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Lepe A, Muhamed TAS, Reijneveld SA, de Kroon MLA. Mediation by parent health literacy and behaviour of socioeconomic inequality in child overweight. Pediatr Obes 2024:e13156. [PMID: 39075886 DOI: 10.1111/ijpo.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 06/14/2024] [Accepted: 07/10/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Socioeconomic inequalities contribute to childhood overweight. Identifying mediators could help reduce these inequalities. OBJECTIVE We assessed to what extent and how parental health literacy and health behaviours mediate the relationship between parental socioeconomic status and childhood overweight. METHODS Data were taken from the multigenerational prospective Dutch Lifelines Cohort Study. We included 6683 children, baseline age 9.8 years (SD = 2.6), with an average follow-up of 36.2 months (SD = 9.3). Overweight was defined using age- and sex-specific cut-offs. Three indicators of socioeconomic status were included: education, income and occupation. We assessed the mediating role of parental health literacy and health behaviours (smoking, diet, physical activity and alcohol) using causal mediation. RESULTS Four additional years of education and an SD-increase in both income and occupation decreased the odds of childhood overweight by 42%, 12% and 20%, respectively. Only parental smoking independently mediated the relationship of both education (6.6%) and occupation (5.7%) with overweight. Parental health behaviours jointly explained 8.4% (education), 19.4% (income) and 9.8% (occupation) per relationship. Lastly, adding parental health literacy explained 10.8% (education), 27.4% (income) and 13.3% (occupation) of these relationships. CONCLUSIONS We found large socioeconomic inequalities in childhood overweight. Remarkably, parental smoking was a key mediator. Therefore, prevention targeting smoking may reduce socioeconomic inequalities in childhood overweight.
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Affiliation(s)
- Alexander Lepe
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tamool A S Muhamed
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marlou L A de Kroon
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Li S, Wang J, Ren L, Ye P, Niu W, Yu M, Hu Y, Jiang Y, Wu Y, Tian M, Zhao Y, Yao Y. Health literacy and falls among community-dwelling older people in China: is there a sex difference? Aging Clin Exp Res 2024; 36:148. [PMID: 39023697 PMCID: PMC11258050 DOI: 10.1007/s40520-024-02788-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/03/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Health literacy is one of the important determinants of healthy aging, yet few studies have focused on the association between health literacy and falls. AIMS This study aims to explore the relationship between health literacy and falls, with a focus on sex differences among older people in China. METHODS This cross-sectional study enrolled 2,144 older people aged ≥ 60 years from Shandong Province, China in 2021. We used general health literacy screening scale to assess health literacy, and collected the incidence of falls in the past year. Logistic regression models were employed to analyze the relationship between health literacy and falls. We investigated the sex differences by subgroup analyses. RESULTS The prevalence of adequate health literacy and falls was 21.7% (95% CI: 20.0-23.5%) and 25.4% (95% CI: 23.6-27.3%), respectively. In a fully-adjusted model, adequate health literacy was associated with a lower prevalence of falls in older adults (OR = 0.71, 95%CI: 0.52-0.96). Subgroup analysis revealed sex differences in this relationship (Pfor interaction <0.05). Specifically, the female group showed no significant relationship between health literacy and falls (OR = 0.92, 95% CI: 0.59-1.44); however, the male group demonstrated a robust and significant relationship (OR = 0.58, 95% CI: 0.37-0.90). CONCLUSIONS Older people with adequate health literacy have lower prevalence of falls, which appears to differ by sex. This relationship was significant among men but not among women. These findings emphasize the need for policymakers and healthcare providers to consider sex differences when designing and implementing programs aimed at improving health literacy and preventing falls in the older population. Improving health literacy among older women could be a strategic component in bridging sex inequality in falls.
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Affiliation(s)
- Shaojie Li
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Jingjing Wang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Longbing Ren
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Pengpeng Ye
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Wenyi Niu
- School of Public Health, Peking University, Beijing, China
| | - Mingzhi Yu
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Hu
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yuling Jiang
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yifei Wu
- School of Public Health, Peking University, Beijing, China
| | - Maoyi Tian
- School of Public Health, Harbin Medical University, Harbin, 150081, China
- Department of General Practice, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yao Yao
- School of Public Health, Peking University, Beijing, China.
- China Center for Health Development Studies, Peking University, Beijing, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
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Yogesh M, Makwana N, Trivedi N, Damor N. Multimorbidity, health Literacy, and quality of life among older adults in an urban slum in India: a community-based cross-sectional study. BMC Public Health 2024; 24:1833. [PMID: 38982428 PMCID: PMC11234527 DOI: 10.1186/s12889-024-19343-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND India is experiencing a rising burden of chronic disease multimorbidity due to an aging population and epidemiological transition. Older adults residing in urban slums are especially vulnerable due to challenges in managing multimorbidity amid deprived living conditions. This study aimed to assess the prevalence of multimorbidity, associated health literacy, and quality of life impact in this population. METHODS A community-based cross-sectional study was conducted among 800 adults aged ≥ 65 years in an urban slum in Gujarat, India. Data on sociodemographics, physical and mental health conditions, health literacy (HLS-SF-47), quality of life (Short Form-12 scale), and social determinants of health were collected. Multimorbidity is ≥ 2 physical or mental health conditions in one person. RESULTS The prevalence of multimorbidity was 62.5% (500/800). Multimorbidity was significantly associated with lower physical component summary (PCS) and mental component summary (MCS) scores on the SF-12 (p < 0.001). After adjusting for sociodemographic variables, the odds ratio of 0.81 indicates that for every 1 unit increase in the health literacy score, the odds of having multimorbidity decrease by 19%. Older age within the older adult cohort (per year increase) was associated with greater odds of multimorbidity (AOR 1.05, 95% CI 1.02-1.09). Physical inactivity (AOR 1.68, 95% CI 1.027-2.77) and lack of social support (AOR 1.57, 95% CI 1.01-2.45) also increased the likelihood of multimorbidity. CONCLUSION There is a substantial burden of multimorbidity among urban slum dwellers aged ≥ 65 years in India, strongly linked to modifiable risk factors like poor health literacy and social determinants of health. Targeted interventions are essential to alleviate this disproportionate burden among urban slum older adults.
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Affiliation(s)
- M Yogesh
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India.
| | - Naresh Makwana
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Nidhi Trivedi
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Naresh Damor
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
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Kharaba Z, Alfoteih Y, Jirjees F, Albarbandi M, Hussain Z, Al Obaidi H, Mansour S, Ahmed M, Eltayib E, Barakat M, AlSalamat HA, Alzayer R, El Khatib S, Al-Mohammad S, Hallit S, Malaeb D, Hosseini H. Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study. Sci Rep 2024; 14:15426. [PMID: 38965262 PMCID: PMC11224319 DOI: 10.1038/s41598-024-64935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 06/14/2024] [Indexed: 07/06/2024] Open
Abstract
Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.
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Affiliation(s)
- Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, 64141, Abu Dhabi, United Arab Emirates
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Yassen Alfoteih
- College of Dental Surgery, City University Ajman, 18484, Ajman, United Arab Emirates
- College of General Education, City University Ajman, 18484, Ajman, United Arab Emirates
| | - Feras Jirjees
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohammad Albarbandi
- Department of Neurosurgery, Ibn Al-Nafees Hospital, Damascus, Syria
- Department of Neurosurgery, Damascus Hospital, Damascus, Syria
| | - Zainab Hussain
- Department of Biology, College of Science, University of Baghdad, Baghdad, Iraq
| | | | - Sara Mansour
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Munazza Ahmed
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Eyman Eltayib
- College of Pharmacy, Al Jouf University, Jouf, Saudi Arabia
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Husam A AlSalamat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, 19117, Jordan
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Reem Alzayer
- Clinical Pharmacy Practice, Mohammed Al-Mana College for Medical Sciences, Dammam, Saudi Arabia
| | - Sami El Khatib
- Department of Biomedical Sciences, Lebanese International University, Bekaa, Lebanon
- Center for Applied Mathematics and Bioinformatics (CAMB), Gulf University for Science and Technology, Mubarak Al-Abdullah, Kuwait
| | | | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O Box 446, Jounieh, Lebanon
- Department of Psychology, College of Humanities, Effat University, 21478, Jeddah, Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
| | - Hassan Hosseini
- UPEC-University Paris-Est, Creteil, France
- RAMSAY SANTÉ, HPPE, Champigny sur Marne, France
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Jing Y, Ma L, Zhang Y, Li X, Jiang J, Long J, Ma L. Impact of health literacy, social support, and socioeconomic position on the serum uric acid level in asymptomatic hyperuricaemia patients in China: a structural equation model. BMC Public Health 2024; 24:1606. [PMID: 38886726 PMCID: PMC11181562 DOI: 10.1186/s12889-024-19085-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 06/07/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hyperuricaemia (HUA) poses a significant public health challenge on a global scale. It is mostly asymptomatic hyperuricemia (AHU) with unsatisfactory recognition and control rates. The role of health literacy in influencing health outcomes is of utmost importance, and enhancing health literacy is helpful for patients in managing risk factors. Additionally, social support and socioeconomic position (SEP) have been identified as potential factors influencing health. However, the exact relationships between these factors and AHU remain unclear. This study aimed to investigate the status of health literacy among patients with AHU and explore the relationships between health literacy, social support, SEP, and serum uric acid (SUA) levels. METHODS A cross-sectional study was conducted among 349 participants with AHU in Luzhou, China. The research instruments included a sociodemographic characteristics questionnaire, the Health Literacy Scale for Chronic Patients (HLSCP), and the Social Support Scale (SSRS). The construction of the SEP index was achieved through the application of principal component analysis. Univariate and hierarchical regression analyses were used to evaluate the associations between SEP, social support, health literacy, and SUA levels. Furthermore, structural equation modelling (SEM) was utilized to examine these associations. RESULTS (1) Most patients exhibited low health literacy (90.18 ± 15.11), and only 44.4% possessed basic health literacy. (2) SEP was positively correlated with SUA levels (β = 4.086, P < 0.001), and health literacy was negatively related to SUA levels (β = -0.399, P < 0.001). There was no significant relationship between social support and SUA levels (β = 0.051, t = 1.085). (3) Health literacy mediated the association between SEP and SUA levels (β = -0.490, 95% CI: -0.620 to -0.382). SEP had a direct positive effect on SUA levels (β = 0.723) and health literacy (β = 0.696), and the total effect of SEP on SUA levels was 0.233. CONCLUSIONS The findings indicate a low level of health literacy among patients with AHU and suggest that health literacy might play a mediating role in the relationship between SEP and SUA levels. Consequently, future initiatives are recommended to prioritize health literacy and devise appropriate intervention strategies to enhance the self-management capabilities of patients with AHU.
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Affiliation(s)
- Yunfang Jing
- Suining First People's Hospital, Sichuan Province, Suining, 629000, China
| | - Lilai Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Southwest Medical University, Sichuan Province, Luzhou, 646000, China
| | - Yuanfan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Southwest Medical University, Sichuan Province, Luzhou, 646000, China
| | - Xiaohong Li
- Health Management Center, The Affiliated Hospital, Southwest Medical UniversitySichuan Province, Luzhou, 646000, China
| | - Jun Jiang
- Suining First People's Hospital, Sichuan Province, Suining, 629000, China
| | - Jie Long
- Suining First People's Hospital, Sichuan Province, Suining, 629000, China
| | - Ling Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Southwest Medical University, Sichuan Province, Luzhou, 646000, China.
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Christiansen J, Lasgaard M, Pedersen SS, Pedersen MH, Friis K. Social Disconnectedness in Individuals with Cardiovascular Disease: Associations with Health Literacy and Treatment Burden. Int J Behav Med 2024; 31:363-371. [PMID: 38480621 PMCID: PMC11106123 DOI: 10.1007/s12529-024-10263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Knowledge is limited on associations between social disconnectedness (i.e. loneliness and social isolation), health literacy and perceived treatment burden in individuals with cardiovascular disease (CVD). However, understanding these associations may be important for clinical practice. METHODS This study used cross-sectional self-reported data from the 2017 Danish health and morbidity survey entitled 'How are you?', investigating the associations of loneliness and social isolation with low health literacy and high treatment burden in individuals with CVD (n = 2521; mean age = 65.7 years). RESULTS Logistic regression analysis showed that loneliness and social isolation were associated with low health literacy in terms of difficulties in 'understanding health information' (loneliness: adjusted odds ratio (AOR) = 1.32, 95% confidence intervals (CI) [1.16, 1.50]; social isolation: AOR = 1.47, 95% CI [1.24, 1.73]) and 'engaging with healthcare providers' (loneliness: AOR = 1.53, 95% CI [1.37, 1.70]; social isolation: AOR = 1.21, 95% CI [1.06, 1.40]) and associated with high treatment burden (loneliness: AOR = 1.49, 95% CI [1.35, 1.65]; social isolation: AOR = 1.20, 95% CI [1.06, 1.37]). CONCLUSIONS Our findings show that loneliness and social isolation coexisted with low health literacy and high treatment burden in individuals with CVD. These findings are critical as socially disconnected individuals experience more health issues. Low health literacy and a high treatment burden may potentially exacerbate these issues.
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Affiliation(s)
- Julie Christiansen
- Department of Psychology, University of Southern Denmark, Odense, Denmark.
- DEFACTUM - Public Health Research, Central Denmark Region, Aarhus, Denmark.
| | - Mathias Lasgaard
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- DEFACTUM - Public Health Research, Central Denmark Region, Aarhus, Denmark
| | - Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Marie Hauge Pedersen
- DEFACTUM - Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Karina Friis
- DEFACTUM - Public Health Research, Central Denmark Region, Aarhus, Denmark
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Ahmad I, Taimur H, Shabbir S, Shabbir CA, Ahsan A, Ahmad HS, Masuda G. Examining Communicative, Critical Health Literacy and eHealth Literacy among International University Students Residing in Japan. Healthcare (Basel) 2024; 12:941. [PMID: 38727498 PMCID: PMC11083772 DOI: 10.3390/healthcare12090941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: International students with sufficient health literacy are better equipped to respond to public health emergencies and reduce any unintentional harm that may occur during such events. This study aims to assess the current status of health literacy among international students and investigate the factors that influence health literacy. (2) Methods: A cross-sectional study was conducted in Tokyo on international university students using a questionnaire consisting of the Communicative and Critical Health Literacy and eHealth Literacy Scales. The study analyzed 205 valid responses. Descriptive statistics were utilized to assess the level of health literacy, and linear regression was used to identify the association of socio-demographic characteristics and disease status with health and e-health literacy. (3) Results: Health literacy and e-health literacy were low in 48.29% and 47.29% of international students, respectively. The mean scores of CCHL items ranged from 3.13 to 3.26, while the mean scores of eHEALS items ranged from 3.33 to 3.49. Both health literacy and e-health literacy were better with unmarried status (p = 0.015), and e-health literacy was worse with higher age (p = 0.007). (4) Conclusions: Overall, international students' health literacy and e-health literacy were at intermediate levels, with considerable room for improvement, and affected by certain student attributes.
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Affiliation(s)
- Ishtiaq Ahmad
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Hira Taimur
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Sameera Shabbir
- Central Campus, International Higher School of Medicine, Bishkek 720054, Kyrgyzstan
| | - Chaudhry Ahmed Shabbir
- Department of Medical Quality and Safety Management, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Ali Ahsan
- Department of Biology, Graduate School of Science, Osaka Metropolitan University, Osaka 558-8585, Japan
| | - Hafiz Sultan Ahmad
- Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Pakistan
| | - Gaku Masuda
- The Section of Global Health, Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
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Berete F, Gisle L, Demarest S, Charafeddine R, Bruyère O, Van den Broucke S, Van der Heyden J. Does health literacy mediate the relationship between socioeconomic status and health related outcomes in the Belgian adult population? BMC Public Health 2024; 24:1182. [PMID: 38678179 PMCID: PMC11055376 DOI: 10.1186/s12889-024-18676-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/22/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Health literacy (HL) has been put forward as a potential mediator through which socioeconomic status (SES) affects health. This study explores whether HL mediates the relation between SES and a selection of health or health-related outcomes. METHODS Data from the participants of the Belgian health interview survey 2018 aged 18 years or older were individually linked with data from the Belgian compulsory health insurance (n = 8080). HL was assessed with the HLS-EU-Q6. Mediation analyses were performed with health behaviour (physical activity, diet, alcohol and tobacco consumption), health status (perceived health status, mental health status), use of medicine (purchase of antibiotics), and use of preventive care (preventive dental care, influenza vaccination, breast cancer screening) as dependent outcome variables, educational attainment and income as independent variables of interest, age and sex as potential confounders and HL as mediating variable. RESULTS The study showed that unhealthy behaviours (except alcohol consumption), poorer health status, higher use of medicine and lower use of preventive care (except flu vaccination) were associated with low SES (i.e., low education and low income) and with insufficient HL. HL partially mediated the relationship between education and health behaviour, perceived health status and mental health status, accounting for 3.8-16.0% of the total effect. HL also constituted a pathway by which income influences health behaviour, perceived health status, mental health status and preventive dental care, with the mediation effects accounting for 2.1-10.8% of the total effect. CONCLUSIONS Although the influence of HL in the pathway is limited, our findings suggest that strategies for improving various health-related outcomes among low SES groups should include initiatives to enhance HL in these population groups. Further research is needed to confirm our results and to better explore the mediating effects of HL.
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Affiliation(s)
- Finaba Berete
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium.
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
| | - Lydia Gisle
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Stefaan Demarest
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing Research Unit in Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
| | | | - Johan Van der Heyden
- Department of Epidemiology and Public Health, Sciensano, Juliette Wytsmanstraat 14, Brussels, 1050, Belgium
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Zou H, Liu J, Jiang D, Hou L, Wang W, Zhang L. The Effect of Health Literacy on Disease Management Self-Efficacy in Chronic Disease Patients: The Mediating Effects of Social Support and the Moderating Effects of Illness Perception. Patient Prefer Adherence 2024; 18:657-666. [PMID: 38500561 PMCID: PMC10944975 DOI: 10.2147/ppa.s447320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose To test a hypothetical pathway model to estimate the links between health literacy, social support, illness perception, and disease management self-efficacy. Methods This cross-sectional study, conducted from June to October 2022, involved the recruitment of 210 patients with chronic diseases at two primary care facilities. Participants completed the Health Literacy Management Scale, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Social Support Rating Scale and Brief Illness Perception Questionnaire. We used the PROCESS macro for R to determine the hypothetical pathway model. Results The direct effect of health literacy on self-efficacy was significant (β=0.1792, 95% CI: 0.0940-0.2644), and social support played a partial mediating role between health literacy and self-efficacy (ES=0.0761, 95% CI: 0.0398-0.1204). Illness perception moderated the relationship between social support and self-efficacy (β=-0.0153, 95% CI: -0.0268- -0.0039). Conclusion Proposed a conceptual model including the mediating effect of social support and the moderating effect of illness perception, which helps to clarify the underlying mechanisms between health literacy and self-efficacy.
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Affiliation(s)
- Hao Zou
- Nursing Department, The Second Affiliated Hospital of Xi’an Medical University, Shanxi, People’s Republic of China
| | - Jianrong Liu
- Nursing Department, The Second Affiliated Hospital of Xi’an Medical University, Shanxi, People’s Republic of China
| | - Dongxu Jiang
- Department of Nursing, Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Linlin Hou
- Nursing Department, The second Affiliated Hospital of Xi’an Jiaotong University, Shanxi, People’s Republic of China
| | - Weiliang Wang
- Nursing Department, Xuzhou Medical university, Jiangsu, People’s Republic of China
| | - Linlin Zhang
- Department of Nursing, School of Pharmacy, Changzhou University, Jiangsu, People’s Republic of China
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Gao Q, Mak HW, Fancourt D. Longitudinal associations between loneliness, social isolation, and healthcare utilisation trajectories: a latent growth curve analysis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02639-9. [PMID: 38429539 DOI: 10.1007/s00127-024-02639-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE To explore the longitudinal associations between eight-year trajectories of loneliness, social isolation and healthcare utilisation (i.e. inpatient, outpatient, and nursing home care) in US older adults. METHODS The study used data from the Health and Retirement Study in 2006-2018, which included a nationally representative sample of American adults aged 50 and above (N = 6,832). We conducted latent growth curve models to assess the associations between trajectories of loneliness and isolation and healthcare utilisation over 8 years. RESULTS Independent of sociodemographic and health-related confounders, social deficits were associated with a lower likelihood of baseline physician visits (loneliness β= -0.15, SE = 0.08; social isolation β= -0.19, SE = 0.08), but there was a positive association between loneliness and number of physician visits (β = 0.06, SE = 0.03), while social isolation was associated with extended hospital (β = 0.07, SE = 0.04) and nursing home stays (β = 0.05, SE = 0.02). Longer nursing home stays also predicted better trajectories of loneliness and isolation over time. CONCLUSION Loneliness and social isolation are cross-sectionally related to complex patterns of different types of healthcare. There was no clear evidence that social deficits led to specific trajectories of healthcare utilisation, but nursing home stays may over time help provide social contact, supporting trajectories of isolation and potentially loneliness. Non-clinical services such as social prescribing could have the potential to address unmet social needs and further promote patients' health-seeking profiles for improving healthcare equity.
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Affiliation(s)
- Qian Gao
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- School of Public Health, Imperial College London, London, UK
| | - Hei Wan Mak
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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11
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Lima ACP, Maximiano-Barreto MA, Martins TCR, Luchesi BM. Factors associated with poor health literacy in older adults: A systematic review. Geriatr Nurs 2024; 55:242-254. [PMID: 38070263 DOI: 10.1016/j.gerinurse.2023.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVES To identify factors associated with poor health literacy in older adults. METHODS A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy". PROSPERO - CRD 42022350140. RESULTS Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others). CONCLUSIONS The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies.
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Affiliation(s)
- Ana Caroline Pinto Lima
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | | | - Tatiana Carvalho Reis Martins
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Bruna Moretti Luchesi
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil.
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12
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Chen C, Liu GG, Wang T, Tan J. Ex-ante moral hazard and health insurance: Evidence from China's urban residence basic medical insurance scheme. HEALTH ECONOMICS 2023; 32:2516-2534. [PMID: 37462541 DOI: 10.1002/hec.4738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/26/2023] [Accepted: 07/02/2023] [Indexed: 10/04/2023]
Abstract
This study examines whether implementing Urban Residents Medical Insurance Scheme decreased an individual's risky lifestyle behavior before illness, termed ex-ante moral hazard. Ex-ante moral hazard is predicted by the classical economic theory suggesting that health insurance coverage reduces an individual's incentive to take preventive efforts to remain healthy. Studies have provided mixed evidence for this prediction. China's 2006 nationwide social experiment of implementing the Urban Residents Basic Medical Insurance Scheme offers an excellent opportunity for examining the effect of the transition from uninsured to insured on an individual's health behaviors. We exploit the longitudinal dimension of a representative survey data for 2007-2010 and employ the instrumental variable technique, thereby addressing the issue of self-selection into voluntary health insurance schemes. The results do not provide evidence for and contrast the prediction of the ex-ante moral hazard. Significant differences exist between insured and uninsured groups with respect to smoking, drinking habits, and being overweight. People with insurance care more about their health than people without insurance do. The main results still hold if we use alternative estimation methods and other robustness tests.
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Affiliation(s)
- Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Gordon Guoen Liu
- Institute for Global Health and Development, National School of Development, Peking University, Beijing, China
| | - Tangxin Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
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13
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Sponselee HCS, ter Beek L, Renders CM, Kroeze W, Fransen MP, van Asselt KM, Steenhuis IHM. Letting people flourish: defining and suggesting skills for maintaining and improving positive health. Front Public Health 2023; 11:1224470. [PMID: 37900021 PMCID: PMC10602807 DOI: 10.3389/fpubh.2023.1224470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Background The concept of "positive health" emerged from the need for a holistic and more dynamic perspective on health, emphasising the ability of individuals to adapt and self-manage. The positive health conversation tool helps understand how people score on six positive health dimensions. However, skills within these dimensions to maintain or improve health have not yet been described. This is important for enabling individuals to put health advice into practise. Therefore, this paper aims to define and suggest skills for maintaining and improving positive health. Subsections Suggestions for definitions of skills within the positive health dimensions are described using the functional, interactive, and critical health literacy framework. Additionally, executive functions and life skills were incorporated. Moreover, the environment's role in these individual skills was noted, mentioning organisational health literacy that emphasises organisations' responsibility to provide comprehensible health information to all individuals. We propose that health promotion interventions can incorporate the proposed skills in practical exercises while aligning intervention materials and implementation tools with end-users and implementers. Discussion and conclusion The suggested skills for maintaining and improving positive health are a first step towards a more comprehensive understanding and open to discussion. These skills may also be applied to other practical conversation tools for maintaining or improving health. Increasing positive health through the defined skills may be especially relevant to those with a lower socioeconomic position who also have limited health literacy and thereby may contribute to reducing health inequalities. Taken together, strengthening the defined skills may hopefully contribute to allowing people to flourish in life.
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Affiliation(s)
- Hanne C. S. Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lies ter Beek
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, Ede, Netherlands
| | - Mirjam P. Fransen
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, Netherlands
| | - Kristel M. van Asselt
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ingrid H. M. Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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14
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Wieczorek M, Meier C, Kliegel M, Maurer J. Relationship Between Health Literacy and Unhealthy Lifestyle Behaviours in Older Adults Living in Switzerland: Does Social Connectedness Matter? Int J Public Health 2023; 68:1606210. [PMID: 37876738 PMCID: PMC10590881 DOI: 10.3389/ijph.2023.1606210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
Objectives: To investigate the association between health literacy (HL) and unhealthy lifestyle behaviours and to explore the moderating role of social connectedness in this relationship in older adults in Switzerland. Methods: We used data from 1,455 respondents to Wave 8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE). Associations between the number of unhealthy lifestyle behaviours (smoking, risky alcohol consumption, suboptimal daily consumption of fruits/vegetables, lack of vigorous physical activity) and HL were examined using multivariable Poisson regression models, which allowed for interactions between HL and social connectedness to test the moderation hypothesis. Results: Respondents with inadequate HL were significantly more likely to have a higher number of unhealthy lifestyle behaviours than respondents with sufficient HL. We found a stronger positive association between inadequate HL and the number of unhealthy lifestyle behaviours among socially isolated individuals. Conclusion: Greater social connectedness seems to buffer the negative impact of inadequate HL on unhealthy lifestyle behaviours in older adults, highlighting the importance of good HL for healthy lifestyles, especially in individuals with low social reserve.
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Affiliation(s)
- Maud Wieczorek
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
| | - Clément Meier
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
- Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Matthias Kliegel
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Jürgen Maurer
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, Switzerland
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
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15
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Han Y, Xing F, Huang J, Wang M. Associated factors of health-promoting lifestyle of the elderly based on the theory of social ecosystem. Aten Primaria 2023; 55:102679. [PMID: 37295306 PMCID: PMC10272280 DOI: 10.1016/j.aprim.2023.102679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/07/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECT To explore the factors related to health-promoting lifestyles of the elderly based on social-ecosystem theory. DESIGN A cross-sectional survey study was carried out to include 627 elderly people in communities in three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou) from October 2021 to January 2022 for questionnaire survey (601 validly returned cases). VENUE Three cities of Hebei Province (Shijiazhuang, Tangshan, and Zhangjiakou). PARTICIPANTS 627 elderly people. INTERVENTIONS A cross-sectional survey study. MAIN MEASUREMENTS The questionnaire survey was conducted by using the general demographic data, health promotion life scale, frailty scale, general self-efficacy scale, health engagement scale, General Self-Efficacy Scale, The family Adaptability, Partnership, Growth, Affection, and Resolve scale, and Perceived Social Support Scale. RESULTS The total health promotion lifestyle score for the elderly was 100.20±16.21, which was at the lower limit of the good level, with the highest mean score for nutrition (2.71±0.51) and the lowest mean score for physical activity (2.25±0.56). Stepwise linear regression showed that exercise frequency (95% confidence interval (CI) 1.304-3.885), smoking status (95% CI -4.190 to -1.556), self-efficacy (95% CI 0.071-0.185), health management (95% CI 0.306-0.590), frailty (95% CI -3.327 to -1.162) in the microsystem, marital status (95% CI 0.677-3.660), children's attention to the elderly health (95% CI 4.866-11.305), family care in the mesosystem (95% CI 1.365-4.968), and pre-retirement occupation (95% CI 2.065-3.894), living area (95% CI 0.813-3.912), whether receive community-based chronic disease prevention and management services (95% CI 2.035-8.149), social support (95% CI 1.667-6.493) in the macrosystem were the main factors affecting health promotion of life in the elderly (P<0.05). Hierarchical regression analysis showed the microsystem accounted for 17.2%, the mesosystem accounted for 7.1%, and the macrosystem accounted for 11.4%. CONCLUSION The health promotion lifestyle of the elderly in Hebei Province was at the lower limit of good level. Among them, exercise frequency, children's attention to the elderly health, and pre-retirement occupation played a major role in relation to the health-promoting lifestyle of the elderly. Hence, it needs the joint action of individuals, families, and society to promote the elderly to adopt the health promotion lifestyle and realize healthy aging.
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Affiliation(s)
- Ying Han
- College of Nursing and Rehabilitation, North China University of Science and Technology, China.
| | - Fengmei Xing
- School of Clinical Medicine, North China University of Science and Technology, China
| | - Jiali Huang
- College of Nursing and Rehabilitation, North China University of Science and Technology, China
| | - Mengyi Wang
- College of Nursing and Rehabilitation, North China University of Science and Technology, China
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16
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Lin CW, Lin WH, Hung WC, Lee YC, Yang YC, Wang YW, Ho CJ, Tang TQ. Examining Health Literacy in Taiwanese Smoking Cessation Populations: A Multidimensional Evaluation of Sociodemographic Factors and Domain-Specific Competencies. Healthcare (Basel) 2023; 11:2350. [PMID: 37628547 PMCID: PMC10454805 DOI: 10.3390/healthcare11162350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Cigarette smoking is a serious global health issue. Limited studies previously analyzed health literacy components in patients undergoing smoking cessation interventions. This study focuses on individuals enrolled in smoking cessation services and investigates the distribution of health literacy in three domains (health care, disease prevention, and health promotion) and four abilities (access, understand, appraise, and apply health information). The study also explores the correlation between background factors (age, BMI, etc.) and health literacy, as well as the differences in health literacy levels among different background variables (gender, etc.). METHODS 228 individuals completed the health literacy questionnaire. Descriptive statistical analysis, Pearson Correlation, and a Chi-Squared Test were employed to investigate the various health literacy levels and background variables. RESULTS 68% had excellent or sufficient health literacy. A total of 32% were considered problematic or to have inadequate health literacy. Of the three domains of health literacy, participants performed better in the healthcare domain. More than one-third were problematic in accessing and appraising information. CONCLUSIONS this paper, being the pilot study in providing an analysis of health literacy components in individuals undergoing smoking cessation, could serve as a useful reference for devising interventions for different population groups in trying to maximize successful cessation rates.
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Affiliation(s)
- Chi-Wei Lin
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 84001, Taiwan;
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan; (W.-C.H.); (Y.-C.L.)
| | - Wei-Hsuan Lin
- Department of Family and Community Medicine, E-Da Hospital, Kaohsiung City 84001, Taiwan;
| | - Wei-Chieh Hung
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan; (W.-C.H.); (Y.-C.L.)
- Department of Family Medicine, E-Da Hospital, Kaohsiung City 84001, Taiwan
| | - Yi-Che Lee
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan; (W.-C.H.); (Y.-C.L.)
- Division of Nephrology, Department of Internal Medicine, E-Da Hospital, Kaohsiung City 84001, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan City 704302, Taiwan;
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan City 70401, Taiwan
| | - Ying-Wei Wang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien City 970473, Taiwan;
- Department of Medical Humanities, School of Medicine, Tzu Chi University, Hualien City 97004, Taiwan
| | - Ching-Jung Ho
- Graduate Institute of Adult Education, National Kaohsiung Normal University, Kaohsiung City 80201, Taiwan
| | - Tao-Qian Tang
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung City 84001, Taiwan;
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung City 84001, Taiwan
- International Intercollegiate Ph.D. Program, National Tsing Hua University, Hsinchu City 30013, Taiwan
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17
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Uemura K, Tsukasa K, Watanabe A, Okamoto H, Yamada M. Association between community-level health literacy and frailty in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1253-1261. [PMID: 37087703 DOI: 10.1007/s40520-023-02405-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/31/2023] [Indexed: 04/24/2023]
Abstract
AIMS We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults. METHODS A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65 years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates. RESULTS The primary analysis included 6230 individuals (mean age = 74.3 years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates. CONCLUSIONS Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.
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Affiliation(s)
- Kazuki Uemura
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-City, Osaka, 583-8555, Japan.
| | - Kamitani Tsukasa
- Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan
| | - Atsuya Watanabe
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Hiroshi Okamoto
- Center for Liberal Arts and Sciences, Faculty of Engineering, Toyama Prefectural University, Imizu, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
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18
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Farina FR, Pavithra P, An H, Marquez M, O'Loughlin P, Regan J, Taddeo M, Bennett M, Lenaert B, Griffith JW. Validation of the Fear and Avoidance of Memory Loss scale in community-based older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12432. [PMID: 37101711 PMCID: PMC10123382 DOI: 10.1002/dad2.12432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 04/28/2023]
Abstract
Introduction Alzheimer's disease and related dementias (ADRD) are among the most feared conditions. However, research around ADRD-specific fear and avoidance behaviors is lacking. Here, we validated a novel measure of fear and avoidance specific to memory loss, the Fear and Avoidance of Memory Loss (FAM) scale, and examined associations between fear avoidance and psychosocial functioning in older adults. Methods We assessed FAM Scale internal reliability and concurrent validity, and candidate subscales across two samples (total N = 813). We then examined associations between fear avoidance and memory performance, anxiety, depressive symptoms, sleep, social functioning, and quality of life. Results We identified two subscales: fear and avoidance, which yielded strong psychometric validity. Higher fear was associated with memory failures and sleep disturbance. Higher avoidance was associated with memory failures, poorer verbal memory, reduced social functioning, and quality of life. Discussion We present the first measure of fear avoidance specific to memory loss. We propose that targeting fear avoidance can promote ADRD risk reduction and resiliency.
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Affiliation(s)
- Francesca R. Farina
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
- Global Brain Health InstituteTrinity College DublinDublinIreland
- School of PsychologyTrinity College DublinDublinIreland
| | | | - Hosanna An
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Melissa Marquez
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
| | | | - John Regan
- School of PsychologyTrinity College DublinDublinIreland
| | - Michelle Taddeo
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
| | - Marc Bennett
- School of PsychologyUniversity College DublinDublinIreland
| | - Bert Lenaert
- Faculty of PsychologyOpen UniversityHeerlenthe Netherlands
- Faculty of Health, Medicine and Life Sciences, Limburg Brain Injury CentreMaastricht UniversityMaastrichtthe Netherlands
| | - James W. Griffith
- Feinberg School of MedicineDepartment of Medical Social SciencesNorthwestern UniversityChicagoIllinoisUSA
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Costa A, Feteira-Santos R, Alarcão V, Henriques A, Madeira T, Virgolino A, Arriaga M, Nogueira PJ. Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4172. [PMID: 36901182 PMCID: PMC10002045 DOI: 10.3390/ijerph20054172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Although the health literacy level of the general population was described recently, little is known about its specific levels among older adults in Portugal. Therefore, this cross-sectional study aimed to investigate the levels of health literacy demonstrated by older adults in Portugal and explore associated factors. Using a randomly generated list of telephone numbers, adults aged 65 years or more living in mainland Portugal were contacted in September and October 2022. Sociodemographic, health and healthcare-related variables were collected, and the 12-item version of the European Health Literacy Survey Project 2019-2021 was used to measure health literacy. Then, binary logistic regression models were used to investigate factors associated with limited general health literacy. In total, 613 participants were surveyed. The mean level of general health literacy was (59.15 ± 13.05; n = 563), whereas health promotion (65.82 ± 13.19; n = 568) and appraising health information (65.16 ± 13.26; n = 517) were the highest scores in the health literacy domain and the dimension of health information processing, respectively. Overall, 80.6% of respondents revealed limited general health literacy, which was positively associated with living in a difficult household financial situation (4.17; 95% Confidence Interval (CI): 1.64-10.57), perceiving one's own health status as poorer (7.12; 95% CI: 2.02-25.09), and having a fair opinion about a recent interaction with primary healthcare services (2.75; 95% CI: 1.46-5.19). The proportion of older adults with limited general health literacy in Portugal is significant. This result should be considered to inform health planning according to the health literacy gap of older adults in Portugal.
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Affiliation(s)
- Andreia Costa
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CIDNUR—Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, 1600-190 Lisboa, Portugal
- CRC-W—Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Rodrigo Feteira-Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Violeta Alarcão
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Centro de Investigação e Estudos de Sociologia (CIES-Iscte), Instituto Universitário de Lisboa (Iscte), 1649-026 Lisboa, Portugal
| | - Adriana Henriques
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CIDNUR—Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, 1600-190 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Teresa Madeira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Miguel Arriaga
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- CIDNUR—Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa, Escola Superior de Enfermagem de Lisboa, 1600-190 Lisboa, Portugal
- CRC-W—Católica Research Centre for Psychological, Family and Social Wellbeing, Universidade Católica Portuguesa, 1649-023 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Paulo J. Nogueira
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- EPI Task-Force FMUL, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
- Comprehensive Health Research Center, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisboa, Portugal
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Vasan S, Eikelis N, Lim MH, Lambert E. Evaluating the impact of loneliness and social isolation on health literacy and health-related factors in young adults. Front Psychol 2023; 14:996611. [PMID: 36777213 PMCID: PMC9911678 DOI: 10.3389/fpsyg.2023.996611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/03/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives In current study, we aim to extend previous research by investigating the unique impact of loneliness on health literacy and health-related factors of young adults, after controlling for social isolation, depressive symptomology, and social anxiety, as well as evaluate how social isolation and loneliness differ in their impact on health literacy, and health-related factors among young adults, after accounting for abovementioned concomitant variables. Methods Using a cross-sectional study design, 521 young adults completed an online survey in 2020, where they self-reported their loneliness, social isolation, health-related factors, and health literacy data. Results Increased loneliness was associated with decrease in several health literacy domains (e.g., poorer social support for health, lower appraisal of health information, among others) and increase in some health-related factors (e.g., higher perceived stress, higher negative affect), among young adults, even after controlling for social anxiety, depressive symptomology, and social isolation. Contrastingly, increase in social isolation was associated with changes in some health-related factors - more somatic health complaints, higher alcohol use, poorer cognitive and physical functioning, and lower scores for only one health literacy domain (i.e., social support for health) among young adults, after adjusting for the influence of social anxiety, depressive symptomology, and loneliness. Conclusion Even after accounting for the influence of several co-occurring social and mental health symptoms, higher loneliness was associated poorer health literacy and health-related factors in young adults. We also found loneliness and social isolation may differ in the mechanisms through which they impact health literacy and health-related factors in young adults.
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Limited Health Literacy and Its Associated Health Outcomes Among Adults With at Least 2 Atopic Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1429-1438.e6. [PMID: 36634845 DOI: 10.1016/j.jaip.2022.12.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Health literacy (HL) is essential for patients with multiple atopic diseases to improve their health, given the complexity of their disease and treatment regimens. OBJECTIVE To estimate the proportion of adults with multiple atopic diseases (at least 2 of atopic dermatitis, asthma, allergic rhinitis, and food allergy) in the Dutch general population and to evaluate the prevalence of limited HL, and its association with socioeconomic status (SES), lifestyle factors, and health-related quality of life (HR-QoL) in this patient population. METHODS This cross-sectional study was conducted within the Lifelines Cohort Study via sending an add-on digital questionnaire, including (among others) questions on atopic dermatitis, to all adult participants (n = 135,950) between February and May 2020. Data on asthma, allergic rhinitis, lifestyle factors, HR-QoL, and SES were extracted from baseline assessment between 2006 and 2013. Functional, communicative, and critical HL were measured by validated items from Chew and the Dutch Functional Communicative and Critical Health Literacy questionnaires between 2012 and 2016. Food allergy was measured by the Food Allergy Questionnaire between 2014 and 2016. RESULTS In total, 11.8% of the overall study population reported ever having multiple atopic diseases; of those, 23.6% reported having limited functional HL, with a higher prevalence among those with a low SES. Limited functional HL showed positive associations with smoking, obesity, chronic stress, a low diet quality, and decreased HR-QoL among subjects with multiple atopic diseases. CONCLUSIONS We identified an HL deficit, and its association with a low SES and poor health outcomes among patients with multiple atopic diseases. Further research is warranted to utilize a more extensive assessment to measure HL and include more health outcomes, such as treatment adherence and disease control.
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Hirooka N, Kusano T, Kinoshita S, Aoyagi R. Association of Health Literacy With the Prevalence of Cardiovascular Diseases and Their Risk Factors Among Older Japanese Health Management Specialists. Gerontol Geriatr Med 2023; 9:23337214231189059. [PMID: 37492034 PMCID: PMC10363860 DOI: 10.1177/23337214231189059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023] Open
Abstract
In this study, we aimed to determine the association between health literacy and the development of cardiovascular diseases (CVDs), among an older population. This cross-sectional study was conducted among Japanese health management specialists (N = 593). Higher levels (communicative and critical) of health literacy and CVD risk factors (diabetes mellitus, hypertension, dyslipidemia, and obesity) were measured. The mean patient age was 71.3 years. Logistic regression analyses showed statistically significant associations between higher levels of health literacy and the prevalence of CVDs (β coefficient = -.091, p < .05) and metabolic risk factors (β coefficient = -.084, p < .01). There was a statistically significant association between health literacy and the count of CVDs (and its risk factors) (β coefficients of Poisson regression = -.036, p < .05). The results show health literacy to be fundamentally related to low prevalence of cardiovascular diseases and their associated metabolic risk factors.
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23
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Vasan S, Lambert E, Eikelis N, Lim MH. Impact of loneliness on health-related factors in Australia during the COVID-19 pandemic: A retrospective study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5293-e5304. [PMID: 35899552 PMCID: PMC9353389 DOI: 10.1111/hsc.13948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 05/23/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 pandemic and its associated social and physical distancing restrictions may have had a severe impact on health. In the present study, we investigate the changes in physical, social and mental health, as well as the health literacy of Australians subsequent to the onset of COVID-19 pandemic, and examine the influence of loneliness on these health-related factors. Using a retrospective cross-sectional study design, 607 Australian adults completed a self-report online survey which assessed their health-related factors before and after onset of the COVID-19 pandemic (data collected between June 2020 to November 2020). Australians reported statistically significant increase in a number of (poorer) health-related factors (e.g., weight gain, sleeping difficulties, poor somatic health, higher loneliness, more issues navigating the healthcare system) post onset of COVID-19 pandemic. Further, after adjusting for covariates, higher loneliness during pandemic predicted poorer health-related outcomes (e.g., more somatic health complaints, poorer quality of diet, poorer social support for health). The COVID-19 pandemic and its associated social and physical distancing restrictions may have contributed towards poorer health-related factors among Australian adults. Further, increased loneliness during the pandemic may have further worsened physical health and health literacy outcomes among Australians.
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Affiliation(s)
- Shradha Vasan
- Iverson Health Innovation Research Institute, Swinburne University of TechnologyHawthornAustralia
| | - Elisabeth Lambert
- Iverson Health Innovation Research Institute, Swinburne University of TechnologyHawthornAustralia
| | - Nina Eikelis
- Iverson Health Innovation Research Institute, Swinburne University of TechnologyHawthornAustralia
| | - Michelle H. Lim
- Iverson Health Innovation Research Institute, Swinburne University of TechnologyHawthornAustralia
- Centre for Mental HealthSwinburne University of TechnologyHawthornAustralia
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Henry JD, Coundouris SP, Mead J, Thompson B, Hubbard RE, Grainger SA. Social Frailty in Late Adulthood: Social Cognitive and Psychological Well-Being Correlates. J Gerontol B Psychol Sci Soc Sci 2022; 78:87-96. [PMID: 36190802 PMCID: PMC9890915 DOI: 10.1093/geronb/gbac157] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Social frailty poses a major threat to successful aging, but its social cognitive and psychological well-being correlates remain poorly understood. This cross-sectional study provides initial insights into whether social cognitive difficulties in older age are associated with social frailty, as well as how social frailty is linked to psychological characteristics known to be important for health and well-being. METHOD Ninety community-dwelling older adults completed measures of social frailty and social cognition (social perception, theory of mind, affective empathy, and informant-rated social behavior) as well as measures of psychological function known to be important for health and well-being, both positively (resilience and life satisfaction) and negatively (demoralization, social anxiety, and apathy). Measures of cognitive frailty, physical frailty, and depression were also administered to test the specificity of any observed relationships with social frailty. RESULTS Both affective empathy and social behavior were predictive of increased social frailty, but social behavior emerged as the only unique predictor after controlling for covariates. Social frailty also predicted unique variance in all five measures of psychological well-being, and for three of these measures (demoralization, resilience, and life satisfaction), the effects remained significant even after adjusting for covariates. DISCUSSION Findings are discussed in relation to models of socioemotional aging and frailty. Potential mechanisms linking social behavior to social capital in older age are identified, as well as how loss of social resources might both directly and indirectly impact well-being.
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Affiliation(s)
- Julie D Henry
- Address correspondence to: Julie D. Henry, PhD, School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia. E-mail:
| | - Sarah P Coundouris
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Jessica Mead
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Brielle Thompson
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Sarah A Grainger
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
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Striberger R, Axelsson M, Kumlien C, Zarrouk M. Health literacy in patients with intermittent claudication in relation to clinical characteristics, demographics, self-efficacy and quality of life – A cross-sectional study. JOURNAL OF VASCULAR NURSING 2022; 40:121-127. [DOI: 10.1016/j.jvn.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/07/2022]
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Li M, Sonoda N, Koh C, Yasumoto R, Morimoto A. Meta-analysis of the association between health literacy and smoking. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Chinese Tourists’ Health Risk Avoidance Behavior in the Context of Regular Epidemic Prevention and Control: An Empirical Analysis. SUSTAINABILITY 2022. [DOI: 10.3390/su14116750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The health risk avoidance behavior of tourists in China, a country actively combating COVID-19, is of research significance. This study proposes and tests a model based on three theories—stimulus-organism-response model, motivation-opportunity-ability model, and health belief model—to examine the impact mechanism of tourists’ health risk avoiding behavior under COVID-19′s regular epidemic prevention and control situations and the moderating effect of health risk perception. The results reveal that, from the stimulus perspective, tourists’ motivation, opportunities to travel, and the ability to travel negatively affect tourists’ health risk avoidance behavior. That is to say, the stronger the motivation of tourists to undertake tourist activities, the stronger the safeguards provided by the government, and the better that tourists are informed of the virus and more equipped with healthy habits and skills, the more likely it is that tourists will not take avoidance behavior. From the organism perspective, perceived severity and perceived susceptibility, as mediating factors, positively influence tourists’ health risk avoidance behavior. In contrast, if tourists are more likely to believe in the controllability of the health risk of the epidemic, then they are more likely to travel and less likely to show avoidance behavior. Managerial implications and theoretical contributions are also provided.
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Association between health literacy and purpose in life and life satisfaction among health management specialists: a cross-sectional study. Sci Rep 2022; 12:8310. [PMID: 35585083 PMCID: PMC9117675 DOI: 10.1038/s41598-022-11838-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 04/29/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose in life is anchored as a goal in national health promotion plans in several countries. Health literacy is the ability to find, understand, use, and evaluate health-related information; this ability has been investigated in terms of its effect on health outcomes and is said to play a critical role in health promotion. In the context of national health promotion, the effect of health literacy on purpose in life and life satisfaction remains unclear; therefore, this study aims to determine the effect of health literacy. A cross-sectional study was conducted on Japanese health management specialists (N = 1920). Health literacy was measured using the Communicative and Critical Health Literacy scale. Purpose in life and life satisfaction were measured using the Ikigai-9 scale and a Likert scale, respectively. We analyzed the associations between health literacy and purpose in life and life satisfaction with regression analyses. Age, sex, income, education, marital status, psychological stress, and diseases as present illness were adjusted in the statistical models. Our multiple linear regressions indicated that health literacy was significantly associated with purpose in life (β = 0.199, p < 0.001), after adjusting for covariates (age, sex, income, education, marital status, psychological factor, and disease status). Life satisfaction was also significantly associated with health literacy (β = 0.126, p < 0.001). Health literacy is associated with purpose in life and life satisfaction among specialists in health management. Health literacy plays a critical role in lifestyle-related disease prevention and health promotion. Interventions to improve health literacy may be warranted in the context of national health promotion.
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Rababah JA, Al-Hammouri MM, Aldalaykeh M. Validation and measurement invariance of the Arabic Health Literacy Questionnaire. Heliyon 2022; 8:e09301. [PMID: 35497048 PMCID: PMC9043993 DOI: 10.1016/j.heliyon.2022.e09301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/05/2022] [Accepted: 04/14/2022] [Indexed: 11/21/2022] Open
Abstract
Health literacy plays a key role in empowering individuals and enabling them to make health-related decisions. Despite the advances in health literacy research, there are gaps in the literature that require further inquiry, and establishing comprehensive and valid measurements is one of them. Thus, this research was conducted to examine the psychometric properties of the Arabic Health Literacy Questionnaire (HLQ), including the reliability, validity, and measurement invariances of the nine HLQ scales. A cross-sectional design was used in this study. A sample of university students (N = 1011) was recruited, the mean of age was 21.1 years old (SD = 2.28). The Arabic HLQ and a demographics questionnaire were completed by the participants. Confirmatory factor analyses (CFA) and measurement invariances were performed for each HLQ scale. The values of Cronbach's α and composite reliability were above .70 for all HLQ scales. The CFA analyses showed that all HLQ scales meet the criteria that were set a priori: RMSEA ≤.07, CFI ≥.95, and Chisq/df < 5. In addition, all standardized factor loadings were above .50. Regarding the measurement invariance, the results supported the equal form measurement invariance for all HLQ scales. The equality of factor loadings measurement invariance across gender was also supported for all HLQ scales. Measurement invariance of factor loadings and equality of indicator intercepts was partially supported. These results show that the internal consistency, convergence, and factor structure of the HLQ are all supported. The Arabic HLQ is a reliable, valid tool to measure health literacy among Arabic-speaking populations.
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Affiliation(s)
- Jehad A. Rababah
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammed M. Al-Hammouri
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Jordan
| | - Mohammed Aldalaykeh
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Jordan
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Singh S, Zaki RA, Farid NDN, Kaur K. The Determinants of Mental Health Literacy among Young Adolescents in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063242. [PMID: 35328930 PMCID: PMC8953899 DOI: 10.3390/ijerph19063242] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 02/05/2023]
Abstract
Mental health literacy (MHL) is an established multifaceted concept that comprises mental health knowledge, help-seeking, and stigma. Adequate MHL (i.e., the ability to correctly recognize mental health disorders alongside having the intention to seek help) is able improve mental health outcomes among individuals. This study aims to examine the determinants of MHL among young Malaysian adolescents. A cross-sectional study was conducted among 1400 adolescents between 13 and 14 years old from nine national secondary schools in Selangor state, Malaysia. Sociodemographic determinants assessed included gender, age, ethnicity, smoking status, alcohol consumption, history of being bullied, feeling lonely, parental marital status, and parental income which were assessed using the Global School Based Student Health Survey. MHL was assessed using the Mental Health Literacy and Stigma questionnaire. Several factors were significantly associated with adequate levels of MHL following multivariate analysis, such as being female (AOR = 1.68; 95% CI 1.12, 2.52), older adolescents (AOR = 1.56; 95% CI 1.07, 2.30), not smoking (AOR = 1.99; 95% CI 1.20, 4.26), not consuming alcohol (AOR = 1.23; 95% CI 1.18, 2.41), and not feeling lonely (AOR = 1.25; 95% CI 1.06, 1.85). Addressing these determinants could be key in assisting the development of policies and programs to prevent mental health disorders among adolescents, which are currently on the rise.
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Affiliation(s)
- Sarbhan Singh
- Institute for Medical Research (IMR), National Institutes of Health (NIH), Ministry of Health Malaysia, Shah Alam 40170, Malaysia
- Correspondence: ; Tel.: +60-122-017-412
| | - Rafdzah Ahmad Zaki
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (R.A.Z.); (N.D.N.F.)
| | - Nik Daliana Nik Farid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia; (R.A.Z.); (N.D.N.F.)
| | - Kushilpal Kaur
- Department of Psychiatry, Hospital Selayang, Ministry of Health Malaysia, Batu Caves 68100, Malaysia;
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Michou M, Costarelli V. Validity and reliability of the european health literacy survey questionnaire (HLS_EU_Q16) in the greek language. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-211538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Having comprehensive and validated tools to effectively measure levels of Health Literacy (HL) in the general population is of great importance, since HL levels appear to be an crucial determinant of the population’s overall health. OBJECTIVE: The aim of the study was to validate the Greek version of the HLS_EU_Q16 questionnaire. METHODS: A total of 496 participants (81.8% women) participated in a self-administrated online, cross-sectional survey. The participants had to concurrently complete the Greek Version of HLS_EU_Q16 and the New Vital Sign (NVS). Certain socioeconomic and anthropometric characteristics also assessed. For test-retest reliability, 149 of the participants completed the questionnaire twice within a 15-day period. Principal Component Analysis, Cronbach’s a Spearman’s rho were used. RESULTS: All 3 factors assessed by the tool: “Health Care”, “Disease Prevention” and “Health Promotion”, had eigenvalues greater than 1. The Cronbach’s a was 0.884, for the total score of the HLS_EU_Q16 and 0.790, 0.710 and 0.800, for the above 3 subscales, respectively. Finally, test–retest reliability, after 15 days for the HLS_EU_Q16, resulted in Spearman’s correlation coefficient of r = 0.628 (p < 0.0001) which show a high correlation. CONCLUSIONS: Results indicate that the HLS_EU_Q16 is a reliable and valid tool for assessing HL in the Greek population.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Economics & Sustainable Development, Harokopio University, Athens, Greece
| | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Economics & Sustainable Development, Harokopio University, Athens, Greece
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Amoah PA, Musalia J, Abrefa Busia K. Health Behaviors and Health Literacy: Questing the Role of Weak Social Ties Among Older Persons in Rural and Urban Ghana. Front Public Health 2022; 10:777217. [PMID: 35296048 PMCID: PMC8919952 DOI: 10.3389/fpubh.2022.777217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background Older persons are one of the most vulnerable groups as regards low health literacy. However, little is known about the extent of limitations and multi-faceted nature of their health literacy, such as its characteristics and social and geographical dimensions. Additionally, most existing studies have predominantly treated health literacy as a risk factor of health and wellbeing of older persons as opposed to an outcome that must be pursued. Objectives This study investigated the moderating role of weak social ties (bridging social capital) in the relationship between health behaviors, such as smoking, alcohol intake, voluntary body check-up and physical exercise, and health literacy among older persons in rural and urban Ghana. Methods Data was drawn from a cross-sectional survey comprising 522 respondents across five administrative regions in Ghana. Ordinary Least Squares regression technique was used to analyse the data. Results Older persons in urban areas had higher health literacy [Mean/Standard deviation (SD) = 9.1/4.1 vs. 10.1/4.2] as well as higher bridging social capital (Mean/SD = 2.0/1.2 vs. 1.6/0.9) than their rural counterparts. Bridging social capital was negatively associated with the health literacy of urban residents (B = -0.997, p < 0.01). We found evidence that smoking (B = -0.787, p < 0.05) and undertaking physical activities (B = 0.812, p < 0.01) were associated with health literacy of older persons in rural areas. Having voluntary body check-ups (B = 0.155, p < 0.01) was associated with health literacy in urban areas. Bridging social capital negatively moderated the association of smoking with health literacy in rural areas (B = -5.032, p < 0.01), but it instead positively modified the relationship between alcohol intake and health literacy in urban areas (B = 0.185, p < 0.05). Conclusion For policymakers and practitioners aiming to promote older persons' health literacy as a public health asset at individual and community levels, an important starting point to achieving such goals is to understand the fundamental indicators (e.g., health behaviors) and the role that social and geographical factors play in shaping their health literacy.
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Affiliation(s)
- Padmore Adusei Amoah
- Department of Applied Psychology, School of Graduate Studies, Institute of Policy Studies, Lingnan University, Tuen Mun, Hong Kong SAR, China
| | - John Musalia
- Department of Sociology and Criminology, Western Kentucky University, Bowling Green, KY, United States
| | - Kwaku Abrefa Busia
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong SAR, China
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Liu L, Jia HH, Zhou YQ, Liu YR, Yin F, Liu XF. The illness perception and health promotion behaviour of young and middle-aged patients with hyperuricaemia: A qualitative study. Nurs Open 2022; 9:1343-1352. [PMID: 35092168 PMCID: PMC8859027 DOI: 10.1002/nop2.1179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/01/2021] [Accepted: 01/09/2022] [Indexed: 11/07/2022] Open
Abstract
AIM The purpose of this qualitative study was to describe the health-promoting behaviours of patients with hyperuricaemia and influencing factors. DESIGN A descriptive qualitative design was used to gain insight into the personal experience of health promotion behaviour in patients with hyperuricaemia. METHODS Sixteen patients were sampled in face-to-face interviews with maximum variation, and the data were transcribed verbatim. The data analysis was based on the phrases of thematic analysis outlined by Braun and Clarke (2006). RESULTS Four main themes were identified in the data: (a) Perception of disease; (b) Motivation to change health-promoting behaviour; (c) Strategies for health-promoting behaviour; and (d) Encounter obstacles to change health-promoting behaviour.
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Affiliation(s)
- Li Liu
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Hong-Hong Jia
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Yan-Rui Liu
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
| | - Fei Yin
- Department of Nursing, Harbin Medical University (Daqing), Daqing, China
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Ying Y, Jing C, Zhang F. The Protective Effect of Health Literacy on Reducing College Students' Stress and Anxiety During the COVID-19 Pandemic. Front Psychiatry 2022; 13:878884. [PMID: 35664470 PMCID: PMC9161275 DOI: 10.3389/fpsyt.2022.878884] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic threatens people's health and well-being all around the world, resulting in increased stress and anxiety. Existing literature has found health literacy has a protective effect on health, and the study has taken a closer look at the effects of health literacy on perceived stress and anxiety among Chinese college students. METHODS With structural questionnaires, a cross-sectional survey was conducted to collect the responses of 1,251 participants from different universities in Hubei and Guangdong, China. Participants' health literacy and perceived stress and anxiety symptoms were evaluated. RESULTS Only 11.83% of the participants reported sufficient health literacy. Compared with college students from Hubei and Guangdong with a major in medicine showed a higher percentage of having sufficient literacy. Moreover, having sufficient health literacy showed a protective effect in reducing the risk of stress (OR = 0.14, 95%CI= 0.01-0.04; p < 0.001) and anxiety (OR = 0.02, 95%CI = 0-0.61; p < 0.001). CONCLUSION Health literacy was found to have a protective effect in reducing anxiety and stress among college students. This effect has remained among students from different majors and locations. However, it is noteworthy that the overall level of health literacy is relatively low among college students, particularly among those from Hubei Province or with non-medical majors. Therefore, more effort should be put into developing health education programs promoting health literacy and mental health on campus.
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Affiliation(s)
- Yuting Ying
- Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chunxia Jing
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Motamedi N, Taherian Z. Effect of a 12-week community-based intervention to improve social capital, quality of life, self-care, and health literacy among older people: A quasi-experimental trial. Adv Biomed Res 2022; 11:23. [PMID: 35720209 PMCID: PMC9201224 DOI: 10.4103/abr.abr_101_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction: The aim of this study was to assess the effect of a community-based intervention on social capital, quality of life, self-care, and health literacy among elderly. Materials and Methods: This quasi-experimental trial was conducted at two health-care centers in Isfahan, Iran, which assigned to the intervention and control groups. A total of 86 elderly (60 years or above) enrolled in the study. The intervention program consisted of 12 weekly group sessions with various health topics. Nine sessions held in the health-care center and three local tours in different locations of the neighborhood. The control group received routine care of health centers. Social capital, quality of life, self-care, and health literacy were assessed at baseline and 1 month after the intervention in two groups. Results: Mental component of quality of life (P = 0.026), self-care, and health literacy (P < 0.001) showed a significant increase in the intervention group compared to the control group at 1 month after the intervention. The total score of social capital and the dimensions of local community participation, social agency, feelings of security and trust, interactions with neighbors, and interactions with family and friends improved in the intervention group (P < 0.001). However, there was no significant difference in the dimensions of tolerance of diversity (P = 0.241) and value of life (P = 0.928). Conclusions: This community-based interventions with a variety of diverse and participatory components can be used as a strategy to promote the health of the elderly in primary health care.
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Pathways Linking Health Literacy to Self-Management in People with Type 2 Diabetes. Healthcare (Basel) 2021; 9:healthcare9121734. [PMID: 34946460 PMCID: PMC8701917 DOI: 10.3390/healthcare9121734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/09/2021] [Accepted: 12/12/2021] [Indexed: 11/23/2022] Open
Abstract
Health literacy is considered to be an emerging determinant of health behaviors and outcomes. The underlying mechanisms linking health literacy to diabetes self-management are currently unclear. This study assessed a mediation model consisting of a direct pathway between health literacy and self-management, and indirect pathways via social isolation only, self-efficacy only, and social isolation and self-efficacy serially in people with type 2 diabetes. A cross-sectional design was employed, and a total of 524 participants were recruited from outpatient clinics of multi-institutions from June 2020 to February 2021. The mediation model was analyzed using the PROCESS macro on SPSS with bootstrap bias-corrected 95% confidence intervals (CIs) with 10,000 bootstrapping iterations. Health literacy positively affected self-management. The estimated indirect effect of health literacy on self-management via social isolation was significant, at 0.018 (95% CI = 0.004–0.036). The indirect effect via self-efficacy was estimated at 0.214 (95% CI = 0.165–0.266). The indirect effect via social isolation and self-efficacy serially was 0.013 (95% CI = 0.006–0.023). The findings of this study suggest that clinical practice can be improved through more comprehensive diabetes self-management interventions that promote all of the components of health literacy, social contacts/networks, and self-efficacy in particular.
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Teles M, Kaya S. Health literacy of cardiology patients: determinants and effects on patient outcomes. SOCIAL WORK IN HEALTH CARE 2021; 60:656-673. [PMID: 34877925 DOI: 10.1080/00981389.2021.2014615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/30/2021] [Indexed: 06/13/2023]
Abstract
Health literacy is important for the management of chronic cardiovascular diseases. Comprehensive studies related to health literacy of cardiac patients are limited. The aims of this study were to determine the determinants of health literacy and its effects on patient outcomes in cardiology patients. The European Health Literacy Survey Questionnaire (HLS-EU-Q- 47 items) was applied to 530 patients who presented to cardiology polyclinics of a university hospital in Ankara. Correlation coefficients, univariate and multi-linear regression analyses were used in the study. Determinants of health literacy were sex, education level, place of residence and perception of social status (p < .05). Although adjustments were made based on relevant control variables in multivariate analyses, health literacy was found to affect 14 of 26 patient outcomes within the scope of the study (p < .05). Higher education level and perception of social status, residing in the city center and being female were among the determinants of high health literacy. Higher health literacy was associated with more positive patient outcomes. Health literacy affected health behaviors and risks, drug use habits, health status, use of preventive health services and patient satisfaction.
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Affiliation(s)
- Mesut Teles
- Niğde Zübeyde Hanım School of Health, Department of Health Management, Niğde Ömer Halisdemir University, Turkey
| | - Sıdıka Kaya
- Faculty of Economics and Administrative Sciences, Department of Health Care Management, Hacettepe University, Ankara, Turkey
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Skoumalova I, Madarasova Geckova A, Rosenberger J, Majernikova M, Kolarcik P, Klein D, de Winter AF, van Dijk JP, Reijneveld SA. Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population. Int J Public Health 2021; 66:585801. [PMID: 34744558 PMCID: PMC8565259 DOI: 10.3389/ijph.2021.585801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/05/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL. Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test. Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001. Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.
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Affiliation(s)
- Ivana Skoumalova
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Andrea Madarasova Geckova
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic.,FMC-Dialysis Services Slovakia, Kosice, Slovakia
| | | | - Peter Kolarcik
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands.,Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.,Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Daniel Klein
- Institute of Mathematics, Faculty of Science, Pavol Jozef Safarik University, Kosice, Slovakia
| | - Andrea F de Winter
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Jitse P van Dijk
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
| | - Sijmen A Reijneveld
- Department of Community and Occupational Medicine, University Medical Center Groningen, Groningen, Netherlands
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Aygun O, Cerim S. The relationship between general health behaviors and general health literacy levels in the Turkish population. Health Promot Int 2021; 36:1275-1289. [PMID: 33378444 DOI: 10.1093/heapro/daaa151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of our study was to determine the health literacy level of the study participants and examine the relationship between health literacy levels and sociodemographic characteristics, health self-assessment levels and health protective behaviors. We recruited 826 individuals into the study, selecting the participants by using a systematic random sampling method. Data were collected with a descriptive information form, the European Health Literacy Scale and a General Health Behaviors Scale. The analysis of the data was carried out using numbers and percentages, the Chi Square test and ordinal regression analysis. We found that the level of health literacy was inadequate in 25.9% of the study participants, problematic/limited in 41.4% had, adequate in 23.6% and excellent in 9.1%. A statistically significant correlation was found between an adequate level of health literacy and being relatively more educated, having a chronic disease, being able to follow up on health news, reading publications on health and being better able to evaluate one's own health (p < 0.05). Additionally, a statistically significant correlation was observed between adequate health literacy levels and being in the later stages of the transtheoretical model in terms of general health behaviors in the domains outside of monitoring one's own weight and avoiding the sun (p < 0.05). The level of adequate health literacy was discovered to be lower in our study than in Europe. Health protective behaviors show an increase among individuals who display an adequate level of health literacy.
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Affiliation(s)
- Ozcan Aygun
- Division of Nursing, Public Health Nursing Department, Fethiye Faculty of Health Science, Mugla Sitki Kocman University, Calica Mevkii/Karaculha, Fethiye/Mugla, Turkey
| | - Selda Cerim
- Division of Nursing, Public Health Nursing Department, Faculty of Health Science, Mugla Sitki Kocman University, Kötekli Mah. Marmaris Yolu Üzeri Tıp Fakültesi Arkası Menteşe/Mugla, Turkey
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Lim ML, van Schooten KS, Radford KA, Delbaere K. Association between health literacy and physical activity in older people: a systematic review and meta-analysis. Health Promot Int 2021; 36:1482-1497. [PMID: 33450020 DOI: 10.1093/heapro/daaa072] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Physical inactivity is common in older people and contributes to morbidity and mortality. Health literacy might play a role in motivating people to become or stay physically active. However, little is known about the influence of health literacy on physical activity in older people. This review aims to determine the association between health literacy and physical activity in older people. A systematic search was conducted in CINAHL, MEDLINE, PsychINFO and CENTRAL. Inclusion criteria: (i) community-dwelling people with an average age of ≥55 and (ii) reported on the association between health literacy and physical activity. Exclusion criteria: (i) population with a health condition and (ii) case study or qualitative study. Data were extracted independently by two reviewers. Risk of bias was assessed using the Downs and Black checklist. A meta-analysis was conducted using random-effects models with inverse variance. Thirteen articles were included in the review and five articles were selected for the meta-analysis. Older people with inadequate health literacy were 38% less likely than older people with adequate health literacy to report engaging in physical activity on ≥5 days per week [odds ratio = 0.62, 95% confidence interval (CI) 0.55-0.77]. Only two articles used activity monitors; the mean number of steps taken per day was not significantly different between older people with adequate and inadequate health literacy (standardized mean difference = -0.15, 95% CI -0.30 to 0.01). Physical activity could potentially be fostered by increasing health literacy and empowering older people to make beneficial health decisions.
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Affiliation(s)
- Mei Ling Lim
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW 2031, Australia.,School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW 2033, Australia
| | - Kimberley S van Schooten
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW 2031, Australia.,School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW 2033, Australia
| | - Kylie A Radford
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW 2031, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW 2052, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW 2031, Australia.,School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW 2033, Australia
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Social Interaction and Physical Activity Among Rural Older Adults: A Scoping Review. J Aging Phys Act 2021; 30:495-509. [PMID: 34611053 DOI: 10.1123/japa.2021-0046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/18/2022]
Abstract
Social interaction and physical activity are critical components in supporting health among older adults, yet rates of activity are low in rural communities. There is significant merit in exploring the relationship between these interrelated concepts. A scoping review was conducted to synthesize existing literature. Search results identified 26 studies meeting inclusion criteria. Findings indicated that social interaction and physical activity were important for many older adults to maintain health; however, not all older adults preferred the social aspect of group-based exercise. Opportunities for physical activity and social interaction were limited based on geographical location and other socioeconomic factors. This was evident in rural communities where populations were lower and education and income levels varied. Differences on the defining role and meaning of physical activity also emerged. Increasing physical activity and social interaction must account for negative associations to address the lower rates of participation among rural older adults.
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Praveen S, Parmar J, Chandio N, Arora A. A Systematic Review of Cross-Cultural Adaptation and Psychometric Properties of Oral Health Literacy Tools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10422. [PMID: 34639729 PMCID: PMC8508111 DOI: 10.3390/ijerph181910422] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/22/2021] [Accepted: 09/29/2021] [Indexed: 12/21/2022]
Abstract
The aims of this systematic review were to critically appraise the quality of the cross-cultural adaptation and the psychometric properties of the translated versions of oral health literacy assessment tools. CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), and ProQuest Dissertation and Thesis were searched systematically. Studies focusing on cross-cultural adaptation and psychometric properties of oral health literacy tools were included. The methodological quality of included studies was assessed according to the COSMIN Risk of Bias checklist. Sixteen oral health literacy instruments in 11 different languages were included in this systematic review. However, only seven instruments met the criteria for an accurate cross-cultural adaptation process, while the remaining tools failed to meet at least one criterion for suitable quality of cross-cultural adaptation process. None of the studies evaluated all the aspects of psychometric properties. Most of the studies reported internal consistency, reliability, structural validity, and construct validity. Despite adequate ratings for some reported psychometric properties, the methodological quality of studies on translated versions of oral health literacy tools was mostly doubtful to inadequate. Researchers and clinicians should follow standard guidelines for cross-cultural adaptation and assess all aspects of psychometric properties for using oral health literacy tools in cross-cultural settings.
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Affiliation(s)
- Sobiya Praveen
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
| | - Jinal Parmar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
| | - Navira Chandio
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (S.P.); (J.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
- Clinical School Child and Adolescent Health, The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
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Mahmoodi R, Hassanzadeh A, Rahimi M. Health literacy and its dimensions in elderly people in Farsan city, Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:362. [PMID: 34761048 PMCID: PMC8552271 DOI: 10.4103/jehp.jehp_149_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Health literacy is an important variable in the promotion and improvement of the health of all social groups, especially the elderly people. It indicates cognitive and social skills that specify the individuals' motivation and ability to access and perceive information using methods for health retention and improvement. The present research aimed to study health literacy and its relevant dimensions in a population over 60 years of age in Farsan city. MATERIALS AND METHODS A cross-sectional study on 384 older people in Farsan city was conducted, using a standard health literacy questionnaire including 33 items and 5 dimensions on a 5-point Likert scale for collecting data. Data analysis was done using descriptive and analytical statistics, using the multiple linear regression analysis. RESULTS Among the dimensions, the highest and lowest scores belonged to decision-making and reading skill dimensions, respectively. The multiple linear regression analysis revealed that among the demographical variables, education level, age, sex, and job were the best predictors of total scores of health literacy (P < 0.001). CONCLUSIONS The health-related institutions should make effort to improve the elderly people's health literacy based on general literacy, using suitable methods with less need to read and paying attention to personal characteristics.
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Affiliation(s)
- Reza Mahmoodi
- MSc, Student, Research Committee, Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Rahimi
- Department of Health Education and Promotion, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
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Tarihoran DETAU, Honey M, Slark J. Educational Strategies for Secondary Stroke Prevention: An Integrative Literature Review. AMERICAN JOURNAL OF HEALTH EDUCATION 2021. [DOI: 10.1080/19325037.2021.1973616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Liu Y, Meng H, Conner KO, Qiao M, Liu D. The Influence of Health Literacy and Social Support on Loneliness Among Patients With Severe Mental Illness in Rural Southwest China. Front Psychol 2021; 12:564666. [PMID: 34566737 PMCID: PMC8455823 DOI: 10.3389/fpsyg.2021.564666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/13/2021] [Indexed: 02/05/2023] Open
Abstract
Loneliness is an important risk factor for poor health outcomes among adults, especially among those with severe mental illnesses (SMIs). Existing research has shown that adults with SMIs often lack health literacy, which contributes to more restricted social networks and low levels of social support. The objective of this cross-sectional study was to examine the influence of health literacy and social support on the loneliness of patients with SMI in rural Southwest China. We recruited 300 patients with SMI in rural Southwest China between December, 2017 to May, 2018 via a multi-stage stratified random sampling approach. We used structural equation modeling (SEM) test the hypothesized relationships among the variables of the 270 patients who completed the survey. Results of the SEM showed that health literacy was both directly and indirectly associated with loneliness, with social support playing a mediating role. These findings suggest psychoeducation for SMI patients, and their informal caregivers, may offer beneficial effects toward reducing loneliness in this vulnerable population. Further, social support is another potential target for intervention development for improving patient outcomes.
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Affiliation(s)
- Yan Liu
- Department of Health Behavioral and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Department of Academic Affairs, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Hongdao Meng
- School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States
| | - Kyaien O Conner
- Department of Mental Health Law & Policy, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, United States
| | - Mutian Qiao
- Department of Health Behavioral and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Danping Liu
- Department of Health Behavioral and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Wells TS, Rush SR, Nickels LD, Wu L, Bhattarai GR, Yeh CS. Limited Health Literacy and Hearing Loss Among Older Adults. Health Lit Res Pract 2021; 4:e129-e137. [PMID: 32510569 PMCID: PMC7274562 DOI: 10.3928/24748307-20200511-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Effective communications between health care providers and patients are critical for high-quality health care. OBJECTIVE This study sampled adults age 65 years and older to explore (1) characteristics associated with limited health literacy (LHL) and (2) medical costs and gaps in care based on health literacy, hearing loss, and hearing aid use status. METHODS The study included 19,223 adults age 65 years and older who completed a health survey that was linked to his or her medical claims that were generated after medical care provided in the year prior to survey completion. Health literacy, hearing loss, and hearing aid use were assessed through self-reports. Health literacy was coded as limited and adequate. Hearing loss and hearing aid use were coded into five categories: no hearing loss, unaided mild, aided mild, unaided severe, and aided severe hearing loss. KEY RESULTS Seven percent reported LHL and 41% reported hearing loss. Hearing loss, especially unaided severe, was associated with LHL, as were memory loss, depression, loneliness, older age, and male gender. People with aided severe hearing loss and LHL had higher annual medical costs than those with adequate health literacy. Similarly, those with no hearing loss and LHL had higher annual medical costs than those with adequate health literacy. CONCLUSIONS Unaided mild, aided severe, and unaided severe hearing loss were positively associated with LHL, although the association was reduced among hearing aid users. Specifically, aided mild or severe hearing loss had lower odds of LHL, compared to unaided mild or severe hearing loss, respectively. We also observed that people with both hearing loss and LHL were more likely to have higher medical costs. Continued focus on solutions to address both LHL and hearing loss remains warranted. [HLRP: Health Literacy Research and Practice. 2020;4(2):e129-e137.] PLAIN LANGUAGE SUMMARY: Health survey and medical claims data were used for this study. Hearing loss, especially unaided severe, was associated with limited health literacy, as were memory loss, depression, loneliness, older age, and male gender. Those with both limited health literacy and hearing loss had the highest medical costs. Health literacy and hearing loss can affect health care communications, warranting further study.
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Affiliation(s)
- Timothy S. Wells
- Address correspondence to Timothy S. Wells, PhD, Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108;
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Davis B, Jansen CJM. Deploying a Fotonovela to Combat Methamphetamine Abuse among South Africans with Varying Levels of Health Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126334. [PMID: 34208087 PMCID: PMC8296184 DOI: 10.3390/ijerph18126334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/16/2022]
Abstract
Poor health literacy in the Western Cape Province of South Africa is one of the main factors hampering methamphetamine (MA) use prevention efforts in the area, where the abuse of this drug is a major health and social problem affecting especially previously disadvantaged communities. In the first part of a two-part study, we compared a health-related fotonovela about MA to an existing brochure group and a control group. Main findings show that the vast majority of readers preferred the fotonovela over the existing brochure. This included participants from all three age groups and for both levels of health literacy (low/high) distinguished (n = 372). Furthermore, specifically for older people with low levels of health literacy, the fotonovela outperformed the existing brochure condition for knowledge level. In the second part of the study, we found that healthcare providers (n = 75) strongly prefer a fotonovela over an existing brochure, while this cohort viewed the potential use of fotonovelas in a health care setting as very positive. Our findings add to the promising results of an earlier fotonovela study about MA use in South Africa, providing further support for considering using narratives in health communication as a serious option to effectively communicate convincing health information about this drug to target audiences in the Western Cape Province.
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Affiliation(s)
- Burt Davis
- Africa Centre for HIV/AIDS Management, Faculty of Economic and Management Sciences, Stellenbosch University, Stellenbosch 7602, South Africa
- Correspondence:
| | - Carel J. M. Jansen
- Department of Communication and Information Sciences, Faculty of Arts, University of Groningen, 9712 EK Groningen, The Netherlands;
- Language Centre, Stellenbosch University, Stellenbosch 7600, South Africa
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Gurgel do Amaral M, Reijneveld SA, Almansa J, Navis G, de Winter AF. Do Uncontrolled Hypertension, Diabetes, Dyslipidemia, and Obesity Mediate the Relationship Between Health Literacy and Chronic Kidney Disease Complications? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105235. [PMID: 34069095 PMCID: PMC8157126 DOI: 10.3390/ijerph18105235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/30/2022]
Abstract
Health literacy is the ability to deal with information related to one’s health. Patients with low health literacy and chronic diseases, such as chronic kidney disease (CKD), have poor disease-management skills, which could lead to complications. We used logistic regressions and structural equational modeling to assess whether low health literacy is associated with the development of cardiovascular disease and mortality in patients with CKD, and whether this association is mediated by the presence of uncontrolled hypertension, diabetes, dyslipidemia, obesity, or albuminuria. Data from 2742 adult participants with CKD from the Lifelines study were analyzed at baseline and after approximately four years. Low health literacy was associated with cardiovascular disease and mortality in the crude models, with OR and 95%CI of 1.93 (1.46 to 2.55) and 1.59 (1.08 to 2.36), respectively. After adjustment for age and sex, low health literacy was only associated with cardiovascular disease (OR 1.76 (1.31 to 2.23)). This association was mediated by uncontrolled diabetes (27.1%) and obesity (8.0%). Low health literacy is associated with the development of cardiovascular disease after adjustment for age and sex, and this association is mediated by uncontrolled diabetes and obesity.
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Affiliation(s)
- Matheus Gurgel do Amaral
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
- Correspondence:
| | - Sijmen A. Reijneveld
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Josue Almansa
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
| | - Gerjan Navis
- Department of Nephrology, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands;
| | - Andrea F. de Winter
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands; (S.A.R.); (J.A.); (A.F.d.W.)
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49
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Health Literacy, Self-Perceived Health, and Substance Use Behavior among Young People with Alcohol and Substance Use Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084337. [PMID: 33921885 PMCID: PMC8073264 DOI: 10.3390/ijerph18084337] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/17/2022]
Abstract
Licit and illicit substance use is one of the major public health issues with severe negative health consequences for individuals and society. Health literacy is essential for improving one's health and navigation in the healthcare system. However, the evidence of health literacy in people with substance use disorders is limited. This study aims to examine health literacy and its socio-demographic, health-related, and substance use-related correlates in young people with alcohol (AUD) and substance use disorders (SUD). In this study, cross-sectional data of young people undergoing addiction treatment for AUD (N = 201, mean age 37.6) and SUD (N = 165, mean age 31.1) were used. Health literacy was assessed using the HLS-EU-Q47. Simple and multiple linear regression was performed to estimate the correlates of health literacy. In total, 37.8% of participants with AUD and 41.8% of SUD had limited health literacy. In participants with AUD, living condition factors, self-perceived health indicators, and frequency of alcohol use showed a significant effect on health literacy. In participants with SUD, financial factors, self-perceived health indicators, and injection sharing showed a significant effect. Increasing health literacy might contribute to improved health outcomes and decreased high-risk substance use-related behavior in people undergoing addiction treatment.
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Matsumoto M, Suganuma H, Ozato N, Shimizu S, Katashima M, Katsuragi Y, Mikami T, Itoh K, Nakaji S. Association between Serum Concentration of Carotenoid and Visceral Fat. Nutrients 2021; 13:nu13030912. [PMID: 33799771 PMCID: PMC7999533 DOI: 10.3390/nu13030912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/27/2021] [Accepted: 03/08/2021] [Indexed: 01/17/2023] Open
Abstract
Consumption of fruits and vegetables rich in carotenoids has been widely reported to prevent cardiovascular diseases. However, the relationship between serum carotenoid concentrations and visceral fat area (VFA), which is considered a better predictor of cardiovascular diseases than the body-mass index (BMI) and waist circumference, remains unclear. Therefore, we examined the relationship in healthy individuals in their 20s or older, stratified by sex and age, to compare the relationship between serum carotenoid concentrations and VFA and BMI. The study was conducted on 805 people, the residents in Hirosaki city, Aomori prefecture, who underwent a health checkup. An inverse relationship between serum carotenoid concentrations and VFA and BMI was observed only in women. In addition, the results were independent of the intake of dietary fiber, which is mainly supplied from vegetables as well as carotenoids. This suggests that consumption of a diet rich in carotenoids (especially lutein and beta-carotene) is associated with lower VFA, which is a good predictor of cardiovascular disease, especially in women. This study is the first to comprehensively evaluate the association between serum carotenoid levels and VFA in healthy individuals.
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Affiliation(s)
- Mai Matsumoto
- Innovation Division, KAGOME CO. LTD., 17 Nishitomiyama, Nasushiobara, Tochigi 329-2762, Japan; (H.S.); (S.S.)
- Correspondence: ; Tel.: +81-80-1581-1874
| | - Hiroyuki Suganuma
- Innovation Division, KAGOME CO. LTD., 17 Nishitomiyama, Nasushiobara, Tochigi 329-2762, Japan; (H.S.); (S.S.)
| | - Naoki Ozato
- Department of Active Life Promotion Sciences, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan; (N.O.); (M.K.); (Y.K.)
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo 131-8501, Japan
| | - Sunao Shimizu
- Innovation Division, KAGOME CO. LTD., 17 Nishitomiyama, Nasushiobara, Tochigi 329-2762, Japan; (H.S.); (S.S.)
- Department of Vegetable Life Science, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan;
- Innovation Center for Health Promotion, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan; (T.M.); (S.N.)
| | - Mitsuhiro Katashima
- Department of Active Life Promotion Sciences, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan; (N.O.); (M.K.); (Y.K.)
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo 131-8501, Japan
| | - Yoshihisa Katsuragi
- Department of Active Life Promotion Sciences, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan; (N.O.); (M.K.); (Y.K.)
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo 131-8501, Japan
| | - Tatsuya Mikami
- Innovation Center for Health Promotion, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan; (T.M.); (S.N.)
| | - Ken Itoh
- Department of Vegetable Life Science, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan;
- Department of Stress Response Science, Center for Advanced Medical Research, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
| | - Shigeyuki Nakaji
- Innovation Center for Health Promotion, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan; (T.M.); (S.N.)
- Department of Social Medicine, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan
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