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Zhang F, Or PPL, Chung JWY. How different health literacy dimensions influences health and well-being among men and women: The mediating role of health behaviours. Health Expect 2021; 24:617-627. [PMID: 33539611 PMCID: PMC8077109 DOI: 10.1111/hex.13208] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/22/2020] [Accepted: 01/15/2021] [Indexed: 01/11/2023] Open
Abstract
Background Health literacy, the ability to access, understand, evaluate and apply health information, was found to contribute to positive health outcomes, possibly via promoting healthy behaviours. However, the specific pathways linking different health literacy skills to health and well‐being have remained unclear. Methods A cross‐sectional survey with structural questionnaires was administered among 2236 adults in Hong Kong (mean age = 46.10 ± 19.05). Health literacy was measured by HLS‐Asian‐47. Participants' physical conditions and subjective well‐being were predicted by health literacy and health behaviours with structural modelling path analysis. Results Health literacy in finding and understanding information showed a direct effect on enhancing physical health, while applying information capacity had an indirect positive effect via promoting health behaviours, which was moderated by sex. Only among women, this indirect effect predicting fewer physical symptoms and better well‐being was significant. Conclusions Different health literacy dimensions showed distinct direct and indirect pathways in influencing health for men and women. Based on the findings, skill trainings should be developed to enhance both gender's abilities of finding and understanding health information, while the ability of applying health information should also be improved for modifying lifestyle and promoting health, particularly for women. Patient or Public Contribution Two thousand and two hundred thirty‐six adults from different districts of Hong Kong participated in the study, and responded to questions on health literacy, behaviours and health status.
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Affiliation(s)
- Fan Zhang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong.,Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Peggy P L Or
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - Joanne W Y Chung
- School of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China
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Bakker MM, Putrik P, Rademakers J, van de Laar M, Vonkeman H, Kok MR, Voorneveld-Nieuwenhuis H, Ramiro S, de Wit M, Buchbinder R, Batterham R, Osborne RH, Boonen A. Addressing Health Literacy Needs in Rheumatology: Which Patient Health Literacy Profiles Need the Attention of Health Professionals? Arthritis Care Res (Hoboken) 2021; 73:100-109. [PMID: 33026713 PMCID: PMC7839720 DOI: 10.1002/acr.24480] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/01/2020] [Indexed: 12/16/2022]
Abstract
Objective To identify and describe health literacy profiles of patients with rheumatic diseases and explore whether the identified health literacy profiles can be generalized to a broader rheumatology context. Methods Patients with rheumatoid arthritis, spondyloarthritis, and gout from 3 hospitals in different regions in The Netherlands completed the Health Literacy Questionnaire (HLQ). Hierarchical cluster analysis was used to identify patients’ health literacy profiles based on 9 HLQ domains. A multinomial regression model with the identified health literacy profiles as the dependent variable was fitted to assess whether patients with a given disease type or attending a given hospital were more likely to belong to a specific profile. Results Among 895 participating patients, the lowest mean HLQ domain scores (indicating most difficulty) were found for “critical appraisal,” “navigating the health system,” and “finding good health information.” The 10 identified profiles revealed substantial diversity in combinations of strengths and weaknesses. While 42% of patients scored moderate to high on all 9 domains (profiles 1 and 3), another 42% of patients (profiles 2, 4, 5, and 6) clearly struggled with 1 or several aspects of health literacy. Notably, 16% (profiles 7–10) exhibited difficulty across a majority of health literacy domains. The probability of belonging to one of the profiles was independent of the hospital where the patient was treated or the type of rheumatic disease. Conclusion Ten distinct health literacy profiles were identified among patients with rheumatic diseases, independent of disease type and treating hospital. These profiles can be used to facilitate the development of health literacy interventions in rheumatology.
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Affiliation(s)
- Mark M Bakker
- Maastricht UMC+ and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Polina Putrik
- Maastricht UMC+ and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jany Rademakers
- Nivel Netherlands Institute for Health Services Research, Utrecht, and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Mart van de Laar
- Medisch Spectrum Twente, Arthritis Center Twente and University of Twente, Enschede, The Netherlands
| | - Harald Vonkeman
- Medisch Spectrum Twente, Arthritis Center Twente and University of Twente, Enschede, The Netherlands
| | - Marc R Kok
- Maasstad Hospital, Rotterdam, The Netherlands
| | | | - Sofia Ramiro
- Leiden University Medical Center, Leiden, and Zuyderland Medical Center, Heerlen, The Netherlands
| | - Maarten de Wit
- Tools2use patient association, Amsterdam, The Netherlands
| | | | - Roy Batterham
- Swinburne University of Technology, Centre for Global Health and Equity, Melbourne, Victoria, Australia, and Thammasat University, Bangkok, Thailand
| | - Richard H Osborne
- Swinburne University of Technology, Centre for Global Health and Equity, Melbourne, Victoria, Australia
| | - Annelies Boonen
- Maastricht UMC+ and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Lee HY, Jin SW, Henning-Smith C, Lee J, Lee J. Role of Health Literacy in Health-Related Information-Seeking Behavior Online: Cross-sectional Study. J Med Internet Res 2021; 23:e14088. [PMID: 33502332 PMCID: PMC7875696 DOI: 10.2196/14088] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 02/20/2020] [Accepted: 08/11/2020] [Indexed: 01/26/2023] Open
Abstract
Background The internet has emerged as a main venue of health information delivery and health-related activities. However, few studies have examined how health literacy determines online health-related behavior. Objective The aim of this study was to investigate the current level of health-related information-seeking using the internet and how health literacy, access to technology, and sociodemographic characteristics impact health-related information-seeking behavior. Methods We conducted a cross-sectional study through a survey with Minnesotan adults (N=614) to examine their health literacy, access to technology, and health-related information-seeking internet use. We used multivariate regression analysis to assess the relationship between health-related information-seeking on the internet and health literacy and access to technology, controlling for sociodemographic characteristics. Results Better health literacy (β=.35, SE 0.12) and greater access to technological devices (eg, mobile phone and computer or tablet PC; β=.06, SE 0.19) were both associated with more health-related information-seeking behavior on the internet after adjusting for all other sociodemographic characteristics. Possession of a graduate degree (β=.28, SE 0.07), female gender (β=.15, SE 0.05), poor health (β=.22, SE 0.06), participation in social groups (β=.13, SE 0.05), and having an annual health exam (β=.35, SE 0.12) were all associated with online health-related information-seeking. Conclusions Our findings indicate that access to online health-related information is not uniformly distributed throughout the population, which may exacerbate disparities in health and health care. Research, policy, and practice attention are needed to address the disparities in access to health information as well as to ensure the quality of the information and improve health literacy.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, The University of Alabama, Tuscaloosa, AL, United States
| | - Seok Won Jin
- School of Social Work, University of Memphis, Memphis, TN, United States
| | - Carrie Henning-Smith
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jongwook Lee
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Jaegoo Lee
- School of Social Work, Jackson State University, Jackson, MS, United States
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Blancafort Alias S, Monteserín Nadal R, Moral I, Roqué Fígols M, Rojano i Luque X, Coll-Planas L. Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: results of the randomized trial AEQUALIS. BMC Public Health 2021; 21:84. [PMID: 33413233 PMCID: PMC7791739 DOI: 10.1186/s12889-020-10094-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence is scarce on how to promote health and decrease cumulative inequalities for disadvantaged older people. Downstream complex interventions focusing on intermediate factors (self-management, health literacy and social capital) may have the potential to mitigate the inequitable impacts of social determinants in health. The aim of the AEQUALIS study was to assess the effectiveness of a group-based intervention to improve self-perceived health as indicator of health inequality. METHODS Pragmatic randomised clinical trial addressed to older adults (≥ 60 years) living in urban disadvantaged areas with low self-perceived health. The intervention was delivered in primary care settings and community assets between 2015 and 2017 and consisted in 12 weekly sessions. The primary outcome was self-perceived health assessed in two ways: with the first item of the SF-12 questionnaire, and with the EQ-5D visual analog scale. Secondary outcomes were health-related quality of life, social capital, self-management, mental health and use of health services. Outcomes were assessed at baseline, post intervention and follow-up at 9 months after the end of the intervention. RESULTS 390 people were allocated to the intervention group (IG) or the control group (CG) and 194 participants and 164 were included in the data analysis, respectively. Self perceived health as primary outcome assessed with SF-12-1 was not specifically affected by the intervention, but with the EQ-5D visual analog scale showed a significant increase at one-year follow-up only in the IG (MD=4.80, 95%CI [1.09, 8.52]). IG group improved health literacy in terms of a better understanding of medical information (- 0.62 [- 1.10, - 0.13]). The mental component of SF-12 improved (3.77 [1.82, 5.73]), and depressive symptoms decreased at post-intervention (- 1.26 [- 1.90, - 0.63]), and at follow-up (- 0.95 [- 1.62, - 0.27]). The use of antidepressants increased in CG at the follow-up (1.59 [0.33, 2.86]), while it remained stable in the IG. CONCLUSIONS This study indicates that a group intervention with a strong social component, conducted in primary health care and community assets, shows promising effects on mental health and can be used as a strategy for health promotion among older adults in urban disadvantaged areas. TRIAL REGISTRATION ClinicalTrials.gov , NCT02733523 . Registered 11 April 2016 - Retrospectively registered.
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Affiliation(s)
- Sergi Blancafort Alias
- Fundació Salut i Envelliment UAB. Casa Convalescència, Sant Antoni Maria Claret, 17, 4a planta, 08041 Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Sant Quintí, 75-77, 08041 Barcelona, Spain
| | - Rosa Monteserín Nadal
- Institute of Biomedical Research (IIB Sant Pau), Sant Quintí, 75-77, 08041 Barcelona, Spain
- Equip d’Atenció Sardenya, EAP Sardenya, Sardenya, 466, 08025 Barcelona, Spain
| | - Irene Moral
- Institute of Biomedical Research (IIB Sant Pau), Sant Quintí, 75-77, 08041 Barcelona, Spain
- Equip d’Atenció Sardenya, EAP Sardenya, Sardenya, 466, 08025 Barcelona, Spain
| | - Marta Roqué Fígols
- Fundació Salut i Envelliment UAB. Casa Convalescència, Sant Antoni Maria Claret, 17, 4a planta, 08041 Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Sant Quintí, 75-77, 08041 Barcelona, Spain
| | - Xavier Rojano i Luque
- Fundació Salut i Envelliment UAB. Casa Convalescència, Sant Antoni Maria Claret, 17, 4a planta, 08041 Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Sant Quintí, 75-77, 08041 Barcelona, Spain
| | - Laura Coll-Planas
- Fundació Salut i Envelliment UAB. Casa Convalescència, Sant Antoni Maria Claret, 17, 4a planta, 08041 Barcelona, Spain
- Institute of Biomedical Research (IIB Sant Pau), Sant Quintí, 75-77, 08041 Barcelona, Spain
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Yodmai K, Pechrapa K, Kittipichai W, Charupoonpol P, Suksatan W. Factors Associated with Good COVID-19 Preventive Behaviors Among Older Adults in Urban Communities in Thailand. J Prim Care Community Health 2021; 12:21501327211036251. [PMID: 34334008 PMCID: PMC8326623 DOI: 10.1177/21501327211036251] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION/OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has affected mobility and mortality entire age, especially older adults. The COVID-19 preventive behaviors among older adults during the pandemic should be determined. To our knowledge, little is known about the preventive behavior during the COVID-19 pandemic among older adults living in urban areas in Thailand and the factors predicted to their behavior. Hence, the present study aimed to assess COVID-19 preventive behaviors among older adults and to identify the associated factors. METHODS This cross-sectional study included 421 participants aged ≥60 years. Data were analyzed using descriptive statistics, binary and multiple logistic regression analysis. RESULTS We found that 321 (72.6%) of the participants had good COVID-19 preventive behaviors. Moreover, 83.4% of the participants had good family support and 58.2% had easy access to health information. Only sufficient income (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.04-2.97), easy access to health services (OR: 3.66, 95% CI: 1.42-9.45) and protective material (OR: 1.98, 95% CI: 1.14-3.45), and good family support (OR: 2.05, 95% CI: 1.10-3.82) were associated with good COVID-19 preventive behaviors. In contrast, health literacy, access to health information, and neighbor and health personnel support were not associated with COVID-19 preventive behaviors. CONCLUSION Based on the present results, interdisciplinary healthcare teams should consider social support, and access to healthcare when developing interventions for encouraging and promoting health outcomes in order to improve physical and psychological COVID-19 preventive behaviors, particularly among elderly people living in urban communities during the COVID-19 pandemic.
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Affiliation(s)
| | | | | | | | - Wanich Suksatan
- HRH Princess Chulabhorn College of Medical Science, Bangkok, Thailand
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Michou M, Panagiotakos DB, Lionis C, Costarelli V. Health and nutrition literacy in adults: Links with lifestyle factors and obesity. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. OBJECTIVES: The aim of this study was to investigate certain lifestyle factors and obesity, in relation to HL and NL. METHODS: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The sample consisted of 1281 individuals, aged ≥18 years. HL, NL sociodemographic characteristics and lifestyle factors (physical activity, smoking status, alcohol consumption,) were assessed. Mann-Whitney U, the Kruskall Wallis, Pearson chi-square tests and multiple linear regression models were used. RESULTS: Linear regression analysis has shown that smoking, alcohol consumption and physical activity, were associated with HL levels (–1.573 points for ex-smokers in comparison to smokers, p = 0.035, –1.349 points for alcohol consumers in comparison to non-consumers, p = 0.006 and 1.544 points for physically active individuals to non-active, p = 0.001). With respect to NL levels, it was also not associated with any of these factors. Obesity was not associated with HL and NL levels. CONCLUSIONS: Certain lifestyle factors, including physical activity, are predicting factors of HL levels, in Greek adults. The results contribute to the understanding of the relationship between lifestyle factors and HL and should be taken into account when HL policies are designed.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
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Chung S, Lee HY, Lee M, Chung S. Health Literacy in Korean Adults and Korean American Immigrants: Implications for Achieving Health Equity. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2020; 42:29-36. [PMID: 33201774 DOI: 10.1177/0272684x20973511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health literacy is necessary to understand health information and make appropriate decisions regarding one's health. This study aims to investigate (1) the health literacy level of Korean citizens and Korean American (KA) immigrants in the United States and (2) factors that influence health literacy across three age groups. A quota sampling method was used to collect cross-sectional survey data from 404 Korean participants and 404 KA immigrants. Andersen's behavioral model was used as the theoretical framework for this study. Overall, Korean participants had a higher mean score on health literacy than did the KA immigrants. Only one of predisposing and enabling factors were significant variables influencing health literacy in KA immigrants, while several predisposing, enabling and need factors were significantly associated with health literacy in Korean adults. Our findings indicate that both countries need to have a community-based health literacy educational program that is tailored to each age group.
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Affiliation(s)
- Soondool Chung
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Hee Yun Lee
- School of Social Work, University of Alabama, Tuscaloosa, United States
| | - Miwoo Lee
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, Korea
| | - Semi Chung
- Department of Social Welfare, Graduate School of Social Welfare, Ewha Womans University, Seoul, Korea
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Health Literacy and Physical Activity: A Systematic Review. J Phys Act Health 2020; 17:1259-1274. [PMID: 33129198 DOI: 10.1123/jpah.2020-0161] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/30/2020] [Accepted: 09/13/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The importance of health literacy (HL) in health promotion is increasingly clear and acknowledged globally, especially when addressing noncommunicable diseases. This paper aimed to collect and summarize all current data from observational studies generating evidence of the association between HL and physical activity (PA) and to analyze intervention studies on the promotion of PA to ascertain whether HL moderates the efficacy of such intervention. METHODS A comprehensive systematic literature search of observational studies investigating the association between HL and PA was performed. Intervention studies on the promotion of PA that also measured the HL levels of participants and its effect on the outcome of the intervention were also identified. RESULTS Of the 22 studies included in this review, 18 found a significant positive association between high HL and high levels of PA. The only intervention study among them indicated that HL was not a significant moderator of the intervention's effectiveness. CONCLUSION HL can enable individuals to make deliberate choices about their PA and thus contribute to preventing many chronic noncommunicable diseases. That said, low levels of HL do not seem to influence the efficacy of health promotion interventions.
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Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207696. [PMID: 33096878 PMCID: PMC7588916 DOI: 10.3390/ijerph17207696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/17/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022]
Abstract
Citizens’ participation in urban environmental quality assessment is important when identifying local problems in the sustainable development and environmental planning policy. The principal aim of this study was to analyze whether any social differences exist between the joint effect of built neighborhood quality and exposure to urban green spaces and the risk of hypertension. The study sample consisted of 580 participants residing in 11 districts in Kaunas city, Lithuania. Using geographic information systems (GIS), individual data on the socioeconomic status (SES) and health were linked to the participants’ perceptions of the environmental quality and exposure to green spaces (NDVI). We used multivariate logistic regression to estimate associations as odds ratios (OR). Those study participants with lower education and those study participants with higher education on low incomes rated their health significantly worse. Low SES persons residing in areas with low exposure to green spaces had a significantly higher risk of hypertension when sex, age, family status, smoking, and income were accounted for (OR 1.83, 95% CI 1.01–3.36). This citizen science study provided evidence that the social environment and the quality of the built environment had a complex effect on disparities in the risk of hypertension.
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Are Health Literacy and Lifestyle of Undergraduates Related to the Educational Field? An Italian Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186654. [PMID: 32932646 PMCID: PMC7558704 DOI: 10.3390/ijerph17186654] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
Background: Health literacy (HL) is a fundamental ability to successfully deal with health and illness issues. This study aimed to assess HL among undergraduates from healthcare and non-healthcare degree courses of two Italian universities and the association between their HL, lifestyles, and BMI assumed as health outcome. Methods: The Health Literacy Assessment Tool (HLAT-8) and the Newest Vital Sign (NVS) were used to assess health literacy dimensions. Demographic and anthropometric data, adherence to Mediterranean diet (MD), physical activity levels, and smoking habits were assessed in the enrolled sample to highlight possible associations. Results: A total sample of 806 undergraduates (46% males, mean age 21.01 ± 1.78 years) was recruited. Higher HL scores were found among healthcare rather than non-healthcare students (28.7 ± 4.5 vs. 26.7 ± 4.2 for HLAT-8 and 4.9 ± 1.5 vs. 3.9 ± 1.8 for NVS, p < 0.01). However, healthcare undergraduates were more likely to report unhealthy behaviors. Body Mass Index (BMI) was associated with literacy and numeracy skills only in non-healthcare undergraduates. Significant associations were found between HL scores and adherence to MD in both groups. In the regression analysis, educational field and MD were shown to be predictors of HL scores. Conclusions: Attending a healthcare related degree course was associated with higher HL scores but not with healthy behaviors. This issue should be addressed considering the role that healthcare professionals may have in educating patients towards a healthy lifestyle. Adherence to MD seems to be related to higher HL scores.
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Fan KS, Ghani SA, Machairas N, Lenti L, Fan KH, Richardson D, Scott A, Raptis DA. COVID-19 prevention and treatment information on the internet: a systematic analysis and quality assessment. BMJ Open 2020; 10:e040487. [PMID: 32912996 PMCID: PMC7485261 DOI: 10.1136/bmjopen-2020-040487] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the quality of information regarding the prevention and treatment of COVID-19 available to the general public from all countries. DESIGN Systematic analysis using the 'Ensuring Quality Information for Patients' (EQIP) Tool (score 0-36), Journal of American Medical Association (JAMA) benchmark (score 0-4) and the DISCERN Tool (score 16-80) to analyse websites containing information targeted at the general public. DATA SOURCES Twelve popular search terms, including 'Coronavirus', 'COVID-19 19', 'Wuhan virus', 'How to treat coronavirus' and 'COVID-19 19 Prevention' were identified by 'Google AdWords' and 'Google Trends'. Unique links from the first 10 pages for each search term were identified and evaluated on its quality of information. ELIGIBILITY CRITERIA FOR SELECTING STUDIES All websites written in the English language, and provides information on prevention or treatment of COVID-19 intended for the general public were considered eligible. Any websites intended for professionals, or specific isolated populations, such as students from one particular school, were excluded, as well as websites with only video content, marketing content, daily caseload update or news dashboard pages with no health information. RESULTS Of the 1275 identified websites, 321 (25%) were eligible for analysis. The overall EQIP, JAMA and DISCERN scores were 17.8, 2.7 and 38.0, respectively. Websites originated from 34 countries, with the majority from the USA (55%). News Services (50%) and Government/Health Departments (27%) were the most common sources of information and their information quality varied significantly. Majority of websites discuss prevention alone despite popular search trends of COVID-19 treatment. Websites discussing both prevention and treatment (n=73, 23%) score significantly higher across all tools (p<0.001). CONCLUSION This comprehensive assessment of online COVID-19 information using EQIP, JAMA and DISCERN Tools indicate that most websites were inadequate. This necessitates improvements in online resources to facilitate public health measures during the pandemic.
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Affiliation(s)
- Ka Siu Fan
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | - Nikolaos Machairas
- Department of HPB Surgery and Liver Transplant, Royal Free Hospital, London, UK
| | - Lorenzo Lenti
- St George's University Hospitals NHS Foundation Trust, London, UK
| | | | | | - Aneya Scott
- St George's University Hospitals NHS Foundation Trust, London, UK
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Dockx YJC, Molenaar EALM, Barten DJJA, Veenhof C. Discriminative validity of the Core outcome set functional independence in a population of older adults. BMC Geriatr 2020; 20:309. [PMID: 32847518 PMCID: PMC7450554 DOI: 10.1186/s12877-020-01705-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinicians are currently challenged to support older adults to maintain a certain level of Functional Independence (FI). FI is defined as "functioning physically safely and independent from another person, within one's own context". A Core Outcome Set was developed to measure FI. The purpose of this study was to assess discriminative validity of the Core Outcome Set FI (COSFI) in a population of Dutch older adults (≥ 65 years) with different levels of FI. Secondary objective was to assess to what extent the underlying domains 'coping', 'empowerment' and 'health literacy' contribute to the COSFI in addition to the domain 'physical capacity'. METHODS A population of 200 community-dwelling older adults and older adults living in residential care facilities were evaluated by the COSFI. The COSFI contains measurements on the four domains of FI: physical capacity, coping, empowerment and health literacy. In line with the COSMIN Study Design checklist for Patient-reported outcome measurement instruments, predefined hypotheses regarding prediction accuracy and differences between three subgroups of FI were tested. Testing included ordinal logistic regression analysis, with main outcome prediction accuracy of the COSFI on a proxy indicator for FI. RESULTS Overall, the prediction accuracy of the COSFI was 68%. For older adults living at home and depending on help in (i)ADL, prediction accuracy was 58%. 60% of the preset hypotheses were confirmed. Only physical capacity measured with Short Physical Performance Battery was significantly associated with group membership. Adding health literacy with coping or empowerment to a model with physical capacity improved the model significantly (p < 0.01). CONCLUSIONS The current composition of the COSFI, did not yet meet the COSMIN criteria for discriminative validity. However, with some adjustments, the COSFI potentially becomes a valuable instrument for clinical practice. Context-related factors, like the presence of a spouse, also may be a determining factor in this population. It is recommended to include context-related factors in further research on determining FI in subgroups of older people.
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Affiliation(s)
- Yvonne J C Dockx
- Physical Therapy Sciences, program in clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Esther A L M Molenaar
- Department Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Di-Janne J A Barten
- Department Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
| | - Cindy Veenhof
- Department Innovation of Human Movement Care, Utrecht University of Applied Sciences, Utrecht, The Netherlands
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, Utrecht, The Netherlands
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Liu Y, Meng H, Tu N, Liu D. The Relationship Between Health Literacy, Social Support, Depression, and Frailty Among Community-Dwelling Older Patients With Hypertension and Diabetes in China. Front Public Health 2020; 8:280. [PMID: 32714893 PMCID: PMC7344226 DOI: 10.3389/fpubh.2020.00280] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/28/2020] [Indexed: 01/23/2023] Open
Abstract
Population aging is one of the major challenges facing modern society and has attracted global attention. With population aging becoming a global phenomenon, the impact of age-related diseases on health is increasing rapidly. Frailty is one of the most pressing issues facing older adults. The purpose of this study was to explore the interrelationship between health literacy, social support, depression, and frailty among older patients with hypertension and diabetes in China. No studies have investigated the mediating effects of social support and depression between health literacy and frailty. The findings of this study can be applied to help ameliorate frailty in older hypertensive and diabetic patients. Data were collected from 637 older hypertensive and diabetic patients aged 65 years and older in Sichuan Province, China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. The results showed that 42.4% of the participants suffered from frailty. The mean scores for health literacy, social support, depression, and frailty were 13.6 ± 5.7, 35.7 ± 6.5, 4.0 ± 3.4, and 3.5 ± 2.1, respectively. Social support had a direct negative association with frailty (β = −0.128, 95%CI: [−0.198, −0.056]), and depression had a direct positive association with frailty (β = 0.326, 95%CI: [0.229, 0.411]), while social support had no direct association with depression. Health literacy had a direct positive association with social support (β = 0.151, 95%CI: [0.077, 0.224]) and a direct negative association with depression (β = −0.173, 95%CI: [−0.246, −0.1]), while health literacy had an indirect negative association with frailty through the mediating effect of social support and depression. To mitigate frailty in older patients with hypertension and diabetes, measures that provide social support, and enhance health literacy, while alleviating depression, should be considered, along with greater attention to patients who are divorced, widowed, or unmarried, those with comorbidities, and those with lower socioeconomic status.
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Affiliation(s)
- Yan Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Chengdu, China
| | - Hongdao Meng
- School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, United States
| | - Naidan Tu
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, FL, United States
| | - Danping Liu
- Department of Health Related Social and Behavioral Science, West China School of Public Health and West China Fourth Hospital, Chengdu, China
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Or PPL, Wong BYM, Chung JWY. To investigate the association between the health literacy and hand hygiene practices of the older adults to help them fight against infectious diseases in Hong Kong. Am J Infect Control 2020; 48:485-489. [PMID: 32037202 PMCID: PMC7132680 DOI: 10.1016/j.ajic.2019.12.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/14/2019] [Accepted: 12/17/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Proper hand hygiene helps prevent infectious diseases, while health literacy plays a critical role in preventive health behaviors. It remains unclear as to why proper hand hygiene practices cannot be sustained and what role health literacy plays in older adults fight against infectious diseases. METHODS A convenience sample of 433 old adults aged 65 and above was recruited. Their hygiene practices and health literacy were evaluated using a structured questionnaire adopted from the Centre for Health Protection and the Chinese version of the HLS-Asia-Q questionnaire. RESULTS The percentage distribution of the hand hygiene performance, from always to never, was 18%-10%. A majority 63.28% (274) of them were classified as having inadequate health literacy (0-25), while a meager 1.62% (7) of them as having excellent health literacy (42.01-50). The Spearman correlation showed a significant positive relationship (P < 0.05) between the participants' health literacy and their hand hygiene practices. CONCLUSIONS Health literacy and hand hygiene are positively related in helping the older adults fight against infectious diseases. To sustain proper hand hygiene practices is to provide frequent hand hygiene training to the older adults.
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Affiliation(s)
- Peggy Pui-Lai Or
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong.
| | - Bonny Yee-Man Wong
- Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong
| | - Joanne Wai-Yee Chung
- Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, Hong Kong
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Finbråten HS, Guttersrud Ø, Nordström G, Pettersen KS, Trollvik A, Wilde-Larsson B. Explaining variance in health literacy among people with type 2 diabetes: the association between health literacy and health behaviour and empowerment. BMC Public Health 2020; 20:161. [PMID: 32013897 PMCID: PMC6998369 DOI: 10.1186/s12889-020-8274-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 01/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background To reflect the health literacy (HL) skills needed for managing type 2 diabetes (T2DM) in everyday life, HL in people with T2DM should be measured from a broader perspective than basic skills, such as proficiency in reading and writing. The HLS-Q12, based on the European Health Literacy Survey Questionnaire (HLS-EU-Q47), assesses four cognitive domains across three health domains. International studies on people with T2DM show inconsistent results regarding the association between HL and general health and the association between HL and glycaemic control. Moreover, knowledge is needed related to the link between HL and empowerment for those with T2DM. The aims of this study were to examine the association between i) HL and general health and diabetes outcomes, ii) HL and health behaviours and iii) HL and empowerment in people with T2DM. Methods During March and April 2015, 388 adults with T2DM responded to a paper-and-pencil self-administered questionnaire. A sequential multiple regression analysis was applied to explore the association between HL, as measured by the HLS-Q12, and health conditions, HbA1c, health behaviours and empowerment. Results For people with T2DM, higher levels of HL were associated with higher levels of education, better overall health conditions and higher self-perceived empowerment. No empirical evidence strengthening either the link between HL and glycaemic control or the link between HL and health behaviours was found. Conclusions The independent variables education level, overall health condition and empowerment explained about one-third of the total observed variance in HL.
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Affiliation(s)
- Hanne Søberg Finbråten
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway. .,Department of Health Sciences, Faculty of Health, Science and Technology, Nursing science, Karlstad University, SE-65188, Karlstad, Sweden.
| | - Øystein Guttersrud
- Norwegian Centre for Science Education, Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1106, Blindern, N-0317, Oslo, Norway
| | - Gun Nordström
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway
| | - Kjell Sverre Pettersen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St Olavs plass, N-0130, Oslo, Norway
| | - Anne Trollvik
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway
| | - Bodil Wilde-Larsson
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway.,Department of Health Sciences, Faculty of Health, Science and Technology, Nursing science, Karlstad University, SE-65188, Karlstad, Sweden
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Beukema L, Reijneveld SA, Jager M, Metselaar J, de Winter AF. The role of functional health literacy in long-term treatment outcomes in psychosocial care for adolescents. Eur Child Adolesc Psychiatry 2020; 29:1547-1554. [PMID: 31925546 PMCID: PMC7595965 DOI: 10.1007/s00787-019-01464-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 12/19/2019] [Indexed: 11/25/2022]
Abstract
Although among adolescents with psychosocial problems low health literacy may increase the risk of poor treatment outcomes, the contributing mechanisms within treatment remain unclear. A better understanding of these mechanisms could contribute to improved treatment processes and outcomes. This study aims to examine the relationship between functional health literacy, treatment processes (treatment adherence, learning processes), and treatment outcome (level of psychosocial problems) in adolescents in psychosocial care. We used data from a prospective cohort study among adolescents aged 12-18 (N = 390), collected in four successive measurements: at entry into care, and 3, 12, and 24 months thereafter. We used a mixed effect model to investigate the association between level of functional health literacy (adequate vs. inadequate) and treatment processes (treatment adherence, learning processes) and treatment outcome (level of psychosocial problems). Between adolescents with adequate and inadequate functional health literacy, we found no differences or change over time in adherence or learning processes. The level of psychosocial problems significantly declined over time (β = - 1.70, 95% CI [- 2.72, - 0.69], p = .001) to a similar degree in both groups, though, in all measurements, the level was consistently higher for adolescents with inadequate health literacy. We conclude that health literacy levels did not affect change in treatment processes nor in outcomes of psychosocial treatment. However, the consistently higher level of psychosocial problems among adolescents with inadequate health literacy suggests an unaddressed need in psychosocial care.
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Affiliation(s)
- L Beukema
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV, Groningen, The Netherlands.
| | - S A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV, Groningen, The Netherlands
| | - M Jager
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV, Groningen, The Netherlands
| | - J Metselaar
- Department of Special Needs Education and Youth Care, University of Groningen, Groningen, The Netherlands
| | - A F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1/FA10, 9713 AV, Groningen, The Netherlands
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Mostardinha AR, Pereira A. Alcohol and tobacco consumption associated factors among college students: A review. PSYCHOLOGY, COMMUNITY & HEALTH 2019. [DOI: 10.5964/pch.v8i1.254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim
Alcohol and tobacco consumption, common among college students, may lead to future health and social problems. We aim to identify the factors associated with those consumptions among college students.
Method
A literature review was performed using PRISMA recommendations. Records were selected through PubMed and Scopus. Through inclusion and exclusion criteria, data from the selected studies were analysed through meta-syntheses.
Results
Twenty studies were included in the analysis. Tobacco consumption was associated with having smoker friends, sedentary behaviours and male sex. Drinking was associated with having parents/friends who drink, having smoker friends and male sex.
Conclusion
This review contributes to identify the consumption factors, allowing health care workers to develop and improve the effectiveness of possible interventions for this population, such as health education programs or psycho-educational interventions, aiming to decrease consumptions behaviours, by targeting the students who are at risk.
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68
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Chen WL, Zhang CG, Cui ZY, Wang JY, Zhao J, Wang JW, Wang X, Yu JM. The impact of social capital on physical activity and nutrition in China: the mediating effect of health literacy. BMC Public Health 2019; 19:1713. [PMID: 31856789 PMCID: PMC6924071 DOI: 10.1186/s12889-019-8037-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 12/04/2019] [Indexed: 12/24/2022] Open
Abstract
Background Physical activity and good nutrition are important behavioral factors in promoting health and preventing disease. It is important to understand the factors affecting physical activity and nutrition. The purpose of this study was to explore whether social capital has an effect on physical activity and nutrition, and whether health literacy plays a mediating role between social capital and physical activity as well as nutrition. Methods This cross-sectional study was performed in a certain district of Shanghai in March and April 2017. Data was collected using a self-reported questionnaire, which included questions on sociodemographic characteristics, social capital, health literacy and health-promoting lifestyle profile-II. Health-promoting lifestyle profile-II measures the behaviours or habits of physical activity and healthy nutrition. An explore factor analysis of the principal components with varimax rotation was carried out on the social capital scale. Descriptive statistics was used to summarize the sociodemographic of participants. Mediation analysis was performed using the bootstrapping tests to examine whether health literacy mediate the relationship between social capital and physical activity as well as nutrition. Results The explore factor analysis results showed that social capital has five dimensions, namely social participation, social support, social network, control over life and feelings about the community. There is a positive correlation between social capital, health literacy, physical activity and nutrition. The correlation coefficient varied from 0.135 to 0.594. Mediation analysis demonstrated health literacy played a partial mediating effect between social capital and physical activity as well as nutrition. In the relationship between physical activity and social capital, the indirect effect of health literacy accounted for 8.20 to 12.65% of the total effect. In the relationship between nutrition and social capital, the mediation effect of health literacy accounted for 4.93 to 12.71% of the total effect. Conclusion Social capital can promote physical activity and nutrition by disseminating health information. Enhancing the social capital of residents will help increase physical activity and develop healthy eating habits. Attention should also be paid to the improvement of residents’ health literacy.
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Affiliation(s)
| | - Cheng-Gang Zhang
- , Xuhui District Center for Disease Control and Prevention, No. 50 Yongchuan Road, Xuhui District, Shanghai, China.
| | - Zi-Yi Cui
- , Xuhui District Center for Disease Control and Prevention, No. 50 Yongchuan Road, Xuhui District, Shanghai, China
| | - Jing-Ya Wang
- Key Lab of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Xuhui District, Shanghai, China
| | - Jie Zhao
- Key Lab of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Xuhui District, Shanghai, China
| | - Ji-Wei Wang
- Key Lab of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Xuhui District, Shanghai, China.
| | - Xian Wang
- , Xuhui District Center for Disease Control and Prevention, No. 50 Yongchuan Road, Xuhui District, Shanghai, China
| | - Jin-Ming Yu
- Key Lab of Health Technology Assessment of National Health Commission, School of Public Health, Fudan University, No. 130 Dong'an Road, Xuhui District, Shanghai, China
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Influence of Health Literacy on the Physical Activity of Working Adults: A Cross-Sectional Analysis of the TRISEARCH Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019. [PMID: 31817592 DOI: 10.3390/ijerph16244948.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies show that high health literacy (HL) can support the promotion and maintenance of healthy behavior such as physical activity (PA). However, most studies rely on subjective data. The aim of the present study is to investigate the relationship between HL and PA, not only with subjectively but also with objectively measured PA data. The present study is a pooled analysis of baseline data from the research association TRISEARCH (2015-2018), which focused on the HL of working adults. HL was measured by Lenartz' questionnaire, and PA by the Global Physical Activity Questionnaire (GPAQ; n = 1056). A subsample (n = 124) also received accelerometers (Actigraph GT3X+) to provide more objective PA data. Partial correlations and regression models were used to investigate the relationship between HL and questionnaire- and accelerometer-derived PA. Very low and medium partial correlations could be found for HL subscales and daily PA by questionnaire (r = -0.06, p < 0.05) and accelerometer (r = 0.26, p < 0.01). No subscale of HL made a significant contribution to the amount of daily PA (all p > 0.05). Not all subscales of HL seem to have an influence on the occurrence of healthy behavior, such as PA. This should be considered when HL-based interventions are designed. Further investigation of the relationship between HL and PA is needed. Objective assessments of both HL and PA can provide additional information for this task.
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70
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Rudolf K, Biallas B, Dejonghe LAL, Grieben C, Rückel LM, Schaller A, Stassen G, Pfaff H, Froböse I. Influence of Health Literacy on the Physical Activity of Working Adults: A Cross-Sectional Analysis of the TRISEARCH Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244948. [PMID: 31817592 PMCID: PMC6950634 DOI: 10.3390/ijerph16244948] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/03/2019] [Indexed: 01/01/2023]
Abstract
Studies show that high health literacy (HL) can support the promotion and maintenance of healthy behavior such as physical activity (PA). However, most studies rely on subjective data. The aim of the present study is to investigate the relationship between HL and PA, not only with subjectively but also with objectively measured PA data. The present study is a pooled analysis of baseline data from the research association TRISEARCH (2015–2018), which focused on the HL of working adults. HL was measured by Lenartz’ questionnaire, and PA by the Global Physical Activity Questionnaire (GPAQ; n = 1056). A subsample (n = 124) also received accelerometers (Actigraph GT3X+) to provide more objective PA data. Partial correlations and regression models were used to investigate the relationship between HL and questionnaire- and accelerometer-derived PA. Very low and medium partial correlations could be found for HL subscales and daily PA by questionnaire (r = −0.06, p < 0.05) and accelerometer (r = 0.26, p < 0.01). No subscale of HL made a significant contribution to the amount of daily PA (all p > 0.05). Not all subscales of HL seem to have an influence on the occurrence of healthy behavior, such as PA. This should be considered when HL-based interventions are designed. Further investigation of the relationship between HL and PA is needed. Objective assessments of both HL and PA can provide additional information for this task.
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Affiliation(s)
- Kevin Rudolf
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Bianca Biallas
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Lea A L Dejonghe
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Christopher Grieben
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Lisa-Marie Rückel
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Andrea Schaller
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
- Working Group Physical Activity-Related Prevention Research, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Gerrit Stassen
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
- Working Group Physical Activity-Related Prevention Research, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
| | - Holger Pfaff
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR) of the University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Ingo Froböse
- Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany
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Biraguma J, Mutimura E, Frantz JM. Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda. Afr Health Sci 2019; 19:3181-3189. [PMID: 32127895 PMCID: PMC7040312 DOI: 10.4314/ahs.v19i4.41] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV's NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes. OBJECTIVE To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda. METHODS A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients' public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23. RESULTS Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count (< 350 cells/mm3) and normotension. CONCLUSION The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases' risk factors for adults living with HIV in Rwanda.
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Affiliation(s)
- Juvenal Biraguma
- University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
- University of the Western Cape, Faculty of Community and Health Sciences, Cape Town, South Africa
| | - Eugene Mutimura
- University of Rwanda, College of Medicine and Health Sciences, Kigali, Rwanda
- Regional Alliance for Sustainable Development (RASD), Kigali, Rwanda
| | - José M Frantz
- University of the Western Cape, Faculty of Community and Health Sciences, Cape Town, South Africa
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Using Photo Stories to Support Doctor-Patient Communication: Evaluating a Communicative Health Literacy Intervention for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193726. [PMID: 31623324 PMCID: PMC6801765 DOI: 10.3390/ijerph16193726] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022]
Abstract
Older adults often have limited health literacy and experience difficulties in communicating about their health. In view of the need for efficacious interventions, we compared a narrative photo story booklet regarding doctor-patient communication with a non-narrative but otherwise highly similar brochure. The photo story booklet included seven short picture-based stories about themes related to doctor-patient communication. The non-narrative brochure had comparable pictures and layout and dealt with the same themes, but it did not include any stories. We conducted two Randomized Controlled Trials (RCTs) among older adults with varying levels of health literacy: one RCT in Germany (N = 66) and one RCT in the Netherlands (N = 54); the latter one was followed by an in-depth interview study among a subset of the participants (81.5%; n = 44). In the RCTs, we did not find significant differences between the photo story booklet and the non-narrative brochure. In the interview study, a majority of the participants expressed a preference for the photo story booklet, which was perceived as recognizable, relevant, entertaining and engaging. We conclude that photo story booklets are a promising format but that there is room for improving their effectiveness.
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73
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Liu XL, Willis K, Wu CJJ, Fulbrook P, Shi Y, Johnson M. Preparing Chinese patients with comorbid heart disease and diabetes for home management: a mixed methods study. BMJ Open 2019; 9:e029816. [PMID: 31530604 PMCID: PMC6756451 DOI: 10.1136/bmjopen-2019-029816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To explore how health education received by patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (T2DM) influences patients' self-efficacy and self-management and changes in behaviour at, and following, hospital discharge. DESIGN This study used a convergent mixed methods design. PARTICIPANTS Twenty-one participants with completed surveys and interviews at discharge and home follow-up were included in the analysis. SETTING At a coronary care unit of a major hospital in Shanghai, China. RESULTS Most participants (n=17) did not perceive they had sufficient education or ability to manage both conditions. More concerning was that most participants (n=16) reported low self-efficacy in the management of ACS symptoms. Three major themes were identified: self-management of ACS and T2DM represents a complex interplay between individual self-efficacy, knowledge and skills, as individuals navigate shifting self-management priorities due to perceived condition severity; the social environment is integral to lifestyle and behaviour change and managing multiple health conditions requires body and mind systems' harmony. CONCLUSIONS The inpatient education received did not enhance participants' confidence to manage either condition on discharge. While an unhealthy lifestyle was embedded within social roles and norms, some social activities, such as square dancing, positively influenced health behaviour. Culturally appropriate education for Chinese people with diabetes and ACS should contain information on maintaining mind and body harmony. Family members should be involved in formal education.
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Affiliation(s)
- Xian-Liang Liu
- Shenzhen Nanshan People's Hospital, Shenzhen, China
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University (McAuley Campus), Brisbane, Queensland, Australia
- Tenth People's Hospital of Tongji University, Shanghai, China
- School of Nursing, Jinggangshan University, Ji'an, China
| | - Karen Willis
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Allied Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Chiung-Jung Jo Wu
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast (USC), Sippy Downs, Queensland, Australia
- Honorary Research Fellow, Royal Brisbane and Women's Hospital (RBWH), Herston, Queensland, Australia
- Honorary Research Fellow, Mater Medical Research Institute-University of Queensland (MMRI-UQ), Brisbane, Queensland, Australia
| | - Paul Fulbrook
- School of Nursing, Midwifery & Paramedicine, Australian Catholic University (McAuley Campus), Brisbane, Queensland, Australia
- Nursing Research & Practice Development Centre, The Prince Charles Hospital Metro North Health Service District, Brisbane, Queensland, Australia
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yan Shi
- Tenth People's Hospital of Tongji University, Shanghai, China
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
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Huang CH, Talley PC, Lin CW, Huang RY, Liu IT, Chiang IH, Lu IC, Lai YC, Kuo KM. Factors associated with low health literacy among community-dwelling women in Taiwan. Women Health 2019; 60:487-501. [PMID: 31488046 DOI: 10.1080/03630242.2019.1662872] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The present study investigated factors associated with health literacy in community-dwelling Taiwanese women, particularly focusing on those associated with prevalent unhealthy behaviors. This cross-sectional study recruited 353 community-dwelling women aged 39-89 years from February to October 2015 in urban, suburban, and rural areas. Variables investigated included physical activity, community activity, tobacco usage, alcohol consumption, and betel-nut chewing. Degree of health literacy was evaluated using the Chinese-language version of the European Health Literacy Survey Questionnaire. Most respondents had inadequate (17.6%), or problematic (49.3%), general health literacy. Multiple logistic regression analyses showed that low educational attainment was closely associated with inadequate or problematic general health literacy. Women who did not engage in regular physical activity or direct community activity were more likely to have inadequate and problematic general health literacy, respectively. Selected unhealthy behaviors (tobacco usage, alcohol consumption, betel-nut chewing) were not associated with health literacy. Low health literacy was prevalent among participants. Lower educational attainment and a lack of physical or community activity were associated with low health literacy. Health literacy should be considered during the process of delivering health information, and health education programs must enhance health literacy tailored to address individuals' lifestyles.
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Affiliation(s)
- Chi-Hsien Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,Center for Evidence-based Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China.,Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Paul C Talley
- Department of Applied English, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - Chi-Wei Lin
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - Ru-Yi Huang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China.,Center for International Medical Education, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China
| | - I-Ting Liu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China.,Institute of Gerontology, National Cheng Kung University, Tainan City, Tainan City, Republic of China
| | - I-Hui Chiang
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - I-Cheng Lu
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan, Republic of China
| | - Yu-Cheng Lai
- Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, Republic of China
| | - Kuang-Ming Kuo
- Department of Healthcare Administration, I-Shou University, Kaohsiung City, Taiwan, Republic of China
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75
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de Almeida KMV, Toye C, Silveira LVDA, Slatyer S, Hill K, Jacinto AF. Assessment of functional health literacy in Brazilian carers of older people. Dement Neuropsychol 2019; 13:180-186. [PMID: 31285792 PMCID: PMC6601306 DOI: 10.1590/1980-57642018dn13-020006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Individuals with low health literacy have less knowledge of their own health condition. Carers play a key role in older people's activities of daily living. Objective to evaluate the performance of carers of older people using the S-TOFHLA (Short Test of Functional Health Literacy in Adults) and to identify caregiver characteristics associated with low functional health literacy. Methods a cross-sectional study was conducted. The S-TOFHLA, a sociodemographic instrument, the Mini-Mental State Exam and the Patient Health Questionnaire-2 were applied to 80 carers of older patients routinely followed by doctors from the Primary Health Care Sector of the City of Botucatu, São Paulo. The multivariate analysis used an ordinal logistic regression model with test (S-TOFHLA) scores as the dependent variable. The level of statistical significance adopted was 0.05. Results the individuals had a mean age of 54.6 (± 11.7); 27% of the carers evaluated had inadequate levels of health literacy (S-TOFHLA ≥54). A higher proportion of individuals with low education had inadequate or marginal health literacy (p<0.001). Conclusion nearly 1/3 of the carers had marginal or inadequate levels of health literacy. These results highlight the difficulties of many carers in understanding health information.
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Affiliation(s)
- Kaoana Maria Vieira de Almeida
- Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina Campus de Botucatu Ringgold standard institution, Botucatu, SP, Brazil
| | - Christine Toye
- Curtin University Ringgold standard institution, Perth, Australia
| | - Liciana Vaz de Arruda Silveira
- Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina Campus de Botucatu Ringgold standard institution, Botucatu, SP, Brazil
| | - Susan Slatyer
- Curtin University Ringgold standard institution, Perth, Australia
| | - Keith Hill
- Curtin University Ringgold standard institution, Perth, Australia
| | - Alessandro Ferrari Jacinto
- Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina Campus de Botucatu Ringgold standard institution, Botucatu, SP, Brazil
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76
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Michou M, Panagiotakos DB, Costarelli V. Low health literacy and excess body weight: a systematic review. Cent Eur J Public Health 2019; 26:234-241. [PMID: 30419628 DOI: 10.21101/cejph.a5172] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE There is recent evidence that poor health literacy (HL) could be implicated in the aetiology of obesity and could be an important reason behind obese people's inability to encounter difficulties in overcoming obesity issues. The current study reviews the recent scientific evidence investigating the possible link between poor HL levels and excess body weight in adults and children. METHODS The authors performed a thorough systematic computer-assisted literature search from 1 January 2005 up to 31 May 2017. Only English original studies in healthy people, investigating the relationship between HL and excess body weight, were included. RESULTS Twenty-two studies in total were included in this literature review, 17 studies were conducted in adults and 5 in children. In 17 out of 22 studies reviewed, low HL was significantly associated with increased body mass index, overweight and obesity. In case of children and adolescents, the above association seems to be more consistent compared to adults. CONCLUSION There is good evidence that low levels of HL are associated with excess body weight, particularly in children. Initiatives to improve health literacy levels could be a useful tool in the management of the obesity epidemic.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | | | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
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77
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Jin SW, Lee Y, Dia DA. Analyzing paths from online health information seeking to colorectal cancer screening using health literacy skills frame and cognitive mediation model. PATIENT EDUCATION AND COUNSELING 2019; 102:416-423. [PMID: 30448041 DOI: 10.1016/j.pec.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/19/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To test the hypothesized paths for Online Health Information Seeking (OHIS) behaviors in developing health literacy, leading to colorectal cancer (CRC) screening among Korean Americans (KAs) using Health Literacy Skills Frameworks (HLSF) and Cognitive Mediation Model (CMM). METHODS A total of 433 KAs aged 50 through 75 in a metropolitan area in the Southeastern U.S. completed a cross-sectional survey regarding sociodemographics, OHIS behaviors, information overload, health literacy, decisional balance, and CRC screening history. Path analyses were implemented to assess the hypothesized causal models by examining the relationships among these variables. RESULTS OHIS was positively associated with information overload and health literacy; information overload was negatively associated with health literacy. Health literacy was positively associated with decisional balance; decisional balance was positively associated with uptake of sigmoidoscopy and colonoscopy. CONCLUSION The findings supported both theoretical frameworks, HLSF and CMM, for OHIS to develop health literacy, leading to CRC screening. These findings highlight the significant roles of information overload and attitudes and beliefs about screening in enhancing health literacy and CRC screening among KAs. PRACTICE IMPLICATIONS Practice efforts for facilitating CRC screening among medically underserved older KAs should target improving access to and use of OHIS and culturally-tailored health information delivery.
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Affiliation(s)
- Seok Won Jin
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
| | - Yeonggeul Lee
- Department of Social Welfare, University of Seoul, 163 Seoulsiripdaero, Dongdaemun-gu, Seoul 02504, South Korea.
| | - David A Dia
- School of Social Work, The University of Memphis, 226 McCord Hall, Memphis, TN 38152, USA.
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Örsal Ö, Duru P, Örsal Ö, Tırpan K, Çulhacı A. Analysis of the relationship among health awareness and health literacy, patient satisfaction levels with primary care in patients admitting to primary care health centers. PATIENT EDUCATION AND COUNSELING 2019; 102:376-382. [PMID: 30217576 DOI: 10.1016/j.pec.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of the study was to examine the relationships between health literacy, primary care satisfaction levels and health awareness of the patients who were admitted to primary care centers (Family Health Centers). METHODS This is a cross-sectional study conducted on individuals who were admitted to Family Health Centers (n = 1.055) in Eskisehir province. The study data were collected by using Turkish Health Literacy Scale, the European Patients Evaluate General/Family Practice Scale and Health Awareness Scale. RESULTS As health literacy of participants increases, health awareness and satisfaction with primary care also increases (for each, p < .001). Health awareness increases health literacy by 0.55 points, health literacy increases satisfaction in primary care by 0.26 points. CONCLUSION In the province of Eskisehir, the health literacy level of 7 out of 10 patients, who admitted to the primary care institution, is inadequate or problematic. As health awareness of participants increases, their level of health literacy also increases. As health literacy of participants increases, their satisfaction with family physicians also increases. PRACTICE IMPLICATIONS As an integral part of preventive health services, studies should be performed to increase and improve the level of health literacy of patients who are admitted to primary care services.
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Affiliation(s)
- Özlem Örsal
- Department of Public Health Nursing, Eskisehir Osmangazi University, Meselik Campus, 26480, Eskisehir, Turkey.
| | - Pınar Duru
- Department of Public Health Nursing, Eskisehir Osmangazi University, Meselik Campus, 26480, Eskisehir, Turkey.
| | - Özgül Örsal
- Department of Public Health Nursing, Marmara University, Basibuyuk Campus, 34854, İstanbul, Turkey.
| | - Kazım Tırpan
- Kemal Nurhan Mani Family Health Center, Erenköy Street, 26060, Eskisehir, Turkey.
| | - Abdullah Çulhacı
- Yeni Family Health Center, Sivrikaya Street, 26120, Eskisehir, Turkey.
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79
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Mohammadi F, Seifollahzadeh S, Motalebi S, Amirzadeh Iranagh J, Mafi M. Predictors of health literacy in community-dwelling elderly. SOCIAL HEALTH AND BEHAVIOR 2019. [DOI: 10.4103/shb.shb_27_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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80
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Matsuda N, Murata S, Ono R. [Association between life space and health literacy in community-dwelling older adults]. Nihon Ronen Igakkai Zasshi 2018; 55:650-656. [PMID: 30542031 DOI: 10.3143/geriatrics.55.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To examine the association between health literacy (HL) and life space in community-dwelling older adults. METHODS In this cross-sectional study, we analyzed 210 community-dwelling older adults (mean age: 74.6 years, women: 63.8%). Health literacy was measured using the 14-item Health Literacy Scale (HLS-14). The 14 items consist of 5 items for functional HL (FHL), 5 items for interactive HL (CHL), and 4 items for critical HL (IHL). We calculated the total score, FHL score, CHL score, and IHL score. Life space was measured using the life-space assessment (LSA). A linear regression model was used to analyze the association between the HLS-14 score and LSA score. We adjusted for variables associated with the LSA score. RESULTS The FHL score was significantly associated with the LSA score (crude model: β = 1.40, p < 0.01, adjusted model: β = 1.11, p = 0.01). However, the total score, IHL, and CHL were not significantly associated with the LSA score. CONCLUSIONS A higher FHL is significantly associated with a greater larger life space in community-dwelling older adults. This finding may help elderly people maintain a greater life space which will help them to improve their HL while also making it possible for them to obtain easy-to-understand information.
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Affiliation(s)
- Naoka Matsuda
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences
| | - Shunsuke Murata
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences.,Research Fellowship for Young Scientists, Japan Society for the Promotion of Science
| | - Rei Ono
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences
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81
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Lacey RJ, Campbell P, Lewis M, Protheroe J. The Impact of Inadequate Health Literacy in a Population with Musculoskeletal Pain. Health Lit Res Pract 2018; 2:e215-e220. [PMID: 31294297 PMCID: PMC6608902 DOI: 10.3928/24748307-20181101-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/01/2018] [Indexed: 01/22/2023] Open
Abstract
Musculoskeletal conditions are a major cause of ill health and disability. Inadequate health literacy may partly explain why musculoskeletal self-management programs are not effective for some patients. This study prospectively evaluated the impact of patients' health literacy level on their musculoskeletal pain and physical function (PF) following usual primary care. Primary care patients (N = 4,720) who had consulted for musculoskeletal pain were mailed a baseline questionnaire; responders were sent a 6-month follow-up questionnaire. The measure of health literacy used was the single-item Literary Screener at baseline, and the outcomes were PF and pain intensity at the 6-months follow-up. Analysis was conducted by linear regression. The number of patients who responded was 1,890 (40%); 17.3% (95% CI [15.6%–19%]) of them had inadequate health literacy. Inadequate health literacy was associated with older age (p < .05), lower education, mental health, and comorbidities (all p < .001), but not by gender (p = .642). At the 6-month follow-up stage, patients with inadequate health literacy had lower PF (mean difference −12.2; 95% CI [−16.7, −7.6]) and higher pain intensity (mean difference 1; 95% CI [0.6, 1.4]), which was adjusted for age, gender, education, mental health, and comorbidities. Differences in PF and particularly pain scores between patients with inadequate and adequate health literacy increased over 6 months. Future studies should develop interventions that better support patients who have musculoskeletal pain with inadequate health literacy to successfully manage their pain. [HLRP: Health Literacy Research and Practice. 2018;2(4):e214–e220.]
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Affiliation(s)
| | | | | | - Joanne Protheroe
- Address correspondence to Joanne Protheroe, PhD, FRCGP, Arthritis Research United Kingdom (UK) Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire ST5 5BG, UK;
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82
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Fawns-Ritchie C, Starr JM, Deary IJ. Health literacy, cognitive ability and smoking: a cross-sectional analysis of the English Longitudinal Study of Ageing. BMJ Open 2018; 8:e023929. [PMID: 30368451 PMCID: PMC6224719 DOI: 10.1136/bmjopen-2018-023929] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES We used logistic regression to investigate whether health literacy and cognitive ability independently predicted whether participants have ever smoked and, in ever smokers, whether participants still smoked nowadays. DESIGN Cross-sectional study. SETTING This study used data from Wave 2 (2004-05) of the English Longitudinal Study of Ageing, which is a cohort study of adults who live in England and who, at baseline, were aged 50 years and older. PARTICIPANTS 8734 (mean age=65.31 years, SD=10.18) English Longitudinal Study of Ageing participants who answered questions about their current and past smoking status, and completed cognitive ability and health literacy tests at Wave 2. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measures were whether participants reported ever smoking at Wave 2 and whether ever smokers reported still smoking at Wave 2. RESULTS In models adjusting for age, sex, age left full-time education and occupational social class, limited health literacy (OR=1.096, 95% CI 0.988 to 1.216) and higher general cognitive ability (OR=1.000, 95% CI 0.945 to 1.057) were not associated with reporting ever smoking. In ever smokers, limited compared with adequate health literacy was associated with greater odds of being a current smoker (OR=1.194, 95% CI 1.034 to 1.378) and a 1 SD higher general cognitive ability score was associated with reduced odds of being a current smoker (OR=0.878, 95% CI 0.810 to 0.951), when adjusting for age, sex, age left full-time education and occupational social class. CONCLUSIONS When adjusting for education and occupation variables, this study found that health literacy and cognitive ability were independently associated with whether ever smokers continued to smoke nowadays, but not with whether participants had ever smoked.
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Affiliation(s)
- Chloe Fawns-Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - John M Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
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83
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Uemura K, Yamada M, Okamoto H. Effects of Active Learning on Health Literacy and Behavior in Older Adults: A Randomized Controlled Trial. J Am Geriatr Soc 2018; 66:1721-1729. [DOI: 10.1111/jgs.15458] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/26/2018] [Accepted: 04/24/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Kazuki Uemura
- Department of 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
| | - Hiroshi Okamoto
- Department of Liberal Arts and Sciences, Faculty of Engineering; Toyama Prefectural University; Imizu Japan
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Finbråten HS, Wilde-Larsson B, Nordström G, Pettersen KS, Trollvik A, Guttersrud Ø. Establishing the HLS-Q12 short version of the European Health Literacy Survey Questionnaire: latent trait analyses applying Rasch modelling and confirmatory factor analysis. BMC Health Serv Res 2018; 18:506. [PMID: 29954382 PMCID: PMC6022487 DOI: 10.1186/s12913-018-3275-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 06/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is widely used in assessing health literacy (HL). There has been some controversy whether the comprehensive HLS-EU-Q47 data, reflecting a conceptual model of four cognitive domains across three health domains (i.e. 12 subscales), fit unidimensional Rasch models. Still, the HLS-EU-Q47 raw score is commonly interpreted as a sufficient statistic. Combining Rasch modelling and confirmatory factor analysis, we reduced the 47 item scale to a parsimonious 12 item scale that meets the assumptions and requirements of objective measurement while offering a clinically feasible HL screening tool. This paper aims at (1) evaluating the psychometric properties of the HLS-EU-Q47 and associated short versions in a large Norwegian sample, and (2) establishing a short version (HLS-Q12) with sufficient psychometric properties. Methods Using computer-assisted telephone interviews during November 2014, data were collected from 900 randomly sampled individuals aged 16 and over. The data were analysed using the partial credit parameterization of the unidimensional polytomous Rasch model (PRM) and the ‘between-item’ multidimensional PRM, and by using one-factorial and multi-factorial confirmatory factor analysis (CFA) with categorical variables. Results Using likelihood-ratio tests to compare data-model fit for nested models, we found that the observed HLS-EU-Q47 data were more likely under a 12-dimensional Rasch model than under a three- or a one-dimensional Rasch model. Several of the 12 theoretically defined subscales suffered from low reliability owing to few items. Excluding poorly discriminating items, items displaying differential item functioning and redundant items violating the assumption of local independency, a parsimonious 12-item HLS-Q12 scale is suggested. The HLS-Q12 displayed acceptable fit to the unidimensional Rasch model and achieved acceptable goodness-of-fit indexes using CFA. Conclusions Unlike the HLS-EU-Q47 data, the parsimonious 12-item version (HLS-Q12) meets the assumptions and the requirements of objective measurement while offering clinically feasible screening without applying advanced psychometric methods on site. To avoid invalid measures of HL using the HLS-EU-Q47, we suggest using the HLS-Q12. Valid measures are particularly important in studies aiming to explain the variance in the latent trait HL, and explore the relation between HL and health outcomes with the purpose of informing policy makers.
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Affiliation(s)
- Hanne Søberg Finbråten
- Department of Public Health and Department of Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway. .,Department of Health Sciences, Faculty of Health, Science and Technology, Nursing science, Karlstad University, SE-65188, Karlstad, Sweden.
| | - Bodil Wilde-Larsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Nursing science, Karlstad University, SE-65188, Karlstad, Sweden.,Department of Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway
| | - Gun Nordström
- Department of Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway
| | - Kjell Sverre Pettersen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, PO Box 4, St Olavs plass, N-0130, Oslo, Norway
| | - Anne Trollvik
- Department of Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, PO Box 400, N-2418, Elverum, Norway
| | - Øystein Guttersrud
- Norwegian Centre for Science Education, Faculty of Mathematics and Natural Sciences, University of Oslo, PO Box 1106, Blindern, N-0317, Oslo, Norway
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Magnani JW, Mujahid MS, Aronow HD, Cené CW, Dickson VV, Havranek E, Morgenstern LB, Paasche-Orlow MK, Pollak A, Willey JZ. Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association. Circulation 2018; 138:e48-e74. [PMID: 29866648 PMCID: PMC6380187 DOI: 10.1161/cir.0000000000000579] [Citation(s) in RCA: 226] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Health literacy is the degree to which individuals are able to access and process basic health information and services and thereby participate in health-related decisions. Limited health literacy is highly prevalent in the United States and is strongly associated with patient morbidity, mortality, healthcare use, and costs. The objectives of this American Heart Association scientific statement are (1) to summarize the relevance of health literacy to cardiovascular health; (2) to present the adverse associations of health literacy with cardiovascular risk factors, conditions, and treatments; (3) to suggest strategies that address barriers imposed by limited health literacy on the management and prevention of cardiovascular disease; (4) to demonstrate the contributions of health literacy to health disparities, given its association with social determinants of health; and (5) to propose future directions for how health literacy can be integrated into the American Heart Association's mandate to advance cardiovascular treatment and research, thereby improving patient care and public health. Inadequate health literacy is a barrier to the American Heart Association meeting its 2020 Impact Goals, and this statement articulates the rationale to anticipate and address the adverse cardiovascular effects associated with health literacy.
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Agarwal G, Habing K, Pirrie M, Angeles R, Marzanek F, Parascandalo J. Assessing health literacy among older adults living in subsidized housing: a cross-sectional study. Canadian Journal of Public Health 2018; 109:401-409. [PMID: 29981094 DOI: 10.17269/s41997-018-0048-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/25/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES This study aimed to assess functional health literacy levels among older adults living in subsidized housing in Hamilton, Ontario, and to assess the relationships between health literacy and other important health indicators, such as education level, age, ethnicity, body mass index (BMI), and self-reported health status. METHODS Older adults (n = 237) living in subsidized housing buildings in Hamilton, ON, were assessed using the NVS-UK as a measure of functional health literacy in addition to a health indicator questionnaire through structured interview. Health literacy levels were analyzed using descriptive statistics and logistic regression to determine relationships between health literacy levels and other health indicators. RESULTS Participants' mean age was 73 years, 67% were female, 70% were not educated beyond high school, and 91% were white. Over 82% of participants had below adequate health literacy levels using the NVS-UK. Multivariable logistic regression revealed significant relationships between functional health literacy and BMI, education level, and pain and discomfort levels. No significant relationships were found between health literacy level and age group, anxiety and depression levels, CANRISK (Diabetes risk) score, gender, marital status, mobility issues, self-care issues, self-reported health status, or performance of usual activities. CONCLUSIONS As the population of older adults continues to grow, the appropriate resources must be available to both improve and support the health literacy level of the population. Future health research should gather information on the health literacy levels of target populations to ensure more equitable health service. This research provides a significant opportunity to better understand populations with health literacy barriers.
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Affiliation(s)
- Gina Agarwal
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada. .,Department of Health, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
| | - Kendra Habing
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Melissa Pirrie
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Ric Angeles
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Francine Marzanek
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Jenna Parascandalo
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
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Cheng YL, Shu JH, Hsu HC, Liang Y, Chou RH, Hsu PF, Wang YJ, Ding YZ, Liou TL, Wang YW, Huang SS, Lin CC, Lu TM, Leu HB, Lin SJ, Chan WL. High health literacy is associated with less obesity and lower Framingham risk score: Sub-study of the VGH-HEALTHCARE trial. PLoS One 2018; 13:e0194813. [PMID: 29590183 PMCID: PMC5874050 DOI: 10.1371/journal.pone.0194813] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 03/09/2018] [Indexed: 02/06/2023] Open
Abstract
Backgrounds Lower health literacy (HL) is associated with several cardiovascular disease (CVD) risk factors such as diabetes, hypertension, and metabolic syndrome (MS). The aim of our study was to investigate the association between HL and the Framingham 10-year risk score of CVD. Methods From 2015–2016, 1010 subjects aged 23 to 88 years receiving health check-up in Taipei Veterans General Hospital had complete clinical evaluations and laboratory examinations. Fatty liver was diagnosed by ultrasonography. The short form questionnaire adapted from the Mandarin Health Literacy Scale was used to assess HL. The Framingham risk score was calculated by patient characteristics. Results Subjects with higher BMIs were associated with lower HL scores. The proportion of subjects with MS was higher in the lower health literacy score group (≤ 9) at 28.8%; further analysis found that lower HL was significantly associated with MS in women but not in men. The Spearman’s rho demonstrated that the HL score was significantly associated with the BMI-based (rho = -0.11; P < 0.001) or lipid-based (rho = -0.09; P < 0.004) Framingham risk score. Conclusions Higher HL scores were associated with less CVD risk such as lower BMIs, less MS in women, and less fatty liver disease. Furthermore, HL had an inverse association with the Framingham risk score as expected. Therefore, HL in patients with CVD risk should be improved and considered as an important issue in terms of CVD reduction.
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Affiliation(s)
- Yuan-Lung Cheng
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Jiah-Hwang Shu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Chuan Hsu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying Liang
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (YJW); (YL)
| | - Ruey-Hsing Chou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Pai-Feng Hsu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Yuan-Jen Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (YJW); (YL)
| | - Yaw-Zon Ding
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Teh-Ling Liou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying-Wen Wang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shao-Sung Huang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Chi Lin
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of public health, National Yang-Ming University, Taipei, Taiwan
| | - Tse-Min Lu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Bang Leu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Jong Lin
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Leong Chan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular research center, National Yang-Ming University, Taipei, Taiwan
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Koops van 't Jagt R, Hoeks JCJ, Duizer E, Baron M, Molina GB, Unger JB, Jansen CJM. Sweet Temptations: How Does Reading a Fotonovela About Diabetes Affect Dutch Adults with Different Levels of Literacy? HEALTH COMMUNICATION 2018; 33:284-290. [PMID: 28094559 DOI: 10.1080/10410236.2016.1258617] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Recent studies suggest that health-related fotonovelas-booklets that portray a dramatic story using photographs and captions-may be effective health communication tools, especially for readers with a low level of literacy. In this experiment, effects on knowledge and behavioral intentions were assessed of a fotonovela originally developed for a Latin-American audience. Dutch readers from a low literacy group (N = 89) and a high literacy group (N = 113) were randomly assigned to one of three conditions: a fotonovela condition (all captions translated into Dutch), a traditional brochure condition (also in Dutch), and a control condition. On knowledge about diabetes, participants in the fotonovela condition outperformed participants in both other conditions. This finding was consistent across literacy levels. On behavioral intentions, however, readers of the fotonovela did not score significantly higher than participants in the other conditions. We also evaluated hypotheses proposed in the Entertainment Overcoming Resistance Model (EORM; Moyer-Gusé, 2008) on the possible mechanisms underlying persuasion through narratives. No support was found for the mechanisms proposed in the EORM. The outcomes of this study suggest that a fotonovela may be a valuable health education format for adults with varying levels of literacy, even if it was developed for a target group with a different cultural background.
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Affiliation(s)
| | - John C J Hoeks
- a Department of Communication and Information Sciences , University of Groningen
| | - Evelien Duizer
- a Department of Communication and Information Sciences , University of Groningen
| | - Melvin Baron
- b School of Pharmacy , University of Southern California
| | | | | | - Carel J M Jansen
- a Department of Communication and Information Sciences , University of Groningen
- c Language Centre, Stellenbosch University
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89
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Mantwill S, Allam A, Camerini AL, Schulz PJ. Validity of Three Brief Health Literacy Screeners to Measure Functional Health Literacy - Evidence from Five Different Countries. JOURNAL OF HEALTH COMMUNICATION 2018; 23:153-161. [PMID: 29319424 DOI: 10.1080/10810730.2017.1417515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Self-reported health literacy measures have seen increased application throughout the last years, among those are the brief health literacy screeners (BHLS) developed by Chew and colleagues (2004). There has been little systematic research on the performance of these measures across different contexts, including countries and languages, to draw conclusions about their predictive power outside of the United States. This study aimed at replicating the original validation of the BHLS. Receiver operating characteristic (ROC) analysis was applied to data from Hungary, Italy, Lebanon, Switzerland, and Turkey. In addition, logistic regression models incorporating ROC analysis using BHLS as predictors were compared to models using socio-demographics only to identify individuals with inadequate and inadequate or marginal health literacy as measured with the Short Test of Functional Health Literacy in Adults. Analyses showed that in all cases the BHLS were not sufficiently able to identify individuals with different health literacy levels. Logistic regression models using socio-demographics only as predictors outperformed models using the BHLS. The findings highlight the limitations of using the BHLS outside the United States. Further, they question in how far self-reported health literacy measures are comparable across different contexts and whether thresholds for different health literacy levels are universally applicable.
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Affiliation(s)
- Sarah Mantwill
- a Department of Health Sciences & Health Policy , University of Lucerne , Lucerne Switzerland
| | - Ahmed Allam
- b Department of Pathology , Yale University School of Medicine , New Haven , CT , USA
| | - Anne-Linda Camerini
- c Institute of Communication and Health Università della Svizzera italiana , Lugano Switzerland
| | - Peter J Schulz
- c Institute of Communication and Health Università della Svizzera italiana , Lugano Switzerland
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90
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Son YJ, Kim SH, Kim GY, Son H. Associations between Health Literacy, Cancer-Related Knowledge, and Preventive Health Behaviors in Community-Dwelling Korean Adults. JOURNAL OF HEALTH COMMUNICATION 2017; 22:999-1006. [PMID: 29206573 DOI: 10.1080/10810730.2017.1401687] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This cross-sectional study aimed to examine the association between health literacy, cancer-related knowledge, and preventive health behaviors among community-dwelling adults in Korea. Data were collected from 542 adults aged ≥ 18 years living in five big provinces in Korea (Seoul, Gyeonggi-do, Gyeongsang-do, Chungcheong-do, and Gangwon-do). Socio-demographic and health-related characteristics were determined using structured questionnaires. Health literacy, cancer-related knowledge, and engagement in preventive health behaviors were measured using validated instruments. These three variables differed according to socio-demographic and health-related characteristics, such as education, sex, age, and marital status. In the hierarchical regression analysis, health literacy (β = 0.26, p < .001) and cancer-related knowledge (β = 0.21, p < .001) were significant predictors of preventive health behavior after adjusting for confounding variables. Cancer-related knowledge partially mediated the effect of health literacy on preventive health behaviors. Health literacy can play a key role in cancer prevention. It is important for healthcare providers to know how to deliver cancer-related knowledge and how to help people with low health literacy to engage in preventive health behaviors, using a variety of health information resources. Further research is needed to develop the instruments to assess comprehension of spoken and written health messages for cancer prevention and screening.
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Affiliation(s)
- Youn-Jung Son
- a Red Cross College of Nursing , Chung-Ang University, Seoul, Korea
| | - Sun-Hee Kim
- b College of Nursing , Korea University, Seoul, Korea
| | - Gi Yon Kim
- c Department of Nursing , Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Heesook Son
- a Red Cross College of Nursing , Chung-Ang University, Seoul, Korea
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Abstract
AbstractObjectiveAdequate fruit and vegetable intake is important in the prevention of chronic disease. Health literacy is associated with health outcomes but its role in dietary behaviour has received little attention. The present study investigated the association between a multidimensional measure of health literacy, sociodemographic characteristics, and fruit and vegetable intake in rural Australia.DesignA cross-sectional survey on intake of fruits and vegetables (servings/d), demographic characteristics and health literacy profile using a nine-scale Health Literacy Questionnaire (HLQ). Associations between health literacy and fruit and vegetable intake were assessed using logistic regression.SettingA large rural area of Victoria.SubjectsAdults residing in the Grampians region (n1154; 61 % female, mean age 52 (sd17) years).ResultsThe HLQ scale ‘Actively managing my health’ predicted (OR; 95 % CI) fruit (2·31; 1·87, 2·84) and vegetable (1·81; 1·45, 2·26) intake. The scales ‘Appraisal of health information’ (fruits: 1·73; 1·41, 2·13; vegetables: 1·49; 1·20, 1·86), ‘Social support for health’ (fruits: 1·31; 1·06, 1·63; vegetables: 1·40; 1·10, 1·76) and ‘Ability to find good health information’ (fruits: 1·25; 1·05, 1·48; vegetables: 1·36; CI 1·13, 1·63) also predicted fruit and vegetable intake. These associations remained significant after adjusting for age, gender, educational attainment and having private health insurance.ConclusionsHealth literacy, particularly being proactive, appraising information and having social support for health, is associated with greater fruit and vegetable intake. Future interventions should consider the health literacy needs of the community to improve fruit and vegetable intake.
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Sentell T, Pitt R, Buchthal OV. Health Literacy in a Social Context: Review of Quantitative Evidence. Health Lit Res Pract 2017; 1:e41-e70. [PMID: 31294251 PMCID: PMC6607851 DOI: 10.3928/24748307-20170427-01] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 04/27/2017] [Indexed: 11/20/2022] Open
Abstract
Background Conceptual literature has consistently noted that health literacy exists within a social context. This review examined how the intersection of social context and health literacy has been operationalized in quantitative, empirical research. Methods Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched seven databases, including PubMed and CINAHL (The Cumulative Index to Nursing and Allied Health Literature), using a range of potentially relevant keywords, and we hand-searched bibliographies. Inclusion criteria were quantitative studies of any design in which measurement of health literacy and measurement of social context intersected. We identified 1,052 unduplicated articles; 34 met inclusion criteria. Key Results We found three distinct perspectives on the intersection between health literacy and social context. Most common (n = 23) were studies measuring an association between individual health literacy and individual social capital, social support, or social engagement, particularly whether social support varied by health literacy and/or if this relationship mediated health outcomes. Another group of studies (n = 6) took the perspective that being health literate by definition included social context, including access to and/or use of social support as a domain in individual health literacy assessment. Five studies considered the social context of health literacy as an independent property measured beyond the individual level; two measured community-level health literacy and three measured health literacy capacity/concordance in caregiving dyads. The studies showed significant definitional and measurement complexity and overlap. In the most dramatic example, a similar question was used across various studies to measure (1) health literacy, (2) a social support domain in health literacy, (3) social support, and (4) a study outcome distinct from, but associated with, health literacy. Potential useful methods, such as social network analyses, were missing from the literature. Discussion Existing quantitative research on health literacy in a social context supports more attention to this topic. This review quantified evidence, revealed gaps, noted limitations, and identified important questions for future research. [Health Literacy Research and Practice . 2017;1(2):e41-e70.]. Plain Language Summary This study systemically compiles existing quantitative empirical research (34 articles) focusing on the intersection of health literacy in the social context. We find considerable measurement complexity in the current body of work on this topic and identify three distinct perspectives that researchers have taken while considering this topic. This information will be useful for future development of this important research area.
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