attainment, health literacy and self-rated health. The data were obtained from the 2003 National Assessment of Adult Literacy survey restricted file. Focusing on nationally representative community-dwelling adults age 25 years and older, self-rated health was modeled as a function of health literacy, educational attainment, cohorts (defined by 10-year age periods), other demographic characteristics and socio-economic status. While the youngest cohort was positively associated with self-rated health, middle-age cohorts were more likely to have lower self-rated health (compared with the age 65 years and older cohort). Interestingly, age was no longer statistically significant after adjusting for cohort and other covariates. Recognition of possible cohort effects in education, health literacy and health should be reflected in future health literacy research and intervention programs for addressing health disparities in the USA.
Conclusions: Limited or insufficient health literacy was associated with reduced adoption of protective behaviours such as immunization, and an inadequate understanding of antibiotics, although the relationship was not consistent. Large gaps remain in relation to infectious diseases with a high clinical and societal impact, such as tuberculosis and malaria.
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…
Grace, Marcus; Woods-Townsend, Kathryn; Griffiths, Janice; Christodoulou, Andri; Byrne, Jenny; Bay, Jacquie; Godfrey, Keith; Inskip, Hazel; Hanson, Mark
This article outlines a project called "LifeLab," developed by researchers at the Education School, Faculty of Medicine and the NIHR Biomedical Research Centre at the University of Southampton (UK), to promote a science-oriented approach to health literacy among teenagers. The main purposes of "LifeLab" are: (1) to improve…
May 20, 2011 ... Abstract. 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 ...
McQuistan, Michelle R
The association between oral health literacy and missed dental appointments. Baskaradoss JK. JADA 2016;147(11):867-74. Information not available TYPE OF STUDY/DESIGN: Unmatched case-control study that used a convenience nonprobability sampling method. Copyright © 2017 Elsevier Inc. All rights reserved.
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 ...
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...
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
Cordasco, Kristina M.; Homeier, Diana C.; Franco, Idalid; Wang, Pin-Chieh; Sarkisian, Catherine A.
Objective: We describe the performance of Single Item Literacy Screener (SILS) questions, and educational attainment, as screening for inadequate health literacy (IHL) in older monolingual Spanish speakers. Design: We used a cross-sectional design, interviewing participants once at the time of their arrival for a clinic appointment. Setting: We…
Ip, Eric J; Tang, Terrill T-L; Cheng, Vincent; Yu, Junhua; Cheongsiatmoy, Derren S
Patient understanding of acetaminophen is important for its safe and appropriate self-use. A cross-sectional survey was conducted in the San Francisco Bay Area to determine the impact of educational level, patient health literacy score, and other demographic characteristics on acetaminophen knowledge. A 17-item, in-person, paper-and-pen questionnaire containing questions about demographics and acetaminophen knowledge was administered to 311 adults outside 5 local grocery stores in varying socioeconomic communities. Knowledge assessed was whether Tylenol-McNeil contains acetaminophen, maximum daily dose, and primary organ affected by toxicity. Participant health literacy was evaluated using the Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF) test. Of the 300 who successfully completed the study, only 3.8% of all subjects were able to answer all 3 acetaminophen knowledge questions correctly regardless of educational level or health literacy score. This reaffirms that a lack of appropriate acetaminophen knowledge remains present in the general population, and further efforts to educate patients will be needed to prevent adverse events. © The Author(s) 2014.
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
van den Putte, Bas; Giani, Stefano; van Weert, Julia CM
Background 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. Objective 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. Methods 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. Results 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. Conclusions 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
Haghighi, Soheila Tontab; Lamyian, Minoor; Granpaye, Loabat
Health literacy is one of the main determinants of health promotion. Regarding the influential role of the women in a society, enhancing their critical health literacy would be a prerequisite for the promotion of public health. The aims of this study were to determine the level of health literacy among fertile Iranian women with breast cancer and to determine the relationship between the health literacy level and socio demographic factors, such as age, educational level, occupation, age of marriage, duration of marriage, and several clinical factors, including taking psychiatric medication and the type of breast surgery among breast cancer patients. This cross-sectional study was conducted on 260 fertile patients with breast cancer from screening and monitoring centers and breast cancer clinics in Tehran from August 2014 to August 2015. Data were collected using socio demographic and clinical questionnaires developed by the researchers and the questionnaire for health literacy for Iranian adults (HELIA).The results were analyzed using SPSS-IBM version 20 and the Pearson product-moment correlation coefficient, along with Kido's correlation test. The mean age of the participants was 43.32. Most of the participants (68.5%) had high school diplomas or lower school degrees (based on educational system in Iran). The mean score of health literacy was 75.73. The levels of health literacy among the different groups of participants were as follows: insufficient health literacy (6.9% of patients), barely enough health literacy (18.8% of patients), enough health literacy (38.8% of patients) and excellent health literacy (35.1% of patients). Also, significant relationships were found between the level of health literacy and the participants' age of marriage, duration of marriage, educational level, and occupation (p literacy was high among women with breast cancer. This indicates that their high level of health literacy might be used as a contributor to the promotion of the
Zambrana, Ruth E; Meghea, Cristian; Talley, Costellia; Hammad, Adnan; Lockett, Murlisa; Williams, Karen Patricia
Health literacy and the family can be used to promote cancer screenings. We examined the associations of socio-demographic factors, family communication, and cancer literacy in a diverse population. Baseline data from the Kin Keeper(SM) Cancer Prevention randomized controlled trial were analyzed for Black (n=216), Latino (n=65), and Arab (n=235) women. Key variables were based on the Family Adaptability and Cohesion Scale IV, and the Cancer Literacy Assessment Tool. Among Blacks, cervical cancer literacy was positively associated with family communication. Cancer literacy was associated with higher educational level, employment, and family self-rated health status among Black and Arab women. Among Latinas, who were the least educated and had the lowest literacy scores, family communication was inversely related to breast cancer literacy. Family-centered networks may be a viable resource for the transmission of health cancer literacy information, inform health care decision-making, and contribute to decreasing breast and cervical cancer mortality.
Yee, Lynn M; Niznik, Charlotte M; Simon, Melissa A
Diabetes during pregnancy is a substantial and growing public health problem disproportionately affecting women in racial/ethnic minority communities. Health literacy and numeracy are skills needed to function in the health care environment. By definition, health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Health literacy is increasingly recognized as an important mediator of health disparities in the United States, yet it has been rarely studied during pregnancy. Thus, this article aims to describe the problem of inadequate health literacy, outline the relationships between inadequate health literacy and poor health outcomes, and discuss diabetes-specific associations with health literacy. Although literacy has been insufficiently studied during pregnancy, a limited body of work suggests inadequate health literacy may be associated with lesser knowledge and self-care behaviors among pregnant women with diabetes. Health literacy-focused clinical "pearls" for the care of pregnant women with diabetes include: to use multiple educational modalities, to employ teach-back methods, to validate understanding, to provide specific and concrete counseling, and to offer focused, limited messaging. Lastly, future research directions regarding diabetes, health literacy, and pregnancy are addressed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Wallace, Andrea S; Perkhounkova, Yelena; Bohr, Nicole L; Chung, Sophia Jihey
Patient characteristics and lack of preparedness are associated with poor outcomes after hospital discharge. Our purpose was to explore the association between patient characteristics and patient- and nurse-completed Readiness for Hospital Discharge Scale (RHDS). We conducted a prospective study of 70 Veterans being discharged from medical and surgical units. Differences in RHDS knowledge subscale scores were found among literacy levels, with lower perceived knowledge reported for those with marginal or inadequate literacy (p = .03). Differences in RHDS expected support subscale scores were also found, with those who were unmarried and/or living alone (p discharge. No other differences were found. Similar differences were found for the RHDS completed by nurses. These findings suggest that the RHDS appears responsive to differences in health literacy and social environment, adding to evidence of its utility as a tool to identify, and plan interventions for, those at risk for readmission. © The Author(s) 2016.
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...... 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.......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...
Ingram, Racquel; Kautz, Donald D
Low health literacy in patients and families has been called a silent epidemic. Although there is a great deal of literature to assist nurses to address health literacy problems, little has focused on overcoming low health literacy in critical care. This article provides a definition of health literacy, explores how Baker's health literacy model can be applied to the critical care environment using Osborne's practical strategies, and presents 2 patient scenarios in which addressing low health literacy changed the outcomes for the patient and family. The article concludes with recommendations for critical care nurses to overcome low health literacy of patients and their families.
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.
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.
Morris, Nancy S.; Field, Terry S.; Wagner, Joann L.; Cutrona, Sarah L.; Roblin, Douglas W.; Gaglio, Bridget; Williams, Andrew E; Han, Paul J. K.; Costanza, Mary E.; Mazor, Kathleen M
Using a multidimensional assessment of health literacy (the Cancer Message Literacy Test-Listening, the Cancer Message Literacy Test-Reading, and the Lipkus Numeracy Scale), the authors assessed a stratified random sample of 1013 insured adults (40?70 years of age). The authors explored whether low health literacy across all 3 domains (n = 111) was associated with sets of variables likely to affect engagement in cancer prevention and screening activities: (a) attitudes and behaviors relating ...
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.
This research explored the effectiveness of narrative advertising and argument advertising in increasing mental illness (depression) literacy. Results showed that narrative advertising was more effective than argument advertising at engaging participants in experiential immersion, resulting in greater sympathy toward those suffering from depression. In addition, narrative advertising better involved participants in issue elaboration and increased willingness to seek professional help. Finally, in comparison with argument advertising, narrative advertisements were rated higher in providing vivid information, resulting in an increase in participants' perceived efficacy in recognizing friends or family suffering from depression.
Kandula, Namratha R; Nsiah-Kumi, Phyllis A; Makoul, Gregory; Sager, Josh; Zei, Charles P; Glass, Sara; Stephens, Quinn; Baker, David W
Multimedia diabetes education programs (MDEP) have the potential to improve communication and education of those with low health literacy. We examined the effect of a MDEP targeted to patients with low literacy on knowledge and assessed the association between literacy and knowledge improvement. We showed the MDEP to 190 patients recruited from clinics at a federally qualified health center and an academic health center. We measured diabetes knowledge before and after viewing the MDEP. Seventy-nine percent of patients had adequate literacy, 13% marginal, and 8% inadequate literacy. Patients across all literacy levels had significant increases in knowledge scores after viewing the MDEP (p-valueliteracy learned significantly less after the MDEP (adjusted beta-coefficient=-2.3, SE=0.70) compared to those with adequate literacy. A MDEP designed for those with low literacy significantly increased diabetes knowledge across literacy levels. However, the MDEP did not overcome the learning gap between patients with low and high literacy. A literacy appropriate MDEP may be an effective way to teach patients about diabetes. Combining the MDEP with other education methods may improve comprehension and learning among those with low literacy. Research is needed to identify which characteristics of low-literate patients influence the ability to learn health information. Identifying these factors and incorporating solutions into a diabetes education intervention may help bridge the learning gap related to literacy status.
Pop, Oana M; Brînzaniuc, Alexandra; Sirlincan, Emanuela O; Baba, Catalin O; Chereches, Razvan M
Health literacy improves knowledge and builds skills to help individuals make appropriate decisions regarding their health. Over the past 20 years, several studies have described associations between health literacy and health outcomes. With respect to Romania, evidence is scarce on the level of health literacy, as well as on its determinants. Thus, the objectives of this study were to briefly screen functional health literacy levels in a sample of rural inhabitants, to assess the relationship between health literacy and reported health status, as well as to explore health literacy determinants within this population. Data were collected between September-November 2010, in four villages in Cluj County, Romania, using a cross-sectional survey. The mean age of respondents in the sample was 56 years, with roughly half of respondents being retired. The brief screening of health literacy suggested inadequate to marginal levels within the sample. Significant associations were observed between health literacy score and education, and self-perceived health status, whereas the relationship between health literacy and gender, and the presence of a chronic disease was not statistically significant. Limited health literacy has been shown to be common in people who rated their health as poor, those who attended only middle school, and individuals lacking basic information about their body. In order to minimize the adverse effects of low health literacy on health and health outcomes, efforts should be invested in identifying and addressing the health needs of adults with low and marginal health literacy, especially in underserved areas such as rural and remote settings, where access to health-related information is limited.
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.
Anne E M Brabers
Full Text Available 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 resources needed for people to access, understand and use information to make decisions about their health. This study aimed to examine the relationship between health literacy and self-reported patient involvement. With respect to health literacy, we focused on those competences relevant for medical decision-making. We hypothesized that people with higher health literacy report that they are more involved in medical decision-making. A structured questionnaire was sent to members of the Dutch Health Care Consumer Panel in May 2015 (response 46%, N = 974. Health literacy was measured using five scales of the Health Literacy Questionnaire. A regression model was used to estimate the relationship between health literacy and self-reported involvement. In general, our results did not show a relationship between health literacy and self-reported involvement. We did find a positive significant association between the health literacy scale appraisal of health information and self-reported involvement. Our hypothesis was partly confirmed. The results from this study suggest that higher order competences, that is to say critical health literacy, in particular, are important in reporting involvement in medical decision-making. Future research is recommended to unravel further the relationship between health literacy and patient involvement in order to gain insight into whether health literacy might be an asset to enhance patient participation in medical decision-making.
Brabers, Anne E M; Rademakers, Jany J D J M; Groenewegen, Peter P; van Dijk, Liset; de Jong, Judith D
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 resources needed for people to access, understand and use information to make decisions about their health. This study aimed to examine the relationship between health literacy and self-reported patient involvement. With respect to health literacy, we focused on those competences relevant for medical decision-making. We hypothesized that people with higher health literacy report that they are more involved in medical decision-making. A structured questionnaire was sent to members of the Dutch Health Care Consumer Panel in May 2015 (response 46%, N = 974). Health literacy was measured using five scales of the Health Literacy Questionnaire. A regression model was used to estimate the relationship between health literacy and self-reported involvement. In general, our results did not show a relationship between health literacy and self-reported involvement. We did find a positive significant association between the health literacy scale appraisal of health information and self-reported involvement. Our hypothesis was partly confirmed. The results from this study suggest that higher order competences, that is to say critical health literacy, in particular, are important in reporting involvement in medical decision-making. Future research is recommended to unravel further the relationship between health literacy and patient involvement in order to gain insight into whether health literacy might be an asset to enhance patient participation in medical decision-making.
Cha, EunSeok; Besse, Jennifer Lee
Implications for practice and research: Obesogenic infant care behaviours may increase childhood obesity, and predict obesity and related health risks in adulthood. Poor parent health literacy predicts poor child health outcomes including childhood obesity. Nurses should assess parent health literacy and provide appropriate support to prevent obesogenic infant care behaviours. Future research could focus on evaluating parent educational programmes tailored to health literacy level and effectiveness on reducing obesogenic care behaviours.
This study investigates whether literacy skills are a distinct dimension of education that influences young adults' health in the southeast African context of Malawi. It uses new data from Tsogolo la Thanzi, a study of young adults in southern Malawi, to achieve three aims. The first is descriptive: to demonstrate a direct assessment for measuring literacy in a population-based survey, and show that it captures variability in skills among young adults, including those with comparable levels of educational attainment. The second aim is to identify whether literacy influences young adults' health - net of their educational attainment and other confounding factors. Multivariate analyses reveal that literacy is associated with two measures of physical health: self-rated health and prolonged sickness. Because literacy is a key determinant of health, the third aim is to provide insight into how to measure it: can commonly used indirect approaches to estimating literacy (e.g., based on educational attainment or self-reports), accurately capture its prevalence and relationship with health? In a second set of analyses, bivariate results show whether, and the extent to which, indirect measures of literacy overestimate literacy's prevalence, and multivariate models assess whether indirect estimates of literacy capture its relationship with health. The findings support future efforts to incorporate literacy assessments into population surveys to accurately estimate literacy's prevalence and health benefits, particularly in contexts like Malawi where access to high-quality schools remains limited. Copyright © 2014 Elsevier Ltd. All rights reserved.
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 < .001), less education (p < .001), and lower income (p = .006). Limited health 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.
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
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
One in five individuals living in the United States has deficient literacy skills, contributing to challenges navigating a complex health system. Low health literacy is a burden to individuals and to society, with global implications to the most vulnerable, including older women. Findings of this qualitative study support the current literature in that health literacy is a social commodity bound to health care access, health promotion, health protection and disease prevention. New insights highlight the importance of the patient-clinician relationship and a focus on patient-centered care to identify and address health literacy needs. Essential themes identified by participants as requisite to working with low literacy older females are time, relationships, communication, education, and empowerment. Although each may be viewed independently, their overlapping was recognized as key to optimizing health, and of this list, relationships and communication were identified as critical to enhancing minimal health literacy in the clinical setting. Copyright © 2015 Elsevier Inc. All rights reserved.
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 HbA1...... across eight 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......c 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 Hb...
Tique, José A; Howard, Leigh M; Gaveta, Sandra; Sidat, Mohsin; Rothman, Russell L; Vermund, Sten H; Ciampa, Philip J
The role of health literacy on HIV outcomes has not been evaluated widely in Africa, in part because few appropriate literacy measures exist. We developed a 16-item scale, the HIV Literacy Test (HIV-LT) to assess literacy-related tasks needed to participate in HIV care. Items were scored as correct or incorrect; higher scores indicated higher literacy skill (range 0-100 %). We tested internal reliability (Kuder-Richardson coefficient) of the HIV-LT in a convenience sample of 319 Portuguese-speaking, HIV infected adults on antiretroviral treatment in Maputo, Mozambique. Construct validity was assessed by a hypothetical model developed a priori. The HIV-LT was reliable and valid to measure participants' literacy skills. The mean HIV-LT score was 42 %; literacy skills applicable to HIV care were challenging for many participants. The HIV-LT could be used to assess the relationship of literacy and HIV-related outcomes in diverse settings, and evaluate interventions to improve health communication for those in HIV care.
Neter, Efrat; Brainin, Esther
Electronic health (eHealth) literacy of consumers is essential in order to improve information and communication technology (ICT) use for health purposes by ordinary citizens. However, performed eHealth literacy is seldom studied. Therefore, the present study assessed perceived and performed eHealth literacy using the recent conceptualization of health literacy skills. The aim of this paper was to examine the association between perceived and performed eHealth literacies. In total, 82 Israeli adults participated in the study, all 50 years and older, with a mean age of 67 (SD 11). Of the participants, 60% (49/82) were women and 72% (59/82) had a post-secondary education. The participants were first surveyed and then tested in a computer simulation of health-related Internet tasks. Performed, perceived (eHealth Literacy Scale, eHEALS), and evaluated eHealth literacy were assessed, and performed eHealth literacy was also recorded and re-evaluated later. Performance was scored for successful completion of tasks, and was also assessed by two researchers for motivation, confidence, and amount of help provided. The skills of accessing, understanding, appraising, applying, and generating new information had decreasing successful completion rates. Generating new information was least correlated with other skills. Perceived and performed eHealth literacies were moderately correlated (r=.34, P=.01) while facets of performance (ie, digital literacy and eHealth literacy) were highly correlated (r=.82, Pliteracy were significantly different: low performers were older and had used the Internet for less time, required more assistance, and were less confident in their conduct than high performers. The moderate association between perceived and performed eHealth literacy indicates that the latter should be assessed separately. In as much, the assessment of performed eHealth literacy in clinical settings should entail the structuring of tasks as well as shortening and automatizing
Shu-Fang Shih; Chieh-Hsing Liu; Li-Ling Liao; Osborne, Richard H.
Abstract Background Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people’s control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and ...
Lundetræ, Kjersti; Gabrielsen, Egil
This study investigated the association between literacy skills and self-reported health among Danish ( n = 7284), Finnish ( n = 5454), Norwegian ( n = 4942) and Swedish ( n = 4555) participants aged 16-65 years. Logistic regression models were used to assess the association between literacy skills and self-reported health after adjusting for sex, age and educational level. Nordic participants aged 16-65 years with literacy skills at the lowest level reported sub-optimal health more often (28-37%) than those with literacy skills at the highest level (7-9%). After adjusting for sex, age and educational level, the likelihood of reporting sub-optimal health was 1.99-3.24 times as high for those with literacy skills at the lowest level as for those with literacy skills at the highest level. These results suggest that poor literacy skills increase the likelihood of experiencing poor health in the Nordic countries, even after controlling for educational level.
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.
Sequeira, Shwetha S; Eggermont, Laura H P; Silliman, Rebecca A; Bickmore, Timothy W; Henault, Lori E; Winter, Michael R; Nelson, Kerrie; Paasche-Orlow, Michael K
Limited health literacy is associated with worse executive function, but the association between limited health literacy and decline in executive function has not been established because of a lack of longitudinal studies. The authors aimed to examine this association by studying a prospective cohort in the setting of a randomized controlled trial to promote walking in older adults. Participants were community-dwelling older adults (65 years of age or older) who scored 2 or more on the Mini-Cog, without depression (score of less than 15 on the 9-item Patient Health Questionnaire), and who completed baseline and 12-month evaluations (n = 226). Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Executive function measured at baseline and 12 months using the Trail Making Test (TMT), Controlled Oral Word Association Test, and Category Fluency. The associations between health literacy and 12-month decline in each test of executive function were modeled using multivariate linear regression. Health literacy was found to be limited in 37% of participants. Limited health literacy was associated with reduced performance on all 3 executive function tests. In fully adjusted models, limited health literacy was associated with greater 12-month decline in performance on the TMT than higher health literacy (p = .01). In conclusion, older adults with limited health literacy are at risk for more rapid decline in scores on the TMT, a measure of executive function.
Thewes, Belinda; McCaffery, Kirsten; Davis, Esther; Garvey, Gail
Indigenous people experience poorer cancer survival outcomes compared with non-Indigenous people. Currently, there is growing awareness of poor health literacy as a determinant of cancer outcomes. However, little attention has been given to researching cancer-related health literacy amongst Indigenous people. To systematically review empirical studies of cancer health literacy amongst Indigenous people worldwide. Articles were identified in Medline (1946-2013); Pre-Medline; CINAHL; PsycINFO (1967-2013); PubMed; Current Contents/All Editions (1993-2013); Allied Health and Complimentary Medicine (1985-2013), and in the reference lists of retrieved articles and by expert consultation. 64 abstracts were screened for inclusion and 16 articles were retained. There is a paucity of high-quality research concerning of health literacy amongst Indigenous cancer patients. No articles used formal measures of health literacy and data on the prevalence of health literacy was not reported. Of the 7 articles describing interventions only one included a control group and the remainder employed quasi-experimental methods. Research is needed to explore the cultural relevance of existing measures of health literacy and to document the prevalence of health literacy amongst Indigenous people with cancer. A better understanding of Indigenous cancer patients' health literacy is required before health literacy interventions can be designed to improve Indigenous cancer outcomes. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
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.
Banister, Elizabeth M; Begoray, Deborah L; Daly, L Kim
Adolescents have particular needs in health care that are often not met. Health care providers can help overcome barriers that hinder adolescents' effective use of health services by incorporating health literacy strategies that are developmentally and contextually appropriate, and that actively involve adolescents in their own learning. Based on extensive practice and research experience in Canada with rural and urban high school adolescent women, we offer suggestions for how health care providers can respond to adolescent women's reproductive health concerns by teaching these young women how to increase their skills in functional, communicative/interactive, and critical health literacy.
Johnston, Robyn; Fowler, Cathrine; Wilson, Valerie; Kelly, Michelle
Most families can access a range of health information and advice. Information and advice sources often include nurses, the Internet, social media, books, as well as family and friends. While the immediate aim may be to find information, it can also be to assist with parenting skills, solve parenting problems or as part of decision-making processes about their child's health. These processes are strongly influenced by the parent's level of health literacy. Health literacy describes a person's capacity to obtain and utilize health related information. Although there are numerous health literacy definitions all have clearly defined steps. These steps are: obtaining relevant information; then understanding this information; and finally being able to use the information to achieve the expected outcome. Previous research has linked low levels of parental health literacy with poorer child health outcomes. Given this link, increasing health literacy levels would be advantageous for both families and health services. Nurses working with families are in a position to support the family to increase their health literacy through the use of a variety of strategies. This article outlines how health literacy can influence the way parents seek help when they are concerned about child health issues, the relevance of parental health literacy for nurses and suggests some tools that could be used to support the increase of health literacy.
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.
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
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
Maindal, H.T.; Rademakers, J.
Health literacy is increasingly being recognised as a crucial `determinant of health and health inequality all over the world. Health literacy enables people to make judgements and take decisions in everyday life concerning healthcare, disease prevention and health promotion to maintain or improve
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.
Rowlands, Gill; Khazaezadeh, Nina; Oteng-Ntim, Eugene; Seed, Paul; Barr, Suzanne; Weiss, Barry D
Health literacy (HL) is an important public health issue. Current measures have drawbacks in length and/or acceptability. The US-developed Newest Vital Sign (NVS) health literacy instrument measures both reading comprehension and numeracy skills using a nutrition label, takes 3 minutes to administer, and has proven to be acceptable to research subjects. This study aimed to amend and validate it for the UK population. We used a three-stage process; (1) a Delphi study with academic and clinical experts to amend the NVS label to reflect UK nutrition labeling (2) community-based cognitive testing to assess and improve ease of understanding and acceptability of the test (3) validation of the NVS-UK against an accepted standard test of health literacy, the Test of Functional Health Literacy in Adults (TOFHLA) (Pearson's r and the area under the Receiver Operating Characteristic (ROC) curve) and participant educational level. A sample size calculation indicated that 250 participants would be required. Inclusion criteria were age 18-75 years and ability to converse in English. We excluded people working in the health field and those with impaired vision or inability to undertake the interview due to cognitive impairment or inability to converse in English. In the Delphi study, 28 experts reached consensus (3 cycles). Cognitive testing (80 participants) yielded an instrument that needed no further refinement. Validation testing (337 participants) showed high internal consistency (Cronbach's Alpha = 0.74). Validation against the TOFHLA demonstrated a Pearson's r of 0.49 and an area under the ROC curve of 0.81. The NVS-UK is a valid measure of HL. Its acceptability and ease of application makes it an ideal tool for use in the UK. It has potential uses in public health research including epidemiological surveys and randomized controlled trials, and in enabling practitioners to tailor care to patient need.
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
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.
Levin-Zamir, Diane; Leung, Angela Yee Man; Dodson, Sarity; Rowlands, Gillian
International and cultural perspectives of health literacy help deepen the understanding of the global context within which health literacy plays an important role. Throughout this chapter, we explore the significance of health literacy initiatives, interventions, practices, and research for addressing health challenges on a variety of levels in the international and global context. More specifically, in this chapter, the notion of health literacy as a dynamic construct is introduced, after which we examine health literacy throughout the life course, emphasizing the impact of health literacy among children and the elderly in their families and in the community. Cultural norms and family interpersonal relations, and values influence health literacy and need to be considered when closing the health literacy disparities. Global trends of migration and immigration bring to the forefront the need for unravelling the complexity of health systems, for which health literacy plays a central role; health literacy initiatives address cultural differences between providers and patients to help narrow the communication gap. The importance of cultural competency among health care providers exemplifies how capacity building in health literacy is critical for maximizing the benefits to the public of the health care system. Health literacy provides a conceptual foundation for community participatory research, involving members of the public to take part in the planning, execution and evaluation of health education interventions. Throughout the chapter, selected case studies and picture boxes from around the globe, exemplify aforementioned topics of interest, showcased in the chapter. Practical recommendations for policy makers, practitioners and research are offered based on the studies conducted in the international context.
Soones, Tacara N; Lin, Jenny L; Wolf, Michael S; O'Conor, Rachel; Martynenko, Melissa; Wisnivesky, Juan P; Federman, Alex D
Limited health literacy is associated with low adherence to asthma controller medications among older adults. We sought to describe the causal pathway linking health literacy to medication adherence by modeling asthma illness and medication beliefs as mediators. We recruited adults aged 60 years and older with asthma from hospital and community practices in New York, New York, and Chicago, Illinois. We measured health literacy and medication adherence using the Short Test of Functional Health Literacy in Adults and the Medication Adherence Rating Scale, respectively. We used validated instruments to assess asthma illness and medication beliefs. We assessed cognition using a cognitive battery. Using structural equation modeling, we modeled illness and medication beliefs as mediators of the relationship between health literacy and adherence while controlling for cognition. Our study included 433 patients with a mean age of 67 ± 6.8 years. The sample had 84% women, 31% non-Hispanic blacks, and 39% Hispanics. The 36% of patients with limited health literacy were more likely to have misconceptions about asthma (P medications (P adherence mediated by medications concerns (β = 0.033; P = .002). Neither medication necessity (β = 0.044; P = .138) nor illness beliefs (β = 0.007; P = .143) demonstrated a mediational role between health literacy and adherence. Interventions designed to improve asthma controller medication adherence in older adults may be enhanced by addressing concerns about medications in addition to using communication strategies appropriate for populations with limited health literacy and cognitive impairments. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Willis, C D; Saul, J E; Bitz, J; Pompu, K; Best, A; Jackson, B
Despite the growing significance of health literacy to public health, relatively little is known about how organizational capacity may be improved for planning, implementing and sustaining health literacy interventions. This study aimed to connect decision makers in a public health agency with evidence of how organizational capacity may be improved for delivering health literacy services. A rapid realist review of published and grey literature was conducted by a partnership between the Public Health Agency of Canada (PHAC) and the InSource Research Group. Realist review methodology attempts to understand what works for whom under what circumstances, and is characterized by its focus on strategies/interventions, contexts, mechanisms and their relationship to outcome. This review was completed in collaboration with a reference panel (comprised of a broad range of PHAC representatives) and an expert panel. Literature searching was conducted using three databases supplemented with bibliographic hand searches and articles recommended by panels. Data were extracted on key variables related to definitions, strategies/interventions associated with increased organizational capacity, contextual factors associated with success (and failure), mechanisms activated as a result of different strategies and contexts, key outcomes, and evidence cited. Strategies found to be associated with improved organizational capacity for delivering health literacy services may be classified into three domains: (1) government action; (2) organizational/practitioner action; and (3) partnership action. Government action includes developing policies to reinforce social norms; setting standards for education; conducting research; and measuring health literacy levels. Organizational/practitioner action relates to appropriate models of leadership (both high-level government engagement and distributed leadership). Innovative partnership action includes collaborations with media outlets, those producing
McLuckie, Alan; Kutcher, Stan; Wei, Yifeng; Weaver, Cynthia
Background 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. Methods We cond...
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.
Echeverri, Margarita; Anderson, David; Nápoles, Anna María
Health literacy is a dynamic construct that changes with specific health conditions; thus, new disease-specific health literacy tools are needed. Since cancer is the leading cause of death among Latinos, the largest and fastest-growing minority population in the nation, there is a need to develop tools to assess cancer health literacy (CHL) among the Spanish-speaking population. The Cancer Health Literacy Test, Spanish version (CHLT-30-DKspa) was applied to identify Spanish-speaking individuals with low CHL and ascertain which items in the tool best discriminate between CHL level groups. Cross-sectional field test of the CHLT-30-DKspa among Spanish-speaking Latinos. Latent class analysis (LCA) identified participants with varying CHL levels. Probability of correct answers, odds ratios, and standardized errors were used to identify the items that allow the classification of individuals among the latent classes. LCA resulted in a three-latent-class model predicting 39.4% of participants to be in the HIGH class, 43.3% in the MEDIUM class, and 17.3% in the LOW class. Eleven items (the CHLT-11-DKspa) meet the criteria to clearly separate participants with HIGH and LOW classes of CHL. Although the best model fit was a three-class solution, results showed a clear separation of individuals from HIGH versus LOW levels of CHL, but separation of those in the MEDIUM level was not as clear. The CHLT-11-DKspa is a shorter measure that may be relatively easy to use in a clinical encounter to identify Spanish-speaking patients with the poorest levels of CHL who may require additional support to understand medical instructions and care plans.
Griffey, Richard T; Kennedy, Sarah K; D'Agostino McGowan, Lucy; McGownan, Lucy; Goodman, Melody; Kaphingst, Kimberly A
The objective was to determine whether patients with low health literacy have higher emergency department (ED) utilization and higher ED recidivism than patients with adequate health literacy. The study was conducted at an urban academic ED with more than 95,000 annual visits that is part of a 13-hospital health system, using electronic records that are captured in a central data repository. As part of a larger, cross-sectional, convenience sample study, health literacy testing was performed using the short test of functional health literacy in adults (S-TOFHLA) and standard test thresholds identifying those with inadequate, marginal, and adequate health literacy. The authors collected patients' demographic and clinical data, including items known to affect recidivism. This was a structured electronic record review directed at determining 1) the median number of total ED visits in this health system within a 2-year period and 2) the proportion of patients with each level of health literacy who had return visits within 3, 7, and 14 days of index visits. Descriptive data for demographics and ED returns are reported, stratified by health literacy level. The Mantel-Haenszel chi-square was used to test whether there is an association between health literacy and ED recidivism. A negative binomial multivariable model was performed to examine whether health literacy affects ED use, including variables significant at the 0.1 alpha level on bivariate analysis and retaining those significant at an alpha of 0.05 in the final model. Among 431 patients evaluated, 13.2% had inadequate, 10% had marginal, and 76.3% had adequate health literacy as identified by S-TOFHLA. Patients with inadequate health literacy had higher ED utilization compared to those with adequate health literacy (p = 0.03). Variables retained in the final model included S-TOFHLA score, number of medications, having a personal doctor, being a property owner, race, insurance, age, and simple comorbidity score
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.
Shibata, Ai; Ishii, Kaori; Oka, Koichiro
Background 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. Objective 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. Methods 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. Results 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
Smith, Samuel G; Curtis, Laura M; Wardle, Jane; von Wagner, Christian; Wolf, Michael S
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, pdefinition. Deficits in either construct could be useful targets for behavioral intervention.
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.
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.
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 socio-demographic 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 socio-demographic 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 vary among diverse audiences. Black/AAs with low eHealth literacy had high perceived trust in YouTube and Twitter, while Black/AAs 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 socio-demographics and eHealth literacy level of an intended audience when tailoring information through trustworthy online health communication channels and information sources. PMID:28001489
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
Ngoh, Lucy Nkukuma
To present a summary of the existing literature on medication nonadherence, health literacy, and use of written patient information in health care and pharmacy in particular. Searches of Medline, PubMed, and International Pharmaceutical Abstracts databases were conducted using one or more of the following terms: adherence/nonadherence, compliance/noncompliance, printed/written information, literacy, patient education, communication, and health literacy. These terms were combined with the following search terms: drug information, readability, medication/drug, patient, pharmacy/pharmacist, and prescription. References of pertinent articles were hand searched to retrieve additional articles. By the author. Articles were grouped and summarized into three broad categories (nonadherence, health literacy, and communicating health information to patients), with an emphasis on the use of written patient information in health care and pharmacy practice in particular. The complexities inherent in nonadherence behavior, health literacy, and patient education are summarized, and suggestions for enhancing medication adherence, especially for patients with low health literacy skills, are provided. The health literacy skills of American adults have not changed considerably during the previous decade. This makes use of written patient medication information in pharmacy practice problematic for some patients. Limited health literacy has been associated with poorer health, medication nonadherence, medication errors, higher medical expenses, and increased hospitalization. A need exists for identifying patients with limited health literacy and tailoring medication counseling to their needs.
Federman, Alex D; Wolf, Michael S; Sofianou, Anastasia; Martynenko, Melissa; O'Connor, Rachel; Halm, Ethan A; Leventhal, Howard; Wisnivesky, Juan P
To examine self-management behaviors, including medication adherence and inhaler technique, in older adults with asthma and their association with health literacy. Observational cohort study. Primary care and pulmonary specialty practices in two tertiary academic medical centers and three federally qualified health centers in New York, New York, and Chicago, Illinois. Adults with moderate or severe persistent asthma aged 60 and older (N = 433). Outcomes were adherence to asthma controller medications, metered dose inhaler (MDI) and dry powder inhaler (DPI) techniques, having a usual asthma physician, and avoidance of four common triggers. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults. The mean age was 67, and 36% of participants had marginal or low health literacy. Adherence was low (38%) overall and worse in individuals with low health literacy (22%) than in those with adequate literacy (47%, P literacy (MDI technique: OR = 0.57, 95% CI = 0.38-0.85; DPI technique: OR = 0.42, 95% CI = 0.25-0.71). Asthma self-monitoring and avoidance of triggers occurred infrequently but were less consistently associated with low health literacy. Adherence to medications and inhaler technique are poor in older adults with asthma and worse in those with low health literacy. Clinicians should routinely assess controller medication adherence and inhaler technique and use low-literacy communication strategies to support self-management in older adults with asthma. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.
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.
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.
Merker, Vanessa L; McDannold, Sarah; Riklin, Eric; Talaei-Khoei, Mojtaba; Sheridan, Monica R; Jordan, Justin T; Plotkin, Scott R; Vranceanu, Ana-Maria
Determining health literacy level is an important prerequisite for effective patient education. We assessed multiple dimensions of health literacy and sociodemographic predictors of health literacy in patients with neurofibromatosis. In 86 individuals with a confirmed diagnosis of neurofibromatosis 1 (NF1), neurofibromatosis 2 (NF2), or schwannomatosis, we assessed health literacy status using two HL tools-the adapted functional, communicative, and critical health literacy scale (adapted FCCHL) and health literacy assessment using talking touchscreen technology (Health LiTT). Factor analyses of the adapted FCCHL in NF patients showed factor structure and psychometric properties similar to pilot work in other patient populations. As a group, patients with NF had moderate scores on the Health LiTT and moderate to high scores on the adapted FCCHL, with the highest score on the functional health literacy subscale. Patients with NF1, those with lower education and those with learning disabilities had lower scores on Health LiTT; in multivariate analysis, learning disability and education remained significant predictors of HealthLiTT scores. Only lower education was associated with lower adapted FCCHL scores. Results suggest utilizing health literacy tools in NF patients is feasible and could provide physicians with valuable information to tailor health communication to subpopulations with lower health literacy levels.
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.
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 ...
A search of some standard books and relevant articles on health literacy among patients and its implications for health service providers was done using the Google and. Yahoo search engine as well as EMBASE and OVID. MEDLINE data bases. Keywords employed were low health literacy, healthcare impact and health ...
Quenzel, G; Vogt, D; Schaeffer, D
Not everyone seems to have adequate health literacy to take care of their own health. Especially older people, people with migration background, and adolescents with lower educational attainment face challenges when dealing with the healthcare system. Our cross-sectional study focuses on these vulnerable groups. We found that vulnerable populations showed high prevalence of limited health literacy, and there were considerable differences between these groups. Older people were more likely to have limited health literacy compared to younger people. Older people with migration background had the lowest health literacy. © Georg Thieme Verlag KG Stuttgart · New York.
Willens, David E; Kripalani, Sunil; Schildcrout, Jonathan S; Cawthon, Courtney; Wallston, Ken; Mion, Lorraine C; Davis, Corinne; Danciu, Iona; Rothman, Russell L; Roumie, Christianne L
Health literacy impacts health outcomes. However, the relationship to blood pressure is inconsistent. This study aimed to determine whether health literacy, assessed by clinic staff, is associated with blood pressure among patients with hypertension. The design was a cross-sectional study of a large sample of primary care patient encounters in 3 academic medical center clinics in Nashville, Tennessee. Health literacy was assessed using the Brief Health Literacy Screen, with higher scores indicating higher health literacy. Blood pressure was extracted from the electronic health record. Using 23,483 encounters in 10,644 patients, the authors examined the association of health literacy with blood pressure in multivariable analyses, adjusting for age, gender, race, education, and clinic location. Independent of educational attainment, 3-point increases in health literacy scores were associated with 0.74 mmHg higher systolic blood pressure (95% CI [0.38, 1.09]) and 0.30 mmHg higher diastolic blood pressure (95% CI [0.08, 0.51]). No interaction between education and health literacy was observed (p = .91). In this large primary care population of patients with hypertension, higher health literacy, as screened in clinical practice, was associated with a small increase in blood pressures. Future research is needed to explore this unexpected finding.
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.
Ha, Hien; Lopez, Tina
To evaluate the efficacy of case-based learning to teach pharmacy students health literacy concepts and skills in managing patients with limited health literacy. A health literacy patient case was developed and incorporated into a case-based learning laboratory. The case involved a patient with limited health literacy and required students to evaluate and formulate a care plan. A comparison of pretest and posttest scores demonstrated that students gained health literacy knowledge and skills through completion of the patient case. Students believed that the case-based exercise was successful in meeting specific learning objectives for the course. Addition of a case-based learning was effective in teaching pharmacy students health literacy concepts and skills.
Kaphingst, Kimberly A; Goodman, Melody S; MacMillan, William D; Carpenter, Christopher R; Griffey, Richard T
Age is generally an inverse predictor of health literacy. However, the role of cognitive dysfunction among older adults in this relationship is not understood. We conducted a cross-sectional survey of 446 adult patients in a large urban academic level one trauma center, assessing health literacy and cognitive dysfunction. Removing older patients (60 years of age and older) who screened positive for cognitive dysfunction attenuated the relationship between age and health literacy (r=-0.16, p=0.001 vs. r=-0.35, pliteracy than older patients screening negative and patients less than 60 years; health literacy scores did not generally differ significantly between the latter groups. Much of the relationship between age and health literacy was driven by cognitive dysfunction among a subset of older adults. Our findings suggest that older patients with cognitive dysfunction have the greatest need for health literacy interventions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Helmer, Robert S; Ray, Shaunta' M; Byrd, Debbie C
To assess pharmacy residents' perceptions regarding the incorporation of health literacy in pharmacy school and pharmacy residency training and to assess confidence while interacting with patients of limited health literacy. Prospective cross-sectional study. United States from March to May 2012. Postgraduate year (PGY)1 and -2 pharmacy residents and pharmacy residency program directors. Online survey. PGY1 and -2 resident perceptions of health literacy incorporation into pharmacy school and residency training. 939 surveys were completed. Residents agreed that their pharmacy school training encouraged the development of health literacy skills ( P training compared with during or following PGY1 residency training ( P training essential to encountering patients of limited health literacy. Future studies should assess whether these perceptions reflect true health literacy awareness and management among pharmacy residents.
Wångdahl, Josefin M; Mårtensson, Lena I
Health literacy (HL) is an important determinant for health and a valuable health indicator within public health. As such, it is a significant outcome variable of health promotion efforts. Valid and reliable instruments are needed to evaluate health promotion interventions and to assess levels of HL in a population. One of the few measurements of communicative and critical HL is the Japanese Communicative and Critical Health Literacy scale (C & C HL scale). To make it possible to use this instrument in Sweden, the C & C HL scale was translated into Swedish and different aspects of validity, including test-retest reliability, of the translated version were tested. After translation and back-translation, The Swedish C & C HL scale was tested for content validity and test-retest reliability. Data were collected from a committee consisting of public health experts and bilingual people, and from a test group of 35 persons. The Swedish C & C HL scale was understandable and showed evidence of content validity. The test-retest confirmed that it was stable over time, percentage agreements for the items ranging from 66% to 89% (M = 74%). The Swedish C & C HL scale is equivalent to the Japanese C & C HL scale in terms of language and content. The items cover the major aspects of communicative and critical HL and are understandable and stable over time, i.e., reliable.
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, Pliteracy was not associated with numeracy. Participants with limited health literacy (23%), numeracy (43%), or computer literacy (25%) were no less likely to access PWPs or HIT, but lower health literacy was associated with less frequent use of a computer to research diabetes medications or treatments. In focus groups, participants spontaneously commented on family support when accessing and using PWPs or HIT for diabetes management. Participants reported family members facilitated access and usage of HIT, taught them usage skills, and acted as online delegates. Participant statements suggest family members may bridge the HIT "digital divide" in diabetes by helping adults access a PWP or HIT for diabetes management.
Mayberry, Lindsay S.; Kripalani, Sunil; Rothman, Russell L.
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. Methods 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. Results Computer literacy was positively associated with health literacy (r=0.41, Pliteracy was not associated with numeracy. Participants with limited health literacy (23%), numeracy (43%), or computer literacy (25%) were no less likely to access PWPs or HIT, but lower health literacy was associated with less frequent use of a computer to research diabetes medications or treatments. In focus groups, participants spontaneously commented on family support when accessing and using PWPs or HIT for diabetes management. Conclusions Participants reported family members facilitated access and usage of HIT, taught them usage skills, and acted as online delegates. Participant statements suggest family members may bridge the HIT “digital divide” in diabetes by helping adults access a PWP or HIT for diabetes management. PMID:21718098
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
Plummer, Leigh C; Chalmers, Kerry A
Physical activity after a diagnosis of breast cancer is associated with many health benefits. Health literacy has been shown to relate to physical activity, but there is limited research on this relationship. The aim of this study was to explore the relationship between health literacy and physical activity in women diagnosed with breast cancer. Specifically, we examined which of Nutbeam's 3 levels of health literacy (functional, interactive, and critical health literacy) predicted physical activity in women who have completed treatment for breast cancer. Participants were women (N = 36) who had attended a local cancer care centre for breast cancer treatment. During a telephone interview conducted 6 to 18 months after completion of treatment, women completed a measure of health literacy and reported on their engagement in physical activity. Results showed that health literacy predicted physical activity after breast cancer treatment. Of the 3 levels of health literacy proposed by Nutbeam, functional health literacy was shown to be the most important predictor of physical activity. These findings highlight the role of health literacy in physical activity in women diagnosed with breast cancer and have implications for targeted supportive physical activity interventions. Copyright © 2016 John Wiley & Sons, Ltd.
Kayser, Lars; Kushniruk, Andre; Osborne, Richard H
and requirements are under differing contexts of use. The extension of this model involved including knowledge about users' competences within the seven domains of eHealth literacy, which had been identified based on systematic engagement with computer scientists, academics, health professionals, and patients...... model with the domains of a new concept of eHealth literacy. METHODS: This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs...... recruited from various patient organizations and primary care. A concept map was constructed based on a structured brainstorm procedure, card sorting, and computational analysis. RESULTS: The new eHealth literacy concept (based on 7 domains) was incorporated as a key factor in expanding the user...
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...
Heide, I.; 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 study was to examine to what extent functional, interactive and critical health literacy are associated with patients’ perceived control over care and with the frequency of GP visits. Methods: Data f...
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 lifespan 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 ...
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.
Full Text Available Abstract Background Research within the framework of Self-Determination Theory (SDT indicates that patients' autonomy is to be considered a critical health care outcome in its own right since it promotes improved mental and physical health. This paper presents an analysis of studies addressing communication and interaction interventions in health literacy curricula for medical and health care practitioners, focusing on patient-oriented skills in “making sense” and “to adapt and self-manage”. For evaluating interventions, underlying communication models were traced. The criteria for good practice are “making sense” and “supporting autonomy in making choices”. For the search of interventions, keywords from both the framework of the EU-project, Intervention Research on Health Literacy among Ageing population (IROHLA (The IROHLA project received financial support from the European Union through FP7 Grant 305831, as well as the SDT (Self Determination Theory were applied. The research question of this paper is to what degree is autonomy supporting communication skills part of the curricula of health literacy (HL for medical and health care practitioners and providers? A Pubmed search revealed: a that “making sense” is clearly represented in HL interventions in curricula; however, b very few interventions teach medical and health care practitioners how to give autonomy support in the interaction with their (future patients. Four promising, beneficial practices were identified. Several recommendations were presented encouraging curriculum developers to adapt skills of supporting autonomy into their programs. Methods A qualitative content analysis of interventions in the curricula of communication and interaction skills for medical students and practitioners. Results A review of literature indicates: a most interventions in curricula for medical students and practitioners are focusing on skills in adequately providing information to
Veenker, Herman; Paans, Wolter
Research within the framework of Self-Determination Theory (SDT) indicates that patients' autonomy is to be considered a critical health care outcome in its own right since it promotes improved mental and physical health. This paper presents an analysis of studies addressing communication and interaction interventions in health literacy curricula for medical and health care practitioners, focusing on patient-oriented skills in "making sense" and "to adapt and self-manage". For evaluating interventions, underlying communication models were traced. The criteria for good practice are "making sense" and "supporting autonomy in making choices". For the search of interventions, keywords from both the framework of the EU-project, Intervention Research on Health Literacy among Ageing population (IROHLA (The IROHLA project received financial support from the European Union through FP7 Grant 305831)), as well as the SDT (Self Determination Theory) were applied. The research question of this paper is to what degree is autonomy supporting communication skills part of the curricula of health literacy (HL) for medical and health care practitioners and providers? A Pubmed search revealed: a) that "making sense" is clearly represented in HL interventions in curricula; however, b) very few interventions teach medical and health care practitioners how to give autonomy support in the interaction with their (future) patients. Four promising, beneficial practices were identified. Several recommendations were presented encouraging curriculum developers to adapt skills of supporting autonomy into their programs. A qualitative content analysis of interventions in the curricula of communication and interaction skills for medical students and practitioners. A review of literature indicates: a) most interventions in curricula for medical students and practitioners are focusing on skills in adequately providing information to patients by using an underlying (advanced) Sender
Keim-Malpass, Jessica; Letzkus, Lisa C; Kennedy, Christine
Children with special health care needs (CSHCN) are children with medical or behavioral diagnoses that require services beyond those generally needed by pediatric populations. They account for a significant portion of pediatric health care expenditures and often have complicated treatment regiments. Health literacy has recently been recognized as a key indicator of quality chronic disease self-management and parental/caregiver health literacy of CSHCN is an understudied area. The purpose of this systematic review was to assess the available evidence of studies investigating parent/caregiver health literacy of CSHCN. Databases were searched to retrieve relevant articles for inclusion (dating from 1998 to 2014). Only studies that assessed the relationship between parent/caregiver health literacy on outcomes pertinent to CSHCN were included. Because of the limited number of studies, there were no restrictions placed on type of outcome. Thirteen studies were included in the final review with a range of health literacy assessments and outcome ascertainment. The majority of studies; (1) focused on the relationship between parental/caregiver health literacy and asthma outcomes, (2) were cross-sectional study designs, and (3) included samples recruited from pediatric clinics in academic medical settings. There were several gaps in the literature where future research is needed including; (1) direct assessment of child/adolescent health literacy, (2) inclusion of children with co-morbid conditions, (3) further assessment of the relationship between health literacy and health care utilization and cost, and (4) assessment of parental/caregiver health literacy in the inpatient care setting.
Chinn, Deborah; McCarthy, Catherine
Our aim was to develop and pilot a tool to measure health literacy in primary health care settings, encompassing functional, communicative and critical health literacy. Following consultation with providers and users of primary health care we developed a fourteen-item self-report scale, which was piloted on 146 participants. The reliability, content and construct validity of the scale was investigated as well as relationships between scores on the scales and participant characteristics. The overall scale had adequate reliability (Cronbach's alpha=0.74), though reliability of the subscales was less consistent. Principal component analysis indicated that scale items loaded on four factors, corresponding to skills in using written health information; communicating with health care providers; health information management and appraisal assertion of individual autonomy with regards to health. Overall scores and different subscale scores were associated with ethnic minority status, educational level, and self-rated health status, though the picture was complex. Health literacy is a complex and evolving construct. Nevertheless, we succeeded in developing a brief measure relating to different health literacy competencies, beyond functional literacy skills. Assessment using the AAHLS can provide important information for health care practitioners about the health literacy needs and capabilities of service users. Copyright © 2012 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.
Geboers, Bas; de Winter, Andrea F.; Luten, Karla A.; Jansen, Carel J. M.; Reijneveld, Sijmen A.
Inadequate health literacy is a common problem among older adults and is associated with poor health outcomes. Insight into the association between health literacy and health behaviors may support interventions to mitigate the effects of inadequate health literacy. The authors assessed the
Manganello, Jennifer A.; DeVellis, Robert F.; Davis, Terry C.; Schottler-Thal, Carrin
Background Health literacy has been found to be a crucial component of successful communication and navigation in health care. Various tools have been developed to measure health literacy skills, but few have been developed specifically for adolescents, and most require in-person administration. This study sought to develop a self-report health literacy scale for adolescents to assess four key health literacy domains: the ability to obtain, communicate, understand, and process health information. Methods We collected data from 272 youth aged 12–19 recruited from a pediatrics clinic (37%) and the community (63%). We administered the Rapid Estimate of Adolescent Literacy in Medicine-Teen, Newest Vital Sign, and three surveys, and used factor analysis to identify scale items. Results Using multiple health literacy assessments, it was clear that many teens struggle with low health literacy skills. When identifying items that can be used as self-report items in future research, factor analysis identified three subscales; a 5-item communication scale (alpha = 0.77), a 4-item confusion scale (alpha = 0.73), and a 6-item functional health literacy scale (alpha = 0.76). The scales performed reasonably well when compared with validation items. Conclusions Self-report items can be used to assess health literacy skills for adolescents when in-person administration is not possible or feasible. Such items will allow for greater study of how health literacy impacts communication in not only health care settings, but for all levels of health communication. The tool will also allow researchers to better understand how adolescent health literacy is related to a variety of health outcomes. Further testing of these scales with different populations is warranted. PMID:27656257
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.
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. PMID:26567035
Menendez, Mariano E; Mudgal, Chaitanya S; Jupiter, Jesse B; Ring, David
To determine the prevalence of and factors associated with limited health literacy among outpatients presenting to an urban academic hospital-based hand surgeon. A cohort of 200 English- and Spanish-speaking patients completed the Newest Vital Sign (NVS) health literacy assessment tool, a sociodemographic survey, and 2 Patient-Reported Outcomes Measurement Information System-based computerized adaptive testing questionnaires: Patient-Reported Outcomes Measurement Information System Pain Interference and Upper-Extremity Function. The NVS scores were divided into limited (0-3) and adequate (4-6) health literacy. Multivariable regression modeling was used to identify independent predictors of limited health literacy. A total of 86 patients (43%) had limited health literacy (English-speaking: 33%; Spanish-speaking: 100%). Factors associated with limited health literacy were advanced age, lower income, and being publicly insured or uninsured. Increasing years of education was a protective factor. Primary language was not included in the logistic regression model because all Spanish-speaking patients had limited health literacy. When evaluating health literacy on a continuum, primary language was the factor that most influenced the NVS scores, accounting for 14% of the variability. Limited health literacy was commonplace among patients seeing a hand surgeon, more so in elderly and disadvantaged individuals. We hope our study raises awareness of this issue among hand surgeons and encourages providers to simplify messages and improve communication strategies. Prognostic II. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
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.
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…
Misra-Hebert, Anita D; Isaacson, J Harry
Health care disparities have multiple causes; the dynamics of the physician-patient encounter is one of the causes that can be modified. Here, we discuss specific recommendations related to cross-cultural communication and health literacy as practical steps to providing more equitable health care to all patients.
Parker, Eleanor J; Jamieson, Lisa M
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. 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. 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. 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.
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.
Richtering, Sarah S; Hyun, Karice; Neubeck, Lis; Coorey, Genevieve; Chalmers, John; Usherwood, Tim; Peiris, David; Chow, Clara K; Redfern, Julie
Electronic health (eHealth) literacy is a growing area of research parallel to the ongoing development of eHealth interventions. There is, however, little and conflicting information regarding the factors that influence eHealth literacy, notably in chronic disease. We are similarly ill-informed about the relationship between eHealth and health literacy, 2 related yet distinct health-related literacies. The aim of our study was to investigate the demographic, socioeconomic, technology use, and health literacy predictors of eHealth literacy in a population with moderate-to-high cardiovascular risk. Demographic and socioeconomic data were collected from 453 participants of the CONNECT (Consumer Navigation of Electronic Cardiovascular Tools) study, which included age, gender, education, income, cardiovascular-related polypharmacy, private health care, main electronic device use, and time spent on the Internet. Participants also completed an eHealth Literacy Scale (eHEALS) and a Health Literacy Questionnaire (HLQ). Univariate analyses were performed to compare patient demographic and socioeconomic characteristics between the low (eHEALSliteracy groups. To then determine the predictors of low eHealth literacy, multiple-adjusted generalized estimating equation logistic regression model was used. This technique was also used to examine the correlation between eHealth literacy and health literacy for 4 predefined literacy themes: navigating resources, skills to use resources, usefulness for oneself, and critical evaluation. The univariate analysis showed that patients with lower eHealth literacy were older (68 years vs 66 years, P=.01), had lower level of education (P=.007), and spent less time on the Internet (Pliteracy. Regarding the comparison between the eHEALS items and HLQ scales, a positive linear relationship was found for the themes "usefulness for oneself" (P=.049) and "critical evaluation" (P=.01). This study shows the importance of evaluating patients
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.
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…
Griffey, Richard T; Melson, Andrew T; Lin, Margaret J; Carpenter, Christopher R; Goodman, Melody S; Kaphingst, Kimberly A
The objective was to quantify the correlation between general numeracy and health literacy in an emergency department (ED) setting. This was a prospective cross-sectional convenience sample study of adult patients in an urban, academic ED with 97,000 annual visits. General numeracy was evaluated using four validated questions and health literacy using three commonly used validated screening tools (Short Test of Functional Health Literacy in Adults [S-TOFHLA], Rapid Estimate of Adult Literacy in Medicine-Revised [REALM-R], and the Newest Vital Sign [NVS]). Scores were dichotomized for health literacy tests to limited (low or marginal) versus adequate health literacy, and the proportion of patients answering all numeracy questions correctly was calculated with the mean proportion of correct responses in these groups. The correlation between numeracy scores and scores on the health literacy screening tools was evaluated using Spearman's correlation. A total of 446 patients were enrolled. Performance on questions evaluating general numeracy was universally poor. Only 18 patients (4%) answered all numeracy questions correctly, 88 patients (20%) answered zero questions correctly, and overall the median number of correct answers was one (interquartile range [IQR] = 1 to 2). Among patients with limited health literacy (LHL) by any of the three screening tools used, the mean number of correct numeracy answers was approximately half that of patients with adequate health literacy. However, even among those with adequate health literacy, the average number of correct answers to numeracy questions ranged from 1.6 to 2.4 depending on the screening test used. When dichotomized into those who answered ≤50% versus >50% of numeracy questions correctly, there was a significant difference between those with LHL and those who scored ≤50% on numeracy. Health literacy screening results were correlated with general numeracy in the low to moderate range: S-TOFHLA rs = 0.428 (p literacy
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...
Low literacy can be described as the inability to read, write or use numbers effectively. The limited ability to read and understand health care instructions directly translates into poor health outcomes. The aim of this study was to assess the English literacy levels of primary health care patients using the Learning Ability ...
Hester, Eva Jackson
The purpose of this study was to examine connections between health literacy and social communication skills in older adults, a population that experiences chronic health conditions but is reported to have low health literacy and declines in communication skills. Sixty-three older adults were administered the "Social Communication"…
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…
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…
Jiang, Yun; Sereika, Susan M; Lingler, Jennifer H; Tamres, Lisa K; Erlen, Judith A
This secondary analysis examined health literacy among informal caregivers of community-dwelling older adults with memory loss and assessed correlates of caregiver health literacy using the Abilities, Skills and Knowledge Model. Caregiver health literacy (n = 91) was assessed by the Newest Vital Sign. Limited health literacy presented in 38.5% caregivers, with significantly low document literacy. Health literacy was associated bivariately with age, education, global cognitive function, executive function, and working memory (all ps academic skills (years of education) (p = 0.004), independently predicted lower health literacy (R 2 = 0.54). Medication knowledge, however, was not found to be an independent predictor in the model. Findings suggest limited health literacy is a potential issue among informal caregivers of adults with memory loss. Appropriate assessment and personalized support are needed for informal caregivers who are at high risk for poor health literacy. Copyright © 2017 Elsevier Inc. All rights reserved.
Yoon K Loke
Full Text Available OBJECTIVES: To estimate the prevalence of low health literacy, and evaluate the impact of low health literacy on outcomes in patients with chronic musculoskeletal conditions. DATA SOURCES: We searched Embase, Pubmed, PsycInfo, and CINAHL in January 2011 for relevant studies, restricted to English-language articles. STUDY SELECTION AND DATA EXTRACTION: Studies were included if they measured health literacy and/or reported on the link between outcomes and health literacy levels in patients with osteoporosis, osteoarthritis, or rheumatoid arthritis. We assessed risk of bias from participant selection, methods of measuring health literacy and functional outcomes, missing data, and potential for confounding. DATA SYNTHESIS: We reviewed 1863 citations and judged 8 studies to be relevant. Most were cross-sectional in nature, and five were based in the United States. Diversity in measurements, participant characteristics, and settings meant that results had to be synthesized narratively. Prevalence of low health literacy varied from 7% to 42%. Of the five studies that reported on musculoskeletal outcomes, only one showed an association (unadjusted between low health literacy and greater pain and limitations in physical functioning. However, other studies, including those with multivariate analyses, found no significant relationship between health literacy and measures of pain or disease specific questionnaires. One clinical trial found short-term improvements in the mental health of patients with musculoskeletal conditions after an intervention to improve health literacy. LIMITATIONS: Most of the studies were cross-sectional in nature, which precludes interpretation of a causal relationship. The sample sizes may not have been sufficiently large to enable detection of significant associations. CONCLUSIONS: The current evidence does not show a consistent association between low health literacy and poorer functional outcomes in patients with chronic
Holtzman, Jennifer S; Atchison, Kathryn A; Macek, Mark D; Markovic, Daniela
Existing evidence demonstrating a relationship between health literacy (HL) and periodontal health is insufficient to identify how providers can help patients manage periodontal disease. This study assesses associations between HL measures (word recognition, numeracy, and conceptual knowledge) and signs of periodontal disease. This study included 325 new patients at a dental school clinic and employed an oral HL (OHL) survey, full-mouth radiographs, and clinical examination. Evaluations included the relationship between each HL measure versus number of teeth, bleeding score, plaque score, and periodontal severity with linear and ordinal logistic regression models before and after adjusting for covariates. Among HL measures, the Newest Vital Sign demonstrated a significant relationship with number of teeth and the Short Test of Functional Health Literacy in Adults showed a significant association with plaque score. The short Rapid Estimate of Adult Literacy in Medicine and Dentistry (REALMD-20) showed participants who performed in the highest quartile had nearly two additional teeth, over 5.5% fewer bleeding sites, and nearly 9% fewer teeth with plaque after adjustment for demographic variables, smoking, and diabetes mellitus (DM). Participants who scored in the highest quartile of the Comprehensive Measure of Oral Health Knowledge (CMOHK) had nearly 9% less plaque. Two OHL instruments (REAMLD-20 and CMOHK) provided statistical associations with clinical measures of periodontal health at a level that could be considered of moderate clinical relevancy. Findings suggest dentists may wish to assess familiarity of their patients with dental terminology and knowledge of periodontal disease to provide education on oral hygiene, smoking, and DM.
Halverson, Julie L; Martinez-Donate, Ana P; Palta, Mari; Leal, Ticiana; Lubner, Sam; Walsh, Matthew C; Schaaf Strickland, Jeanne; Smith, Paul D; Trentham-Dietz, Amy
Health-related quality of life is an important outcome in cancer care. A few studies indicate that health literacy influences cancer patients' health-related quality of life, but additional investigation is needed. The authors examined the relation between health literacy and health-related quality of life among cancer patients. A cross-sectional survey was conducted with cancer patients in Wisconsin during 2006-2007. Data on sociodemographics, clinical characteristics, health-related quality of life, and health literacy were obtained from the state's cancer registry and a mailed questionnaire. Regression analyses were used to characterize the association between health-related quality of life and health literacy. The study sample included 1,841 adults, newly diagnosed with lung, breast, colorectal, or prostate cancer in 2004 (response rate = 68%). Health-related quality of life was measured with the Functional Assessment of Cancer Therapy-General. Adjusting for confounders, higher health literacy was associated with greater health-related quality of life (p literacy categories (p emotional (p literacy is positively and independently associated with health-related quality of life among cancer patients. These findings support adoption of health literacy best practices by cancer care systems.
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
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 (ΔR(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.
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
This study investigates whether literacy skills are a distinct dimension of education that influences young adults’ health in the southeast African context of Malawi. It uses new data from Tsogolo la Thanzi, a study of young adults in southern Malawi, to achieve three aims. The first is descriptive: to demonstrate a direct assessment for measuring literacy in a population-based survey, and show that it captures variability in skills among young adults, including those with comparable levels of educational attainment. The second aim is to identify whether literacy influences young adults’ health—net of their educational attainment and other confounding factors. Multivariate analyses reveal that literacy is associated with two measures of physical health: self-rated health and prolonged sickness. Because literacy is a key determinant of health, the third aim is to provide insight into how to measure it: can commonly used indirect approaches to estimating literacy (e.g., based on educational attainment or self-reports), accurately capture its prevalence and relationship with health? In a second set of analyses, bivariate results show whether, and the extent to which, indirect measures of literacy overestimate literacy’s prevalence, and multivariate models assess whether indirect estimates of literacy capture its relationship with health. The findings support future efforts to incorporate literacy assessments into population surveys to accurately estimate literacy’s prevalence and health benefits, particularly in contexts like Malawi where access to high-quality schools remains limited. PMID:25164414
Faruqi, Nighat; Stocks, Nigel; Spooner, Catherine; El Haddad, Nouhad; Harris, Mark F
Socioeconomically disadvantaged adults are both more likely to be obese and have lower levels of health literacy. Our trial evaluates the implementation and effectiveness of primary care nurses acting as prevention navigators to support obese patients with low health literacy to lose weight. A pragmatic cluster randomised trial will be conducted. Twenty practices in socioeconomically deprived areas, 10 each in Sydney and Adelaide, will be recruited and randomised to intervention and control groups. Twenty to 40 eligible obese patients aged 40-70 years with a BMI ≥ 30 kg/m(2) and with low health literacy will be enrolled per practice. The intervention is based on the '5As' of the chronic disease model approach - Assess, Advise, Agree, Assist and Arrange - and the recommendations of the 2013 Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. In the intervention practices, patients will be invited to attend a health check with the prevention navigator who will assess the patient's risk and provide brief advice, assistance with goal setting and referral navigation. Provider training and educational meetings will be held. The providers' attitudes to obesity, confidence in treating obesity and preventive care they provide to obese people with low health literacy will be evaluated through questionnaires and interviews. Patients' self-assessment of lifestyle risk factors, perception of preventive care received in general practice, health-related quality of life, and health literacy will be assessed in telephone interviews. Patients' anthropometric measures will be recorded and their health service usage will be determined via linkage to the Australian government-held medical and pharmaceutical data. Our trial will provide evidence for the effectiveness of practice nurses as prevention navigators to support better weight management for obese patients with low health literacy. This trial is
Bonaccorsi, Guglielmo; Lorini, Chiara; Baldasseroni, Alberto; Porchia, Barbara Rita; Capecchi, Leonardo
The aim of this study is to make a critical analysis of the different definitions of health literacy to provide a framework of the concept. A literature search was conducted in PubMed, Embase, PsycINFO, ERIC, Health Evidence, Centre for Reviews and Dissemination and Cochrane Library. Google and OpenGrey were searched to find additional papers and unpublished works. Among 7000 papers founded, we selected 26 works. During the 1990s, authors began to systematically study the relationship between health literacy and health status, according to a public health view. In the first decade of the new century, a new fundamental definition established three progressive degrees of health literacy: functional, interactive and critical health literacy. Sørensen (in 2012) provided a framework for the development of new assessment tools and interventions. The improvement of health literacy is a powerful tool for the development of a new type of relationship between individuals and the health system.
Patel, Kristina; Bliss, Donna Z; Savik, Kay
The primary purpose of this study was to examine continence literacy of individuals with fecal incontinence (FI) by identifying terms they used to refer to FI and to explore their emotional responses to FI. A secondary aim was to compare differences based on gender and age in younger (65 years) with FI. Secondary analysis of data collected prospectively in a clinical trial of fiber supplementation for FI. Content analysis of participants' statements reported in field notes of data collectors and their responses to data forms and questions. Only one participant used the term fecal incontinence to describe FI. Alternate terms described stool characteristics, named other gastrointestinal problems, or respondents referred to FI, using a term that seemed to depersonalize the problem. Emotional responses to FI focused on the influence of bothersome symptoms, interference with social activities, and need for control. Some participants used humor to cope with FI and reported emotional benefits gained through participation in a study. Women were impacted by the social limitations of having FI more than men. Younger people were more likely to express feelings of emotional upset than were older respondents. There is a need to increase health literacy about FI. WOC nurses are well qualified to educate patients about FI and to evaluate if higher continence literacy increases reporting of FI. Understanding the various emotional responses to FI may guide the optimal support that WOC nurses can provide and facilitate better management of FI.
Furuya, Yoko; Kondo, Naoki; Yamagata, Zentaro; Hashimoto, Hideki
Health literacy (HL) is a key determinant of health in a contemporary society characterized by abundant information. Previous studies have suggested that basic or functional HL is positively associated with health, whereas evidences on the association between health and communicative/critical HL are scarce. Furthermore, confounding by socioeconomic status on HL-health association has been poorly tested. Using cross-sectional data from a nationally representative community-based survey in Japan, we investigated whether communicative/critical HL is associated with self-rated health independent of socioeconomic status. A total of 1237 subjects participated in this study; the response rate was 62%. To measure communicative/critical HL, we used three questions assessing the respondents' ability to select, to communicate to others and to evaluate specific health-related information. Potential confounders included demographic factors, household income, employment status, and educational attainment. A multivariate model revealed that good self-reported health was significantly associated with younger age [odds ratio (OR), 0.99; 95% confidence interval (CI), 0.97-0.99], employment (OR, 2.89; 95% CI, 1.06-7.88) and higher communicative/critical HL scores (OR 2.75; 95%CI, 1.93-3.90). Respondents with lower education were likely to have poorer communicative/critical HL. These results imply that to close the health gap, policy interventions should focus on the promotion of HL among deprived sociodemographic groups. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Geboers, Bas; de Winter, Andrea F.; Spoorenberg, Sophie L. W.; Wynia, Klaske; Reijneveld, Sijmen A.
Low health literacy is an important predictor of