1
|
Breil C, Lillich M. Health literacy education of children in Austrian elementary schools. HEALTH EDUCATION RESEARCH 2024; 39:29-39. [PMID: 37279512 DOI: 10.1093/her/cyad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 06/08/2023]
Abstract
Health literacy (HL) in children is essential for healthy decision-making from early on. At six Austrian elementary schools, all children (aged 6-11 years) received 3 years of health education (HE). The participating schools were equipped with teaching materials to convey lessons in a child-oriented way. The teachers were professionally accompanied during the implementation process and received specific training. HL and its subprocesses (obtain, understand, comprehend and apply) in children >8 years were measured with a standardized test (QUIGK-K) after 1, 2 and 3 years of education and compared with values from two comparison schools without such lessons. t-Tests showed a significant increase in HL at the end of the second year of HE. After this period, the children showed above-average values on all subprocesses of HL and performed better than children without HE. The third year did not lead to a further increase. Hence, child-oriented HE is suitable to promote HL in elementary school students within 2 years. It is therefore recommended to start HE as early as possible in order to lay the foundation for a long and healthy life.
Collapse
Affiliation(s)
- Christina Breil
- Institut für Gesundheitsförderung und Prävention, Nordbahnstraße 51/8, Vienna 1070, Austria
| | - Michael Lillich
- Institut für Gesundheitsförderung und Prävention, Nordbahnstraße 51/8, Vienna 1070, Austria
| |
Collapse
|
2
|
Zhong B, Xie W, Davis Kempton S, Zhi M, Zhao J. Health Information Processing and Symptom Management in a Cross-Cultural Setting: Insights from IBD Patients. HEALTH COMMUNICATION 2023:1-10. [PMID: 37635287 DOI: 10.1080/10410236.2023.2250940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
The affordances of social media, have significantly transformed how patients seek and process health information online, including those with chronic diseases like irritable bowel disease (IBD). Few studies have explored how information processing may impact symptom management. Guided by social cognitive theory, this study investigates how Chinese and U.S. patients (N = 838) process health information in a cross-cultural setting and the impact on symptom management. It finds that efficient information processing improves treatment understanding and symptom management for IBD patients, regardless of their cultural backgrounds. It also reveals a U-shaped quadratic relationship between IBD severity and emotional and peer support, indicating varying support needs at different IBD stages. These findings provide valuable insights for healthcare professionals, patients, and caregivers in designing interventions for chronic diseases. The study underscores the importance of recognizing the dynamics of health information processing and the need for a more nuanced approach to patient support and care.
Collapse
Affiliation(s)
- Bu Zhong
- Department of Interactive Media, Hong Kong Baptist University
- Wuzhen Institute for Digital Civilization
- Donald P. Bellisario College of Communications, Pennsylvania State University
| | - Wenjing Xie
- School of Communication and the Arts, Marist College
| | | | - Min Zhi
- Department of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-Sen University
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases
| | - Junzhang Zhao
- Department of Gastroenterology, The Sixth Affiliated Hospital of Sun Yat-Sen University
- Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases
| |
Collapse
|
3
|
Bozbulut R, Soysal Acar AŞ, Döğer E, Orhun Çamurdan M, Bideci A. The relationship between alexithymia, health literacy, and diet quality in obese adolescents. J Pediatr Endocrinol Metab 2023; 36:137-146. [PMID: 36588297 DOI: 10.1515/jpem-2022-0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/05/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Alexithymia and low health literacy are the barriers of self-management. This study aims to examine the relationship between alexithymia, health literacy and diet quality in obese adolescents, and their effects on anthropometric and biochemical markers. METHODS The 20-item Toronto alexithymia scale (TAS-20) was used to determine the alexithymic traits of the adolescents, and "The Newest Vital Sign" (NVS) scales were used to determine their health literacy levels. Diet quality was evaluated with the Healthy Eating Index-2010 (HEI-2010). RESULTS 39.7% of the obese adolescents were alexithymic, and 69.4% of alexithymics and 35.1% of non-alexithymics had metabolic syndrome. Alexithymic adolescents were lack of adequate health literacy. There were positive correlations between alexithymia scores and insulin, triglyceride, systolic and diastolic blood pressure levels, and all anthropometric values except height (p<0.05). There was a negative correlation between alexithymia scores and health literacy scores (p<0.05). There were negative correlations between health literacy and alexithymia scores, insulin, total cholesterol, triglyceride, ALT, systolic, diastolic blood pressure levels and all anthropometric values except height, and positive correlation was observed between health literacy scores and diet quality (p<0.05). Total HEI score was negatively correlated with waist circumference, neck circumference, body weight, BMI, triglyceride, AST, ALT, systolic and diastolic blood pressure, and positively correlated with health literacy and HDL levels (p<0.05). CONCLUSIONS As alexithymia severity increased in obese adolescents, the degree of obesity and the incidence of metabolic syndrome increased while the level of health literacy decreased. The increase in health literacy levels, on the other hand, decreased the level of alexithymia and increased the quality of the diet.
Collapse
Affiliation(s)
- Rukiye Bozbulut
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| | | | - Esra Döğer
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| | - Mahmut Orhun Çamurdan
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| | - Aysun Bideci
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| |
Collapse
|
4
|
Pendl D, Maitz KM, Gasteiger-Klicpera B. Examining the relationship between health literacy and individual and sociodemographic factors in secondary school students. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-12. [PMID: 36747506 PMCID: PMC9893979 DOI: 10.1007/s10389-023-01836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
Aim Health literacy (HL) is an important factor in health promotion, especially regarding children and adolescents. The present study aims to identify the individual and sociodemographic factors related to secondary school students' HL. This should make it possible to find specific strategies to improve HL. Subject and methods Data on the sociodemographic background (migrant background, number of books at home and spoken language at home), self-efficacy, online reading behaviour, subjective HL (adapted version of the European Health Literacy [HLS-EU] questionnaire) and the eHealth Literacy Scale (eHEALS) of 544 Austrian secondary school students (age 11-16, 46% girls) were collected. Regression analyses were conducted to test the hypotheses regarding those factors which influence students' subjective HL and eHL. Results Students subjective HL (M = 3.79, SD = .63) and eHL (M = 3.46, SD = .77) scores were rather high on average. Subjective HL was predicted by age, gender and online reading behaviour. However, only students' online reading behaviour was highly significant and was found to be the most influential predictor of subjective HL. Age and online reading behaviour were also found to be highly significant predictors regarding eHL. Conclusion Students' online reading behaviour and age are important factors linked to HL. Educational activities may serve to reduce health inequalities by fostering relevant internet skills, i.e. the skills needed to facilitate effective and critical use of internet information.
Collapse
Affiliation(s)
- Dominik Pendl
- Institute of Education Research and Teacher Education, Inclusive Education Unit, University of Graz, Merangasse 70/2, 8010 Graz, Austria
| | - Katharina Maria Maitz
- Research Center on Inclusive Education, University of Graz, Strassoldogasse 10/2, 8010 Graz, Austria
| | - Barbara Gasteiger-Klicpera
- Institute of Education Research and Teacher Education, Inclusive Education Unit, University of Graz, Merangasse 70/2, 8010 Graz, Austria
| |
Collapse
|
5
|
Kesic MG, Peric M, Gilic B, Manojlovic M, Drid P, Modric T, Znidaric Z, Zenic N, Pajtler A. Are Health Literacy and Physical Literacy Independent Concepts? A Gender-Stratified Analysis in Medical School Students from Croatia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081231. [PMID: 36010123 PMCID: PMC9406589 DOI: 10.3390/children9081231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022]
Abstract
Health literacy (HL) and physical literacy (PL) are concepts responsible for achieving and maintaining positive health behaviors. This study aimed to investigate gender-specific associations: (i) between PL and HL; and (ii) among HL, PL, and body composition. We observed 253 students attending health-area high schools from southern Croatia (181 girls; 16.9 ± 1.4 years). HL was assessed by the European Health Literacy Survey Questionnaire, PL by the PLAYself questionnaire, and body composition by bioimpedance analysis. The t-test was used to assess the differences between genders, and Pearson’s correlation coefficients were calculated to establish the associations between variables. The results showed a similar level of HL (t-test = 0.2; p = 0.83) and PL (t-test = 0.01; p = 0.99) in boys and girls. Significant but small correlations were identified between HL and PL only in the girls (<10% of common variance). The body composition indices were significantly correlated with PL only in the boys (15−20% of common variance). Our research highlights the necessity of the independent evaluation of HL and PL in adolescence. Further studies evaluating other indices of health status in relation to PL and HL are warranted.
Collapse
Affiliation(s)
| | - Mia Peric
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Barbara Gilic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Marko Manojlovic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Toni Modric
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Zeljka Znidaric
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
| | - Natasa Zenic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia
- Correspondence:
| | - Aleksander Pajtler
- Faculty of Civil Engineering, Transportation Engineering and Architecture, University of Maribor, 2000 Maribor, Slovenia
| |
Collapse
|
6
|
Zhang H, Chen L, Zhang F. Revisit the Effects of Health Literacy on Health Behaviors in the Context of COVID-19: The Mediation Pathways Based on the Health Belief Model. Front Public Health 2022; 10:917022. [PMID: 35910896 PMCID: PMC9326304 DOI: 10.3389/fpubh.2022.917022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundEmerging research has identified health literacy as an important resource for individual health care and disease prevention. In the context of COVID-19, People with limited HL are less likely to follow preventive measures such as wearing masks, social isolation, or taking the vaccination. However, the pathways of how health literacy affects decision-making have remained unclear.MethodsWith a cross-sectional study, a total of 613 responses (mean age is 25.64 ± 6.46 years) were collected. The relationship between health literacy and health behaviors under COVID-19 was examined, and the potential mediation pathways were assessed based on the health belief model.ResultsWith linear regression, it was found that health literacy has a direct effect on health behaviors and three constructs in the health belief model, i.e., perceived susceptibility, perceived severity, perceived barriers, as well as an indirect effect on health behaviors via increasing perceived barriers related with COVID-19 preventive measures. The results showed that health literacy only goes through the pathway of perceived barriers to influence health behaviors, and the indirect effects via other pathways were not significant.ConclusionsThe research addressed the mediation model underlying the effects of health literacy on health behaviors and identified a partial mediation role of perceived barriers. Health literacy could promote individual health behavior by reducing the perceived barriers to forming a healthy lifestyle and making health decisions. Future health promotion interventions increasing people's health literacy should be advocated to promote health initiatives in the whole population.
Collapse
Affiliation(s)
- Huiqiao Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Liyuan Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Division of Medical Psychology and Behavior Science, School of Medicine, Jinan University, Guangzhou, China
- *Correspondence: Fan Zhang
| |
Collapse
|
7
|
Niu Z, Qin Z, Hu P, Wang T. Health Beliefs, Trust in Media Sources, Health Literacy, and Preventive Behaviors among High-Risk Chinese for COVID-19. HEALTH COMMUNICATION 2022; 37:1004-1012. [PMID: 33557620 DOI: 10.1080/10410236.2021.1880684] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The coronavirus disease (COVID-19) broke out in China in January 2020 and has been effectively controlled in April 2020 after China's relentless efforts. People's engagement in disease-related preventive behaviors is crucial in containing such infectious disease. Vulnerable populations often have higher chances of developing severe illness from COVID-19 and the mortality rate is also higher. Thus, at-risk populations for COVID-19 request extra attention. The current study conducted a national online survey among vulnerable populations in China in early February 2020 to examine their engagement in coronavirus-related preventive health behaviors (e.g., frequent handwashing) and the potential determinants including factors from the Health Belief Model, trust in different media sources, and health literacy. The results suggested that the vulnerable populations' engagement in coronavirus-related preventive behaviors were significantly associated with barriers, benefits, self-efficacy, trust in doctors' social media, and trust in TV for COVID-19-related information. Besides, barriers, benefits, self-efficacy, trust in doctors' social media, and trust in TV mediated the effects of health literacy on preventive behaviors. Our findings provided directions for future health promotions and interventions targeting vulnerable populations to enhance their preventive behaviors in China.
Collapse
Affiliation(s)
- Zhaomeng Niu
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey
| | - Zhou Qin
- School of Arts and Sciences, Rutgers, The State University of New Jersey
| | | | - Tingting Wang
- Lingnan (University) College, Sun Yat-Sen University
| |
Collapse
|
8
|
Rademakers J, Hahnraths MTH, van Schayck OCP, Heijmans M. Children's Health Literacy in Relation to Their BMI z-Score, Food Intake, and Physical Activity: A Cross-Sectional Study among 8-11-Year-Old Children in The Netherlands. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060925. [PMID: 35740862 PMCID: PMC9221614 DOI: 10.3390/children9060925] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
Overweight and obesity in children are an increasing public health problem. Health literacy (HL) is a determinant of obesity and body mass index (BMI) rates in adults, but few studies have addressed the impact of children’s own HL on their weight and lifestyle. In this study, we aim to assess the impact of Dutch children’s HL on (1) their BMI z-score, (2) dietary behaviour, and (3) the amount of physical activity (PA) they engage in. A sample of 139 children (age 8–11 years) filled out a digital questionnaire, including an HL measurement instrument and questions regarding their food intake and PA. Furthermore, the height and weight of the children were measured, and background information was collected using a parental questionnaire. Multiple regression revealed a significant positive relation between children’s HL and their PA. No significant association between children’s HL and their BMI z-score or dietary behaviour was found. HL of children in primary school thus has an impact on some aspects of children’s lifestyle, although more research in a larger, more diverse sample is needed to further investigate this.
Collapse
Affiliation(s)
- Jany Rademakers
- Netherlands Institute for Health Services Research (Nivel), P.O. Box 1568, 3500 BN Utrecht, The Netherlands;
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.T.H.H.); (O.C.P.v.S.)
- Correspondence:
| | - Marla T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.T.H.H.); (O.C.P.v.S.)
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (M.T.H.H.); (O.C.P.v.S.)
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (Nivel), P.O. Box 1568, 3500 BN Utrecht, The Netherlands;
| |
Collapse
|
9
|
Intarakamhang U, Khammungkul J, Boocha P. General health literacy scale for Thais and comparison between age groups. Heliyon 2022; 8:e09462. [PMID: 35620621 PMCID: PMC9127311 DOI: 10.1016/j.heliyon.2022.e09462] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/25/2021] [Accepted: 05/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background Health literacy (HL) has captured the world's interest since it was first defined by WHO in 1998. In Thailand, a number of HL scales for risk groups have been developed but none for the general population. Therefore, this research aimed to develop a general health literacy (GHL) scale for Thais and compare HL levels between groups, i.e. students, youth, adults, and older. Methods In this mixed-methods study, a focus group was conducted with 20 health policy-makers. Data were collected from 4,000 participants from all regions of Thailand through questionnaires between 2018 and 2019. The participants were divided into 4 age groups: aged 7-14, 15-24, 25-59, and 60-75. All of them were selected using stratified random sampling. Data analysis was performed using CFA and ANOVA. Results 1) The GHL Scale for Thais comprised 47 items, covering 5 domains i.e. access to health information and services, understanding of health information and service leading to practice, health information and service appraisal, communication and social support, and health self-management. The scale had high Cronbach's alpha values for all participants and different age groups (Cronbach's alpha = 0.95-0.97) and factor loadings ranging from 0.45 to 0.77. 2) Most Thai people (58.9%) had a fair level of HL, followed by high HL (24.3%) and low HL (16.8%). 3) The comparison of HL among age groups had different mean scores (P < .05) and low HL was found in adults (25.00%), older (18.60%), youth (12.60%), and students (11.40%), respectively. Conclusion The GHL Scale for Thais can be used to screen people of all ages for potential health problems and develop strategies for promoting health resilience and preventing disease in each age group.
Collapse
Affiliation(s)
| | | | - Piya Boocha
- Innovative Learning Center, Srinakharinwirot University, Bangkok, Thailand
| |
Collapse
|
10
|
What Is the Impact of Nutrition Literacy Interventions on Children's Food Habits and Nutrition Security? A Scoping Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073839. [PMID: 35409523 PMCID: PMC8997863 DOI: 10.3390/ijerph19073839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 01/04/2023]
Abstract
Introduction: Nutrition literacy is a relatively new concept that seems to have a relevant role on the quality of people’s diets; however, we do not know the role of nutrition literacy interventions on children’s food habits and nutrition security. Methods: We conducted a literature review on four databases (PubMed, Embase, Web of Science, and Cochrane) and we considered studies describing the impact of interventions aimed at improving the quality of children’s diet. Results: A total of six articles were finally included. The total number of participants included in the studies was 4016, and the median study size was equal to 224 participants. Studies included in the review reflected a broad heterogeneity of interventions. Conclusions: The results were contrasting and revealed that the most effective type of nutrition literacy interventions included the following characteristics: technological components, involvement with multiple modalities, duration of more than 4 weeks, and face to face sessions.
Collapse
|
11
|
Zare-Zardiny MR, Abazari F, Zakeri MA, Dastras M, Farokhzadian J. The association between body mass index and health literacy in high school Students: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:431. [PMID: 35071637 PMCID: PMC8719543 DOI: 10.4103/jehp.jehp_96_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Obesity and overweight in children and adolescents have become a global problem in recent years. Adolescence increases the likelihood of obesity in adulthood and associated illnesses. Nowadays, health literacy is one of the greatest determinants of the health. This study was conducted to evaluate the correlation between body mass index (BMI) and health literacy in high school students. MATERIALS AND METHODS In this descriptive-analytical study, 430 high school students were enrolled in a multi-stage random method in Yazd city in the center of Iran. The data were collected through The Health Literacy Measure for Adolescents and calculate BMI with measurement of height and weight of adolescents. The data were then analyzed using SPSS 25 and descriptive and inferential statistics (Chi-square and multivariate regression). RESULTS The results showed that the mean score of BMI (21.76 ± 3.76) was in a normal range. The score of health literacy was at the borderline level (58.44 ± 13.79). BMI was not significantly correlated with health literacy (P = 0.09). BMI was significantly different in terms of age, high school grade, school type, and health status. School type and health status predict 37% of the variance of BMI (R 2 = 37%) and the best predictor was health status (P < 0.05). CONCLUSIONS The results of the present study showed that BMI was not correlated with health literacy and student health literacy was at the borderline level. It is necessary to carry out further studies on the causes and facilitators and the barriers to increasing health literacy. Furthermore, educational interventions are needed to prevent the increase of BMI in adolescents and identify determining factors.
Collapse
Affiliation(s)
- Mohammad Reza Zare-Zardiny
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Faroukh Abazari
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Zakeri
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Majid Dastras
- Department of Nursing, Faculty Member of Zahedan University of Medical Sciences, Zahedan, Iran
| | | |
Collapse
|
12
|
The Role of Health Literacy in Health Behavior, Health Service Use, Health Outcomes, and Empowerment in Pediatric Patients with Chronic Disease: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312464. [PMID: 34886185 PMCID: PMC8656602 DOI: 10.3390/ijerph182312464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
About 8% of all children and adolescents worldwide are affected by chronic diseases. Managing chronic conditions requires pediatric patients to be health literate. The purpose of this review is to examine the existing evidence on the links between health literacy and its outcomes proposed by the model by Sørensen et al. in chronically ill pediatric patients. Four electronic databases (PubMed, Scopus, CINAHL, PsycINFO) were searched to identify pertinent articles published up to November 2021. The search was conducted independently by two researchers and restricted to observational studies. Of 11,137 initial results, 11 articles met eligibility criteria. Overall, 6 studies identified a significant association between health literacy and one of the considered outcomes. Regarding health behavior, none of the studies on adherence found significant associations with health literacy. The results in terms of health service use were inconclusive. Regarding health outcomes, health literacy did not affect most physiological parameters, but it significantly improved health-related quality of life. Overall, evidence remains inconclusive but suggests that health literacy is associated with self-efficacy, health-related quality of life, and health service use in pediatric patients. Further research should be undertaken to strengthen the evidence.
Collapse
|
13
|
Muslu L, Sarvan S, Oncel S, Ugur E. Determination of Health Literacy in Different Generations. THE JOURNAL OF SCHOOL HEALTH 2021; 91:617-624. [PMID: 34169537 DOI: 10.1111/josh.13052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 02/27/2020] [Accepted: 06/03/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND The development of health literacy (HL) is critical in reducing lifestyle-related diseases. The purpose of this study was to determine levels of HL and related variables among members of Generations X and Z. METHODS This study was a descriptive survey conducted in the city of Antalya, Turkey. Participants were 350 Generation Z students and 150 Generation X parents. We created a personal data form for both students and parents, and used the Secondary Education HL Scale and Adult HL Scale for data collection. RESULTS The average HL score of Generation Z was 20.98 ± 6.19 and that of Generation X 17.38 ± 3.54. The HL levels of 75% of the Generation Z were low to marginal and those of 33.1% of the Generation X were below average. CONCLUSIONS More than half of the Generation Z students and about one-third of Generation X parents were found to have low HL. Health professionals and nurses can give direction to the different generations to improve overall HL.
Collapse
Affiliation(s)
- Leyla Muslu
- Assistant Professor, , PhD, Faculty of Nursing, Public Health Nursing, Akdeniz University, Campus, Dumlupınar Boulevard, Antalya, Konyaaltı, 07058, Turkey
| | - Sureyya Sarvan
- Lecturer, , PhD, Faculty of Nursing, Pediatric Nursing, Akdeniz University, Campus, Dumlupınar Boulevard, Antalya, Konyaalti, 07058, Turkey
| | - Selma Oncel
- Professor, , PhD, Faculty of Nursing, Public Health Nursing, Akdeniz University, Campus, Dumlupınar Boulevard, Antalya, Konyaaltı, 07058, Turkey
| | - Emine Ugur
- Psychological Counsellor, Guidance Teacher, , Turk Telekom Anatolian High School Muratpaşa, Antalya, Turkey
| |
Collapse
|
14
|
Nash R, Patterson K, Flittner A, Elmer S, Osborne R. School-Based Health Literacy Programs for Children (2-16 Years): An International Review. THE JOURNAL OF SCHOOL HEALTH 2021; 91:632-649. [PMID: 34096058 DOI: 10.1111/josh.13054] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Health literacy impacts children's health and educational attainment. Therefore, determining the most appropriate pedagogical design is critical. The long-term health benefits of health literacy for each child's life course further justify this imperative. School-based health literacy programs are of interest internationally. METHODS We brainstormed the search terms and established inclusion/exclusion criteria for this systematic review. We searched 2 databases (CINAHL, ERIC) following PRISMA guidelines. Three authors screened and sorted the findings. RESULTS We identified 21 relevant studies from 629 retrieved. Few (6/21) studies were situated in the primary school setting. CONCLUSIONS This review found a variety of project designs, evaluation methods, and conceptual models. Descriptive analysis of the final 21 papers highlighted the importance of multicomponent design (whole-of-school and curriculum), cross-curricula integration, professional development for teachers, age of children, role of parents, and role of community. The results of this analysis may inform primary school program design in the future. Schools provide a logical setting for health literacy development. Despite the evidence that adolescence is too late, few studies have been situated in primary schools. Teachers lack confidence to teach health and need ongoing professional development. Parent, child, and community voices are essential for sustained engagement and program success.
Collapse
Affiliation(s)
- Rosie Nash
- Lecturer in Public Health and Health Systems, , College of Health & Medicine, University of Tasmania, Medical Science 2 17 Liverpool Street, Private Bag 34, Hobart, TAS, 7001, Australia
| | - Kira Patterson
- Lecturer in Health Pedagogy, , School of Education, College of Arts, Law and Education, University of Tasmania; Healthspan Advisory Board Member, University of Illinois, Chicago, Locked Bag 1307, Launceston, TAS, 7250, Australia
| | - Anna Flittner
- Associate Lecturer and HealthLit4Kids Research Assistant, , College of Health & Medicine, University of Tasmania, Hobart, TAS, 7001, Australia
| | - Shandell Elmer
- Senior Research Fellow, , School of Health Sciences, Faculty Arts, Health & Design, Swinburne University of Technology, PO Box 218, Hawthorne, VIC, 3122, Australia
- Adjunct Senior Lecturer, School of Education, University of Tasmania, Hobart, TAS, Australia
| | - Richard Osborne
- Global Health Equity, Distinguished Professor of Health Sciences, NHMRC Principal Research Fellow (2019-2023), Prof (Hon), , University of Copenhagen, Denmark; Bualuang ASEAN Chair Professorship, Thammasat University, Thailand; Faculty of Health, Arts and Design, Swinburne University, Hawthorn, Australia
| |
Collapse
|
15
|
Bollweg TM, Okan O, Freţian AM, Bröder J, Domanska OM, Jordan S, Bruland D, Pinheiro P, Bauer U. Adapting the European Health Literacy Survey Questionnaire for Fourth-Grade Students in Germany: Validation and Psychometric Analysis. Health Lit Res Pract 2021; 4:e144-e159. [PMID: 32674162 PMCID: PMC7365660 DOI: 10.3928/24748307-20200428-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 08/26/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Until now, children younger than age 13 years have received little attention in research on health literacy. Although some tools assess children's health literacy, no validated tool is available that assesses self-reported health literacy in a systematic and comparable way. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a valid and reliable measure of adults' self-reported health literacy. It has also been used among adolescents, but it has never been adapted for use with children. We believe it would be worth adapting for younger age groups so that self-reported health literacy could be assessed continuously. OBJECTIVE This study aimed to quantitatively test an adapted scale based on the HLS-EU-Q developed for German-speaking children age 9 and 10 years. METHODS An adapted 26-item HLS-EU-Q scale was given in a paper-and-pencil survey to 907 fourth-grade students in North Rhine-Westphalia, Germany. The psychometric properties of the scale were investigated with item analysis and factor analyses, and both convergent and discriminant validity were assessed. KEY RESULTS Of the 26 tested items, 9 were discarded due to poor performance in terms of missing values, item difficulty, and factor structure. This left a 15-item scale with a high internal consistency (α = .791) that takes only a short time to administer. The scale, called the HLS-Child-Q15, had a low correlation with functional health literacy (r = .107, p < .001), and a moderate correlation with indicators of self-efficacy (ρ = .280 to .306, p < .001). The latter indicates adequate discriminant validity, whereas the former points to a need to further investigate convergent validity. CONCLUSIONS This is the first study to apply an age-adapted version of the HLS-EU-Q to children. Statistical analyses indicated the successful development of a promising instrument, but further research is needed on its factor structure and validity. This study contributes significantly to the comparative assessment of health literacy across the life course by providing a measurement tool for children age 9 and 10 years. [HLRP: Health Literacy Research and Practice. 2020;4(3):e144-e159.] PLAIN LANGUAGE SUMMARY: The European Health Literacy Survey Questionnaire was adapted for German-speaking 9- and 10-year-old children, and 26 adapted items were tested in a written survey of 907 children. Item analysis resulted in a 15-item scale with satisfactory psychometric properties. This scale, the HLS-Child-Q15, shows high internal consistency and can be used to assess self-reported health literacy in German-speaking 9- and 10-year-old children. Nonetheless, further studies are needed to validate these results.
Collapse
Affiliation(s)
- Torsten Michael Bollweg
- Address correspondence to Torsten Michael Bollweg, MA, Centre for Prevention and Intervention in Childhood and Adolescence, Faculty of Educational Science, Bielefeld University, Universitaetsstrasse 25, 33615 Bielefeld, Germany;
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Faus A, Schlaier J. Health Literacy of Youth with Co-Occurring Behavioral and Physical Health Care Needs: A Preliminary Report. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2021. [DOI: 10.1080/15398285.2021.1901053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Amy Faus
- Bergen’s Promise, Inc., Hackensack, New Jersey, USA
| | - Jan Schlaier
- Bergen’s Promise, Inc., Hackensack, New Jersey, USA
| |
Collapse
|
17
|
Taleb S, Itani L. Nutrition Literacy among Adolescents and Its Association with Eating Habits and BMI in Tripoli, Lebanon. Diseases 2021; 9:25. [PMID: 33805571 PMCID: PMC8103266 DOI: 10.3390/diseases9020025] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
(1) Background: Adolescence is a period of increased autonomy and independent decision making; it determines health behaviors that can persist into the future. Individual factors like food choices and unhealthy lifestyle have an essential role in the development and prevention of obesity among adolescents and are associated with the nutrition literacy of parents and other adults. While the association of parents' nutrition literacy with adolescent BMI has been addressed, there is still a scarcity of studies that examine the effect of adolescents' nutrition literacy on their eating habits and body mass index (BMI) status. (2) Methods: A cross-sectional study was conducted that included 189 adolescents (68 with overweight and obesity and 121 with normal weight) aged between 14-19 years from four private schools in Tripoli, Lebanon. A self-administered questionnaire that included the Nutrition Literacy Assessment Instrument (NLAI) and the Adolescent Food Habits Checklist (AFHC) was used. Anthropometrics were measured using standardized procedures. The association between nutrition literacy, food habits and BMI was assessed using a chi squared test for independence and Poisson regression analysis where suitable. (3) Results: Results indicated no association between all five components of nutrition literacy and body mass index categories. Furthermore, there was no association between the Adolescent Food Habits Checklist and overweight or obese BMI status (RR = 0.947, 95%CI: 0.629-1.426) (p = 0.796). No association was observed between nutrition literacy and food habits, except for an inverse association with macronutrients literacy. (4) Conclusions: In conclusion, the study indicated that there was no association between the components of nutrition literacy with body mass index or with food habits, except for macronutrient literacy.
Collapse
Affiliation(s)
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11–5020, Lebanon;
| |
Collapse
|
18
|
An Interaction Path of Mothers' and Preschoolers' Food- and Physical Activity-Related Aspects in Disadvantaged Sicilian Urban Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062875. [PMID: 33799751 PMCID: PMC7998198 DOI: 10.3390/ijerph18062875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/06/2021] [Accepted: 03/08/2021] [Indexed: 11/26/2022]
Abstract
Background: The relationship between mothers and their children’s lifestyle is still unclear, especially in disadvantaged areas. Consequently, the study aims to identify a path explaining the extent to which maternal eating habits and physical activity (PA) level predict food-related aspects, PA practice and Quotient of Gross Motor Development (QGMD) in preschoolers from disadvantaged urban areas. Methods: In this cross-sectional study, a total of 79 dyads of mothers and children were recruited from kindergartens. Information related to family socio-demographic aspects, mothers’ and children’s dietary intake frequencies and PA/sedentariness, mothers’ weight and height, mothers’ perception on children’s food intake, and children’s food literacy (FL) was collected with a questionnaire and the Food Literacy Assessment Tool (preschool-FLAT), while gross-motor skills were measured with the Test of Gross Motor Development (TGMD); weight and height of children were directly collected. Results: Associations were found between mothers’ and children’s food habits; mothers’ and children’s fruit/vegetables consumption, and intake of the other items; mothers’ education or PA level and children’s FL; mothers’ PA or sedentariness and children’s QGMD; mothers’ BMI and food habits and children’s BMI; education and food habits. Conclusions: These findings can be useful to plan effective interventions targeted both to preschoolers and their mothers of disadvantaged urban areas for promoting healthy lifestyles, which have become increasingly difficult to achieve during COVID-19 pandemic.
Collapse
|
19
|
Kanellopoulou A, Katelari A, Notara V, Antonogeorgos G, Rojas-Gil AP, Kornilaki EN, Kosti RI, Lagiou A, Panagiotakos DB. Parental health status in relation to the nutrition literacy level of their children: Results from an epidemiological study in 1728 Greek students. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-200470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Children’s dietary behaviors seem tract into adulthood and as a result preventing strategies to establish healthy behaviors from early stages of life are needed. Nutrition knowledge is essential for behavioral change. OBJECTIVE: To examine whether the status of parental health related to their children’s nutrition literacy level through their perceptions mainly of healthy eating attitudes METHODS: A cross-sectional survey was conducted in Greece among 1,728 schoolchildren aged 10–12 years old. The sample was collected in the school setting during the school years of 2014–2016. Children completed anonymously a self-administered questionnaire about their knowledge and perceptions of a healthy diet while their parents completed another suitable questionnaire about family health status. RESULTS: Paternal BMI status and hypertension were inversely associated with the level of nutrition literacy of their children by b = –0.043 (95%CI: (–0.082, –0.003; p = 0.036) and by b = –0.600 (95%CI: –1.181, –0.019; p = 0.043), respectively. Parental health status, specifically, paternal diabetes and maternal dyslipidemia were associated with children’s higher level of nutrition literacy by b = 0.729 (95%CI: 0.002, 1.456; p = 0.049) and by b = 0.730 (95%CI: 0.086, 1.374; p = 0.026), respectively. CONCLUSIONS: Parental health status partially affects, either negatively or positively, the level of nutrition literacy of their children. This impact depends on whether parents follow nutritional recommendations to improve their health.
Collapse
Affiliation(s)
- Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Angeliki Katelari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Athens, Greece
| | - George Antonogeorgos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Andrea Paola Rojas-Gil
- Department of Nursing, Faculty of Health Sciences, University of Peloponnese, Tripoli, Greece
| | - Ekaterina N. Kornilaki
- Department of Preschool Education, School of Education, University of Crete, Rethymnon, Greece
| | - Rena I. Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, Trikala, Greece
| | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Athens, Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Faculty of Health, University of Canberra, ACT, Australia
| |
Collapse
|
20
|
Chrissini MK, Panagiotakos DB. Health literacy as a determinant of childhood and adult obesity: a systematic review. Int J Adolesc Med Health 2021; 33:9-39. [PMID: 33592684 DOI: 10.1515/ijamh-2020-0275] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/26/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess whether Health Literacy (HL) acts as a determinant of obesity in adults and children by synthesizing the results of recent scientific evidence. CONTENT This is a systematic qualitative review following the MOOSE guidelines. A systematic, computer-assisted literature search via PubMed scientific database, between January 1st, 2000, and September 30th 2020, was conducted. Only cross-sectional epidemiologic research studies that were published in the English language, investigating HL's possible role as a determinant of childhood and adult obesity, were included. SUMMARY After screening 725 citations from the PubMed database, 39 (n=39) studies in total were included in this literature review; Four (n=4) studies were conducted in the children population, seven (n=7) studies were performed in children-parent/caregiver dyads, and 28 studies (n=28) enrolled adults. There is significant evidence that HL knowledge and skills determine the consequent management of obesity and BMI rates in children and adult populations. OUTLOOK Despite policies and action plans put in place by countries globally, overweight and obesity continue to be a pressing public health issue and one of the critical drivers of non-communicable diseases, constituting a health, social and economic burden worldwide. Health Literacy as an essential health policy and promotion agenda item and a critical empowerment strategy could increase children's and adults' control over their overall health and awareness to overcome obesity issues. Initiatives to improve HL levels could be useful tools in managing the obesity epidemic, starting from integrating HL in the school curriculum and further in family and community action plans.
Collapse
Affiliation(s)
- Maria K Chrissini
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Biostatistics, Medical Research Methods & Epidemiology, Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| |
Collapse
|
21
|
Kanellopoulou A, Notara V, Antonogeorgos G, Chrissini M, Rojas-Gil AP, Kornilaki EN, Lagiou A, Panagiotakos DB. Inverse Association Between Health Literacy and Obesity Among Children in Greece: A School-Based, Cross-Sectional Epidemiological Study. HEALTH EDUCATION & BEHAVIOR 2021; 49:54-65. [PMID: 33451250 DOI: 10.1177/1090198120982944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children's health literacy is a crucial pillar of health. This study is aimed to examine the association between health literacy and weight status among Greek schoolchildren aged 10 to 12 years old. A population-based, cross-sectional observational study enrolling 1,728 students (795 boys), aged 10 to 12 years old, was conducted during school years 2014-2016. A health literacy index (range 0-100) was created through an item response theory hybrid model, by combining a variety of beliefs and perceptions of children about health. The mean health literacy score was 70.4 (±18.7). The majority of children (63.8%) had a "high" level (i.e., >67/100) of health literacy, 30.5% had a "medium" level (i.e., 34-66/100) of health literacy, while a small proportion of children (5.7%) had a "low" level (i.e., <33/100). Girls exhibited a higher level of health literacy than boys (71.7 ± 18.3 vs. 68.8 ± 19.1, p < .01). Regarding body weight status, 21.7% of children was overweight and 5.0% was obese. Linear regression models showed that the health literacy score was inversely associated with children's body mass index (regression coefficient [95% CI]: -0.010 [-0.018, -0.001]), after adjusting for dietary habits, physical activity levels, and other potential confounders. Health literacy seems to be a dominant characteristic of children's weight status; therefore, school planning, as well as public health policy actions should emphasize on the ability of children's capacity to obtain, process, and understand basic health information.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Demosthenes B Panagiotakos
- Harokopio University, Athens, Greece.,University of Canberra, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
22
|
Bollweg TM, Okan O, Freţian A, Janner C, Schulenkorf T, Kirchhoff S, Pinheiro P, Bauer U. Dimensionen der Gesundheitskompetenz von Viertklässler*innen. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2020. [DOI: 10.1007/s11553-020-00822-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Zusammenfassung
Hintergrund
Die Gesundheitskompetenz (GK) junger Menschen wird von Wissenschaft und Politik zunehmend als Ansatzpunkt für Gesundheitsförderung und Prävention anerkannt. Gerade die GK von Kindern wurde jedoch, insbesondere in Deutschland, bisher kaum erforscht. Diese Studie widmet sich dieser Forschungslücke, indem sie die GK von Viertklässler*innen in Nordrhein-Westfalen (NRW) untersucht.
Ziel der Arbeit (Fragestellung)
Die Fragestellung ist die explorative Beschreibung verschiedener Dimensionen der GK von Kindern unter Berücksichtigung sozioökonomischer Merkmale.
Material und Methoden
Es wurde eine schriftliche Klassenraumbefragung durchgeführt. Der Fragebogen, der speziell für 9‑ bis 10-Jährige entwickelt wurde, umfasst drei Dimensionen der GK: selbstberichtete allgemeine GK, funktionale GK (schriftsprachliche und numerische Fähigkeiten) und das Gesundheitswissen.
Ergebnisse
Es wurden 899 Schüler*innen an 32 Schulen befragt. Hierbei wurde eine hohe selbstberichtete GK ermittelt: die Befragten empfinden den Umgang mit Gesundheitsinformationen als einfach. Kinder mit niedrigem Wohlstand schneiden in allen Dimensionen der GK signifikant schlechter ab. Dies gilt mit Ausnahme der selbstberichteten GK auch für Kinder, die zuhause nicht nur Deutsch sprechen.
Schlussfolgerung
Diese Studie untersucht erstmals die GK von Viertklässler*innen in NRW. Wenngleich die selbstberichtete GK hoch ist, zeigt sich schon bei dieser jungen Altersgruppe ein sozialer Gradient hinsichtlich Wohlstand und Sprache. Die Forschungslage ist für das Kindesalter zwar noch lückenhaft und es besteht weiterhin Forschungsbedarf, die Ergebnisse deuten aber auf einen frühen Interventionsbedarf hin, um allen Kindern unabhängig von ihrer Herkunft zu ermöglichen, GK in dem Maß zu entwickeln, wie es der eigenen Gesundheit zuträglich ist.
Collapse
|
23
|
Spillane A, Belton S, McDermott C, Issartel J, Osborne RH, Elmer S, Murrin C. Development and validity testing of the Adolescent Health Literacy Questionnaire (AHLQ): Protocol for a mixed methods study within the Irish school setting. BMJ Open 2020; 10:e039920. [PMID: 33177140 PMCID: PMC7661365 DOI: 10.1136/bmjopen-2020-039920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Health literacy research has focused predominantly on the adult population, and much less is understood about this concept from an adolescent perspective. The tools currently available to measure adolescent health literacy have been adapted from adult versions. This limits their applicability to young people because of the developmental characteristics that impact on adolescents' behaviour, including impulse control and judgement skills. This protocol describes the intended development and validity testing of a questionnaire to measure health literacy in adolescents. METHODS AND ANALYSIS This protocol describes this mixed methods study that has three phases: the first phase will involve grounded research with adolescents using qualitative group interviews, co-design and concept mapping workshops to understand what health and healthy behaviours mean to adolescents and to explore their health literacy needs and the potential domains for the questionnaire. The draft health literacy domains identified will be presented to the youth advisory panel, and the questionnaire will be altered based on their feedback. Cognitive pretesting of the questionnaire items will also be conducted. Phase 2 will involve piloting the questionnaire to a two-stage random sample of young people in five urban and rural schools in Ireland. Test-retest reliability will be conducted using Pearson correlation coefficient. Confirmatory factor analysis will also be conducted to analyse the psychometric properties of the questionnaire. Phase 3 will involve the questionnaire being rolled out to a nationally representative sample of adolescents (n=6052) in Ireland to assess their levels of health literacy. ETHICS AND DISSEMINATION Ethical approval to conduct this study has been granted from the University College Dublin Human Research Ethics Committee - Sciences (LS-20-08). Informed assent from adolescents and informed consent from parents/guardians will be sought. The findings of this research will be disseminated at national and international conferences, as well as through publication in peer-reviewed journals.
Collapse
Affiliation(s)
- Ailbhe Spillane
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Sarahjane Belton
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Clare McDermott
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Johann Issartel
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Shandell Elmer
- Centre for Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
24
|
Ozturk Haney M. Health Literacy and Predictors of Body Weight in Turkish Children. J Pediatr Nurs 2020; 55:e257-e262. [PMID: 32553474 DOI: 10.1016/j.pedn.2020.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE This study assessed the association between health literacy (both of children and their parents) and body weight in Turkish schoolchildren. This study also aimed to determine the predictors of body weight in children. DESIGN AND METHODS This was a descriptive, correlational study that enrolled students and their parents from Turkish secondary schools. Data were collected using the Health Literacy Scale for School-Aged Children, Adult Health Literacy Scale, socio-demographic questionnaires and anthropometric measurements. RESULTS The mean child age was 12.76 ± 1.27; 40.2% were male, 41.5% had higher health literacy and 17.2% were obese. Child health literacy did not correlate with body mass index (r = 0.04, p > 0.05), but correlated positively with parent health literacy (r = 0.17, p < 0.05). Parent body mass index was the only explanatory variable in child body mass index. CONCLUSIONS Obesity in schoolchildren correlates with parental obesity. The results showed parents should participate in practising strategies that aim to prevent and treat childhood obesity. PRACTICE IMPLICATIONS Children's health literacy skills can be improved to develop their health and academic achievements.
Collapse
Affiliation(s)
- Meryem Ozturk Haney
- Public Health Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey.
| |
Collapse
|
25
|
Mamudu HM, Wang L, Poole AM, Blair CJ, Littleton MA, Gregory R, Frierson L, Voigt C, Paul TK. Cardiovascular Diseases Health Literacy among Patients, Health Professionals, and Community-Based Stakeholders in a Predominantly Medically Underserved Rural Environment. South Med J 2020; 113:508-513. [PMID: 33005968 DOI: 10.14423/smj.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The central Appalachian region of the United States is disproportionately burdened with cardiovascular disease (CVD); however, the level of literacy about CVD among residents has not been well studied. This study aimed to examine the prevalence and factors of CVD health literacy (HL) among a sample of patients/caregivers, providers/professionals, and community stakeholders. METHODS In 2018, data were collected from central Appalachian residents in six states: Kentucky, North Carolina, Ohio, Tennessee, Virginia, and West Virginia. CVD HL status was determined by assessing correct responses to five interrelated questions about basic knowledge of CVD. Multiple logistic regression analyses were used to examine the associations between potential factors and CVD HL status. RESULTS Of the total respondents (N = 82), <50% correctly answered all 5 CVD HL questions. Multiple logistic regression analyses showed that compared with respondents with advanced college degrees, those with a college degree or less were more likely to have low HL for "typical symptom of CVD," "physical exercise and CVD," "blood pressure and CVD," and "stress and CVD." In addition, compared with respondents younger than 50 years, those 50 years and older were 3.79 times more likely to have low HL for "physical exercise and CVD." CONCLUSIONS These results suggest the incorporation of CVD HL into CVD care and that educational attainments should be part of CVD policies and programs in the region.
Collapse
Affiliation(s)
- Hadii M Mamudu
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Liang Wang
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Amy M Poole
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Cynthia J Blair
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Mary Ann Littleton
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Rob Gregory
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Lynn Frierson
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Carl Voigt
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| | - Timir K Paul
- From the College of Public Health, East Tennessee State University, Johnson City, Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, Karing Hearts Cardiology Services, Johnson City, Mended Hearts, Johnson City Chapter, Johnson City, and the James H. Quillen College of Medicine, East Tennessee State University, Johnson City
| |
Collapse
|
26
|
Giger JT, Barnhart S, Feltner F, Slone M, Lawler MJ, Windsor L, Windsor A. Validating the eHealth Literacy Scale in Rural Adolescents. J Rural Health 2020; 37:504-516. [DOI: 10.1111/jrh.12509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Jarod T. Giger
- College of Social Work University of Kentucky Lexington Kentucky
| | - Sheila Barnhart
- College of Social Work University of Kentucky Lexington Kentucky
| | - Fran Feltner
- Center of Excellence in Rural Health Family and Community Medicine University of Kentucky Hazard Kentucky
| | - Melissa Slone
- Center of Excellence in Rural Health Family and Community Medicine University of Kentucky Hazard Kentucky
| | | | - Leah Windsor
- Institute for Intelligent Systems University of Memphis Memphis Tennessee
| | - Alistair Windsor
- Department of Mathematical Sciences University of Memphis Memphis Tennessee
| |
Collapse
|
27
|
Sousa P, Martinho R, Reis CI, Dias SS, Gaspar PJS, Dixe MDA, Luis LS, Ferreira R. Controlled trial of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower): Effectiveness analysis. J Adv Nurs 2019; 76:1057-1068. [PMID: 31880009 DOI: 10.1111/jan.14301] [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] [Received: 10/03/2019] [Revised: 11/15/2019] [Accepted: 12/17/2019] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the effectiveness on lifestyle change of an mHealth intervention to promote healthy behaviours in adolescence (TeenPower) and to analyse the predictors of the mHealth intervention effectiveness. DESIGN This study is designed as a non-randomized controlled trial with a two-arm structure. METHODS Adolescents of 12-16-year old were recruited from three school districts, with access to the Internet and smartphone/tablet devices. The intervention group was invited to engage in the mHealth intervention (TeenPower) for 6 months in addition to a school-based intervention. The control group only followed the school-based intervention. A repeated measures factorial ANOVA was used and the main effectiveness outcome was the lifestyle change measured by the adolescent lifestyle profile. RESULTS The outcomes of the mHealth intervention (TeenPower) show a significant effect on nutrition (ƞ2 p = 0.03, p = .03), positive life perspective (ƞ2 p = 0.04, p = .01), and global lifestyle (ƞ2 p = 0.02, p = .05), with a dropout rate of 62.1%. The analysis of the effectiveness predictors of the mHealth intervention suggested that older adolescents tended to show a significant increase in the rates of stress management (r = .40; p < .05). CONCLUSIONS Although the considerable dropout rate, the mHealth intervention presented significant impact on multiple lifestyle domains, providing support for the effectiveness of mHealth interventions for health promotion as an add-on to standard interdisciplinary interventions. IMPACT Adolescents must have the necessary and appropriate knowledge for the correct and responsible decision-making regarding their health and lifestyle. Innovative strategies (mHealth intervention) were used to promote healthy behaviours. This study evaluates the effectiveness of an mHealth intervention (TeenPower) specifically designed for adolescents. We found a significant impact in several lifestyle domains such as health responsibility, nutrition, positive life perspective, and global lifestyle.
Collapse
Affiliation(s)
- Pedro Sousa
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.,ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Ricardo Martinho
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal.,Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal
| | - Catarina I Reis
- School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal
| | - Sara S Dias
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal.,EpiDoC Unit - CEDOC, NOVA Medical School - Universidade Nova de Lisboa (NMS-UNL), Lisboa, Portugal
| | - Pedro J S Gaspar
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Maria Dos Anjos Dixe
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Luis S Luis
- ciTechCare, Centre for Innovative Care and Health Technology, Polytechnic Institute of Leiria, Leiria, Portugal.,School of Health Sciences, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Regina Ferreira
- CIIS-UC, UI-IPSantarém, School of Health Sciences, Polytechnic Institute of Santarém, Santarém, Portugal.,UMIS-School of Health Sciences, Santarém, Portugal
| |
Collapse
|
28
|
Toçi E, Burazeri G, Kamberi H, Toçi D, Roshi E, Jerliu N, Bregu A, Brand H. Health literacy and body mass index: a population-based study in a South-Eastern European country. J Public Health (Oxf) 2019; 43:123-130. [DOI: 10.1093/pubmed/fdz103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 07/05/2019] [Accepted: 08/02/2019] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
Background
The relationship of health literacy (HL) with objective measures including anthropometric measurements remains an under-researched topic to date.
Objective
To assess the association between body mass index (BMI) and HL among Albanian adults.
Methods
A cross-sectional study was conducted in Tirana, Albania, in 2012–2014 including a population-based sample of 1154 individuals aged ≥18 years. HL was assessed by the use of HLS-EU-Q instrument. Anthropometrics included measurement of weight and height based on which BMI was calculated. Information on socio-demographic characteristics was also collected. Logistic regression was employed to assess the independent association of BMI and HL controlling all socio-demographic factors.
Results
One-fifth of the participants reported an inadequate HL level, whereas almost one-third (31%) reported an excellent HL level. About 41% of study participants were overweight and further 22% were obese. In multivariate analysis, there was evidence of a strong and significant association between BMI and HL: the odds of overweight/obesity were two times higher (OR = 2.0, 95% CI = 1.3–3.1) among inadequate HL individuals compared with excellent HL participants.
Conclusion
Our findings, pertinent to a transitional country in the South East Europe, point to a strong, consistent and highly significant association between BMI and HL, irrespective of a wide array of socio-demographic characteristics.
Collapse
Affiliation(s)
- Ervin Toçi
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana 1005, Albania
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht 6200, The Netherlands
| | - Genc Burazeri
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana 1005, Albania
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht 6200, The Netherlands
| | - Haxhi Kamberi
- Faculty of Medicine, University of Gjakova “Fehmi Agani”, Gjakova 50000, Republic of Kosovo
- Regional Hospital “Isa Grezda”, Gjakove 50000, Republic of Kosovo
| | - Dorina Toçi
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana 1005, Albania
| | - Enver Roshi
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana 1005, Albania
| | - Naim Jerliu
- Faculty of Medicine, University of Prishtina, Prishtina 10000, Republic of Kosovo
- National Institute of Public Health of Kosovo, Prishtina 10000, Republic of Kosovo
| | - Arjan Bregu
- Department of Public Health, Faculty of Medicine, University of Medicine, Tirana 1005, Albania
| | - Helmut Brand
- Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht 6200, The Netherlands
| |
Collapse
|
29
|
Ludwig B, Smith SS, Heussler H. How Well Do Children Understand the Vocabulary of Sleep? Health Lit Res Pract 2019; 3:e53-e69. [PMID: 31294308 PMCID: PMC6608919 DOI: 10.3928/24748307-20190122-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 09/14/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Sleep surveys, such as the Pediatric Daytime Sleepiness Scale (PDSS), are used to determine a variety of concerns associated with sleep, including excessive daytime sleepiness (hypersomnolence), bedtime sleep behaviors, night awakenings, sleep duration, and sleep-disordered breathing. However, the literacy ability of the patient may not be adequate to ensure comprehension of questions and provision of accurate responses. Objective: To assess children's understanding of the sleep-associated vocabulary included in the PDSS. Methods: A cross-sectional, open-response survey was developed for use with students age 4 to 12 years. Prior to completing the instrument, each student was asked the meaning of six key sleep-related words used in the PDSS: drowsy, sleepy, alert, awakened, tired, and awake. The parents/caregivers were requested to record their child's definitions of these key words exactly as stated. Identification of words for “suitable” definitions was undertaken through consultation of three online dictionaries. This enabled the qualitative process associated with open-response surveys to be followed: identification of common themes, chunking of information, and criteria for coding responses. The final sample consisted of word definitions from 325 students (152 boys and 173 girls) from a school enrollment of 727 (45%). Key Results: A high percentage of children provided “suitable” responses for the words sleepy (84%) and tired (75%). The percentage of “suitable” responses for the words drowsy and awakened gradually increased across the age groups. The words alert and awake were challenging for the children to define, with the sleep-associated definition for alert only being provided by 31% of children overall and awake only being provided by 48% overall. In total, 57% of children were able to provide suitable definitions for at least four words. Conclusions: Our findings suggest that the results of many sleep surveys using these terms may not yield results that accurately reflect a child's actual state of daytime sleepiness and sleep/wake behaviors. Prior to administering a sleep survey, physicians need to clearly explain the meanings of sleep-associated words used in the survey and thus gain a more accurate reflection of a child's sleep and daytime behaviors. [HLRP: Health Literacy Research and Practice. 2019;3(1):e53–e69.] Plain Language Summary: Sleep surveys are used to identify problems with sleep. Children with poor health literacy due to age may not understand the questions and may not provide adequate answers. Children's understanding of sleep-associated vocabulary was assessed using six words: drowsy, sleepy, alert, awakened, tired, and awake. Many of these words were found to be difficult for the children to define.
Collapse
Affiliation(s)
- Beris Ludwig
- Address correspondence to Beris Ludwig, MEd, BSc (Hons) (Psychology), University of Queensland, 881 Ruthven Street, Toowoomba, QLD, Australia, 4350;
| | | | | |
Collapse
|
30
|
Abstract
Health literacy is an important issue to consider in the provision of health-care to children. Similar to the adult population, most parents face health literacy challenges. Of particular concern, 1 in 4 parents have low health literacy, greatly affecting their ability to use health information to make health decisions for their child. High expectations are placed on parents and children to achieve effective disease management and positive health outcomes in the context of complex health-care systems and disease treatment regimens. Low health literacy affects parent acquisition of knowledge, attitudes, and behaviors, as well as child health outcomes across the domains of disease prevention, acute illness care, and chronic illness care. The effect of low health literacy is wide ranging, including 1) poor nutrition knowledge and behaviors, 2) higher obesity rates, 3) more medication errors, 4) more emergency department use, and 5) poor asthma knowledge, behaviors, and outcomes. Health-care providers can mitigate the effects of health literacy by seeking to align health-care demands with the health literacy skills of families. Effective health literacy-informed interventions provide insights into methods that can be used by providers and health systems to improve health outcomes. Health literacy-informed communication strategies should be used with all families in a "universal precautions approach" because all parents likely benefit from clear communication. As scientific advances are made in disease prevention and management, unless families understand how to follow provider recommendations, the benefit of these advances will not be realized and disparities in outcomes will be exacerbated.
Collapse
Affiliation(s)
- Andrea K Morrison
- Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | | | - H Shonna Yin
- Department of Pediatrics and.,Department of Population Health, New York University School of Medicine/NYU Langone Health, New York, NY
| |
Collapse
|
31
|
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.
Collapse
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
| |
Collapse
|
32
|
Haney MO. Psychometric testing of the Turkish version of the Health Literacy for School-Aged Children Scale. J Child Health Care 2018; 22:97-107. [PMID: 29110532 DOI: 10.1177/1367493517738124] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the validity and reliability of the Turkish version of the Health Literacy for School-Aged Children (HLSAC-T) scale. This study was a cross-sectional and methodological design. The sample consisted of 563 sixth and ninth grade students in Izmir, Turkey. Data were collected with the socio-demographic characteristics questionnaire, HLSAC-T, and Turkish version of the Adolescent Lifestyle Profile. Cronbach's α for the scale was .77 and item-total correlations were between .49 and .61 ( p < .001). The model fit indices were determined to be the root mean square error of approximation at .035, the goodness of fit index at .99, and the comparative fit index at .99. The concordance validity and convergent validity were supported and the discriminant validity suggested that the scale successfully discriminated students who cared about healthy lifestyle from the students who did not. The HLSAC-T showed an adequate reliability and validity for determining the subjective health literacy of Turkish school-aged children. The results showed promise that the scale could be translated into other languages.
Collapse
Affiliation(s)
- Meryem Ozturk Haney
- Public Health Nursing Department, Nursing Faculty, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
33
|
Park A, Eckert TL, Zaso MJ, Scott-Sheldon LAJ, Vanable PA, Carey KB, Ewart CK, Carey MP. Associations Between Health Literacy and Health Behaviors Among Urban High School Students. THE JOURNAL OF SCHOOL HEALTH 2017; 87:885-893. [PMID: 29096408 PMCID: PMC5669371 DOI: 10.1111/josh.12567] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/10/2016] [Accepted: 01/27/2017] [Indexed: 05/19/2023]
Abstract
BACKGROUND Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures, and examined cross-sectional and prospective associations between health literacy and adolescent health behaviors and outcomes. METHODS We conducted a short-term prospective study of 250 adolescents (mean age = 14 years; 57% female; 48% African American) who were entering or in the ninth grade in an urban school district. Health literacy was assessed by individual interviews at baseline, and health-related behaviors and outcomes were assessed by a paper-and-pencil survey at baseline and at a 6-month follow-up. RESULTS Nearly half of the sample was reading at least 2 grades below expected levels. Lower baseline health literacy was associated with a lower self-rating of general health, unhealthier diet, heavier weight, and greater engagement in problem behaviors and sexual behaviors at baseline. Lower baseline health literacy also was associated with a greater increase in substance use over time. CONCLUSIONS Results point to the pressing need to improve health literacy in urban high school students.
Collapse
Affiliation(s)
- Aesoon Park
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244; Phone: (315) 443-2391, Fax: (315) 443-4085
| | - Tanya L. Eckert
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244;
| | - Michelle J. Zaso
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244;
| | - Lori A. J. Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Psychiatry and Human Behavior, Alpert Medical School, Brown University, Behavioral and Social Sciences, School of Public Health, Brown University, The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Coro Building, Suite 309, 164 Summit Ave, Providence RI 02906,
| | - Peter A. Vanable
- Syracuse University, Office of Research / Graduate School, 304 Lyman Hall, Syracuse, NY 13244-1200;
| | - Kate B. Carey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI 02912;
| | - Craig K. Ewart
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244;
| | - Michael P. Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital; Professor of Behavioral and Social Sciences, School of Public Health, and Professor of Psychiatry and Human Behavior, Alpert Medical School of Brown University; 164 Summit Avenue, Providence, RI 02906;
| |
Collapse
|
34
|
Zoellner JM, Hill J, You W, Brock D, Frisard M, Alexander R, Silva F, Price B, Marshall R, Estabrooks PA. The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013-2015. Prev Chronic Dis 2017; 14:E87. [PMID: 28957032 PMCID: PMC5621521 DOI: 10.5888/pcd14.160421] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Introduction Few interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose). Methods This pre–post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes. Results No significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than $25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001). Conclusion By incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.
Collapse
Affiliation(s)
- Jamie M Zoellner
- Department of Public Health Sciences, School of Medicine, University of Virginia, PO Box 800717, Charlottesville, VA 22908-0717. .,University of Virginia Cancer Center, Charlottesville, Virginia
| | - Jennie Hill
- Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Wen You
- Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, Virginia
| | - Donna Brock
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Madlyn Frisard
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
| | - Ramine Alexander
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Fabiana Silva
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Bryan Price
- University of Virginia Cancer Center, Charlottesville, Virginia
| | | | - Paul A Estabrooks
- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, Nebraska
| |
Collapse
|
35
|
Olyani S, Tehrani H, Esmaily H, Rezaii MM, Vahedian-Shahroodi M. Assessment of health literacy with the Newest Vital Sign and its correlation with body mass index in female adolescent students. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0103/ijamh-2017-0103.xml. [PMID: 28942437 DOI: 10.1515/ijamh-2017-0103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 07/16/2017] [Indexed: 11/15/2022]
Abstract
Background One of the significant outcomes of health education is health literacy (HL), which should be expanded to improve health promotion. Objective The aim of this study was to assess HL and its relationship with Body Mass Index (BMI) in female adolescent students. Subjects This study was conducted on 235 female students (aged 13-15 years) which were selected with cluster sampling. Methods For assessing HL, the Newest Vital Sign (NVS) was used and BMI Z-score was evaluated following the World Health Organization (WHO) guidelines. Data were analyzed using SPSS version 16. Results Based on this study's results, 11.5%, 37% and 51.5% of adolescents had adequate HL, limited HL and inadequate HL, respectively. There was a negative correlation between adolescents HL and BMI, rs = -0.233 (p < 0.001). Conclusion Most of adolescents had limited HL and students with higher BMI had a worse HL score. As a matter of fact, as adequate HL has a significant role for promoting health in the society policy makers must design educational programs for adolescents especially in non-medical settings such as schools where adolescents spend most of their time.
Collapse
Affiliation(s)
- Samira Olyani
- Health Education and Promotion, Student Research Committee, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (Islamic Republic of)
| | - Habibullah Esmaily
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohammad Vahedian-Shahroodi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran, Phone: +985138546634, Fax: +985138522775
| |
Collapse
|
36
|
Abstract
Child health literacy is a 'hot topic' of late, as researchers and practitioners work to attain an equitable and healthy future. Health literacy emphasizes the wide range of skills that people need to access, understand, evaluate and use health information to promote good health. In light of the recognition that health literacy is an important determinant of health for adults, addressing child health literacy early on is essential to maximize future health outcomes. Meeting children's specific needs arguably includes the delivery of information that can be easily accessed and understood by younger age groups. While much academic discourse pertains to the importance of building parental health literacy, there is less literature that explicitly focuses on child-centred health literacy. On the premise that health literacy is an asset, this paper provides an argument for investing in children's health literacy by working with children to encourage meaningful contributions in research and practice.
Collapse
Affiliation(s)
- Stefania Velardo
- 1 School of Education, Flinders University, Adelaide, South Australia, Australia.,2 Sport, Health and Physical Education Research Centre, Flinders University, Adelaide, South Australia, Australia
| | - Murray Drummond
- 1 School of Education, Flinders University, Adelaide, South Australia, Australia.,2 Sport, Health and Physical Education Research Centre, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
37
|
Okan O, Pinheiro P, Zamora P, Bauer U. [Health literacy in childhood and adolescence: An overview and current state of research]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:930-41. [PMID: 26133161 DOI: 10.1007/s00103-015-2199-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Health literacy is multidisciplinary and brings together many concepts, and is of increasing importance for disease protection, health promotion, and prevention, and for health policy within Europe. Although its importance is increasingly recognised, adults are mostly the target audience, whereas children and adolescents, in addition to education and schools, have so far been neglected. OBJECTIVES The aim is to give an overview of the state of the art in childhood and adolescence health literacy research, and to identify any existing gaps. MATERIALS A literature review has been performed to identify the relevant research data. RESULTS Limitations in developmental and age-adjusted conceptual frameworks and a lack of prevalence data, however, significantly impede our understanding of the meaning of health literacy in children and adolescents. School health promotion programmes could serve as a platform for effective health literacy education, beginning in early childhood. CONCLUSIONS In addition to compatibility with a broader literacy perspective, the proximity to several theories of health promotion and defined concepts, and the importance of school health promotion and education, it is vital to focus research on current gaps in the understanding of health literacy determinants, health literacy as a determinant of health, and in terms of the design and systematic implementation of intervention programmes.
Collapse
Affiliation(s)
- Orkan Okan
- Fakultät für Erziehungswissenschaft, Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Raum: UHG M7-118, Postfach 10 01 31, 33501, Bielefeld, Deutschland,
| | | | | | | |
Collapse
|
38
|
Smith SR, Samar VJ. Dimensions of Deaf/Hard-of-Hearing and Hearing Adolescents' Health Literacy and Health Knowledge. JOURNAL OF HEALTH COMMUNICATION 2016; 21:141-154. [PMID: 27548284 PMCID: PMC5073377 DOI: 10.1080/10810730.2016.1179368] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Deaf and hard-of-hearing (D/HH) adults have lower health literacy compared to hearing adults, but it is unclear whether this disparity also occurs in adolescence. We used the Health Literacy Skills Instrument-Short Form (HLSI-SF), Short Form of the Test of Functional Health Literacy in Adults (S-TOFHLA), Comprehensive Heart Disease Knowledge Questionnaire (CHDKQ), and newly constructed interactive and critical health literacy survey items to quantify D/HH and hearing adolescents' health literacy. We adapted and translated survey materials into sign language and spoken English to reduce testing bias due to variable English language skills. Participants were 187 D/HH and 94 hearing college-bound high school students. When we adjusted for age, gender, race/ethnicity, school grade, and socioeconomic status, D/HH adolescents demonstrated weaker general and functional health literacy and cardiovascular health knowledge than hearing adolescents on the HLSI, S-TOFHLA, and CHDKQ (all ps < .0001). Standard health literacy or knowledge scores were associated with several interactive and critical health literacy skills (all ps < .05). D/HH adolescents who reported greater hearing-culture identity, having hearing aids, experiencing better hearing with assistive devices, having good quality of communication with parents, and attending hearing schools at least half of the time had higher functional health literacy (all ps < .025). Those who reported English as their best language and attending hearing schools at least half of the time had higher cardiovascular health knowledge scores (all ps < .03). Results suggest that interventions to improve D/HH adolescents' health literacy should target their health-related conversations with their families; access to printed health information; and access to health information from other people, especially health care providers and educators.
Collapse
Affiliation(s)
- Scott R. Smith
- National Technical Institute for the Deaf at Rochester Institute of Technology
| | - Vincent J. Samar
- National Technical Institute for the Deaf at Rochester Institute of Technology
| |
Collapse
|
39
|
Liu CH, Liao LL, Cheng CCJ, Chang TC. Development and validation of the Taiwan Children’s Health Literacy Test. Glob Health Promot 2016; 25:34-46. [DOI: 10.1177/1757975916656365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Currently, health literacy (HL) worldwide is measured primarily among adults from a medical perspective. A children’s HL test from a health promotion perspective is needed. This study develops the Taiwan Children’s Health Literacy Test (TCHL) targeted at Taiwanese sixth-graders. Methods: HL indicators were identified through interviews of sixth-grade teachers, primary caregivers, and sixth-graders. They were used to develop a 25-item online test, which was finalized after pretesting and administered to a stratified random sample of 671 students across 29 sixth-grade classes. Results: The response rate was 87.2% (585 participants). Cronbach’s α was 0.60–0.78 for the HL subtests and 0.79 for the overall HL test. Correlation coefficients among subtests ranged from 0.49 to 0.87. The average proportion correct was 0.80 for overall HL. In item response theory analysis, the difficulty level ranged from −2.77 to −0.40, while the degree of discrimination was 0.44–2.65. Item information peaked when the ability value was approximately −1.8. Furthermore, HL scores had a significant positive correlation with health behaviors. Conclusions: Overall, the test was found to be reliable and valid, with a low level of difficulty for basic HL ability. The present results can be used as a reference by government health education units to investigate national HL in children.
Collapse
Affiliation(s)
- Chieh-Hsing Liu
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan
| | - Li-Ling Liao
- Department of Health Management, I-Shou University, Taiwan
| | | | - Tzu-Chau Chang
- Graduate Institute of Environmental Education, National Taiwan Normal University, Taiwan
| |
Collapse
|
40
|
Gibbs HD, Kennett AR, Kerling EH, Yu Q, Gajewski B, Ptomey LT, Sullivan DK. Assessing the Nutrition Literacy of Parents and Its Relationship With Child Diet Quality. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:505-509.e1. [PMID: 27216751 PMCID: PMC4931947 DOI: 10.1016/j.jneb.2016.04.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 03/29/2016] [Accepted: 04/10/2016] [Indexed: 05/14/2023]
Abstract
OBJECTIVE To estimate the reliability and validity of the Nutrition Literacy Assessment Instrument for Parents (NLit-P) and to investigate relationships among parental nutrition literacy, parental and child body mass index, and child diet quality (Healthy Eating Index). METHODS Cross-sectional study of 101 parent-child dyads that collected measures of socioeconomic status, nutrition literacy, 2 24-hour child diet recalls, and body mass index. Reliability of NLit-P was assessed by confirmatory factor analysis. Pearson correlation and multiple linear regression were used. RESULTS Fair to substantial reliability was seen across 5 NLit-P domains, whereas Pearson correlations support concurrent validity for the NLit-P related to child diet quality and parental income, age, and educational attainment (P < .001). For every 1% increase in NLit-P, there was a 0.51 increase in child Healthy Eating Index (multivariate coefficient, 0.174; P < .001). CONCLUSIONS AND IMPLICATIONS The NLit-P demonstrates potential for measuring parental nutrition literacy, which may be an important educational target for improving child diet quality.
Collapse
Affiliation(s)
- Heather D. Gibbs
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, United States
| | - Amy R. Kennett
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, United States
| | - Elizabeth H. Kerling
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, United States
| | - Qing Yu
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States
| | - Byron Gajewski
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States
| | - Lauren T. Ptomey
- Cardiovascular Research Institute, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Debra K. Sullivan
- Department of Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, United States
| |
Collapse
|
41
|
Liao LL, Liu CH, Cheng CC, Chang TC. Defining Taiwanese children's health literacy abilities from a health promotion perspective. Glob Health Promot 2016; 24:69-80. [PMID: 27353116 DOI: 10.1177/1757975915626114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Health literacy is related to health inequality, health behaviors, and health status. Globally, health literacy has primarily focused on adults and has been based on the medical model. It is necessary to understand children's life experiences as they relate to health; thus, this study attempted to evaluate and describe the health literacy abilities of sixth-graders in Taiwan. METHODS Interviews were conducted with 10 teachers and 11 caregivers, and focus groups were conducted with 32 children. Health literacy abilities corresponding to real-life situations were identified from life skills and the Taiwanese Curriculum Guidelines for health education. Three expert meetings were held to redefine children's health literacy using a health promotion perspective and confirmed indicators. RESULTS An operational definition of three aspects of children's health literacy and 25 abilities was proposed: 11 functional health literacy abilities (e.g. understands the connection between personal health care behaviors and health); seven interactive health literacy abilities (e.g. obtains and understands information from various channels); and seven critical health literacy abilities (e.g. analyzes the relationship between personal needs and diet choices for a balanced diet). These indicators cover 10 health education categories. CONCLUSIONS These findings highlight the importance of understanding Taiwanese children's health literacy, and the urgency of developing an appropriate measurement tool. The definition and indicators in this study were identified using a child-centered approach focusing on children's real-life experiences. The result serves as a solid basis for the development of the Taiwan Children's Health Literacy Scale, and provides information for the decision-making sector on health education.
Collapse
Affiliation(s)
- Li-Ling Liao
- 1 Department of Health Management, I-Shou University, Taiwan
| | - Chieh-Hsing Liu
- 2 Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan
| | - Chi-Chia Cheng
- 3 Department of Public Health, Fu Jen Catholic University, Taiwan
| | - Tzu-Chau Chang
- 4 Graduate Institute of Environmental Education, National Taiwan Normal University, Taiwan
| |
Collapse
|
42
|
Shih SF, Liu CH, Liao LL, Osborne RH. Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan. BMC Public Health 2016; 16:280. [PMID: 27000035 PMCID: PMC4802836 DOI: 10.1186/s12889-016-2879-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 02/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. METHODS Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. RESULTS The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese. CONCLUSIONS This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.
Collapse
Affiliation(s)
- Shu-Fang Shih
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Chieh-Hsing Liu
- />Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-An District 106, Taipei, Taiwan
| | - Li-Ling Liao
- />Department of Health Management, I-Shou University, No. 8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445 Taiwan
| | - Richard H. Osborne
- />Deakin University Centre for Population Health Research, School of Health and Social Development, Geelong, Victoria Australia
| |
Collapse
|
43
|
Yokokawa H, Fukuda H, Yuasa M, Sanada H, Hisaoka T, Naito T. Association between health literacy and metabolic syndrome or healthy lifestyle characteristics among community-dwelling Japanese people. Diabetol Metab Syndr 2016; 8:30. [PMID: 27014371 PMCID: PMC4806481 DOI: 10.1186/s13098-016-0142-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 03/08/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Few studies have assessed the association between health literacy (HL) and healthy lifestyle characteristics among Japanese people, and reports on the association between HL and prevalence of metabolic syndrome are also scarce. METHODS The present cross-sectional study included 1817 (781 men and 1036 women) Japanese individuals who participated in a medical health checkup at Bange Kosei General Hospital and Takada Kosei Hospital in Fukushima, Japan, from April 2013-2014. Information regarding HL and healthy lifestyle characteristics listed in Breslow's seven health practices was collected by self-administered questionnaire. RESULTS In multivariate logistic analysis, higher HL (≥14) was positively associated with healthy lifestyle characteristics [odds ratio (OR) = 2.08, 95 % confidence interval (CI) = 1.33-3.23] and inversely associated with prevalence of metabolic syndrome (OR = 0.67, 95 % CI = 0.48-0.95) among men. Among HL items, the ability to make decisions based on health-related information was significantly associated with healthy lifestyle characteristics (OR = 2.04, 95 % CI = 1.34-3.10 for men, OR = 1.38, 95 % CI = 1.30-1.85 for women) and inversely associated with prevalence of metabolic syndrome (OR = 0.62, 95 % CI = 0.44-0.88 for men, OR = 0.68, 95 % CI = 0.49-0.95 for women) in both sexes. CONCLUSIONS We found positive associations between HL and healthy lifestyle characteristics and an inverse association with prevalence of metabolic syndrome among men. Our findings also suggest that men and women are likely to engage in health-promoting behaviors and make decisions based on health-related information. These findings highlight the importance of comprehensive assessments, including HL, for health promotion in the community.
Collapse
Affiliation(s)
- Hirohide Yokokawa
- />Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Hiroshi Fukuda
- />Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Motoyuki Yuasa
- />Department of Public Health, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Hironobu Sanada
- />Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, Sakamizu 50, Aizubange Town, Fukushima, 969-6593 Japan
- />Department of Tumor and Host Bioscience, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1295 Japan
| | - Teruhiko Hisaoka
- />Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| | - Toshio Naito
- />Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421 Japan
| |
Collapse
|
44
|
Relation of intelligence quotient and body mass index in preschool children: a community-based cross-sectional study. Nutr Diabetes 2015; 5:e176. [PMID: 26258767 PMCID: PMC4558558 DOI: 10.1038/nutd.2015.27] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 06/18/2015] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Overweight and obesity in children is a global problem. Besides physical effects, obesity has harmful psychological effects on children. METHODS We carried out cross-sectional community-based study to investigate the relation between body mass index (BMI) and cognitive functioning in preschool children. Thirteen socioeconomical elements of 1151 children were measured and analyzed based on their intelligence quotient (IQ) test results. Thirteen out of 33 provinces were selected randomly, and schools were selected as clusters in rural and urban areas. Descriptive statistics, t-test, analysis of variance and regression were used when appropriate. RESULTS Our analysis showed that IQ was associated with household income, place of residence, delivery type, type of infant feeding and father's and mother's education level (P<0.001 for all). Using penalized linear regression for eliminating the impact of confounding factor, our study shows that, living in metropolitan (β=2.411) and urban areas (β=2.761), the level of participants' father's education (β=5.251) was positively and BMI (β=-0.594) was negatively related with IQ test results.ConclusionsThe findings of the present study showed that a lower IQ score is associated with higher BMI. However, this relation appears to be largely mediated when the socioeconomic status was considered.
Collapse
|
45
|
Tse CK, Bridges SM, Srinivasan DP, Cheng BS. Social media in adolescent health literacy education: a pilot study. JMIR Res Protoc 2015; 4:e18. [PMID: 25757670 PMCID: PMC4376152 DOI: 10.2196/resprot.3285] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 10/23/2014] [Accepted: 11/23/2014] [Indexed: 12/31/2022] Open
Abstract
Background While health literacy has gained notice on a global stage, the initial focus on seeking associations with medical conditions may have overlooked its impact across generations. Adolescent health literacy, specifically in dentistry, is an underexplored area despite the significance of this formative stage on an individual’s approach to healthy lifestyles and behaviors. Objective The aim is to conduct a pilot study to evaluate the efficacy of three major social media outlets - Twitter, Facebook, and YouTube - in supporting adolescents’ oral health literacy (OHL) education. Methods A random sample of 22 adolescents (aged 14-16 years) from an English-medium international school in Hong Kong provided informed consent. Sociodemographic information, including English language background, social media usage, and dental experience were collected via a questionnaire. A pre- and post-test of OHL (REALD-30) was administered by two trained, calibrated examiners. Following pre-test, participants were randomly assigned to one of three social media outlets: Twitter, Facebook, or YouTube. Participants received alerts posted daily for 5 consecutive days requiring online accessing of modified and original OHL education materials. One-way ANOVA ( analysis of variance) was used to compare the mean difference between the pre- and the post-test results among the three social media. Results No associations were found between the social media allocated and participants’ sociodemographics, including English language background, social media usage, and dental experience. Of the three social media, significant differences in literacy assessment scores were evident for participants who received oral health education messages via Facebook (P=.02) and YouTube (P=.005). Conclusions Based on the results of the pilot study, Facebook and YouTube may be more efficient media outlets for OHL promotion and education among adolescent school children when compared to Twitter. Further analyses with a larger study group is warranted.
Collapse
Affiliation(s)
- Carrie Kw Tse
- The University of Hong Kong, Hong Kong, China (Hong Kong)
| | | | | | | |
Collapse
|
46
|
Faruqi N, Spooner C, Joshi C, Lloyd J, Dennis S, Stocks N, Taggart J, Harris MF. Primary health care-level interventions targeting health literacy and their effect on weight loss: a systematic review. BMC OBESITY 2015. [PMID: 26217521 PMCID: PMC4511068 DOI: 10.1186/s40608-015-0035-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Enhancing individual’s health literacy for weight loss is important in addressing the increasing burden of chronic disease due to overweight and obesity. We conducted a systematic review and narrative synthesis to determine the effectiveness of lifestyle interventions aimed at improving adults’ knowledge and skills for weight loss in primary health care. The literature search included English-language papers published between 1990 and 30 June 2013 reporting research conducted within Organisation for Economic Cooperation and Development member countries. Twelve electronic databases and five journals were searched and this was supplemented by hand searching. The study population included adults (≥18 years old) with a body mass index (BMI) ≥25 kg/m2 and without chronic disease at baseline. We included intervention studies with a minimum 6 month follow-up. Three reviewers independently extracted data and two reviewers independently assessed study quality by using predefined criteria. The main outcome was a change in measured weight and/or BMI over 6 or 12 months. Results Thirteen intervention studies, all targeting diet, physical activity and behaviour change to improve individuals’ knowledge and/or skills for weight loss, were included with 2,089 participants. Most (9/13) of these studies were of a ‘weak’ quality. Seven studies provided training to the intervention deliverers. The majority of the studies (11/13) showed significant reduction in weight and/or BMI in at least one follow-up visit. There were no consistent associations in outcomes related to the mode of intervention delivery, the number or type of providers involved or the intensity of the intervention. Conclusions There was evidence for the effectiveness of interventions that focussed on improving knowledge and skills (health literacy) for weight loss. However, there was insufficient evidence to determine relative effectiveness of individual interventions. The lack of studies measuring socio-economic status needs to be addressed in future research as the rates of obesity are high in disadvantaged population groups.
Collapse
Affiliation(s)
- Nighat Faruqi
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, UNSW Australia, Sydney, Australia ; Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| | - Catherine Spooner
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, UNSW Australia, Sydney, Australia ; Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| | - Chandni Joshi
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, UNSW Australia, Sydney, Australia ; Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| | - Sarah Dennis
- Clinical and Rehabilitation Sciences, Faculty of Health Sciences, University of Sydney, Sydney, Australia ; Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| | - Nigel Stocks
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, UNSW Australia, Sydney, Australia ; Discipline of General Practice, University of Adelaide, Adelaide, Australia
| | - Jane Taggart
- Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| | - Mark F Harris
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, UNSW Australia, Sydney, Australia ; Centre for Primary Health Care and Equity, UNSW Australia, Sydney, Australia
| |
Collapse
|
47
|
Mackert M, Champlin S, Su Z, Guadagno M. The Many Health Literacies: Advancing Research or Fragmentation? HEALTH COMMUNICATION 2015; 30:1161-1165. [PMID: 26372026 DOI: 10.1080/10410236.2015.1037422] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Health literacy is the degree to which individuals can obtain, process, understand, and communicate about health-related information needed to make informed health decisions and is an important factor in patient health outcomes and resulting health care costs. Because of its importance across many areas of health, specific attention has been given to studying and measuring health literacy in recent years; however, the field lacks consensus on how health literacy should be defined and measured. As a result, numerous definitions and measures of health literacy exist. This fragmentation and inconsistency creates a barrier to conceptualizing, measuring, and understanding health literacy across health domains and fields. A directed literature search reveals a substantial body of work on health literacy; however, findings from studies often emphasize health literacy within specific health domains, populations, contexts, and languages, which makes the comparison of findings across studies difficult. While there is recognition that the measurement of health literacy should be improved, it is important to take into consideration what can be gained from a general health literacy focus and how this could be applied across domains.
Collapse
Affiliation(s)
- Michael Mackert
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
- b Center for Health Communication , University of Texas at Austin
- c School of Public Health , University of Texas Health Science Center at Houston
| | - Sara Champlin
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
| | - Zhaohui Su
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
| | - Marie Guadagno
- a Stan Richards School of Advertising and Public Relations , University of Texas at Austin
| |
Collapse
|
48
|
Chisolm DJ, Manganello JA, Kelleher KJ, Marshal MP. Health literacy, alcohol expectancies, and alcohol use behaviors in teens. PATIENT EDUCATION AND COUNSELING 2014; 97:291-296. [PMID: 25085549 PMCID: PMC4252970 DOI: 10.1016/j.pec.2014.07.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 05/28/2014] [Accepted: 07/13/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Alcohol expectancies are developed, in part, through exposure to health messages, the understanding of which may be influenced by health literacy. This study explores the relationships among health literacy, alcohol expectancies, and alcohol use behaviors in teens. METHODS We studied alcohol use behaviors in the past six months in youths aged 14-19 recruited from two adolescent medicine clinics. We assessed covariate-adjusted bivariate relationships between HL, expectancies, and four measures of alcohol use and tested health literacy as a moderator of the relationship between expectancies and use. RESULTS Of the 293 study teens, 45 percent reported use of alcohol in the past six months. Use behaviors were positively associated with higher health literacy and positive expectancies. Our moderation model suggested that health literacy moderates the relationship between expectancies and use, with the expectancy/use relationship being significantly stronger in higher literacy teens. CONCLUSION Findings suggest that health literacy can influence alcohol expectancies and behaviors. PRACTICE IMPLICATIONS Health literacy should be explicitly considered in the design of alcohol prevention messages.
Collapse
Affiliation(s)
- Deena J Chisolm
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA; The Research Institute at Nationwide Children's Hospital, Columbus, USA.
| | - Jennifer A Manganello
- Department of Health Policy, Management, and Behavior, University of Albany School of Public Health, Rensselaer, USA
| | - Kelly J Kelleher
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA; The Research Institute at Nationwide Children's Hospital, Columbus, USA
| | | |
Collapse
|
49
|
Lassetter JH, Clark L, Morgan SE, Brown LB, VanServellen G, Duncan K, Hopkins ES. Health literacy and obesity among native Hawaiian and Pacific Islanders in the United States. Public Health Nurs 2014; 32:15-23. [PMID: 25273848 DOI: 10.1111/phn.12155] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Our purpose was to describe relationships between demographic characteristics, body mass index (BMI), and health literacy among Native Hawaiians and other Pacific Islanders (NHPIs). DESIGN AND SAMPLE In this cross-sectional survey, we interviewed 364 NHPI adults. MEASURES We used Newest Vital Sign (NVS), a health literacy tool; measured heights and weights; and demographic questions. RESULTS According to participants' NVS scores, 45.3% had at least a possibility of low health literacy. Lower NVS scores were associated with increased BMI (r = -0.12, p = .027) and increased age (r = -0.26, p < .001). Higher NVS scores were associated with higher incomes (r = 0.21, p = .001) and higher education (r = 0.27, p < .001). Women scored significantly better than men (t = -2.0, p = .05). Participants' NVS scores in Hawaii versus Utah were not significantly different (t = .26, p = .80). CONCLUSIONS Pathways to health literacy are complex; however, age, income, education, and BMI explained a modest 19.95% of the combined variance in NVS scores. Public health nurses working to improve health literacy could include review of critical information on nutrition facts labels, frequently used calculations, and application of this information when making food choices.
Collapse
|
50
|
An Analysis of the Research Trends on Children's Media in the Digital Era. ADONGHAKOEJI 2014. [DOI: 10.5723/kjcs.2014.35.4.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|