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Ahmad I, Taimur H, Shabbir S, Shabbir CA, Ahsan A, Ahmad HS, Masuda G. Examining Communicative, Critical Health Literacy and eHealth Literacy among International University Students Residing in Japan. Healthcare (Basel) 2024; 12:941. [PMID: 38727498 PMCID: PMC11083772 DOI: 10.3390/healthcare12090941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/27/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
(1) Background: International students with sufficient health literacy are better equipped to respond to public health emergencies and reduce any unintentional harm that may occur during such events. This study aims to assess the current status of health literacy among international students and investigate the factors that influence health literacy. (2) Methods: A cross-sectional study was conducted in Tokyo on international university students using a questionnaire consisting of the Communicative and Critical Health Literacy and eHealth Literacy Scales. The study analyzed 205 valid responses. Descriptive statistics were utilized to assess the level of health literacy, and linear regression was used to identify the association of socio-demographic characteristics and disease status with health and e-health literacy. (3) Results: Health literacy and e-health literacy were low in 48.29% and 47.29% of international students, respectively. The mean scores of CCHL items ranged from 3.13 to 3.26, while the mean scores of eHEALS items ranged from 3.33 to 3.49. Both health literacy and e-health literacy were better with unmarried status (p = 0.015), and e-health literacy was worse with higher age (p = 0.007). (4) Conclusions: Overall, international students' health literacy and e-health literacy were at intermediate levels, with considerable room for improvement, and affected by certain student attributes.
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Affiliation(s)
- Ishtiaq Ahmad
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Hira Taimur
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Sameera Shabbir
- Central Campus, International Higher School of Medicine, Bishkek 720054, Kyrgyzstan
| | - Chaudhry Ahmed Shabbir
- Department of Medical Quality and Safety Management, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Ali Ahsan
- Department of Biology, Graduate School of Science, Osaka Metropolitan University, Osaka 558-8585, Japan
| | - Hafiz Sultan Ahmad
- Faculty of Science and Technology, University of Central Punjab, Lahore 54000, Pakistan
| | - Gaku Masuda
- The Section of Global Health, Department of Hygiene and Public Health, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
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Zahedi H, Mohammadinia L, Dehghani SL, Habibzadeh S, Kheibar N. The association between health literacy and pedestrian safety behavior among adults: a cross-sectional study. BMC Public Health 2024; 24:1110. [PMID: 38649846 PMCID: PMC11036549 DOI: 10.1186/s12889-024-18441-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION Pedestrians are considered the most vulnerable and complex road users as human behavior constitutes one of the fundamental reasons for traffic-related incidents involving pedestrians. However, the role of health literacy as a predictor of Pedestrian safety behavior remains underexplored. Therefore, the current study was designed to examine the level of health literacy and its association with the safety behavior of adult pedestrians in the city of Tabriz. METHODS This cross-sectional analytical study was conducted among individuals aged 18 to 65 years in the metropolitan area of Tabriz from January to April 2023. Data were collected using the HELIA standard questionnaire (Health Literacy Instrument for adults), comprising 33 items across 5 domains (access, reading, understanding, appraisal, decision-making and behavior), as well as the Pedestrian Behavior Questionnaire (PBQ) consisting of 29 items. Data were analyzed using descriptive and analytical statistics (independent t-tests, ANOVA, and Pearson correlation coefficient) via SPSS-22 software. RESULTS Based on the results, 94% (376 individuals) had excellent health literacy levels, and their safety behavior scores were at a good level. Health literacy and safety behavior were higher among the age group of 31 to 45 years, women, married individuals, those who read books, and individuals with higher education. However, safety behavior showed no significant association with education level (P > 0.05). There was a significant and positive relationship between health literacy and all its domains and pedestrian safety behavior (r = 0.369, P < 0.001). CONCLUSION This study underscores the significant impact of health literacy on pedestrians' safety behavior. The findings reveal that higher levels of health literacy are associated with better safety behavior among individuals aged 18 to 63. Demographic factors such as age, gender, marital status, and education level also play a role in shaping both health literacy and safety behavior. By recognizing these relationships, interventions can be tailored to improve health literacy levels and promote safer pedestrian practices, ultimately contributing to a healthier and safer community in Tabriz city.
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Affiliation(s)
- Hamideh Zahedi
- Student Research Committee, Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Mohammadinia
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Health in Disasters and emergencies, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | | | - Sajjad Habibzadeh
- MSc of Medical Surgical Nursing, Tabriz University of Medical sciences, Tabriz, Iran
| | - Nasrin Kheibar
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Behbahan Faculty of Medical Sciences, Behbahan, Iran.
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Chen J, Tian H. Associations and gender differences between OHI-seeking behaviors and eHealth literacy among Chinese university students. Rev Esc Enferm USP 2024; 58:e20230340. [PMID: 38602487 PMCID: PMC11021020 DOI: 10.1590/1980-220x-reeusp-2023-0340en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/07/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE to explore associations and gender differences between OHI-seeking (online health information seeking) behaviors and eHealth (electronic health) literacy among Chinese university students. METHODS Online questionnaires of eHealth literacy scale and OHI-seeking behaviors created in software Wenjunxing were used in this survey. Chi-squared tests, t-test, and Pearson correlation analysis were performed using SPSS for data analysis. RESULTS Among 5,383 participants, 72.4% were girls, 77.5% lived in rural areas, 51.2% majored in liberal arts, 76.6% with low education parents. The average C-eHEALS scores of boys and girls were 26.53 ± 5.861 and 26.84 ± 5.816, respectively, with no significant difference (P = 0.084). The top three OHI-seeking behaviors for boys and girls, as well as for the C-eHEALS low and high groups, were "finding information about physical exercises" "reading or sharing health information via social media" "finding information about nutrition and diet", all of which had significant gender and eHealth literacy differences. CONCLUSIONS Gender and eHealth literacy differences should be focused for intervention when developing and implementing eHealth intervention training for parents and adolescents in schools and communities.
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Affiliation(s)
- Jie Chen
- Xinyang Normal University, School of Marxism, Xinyang, China
| | - Hua Tian
- Xinyang Normal University, College of Life Science, Xinyang, China
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Bai L, Tang H, Wang M. Dietary behaviors of rural residents in northeastern China: implications for designing intervention information and targeting high-risk population. Front Public Health 2024; 12:1239449. [PMID: 38389950 PMCID: PMC10883159 DOI: 10.3389/fpubh.2024.1239449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/02/2024] [Indexed: 02/24/2024] Open
Abstract
Background Dietary behavior is a pivotal modifiable determinant in reducing the occurrence of obesity/overweight and chronic non-communicable diseases. Improving the dietary behavior of rural residents in China is imminent due to the poor performance of their dietary behavior. Nutrition knowledge and health literacy are considered as elements that are linked intimately to healthy dietary behaviors but lack research in the Chinese setting. Purpose The study is designed to explore the relationship between nutritional knowledge, health literacy and dietary behaviors and to analyze the performance under different demographic characteristics. Methods A face-to-face survey of 400 rural residents on their nutrition knowledge, functional health literacy and dietary intake of five food categories consisting of 32 items was conducted based on a validated questionnaire. Descriptive analysis, difference test including ANOVA, t-test and non-parametric test, and multivariate linear regression were used for data analysis. Results The results indicate that declarative nutrition knowledge, individuals' information application capacity, and dietary behaviors, especially the intake of fruits, dairy and beans, and vegetable are not ideal and requires improvement. Male, elder, low-income, unmarried, and low-education populations performed significantly worse and were the high-risk group. Procedural nutrition knowledge, information access capacity, information understanding capacity, and information application capacity have remarkable effects on better dietary behavior. Conclusion This study provides evidence-based guidance for prioritizing information and populations for healthy dietary interventions.
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Affiliation(s)
- Li Bai
- School of Biological and Agricultural Engineering, Jilin University, Changchun, China
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Haiheng Tang
- School of Biological and Agricultural Engineering, Jilin University, Changchun, China
| | - Mingliang Wang
- School of Business and Management, Jilin University, Changchun, China
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Chaudhary MN, Lim VC, Sahimin N, Faller EM, Regmi P, Aryal N, Azman AS. Assessing the knowledge of, attitudes towards, and practices in, food safety among migrant workers in Klang Valley, Malaysia. Travel Med Infect Dis 2023; 54:102620. [PMID: 37487946 DOI: 10.1016/j.tmaid.2023.102620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/07/2023] [Accepted: 07/13/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Annually, 600 million individuals are affected by food-borne diseases (FBD), alongside 425,000 fatalities. Improving the general public knowledge of, attitudes towards, and practices in, (KAP) food safety is necessary for minimizing FBD transmission. In Malaysia, migrant workers account for 11.1% of the workforce, with a high proportion involved in food and beverage services. Therefore, this study aimed (i) to evaluate the current food safety KAP, and (ii) to identify the strategies to promote food safety awareness, among migrant workers across occupational sectors in Klang Valley. METHOD A survey was conducted with 403 migrant workers through phone interviews and online self-administered questionnaires. Piecewise structural equation modelling and multinomial regression were applied to identify predictor variables for food safety KAP and to explore differences across nationalities. RESULTS The respondents were Nepalese, Filipino and Indonesian. The majority were male, working in the services industry, had completed high school, aged between 30 and 39 years and had worked in Malaysia for less than ten years. Knowledge was significantly correlated with attitudes and practices. Female respondents had lower knowledge and attitude scores while younger respondents had lower knowledge scores. Indonesian and Filipino respondents had lower knowledge and attitudes scores than Nepalese respondents. Understanding food safety information from social media was positively correlated with the respondents' food safety knowledge and practices. CONCLUSION These findings highlighted: (i) the need to target female, younger, Indonesian and Filipino migrant workers, and (ii) the potential of social media to improve public awareness of food safety and hygienic practices.
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Affiliation(s)
- Maryam Nazir Chaudhary
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Voon-Ching Lim
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia; Department of Biology, Chulalongkorn University, 10330, Bangkok, Thailand; National Primate Research Center of Thailand, Chulalongkorn University, 18110, Saraburi, Thailand
| | - Norhidayu Sahimin
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, 50603, Kuala Lumpur, Malaysia
| | - Erwin Martinez Faller
- Pharmacy Department, School of Allied Health, San Pedro College, 12, Guzman St, Davao City, Davao del Sur, Philippines
| | - Pramod Regmi
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, BH8 8GP, United Kingdom
| | - Nirmal Aryal
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, BH8 8GP, United Kingdom
| | - Adzzie Shazleen Azman
- School of Science, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
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Agner J, Meyer M, Kaukau TM, Liu M, Nakamura L, Botero A, Sentell T. Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai'i. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:837. [PMID: 36613158 PMCID: PMC9820034 DOI: 10.3390/ijerph20010837] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Health literacy is the ability to obtain and utilize health information to make health-related decisions and to navigate health systems. Although health literacy has traditionally been understood as an individual-level construct, current research is revealing the impact that social networks can have on health literacy. To date, no studies have examined associations between health literacy and social networks among people with serious mental illness (PWSMI), who are at high risk of physical illness and premature mortality. To begin to fill this gap, this study explores associations between health literacy, relationships with health discussion partners, and self-reported health outcomes in a racially diverse sample of Clubhouse members in Hawai'i. Clubhouses are community mental health centers that promote recovery from mental illness through destigmatization, meaningful activity, and strong social relationships. Health literacy was assessed using two single-item screeners (SILS). In a sample of 163 members, 56.2% reported adequate ability to understand health-related instructions or pamphlets, and 43.3% reported adequate confidence filling out medical forms independently. This is consistent with other health literacy studies with PWSMI in the United States, and indicates lower health literacy within this group than is reported in national averages. Multivariate logistic regression revealed a larger Clubhouse staff social network and completing high school were significantly associated with requiring less help to read materials. Higher age, male gender, and being Native Hawaiian and/or Pacific Islander were associated with less confidence filling out medical forms, while higher self-efficacy was associated with higher confidence filling out medical forms. This study provides preliminary evidence that relationships fostered within Clubhouses are associated with health literacy among PWSMI, and highlights the need for more research to examine how social networks and health literacy interventions can be leveraged in community mental health settings to improve health outcomes within this vulnerable population.
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Affiliation(s)
- Joy Agner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA 90089, USA
| | - Monet Meyer
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | | | - Maileen Liu
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Lisa Nakamura
- Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Adriana Botero
- Hawai‘i School of Professional Psychology, Chaminade University of Honolulu, Honolulu, HI 96816, USA
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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Amoah PA, Boateng MO, Koduah AO, Acheampong PR. Interplay of health literacy, healthcare access and health behaviors with oral health status among older persons. Front Public Health 2022; 10:997987. [PMID: 36568738 PMCID: PMC9784911 DOI: 10.3389/fpubh.2022.997987] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
This study contributes to the ongoing debate on social determinants of oral health of older persons. Specifically, it examines the direct and indirect effects of health literacy and access to healthcare on oral health status of older persons. The study also investigates whether general health status and health behavior (routine medical check-ups) explain the association of health literacy and healthcare access with oral health status. The gender dimensions of these relationships are also explored. Data were derived from 522 participants aged 50 years and older located in five regions in Ghana. Path analyses in structural equation modeling (SEM) were used to analyse the data. General health status (β = -0.049, p < 0.005), medical check-up (β = 0.124, p < 0.01), and health literacy (β = 0.133, p < 0.01) were positively associated with oral health status. General health status mediated the positive relationship between health literacy and oral health status (β = 0.048, p < 0.01). General health status (β = 0.016, p < 0.05) and medical check-ups (β = 0.025, p < 0.05) mediated the association between access to healthcare and oral health status. The mediational role of routine medical check-up in the association between access to healthcare and oral health status was significantly stronger (B = 0.063, p < 0.01) among men (β = 0.051, p < 0.01) than women (β = 0.003, p > 0.05). Analyses of oral health issues among older persons in Ghana and settings alike must recognize the complex interplay among critical social determinants to initiate pragmatic health and social policy interventions.
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Affiliation(s)
- Padmore Adusei Amoah
- Department of Applied Psychology, School of Graduate Studies, Institute of Policy Studies, Lingnan University, Tuen Mun, Hong Kong SAR, China,*Correspondence: Padmore Adusei Amoah
| | | | - Adwoa Owusuaa Koduah
- Center of Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Princess Ruhama Acheampong
- Department of Health Promotion and Education, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Li M, Sonoda N, Koh C, Yasumoto R, Morimoto A. Meta-analysis of the association between health literacy and smoking. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Singh H, Kolschen J, Samkange-Zeeb F, Brand T, Zeeb H, Schüz B. Modifiable predictors of health literacy in working-age adults - a rapid review and meta-analysis. BMC Public Health 2022; 22:1450. [PMID: 35906567 PMCID: PMC9338662 DOI: 10.1186/s12889-022-13851-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/18/2022] [Indexed: 11/27/2022] Open
Abstract
Background Health literacy comprises the ability to identify, obtain, interpret and act upon health information. Low health literacy is a major risk factor for hospitalizations, use of emergency care and premature mortality among others. Known risk factors for low health literacy such as lower educational attainment, migration history and chronic illnesses overlap with those for long-term unemployment – in itself a risk factor for low health literacy. These factors are difficult to address in interventions to support health literacy. Therefore, the objective of this review is to identify potentially modifiable predictors of HL in populations potentially affected by long-term unemployment. Methods A rapid review (PROSPERO registration number: 290873) was carried out in Pubmed and SCOPUS including quantitative studies on potentially modifiable predictors of health literacy in working-age populations following PRISMA guidelines for systematic reviews. Where possible, reported effect sizes were transformed into r, and random-effects meta-analyses were conducted where appropriate to pool effect sizes for the association between modifiable predictors and health literacy. Results In total, 4765 titles and abstracts were screened, 114 articles were assessed in full-text screening, and 54 were included in the review. Forty-one effect sizes were considered for 9 different meta-analyses. Higher language proficiency, higher frequency of internet use, using the internet as a source of health information more often, being more physically active, more oral health behaviours, watching more health-related TV and a good health status were significantly associated with higher health literacy. Significant heterogeneity suggests between-study differences. Conclusions Improving language proficiency and/or providing information in multiple and simplified languages, together with reliable and accessible health information on the internet and in linear media are potentially promising targets to improve health literacy levels in working-age populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13851-0.
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Affiliation(s)
- Hunny Singh
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany.
| | - Jonathan Kolschen
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Florence Samkange-Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tilman Brand
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Benjamin Schüz
- Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany. .,Health Sciences Bremen, University of Bremen, Bremen, Germany.
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Amoah PA, Adjei SB, Arthur-Holmes F. A Social-Ecological Study of Perceptions and Determinants of Sexual Enhancement Drug Use among Men and Women in Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116521. [PMID: 35682105 PMCID: PMC9180177 DOI: 10.3390/ijerph19116521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
The use and sale of sexual enhancement drugs (particularly unapproved aphrodisiacs) have become a public health concern in Ghana and many other sub-Saharan African countries. While most studies have examined this phenomenon from the level of individual perspectives, this study investigates the multi-dimensional and multi-level factors (e.g., individual characteristics and behaviours, interpersonal factors, community norms and practices, institutional and public policy factors) that influence attitudes, perceptions, and use of aphrodisiacs among men and women in Ghana. Using a concurrent mixed-method design, we derived the data from a semi-structured interview and cross-sectional survey conducted across five administrative regions in Ghana. Interpretative phenomenological analysis and logistic regression techniques were used to analyse the qualitative and quantitative (survey) data, respectively. Approximately 12.6% of participants (17.6% among males and 7.2% among females) had used an aphrodisiac in the six months prior to the study. Approximately 23.4% of the participants had more than one partner during the same period. Among men, being religious (B = −0.238, p < 0.05) and having multiple sexual partners (B = 0.481, p < 0.01) were positively associated with the use of aphrodisiacs. For women, being employed (B = −1.539, p < 0.01), engaging in physical activities (exercising) (B = −0.658, p < 0.05), having good health (B = 0.869, p < 0.05), having multiple sexual partners (B = 1.191, p < 0.01), and taking alcohol (B = 1.041, p < 0.01) were associated with use of aphrodisiacs. Although many participants had used aphrodisiacs, women, in particular, held unfavourable views about the drugs due to perceived negative health implications for themselves and their partners. The findings also show that community-level factors (e.g., social norms and expectations), interpersonal factors (e.g., expectations of partners and friends), public policy (e.g., drug-related regulations), and organisational/institutional factors (e.g., health system arrangements about access and use of drugs) were critical to the sale and use of aphrodisiacs among both men and women in Ghana. A multi-level analysis of the use of sexual enhancement drugs among men and women is crucial to formulating social and public health policies that aim to improve public knowledge of these drugs, reduce uncontrolled production, and protect population health and well-being.
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Affiliation(s)
- Padmore Adusei Amoah
- School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
- Institute of Policy Studies, Lingnan University, Tuen Mun, Hong Kong
- Department of Applied Psychology, Lingnan University, Tuen Mun, Hong Kong
- Correspondence: or
| | - Stephen Baffour Adjei
- Department of Interdisciplinary Studies, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Kumasi P.O. Box 1277, Ghana;
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Amoah PA, Musalia J, Abrefa Busia K. Health Behaviors and Health Literacy: Questing the Role of Weak Social Ties Among Older Persons in Rural and Urban Ghana. Front Public Health 2022; 10:777217. [PMID: 35296048 PMCID: PMC8919952 DOI: 10.3389/fpubh.2022.777217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background Older persons are one of the most vulnerable groups as regards low health literacy. However, little is known about the extent of limitations and multi-faceted nature of their health literacy, such as its characteristics and social and geographical dimensions. Additionally, most existing studies have predominantly treated health literacy as a risk factor of health and wellbeing of older persons as opposed to an outcome that must be pursued. Objectives This study investigated the moderating role of weak social ties (bridging social capital) in the relationship between health behaviors, such as smoking, alcohol intake, voluntary body check-up and physical exercise, and health literacy among older persons in rural and urban Ghana. Methods Data was drawn from a cross-sectional survey comprising 522 respondents across five administrative regions in Ghana. Ordinary Least Squares regression technique was used to analyse the data. Results Older persons in urban areas had higher health literacy [Mean/Standard deviation (SD) = 9.1/4.1 vs. 10.1/4.2] as well as higher bridging social capital (Mean/SD = 2.0/1.2 vs. 1.6/0.9) than their rural counterparts. Bridging social capital was negatively associated with the health literacy of urban residents (B = −0.997, p < 0.01). We found evidence that smoking (B = −0.787, p < 0.05) and undertaking physical activities (B = 0.812, p < 0.01) were associated with health literacy of older persons in rural areas. Having voluntary body check-ups (B = 0.155, p < 0.01) was associated with health literacy in urban areas. Bridging social capital negatively moderated the association of smoking with health literacy in rural areas (B = −5.032, p < 0.01), but it instead positively modified the relationship between alcohol intake and health literacy in urban areas (B = 0.185, p < 0.05). Conclusion For policymakers and practitioners aiming to promote older persons' health literacy as a public health asset at individual and community levels, an important starting point to achieving such goals is to understand the fundamental indicators (e.g., health behaviors) and the role that social and geographical factors play in shaping their health literacy.
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Affiliation(s)
- Padmore Adusei Amoah
- Department of Applied Psychology, School of Graduate Studies, Institute of Policy Studies, Lingnan University, Tuen Mun, Hong Kong SAR, China
| | - John Musalia
- Department of Sociology and Criminology, Western Kentucky University, Bowling Green, KY, United States
| | - Kwaku Abrefa Busia
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong SAR, China
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Senahad N, Loahasiriwong W, Maneenin N. Sociocultural, health knowledge, and health literacy among children ages 9-10 years in Thailand. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:137. [PMID: 35677268 PMCID: PMC9170210 DOI: 10.4103/jehp.jehp_886_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/06/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Health literacy (HL) enables a person to make good decisions regarding health care, disease prevention, and health promotion to maintain and improve health. In Thailand, most existing studies focus on adults' HL rather than children. This research aimed to determine the influence of sociocultural and health knowledge on HL among children ages 9-10 years in Thailand. MATERIALS AND METHODS A cross-sectional study was conducted among 1650 children aged 9-10 years. The respondents were recruited using multistage random sampling from 39 primary schools of 13 provinces in all four regions of Thailand. A self-administered structured questionnaire was used to collect the required data. The multilevel analysis was used to determine the association between sociocultural, health knowledge, and HL while controlling the effects of covariates. The result was presented as adjusted odd ratios and its 95% confidence interval (CI). RESULTS Of the total 1650 respondents, 86.24% (95% CI: 84.49%-87.82%) had adequate and excellent levels of HL. The multivariable analysis indicated factors that were significantly associated with adequate and excellent levels HL including adequacy of per diem (adjusted odds ratio [adj. OR] = 6.78; 95% CI: 3.54-12.97) and had good relationship with teachers (adj. OR = 2.19; 95% CI: 1.55-3.09). Sources of health education which were received health education from parents (adj. OR = 3.51; 95% CI: 2.39-5.14), from teachers (adj. OR = 2.03; 95% CI: 1.43-2.89), and from the Internet (adj. OR = 1.83; 95% CI: 1.12-2.99) were also significantly associated with HL. Another significant factor was had good level of health knowledge (adj. OR = 1.86; 95% CI: 1.30-2.66) when control clustering effect of region, provinces, school, and classroom size. CONCLUSIONS More than 85% of children ages 9-10 years in Thailand had adequate and excellence levels of HL. Sociocultural and health knowledge had influence on children HL.
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Affiliation(s)
- Nopparat Senahad
- Doctor of Public Health Program, Faculty of Public Health, Khon Kaen University, Thailand
| | | | - Naowarat Maneenin
- Lecturer, Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen, Thailand
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Coman MA, Forray AI, Van den Broucke S, Chereches RM. Measuring Health Literacy in Romania: Validation of the HLS-EU-Q16 Survey Questionnaire. Int J Public Health 2022; 67:1604272. [PMID: 35185446 PMCID: PMC8855985 DOI: 10.3389/ijph.2022.1604272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: Empirical data on health literacy (HL) for Romania is almost inexistent. The present study aimed to validate the HLS-EU-Q16 questionnaire for the Romanian population and explore the predictors of HL in the North-West Region of the country. Methods: A non-experimental, cross-sectional study was conducted between March and November 2019 on a representative, stratified random sample of 1,622 participants from the North-Western Region of Romania. Exploratory Factor Analysis (EFA), Principal component analysis (PCA), Pearson correlations, and Chronbach’s Alpha were used to validate the scale. Linear regressions were conducted to assess the determinants of health literacy. Results: Results obtained for the HL scale support its factorial component and reliability, with a Cronbach’s alpha of α = 0.84. Age, gender, education and self-reported health status were identified as determinants of HL. Conclusion: Study findings indicate that the Romanian version of HLS-EU-Q16 is psychometrically sound and comparable to the original version. These results provide the first validated tool to measure HL in Romanian and the first population level data for Romania.
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Affiliation(s)
- Madalina Adina Coman
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
- *Correspondence: Madalina Adina Coman,
| | - Alina Ioana Forray
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Stephan Van den Broucke
- Psychological Sciences Research Institute, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Razvan Mircea Chereches
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
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Emerson MR, Buckland S, Lawlor MA, Dinkel D, Johnson DJ, Mickles MS, Fok L, Watanabe-Galloway S. Addressing and evaluating health literacy in mHealth: a scoping review. Mhealth 2022; 8:33. [PMID: 36338314 PMCID: PMC9634204 DOI: 10.21037/mhealth-22-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Recent surveys have revealed many adults have basic or below basic health literacy, which is linked to medical errors, increased illness, and compromised public health. Health literacy as a concept is multi-faceted extending beyond the individual to include social structures and the context in which health information is being accessed. Delivering health information via mobile devices (mHealth) expands the amount of information available while presenting challenges to ensuring these materials are suitable for a variety of literacy needs. The aims of this study are to discover how health literacy is addressed and evaluated in mHealth app development. METHODS A scoping review of 5 peer-reviewed databases was conducted. Eligible articles were written in English, addressed general literacy or mHealth/digital/eHealth literacy, and collected literacy information in order to incorporate literacy into the design and/or modification of an app or collected literacy information to describe the population being studied. The "Health Literacy Online" (HLO) United States (U.S.) government guide was used as a framework. RESULTS Thirty-two articles were reviewed. Articles included health literacy recommendations for all HLO categories and some recommendations not aligned with these categories. Most articles addressed health literacy using specific HLO categories though none incorporated every HLO category. The most common categories addressed engagement and testing of mHealth content. Though several studies addressed health literacy through a formal assessment tool, most did not. Evaluation of health literacy in mHealth was end-user focused and did not extensively evaluate content for fit to a variety of individuals with limited health literacy. CONCLUSIONS The recommendations seen consistently in our results in conjunction with formal HLO categories can act as beginning steps towards development of a health literacy evaluation tool for mHealth apps themselves. It is clear efforts are being made to reduce barriers to using mHealth for those with literacy deficits, however, it was also clear that this space has room to be more pragmatic in evaluation of mHealth tools for literacy. End user engagement in design and testing is necessary in future mHealth literacy tool development.
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Affiliation(s)
| | - Sydney Buckland
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Maxwell A. Lawlor
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Danae Dinkel
- College of Education Health and Human Sciences, University of Nebraska, Omaha, NE, USA
| | - David J. Johnson
- Department of Psychiatry & Behavioral Science, Mercer University School of Medicine, Atlanta, GA, USA
| | - Maria S. Mickles
- College of Public Health University of Nebraska Medical Center, Omaha, NE, USA
| | - Louis Fok
- College of Public Health University of Nebraska Medical Center, Omaha, NE, USA
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Huang CL, Chiang CH, Yang SC. eHealth Literacy and Beliefs About Medicines Among Taiwanese College Students: Cross-sectional Study. JMIR Med Inform 2021; 9:e24144. [PMID: 34851301 PMCID: PMC8672294 DOI: 10.2196/24144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/28/2020] [Accepted: 10/04/2021] [Indexed: 01/19/2023] Open
Abstract
Background Good eHealth literacy and correct beliefs about medicines are beneficial for making good health care decisions and may further influence an individual's quality of life. However, few studies have discussed these two factors simultaneously. Moreover, gender differences are associated with health literacy and beliefs about medicines. Therefore, it is important to examine the multiple relationships between college students’ eHealth literacy and beliefs about medicines, as well as gender differences. Objective This study aims to (1) examine the multiple relationships between eHealth literacy and beliefs about medicines and (2) analyze gender differences in eHealth literacy and beliefs about medicines with Taiwanese college students. Methods We used a paper-and-pencil questionnaire that included age, gender, 3-level eHealth literacy, and beliefs about medicines to collect data. In total, 475 data points were obtained and analyzed through independent t tests and canonical correlation analyses. Results The t test (t473=3.73; P<.001; t473=–2.10; P=.04) showed that women had lower functional eHealth literacy and more specific concerns about medicines than men. Canonical correlation analyses indicated that the first and second canonical correlation coefficients between eHealth literacy and beliefs about medicines reached a significant level, implying that a multivariate relationship indeed existed. Conclusions These findings reveal that women in Taiwan have lower functional eHealth literacy and stronger concerns about medicines than men. In addition, students with higher eHealth literacy have more positive perceptions of and beliefs about medicines.
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Affiliation(s)
- Chiao Ling Huang
- Faculty of Education, Department of Educational Information Technology, East China Normal University, Shanghai, China
| | - Chia-Hsun Chiang
- Intelligent Electronic Commerce Research Center, Institute of Education, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Shu Ching Yang
- Intelligent Electronic Commerce Research Center, Institute of Education, National Sun Yat-Sen University, Kaohsiung, Taiwan
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Durmuş V. Differences in health literacy level of patients from public and private hospitals: a cross-sectional study in Turkey. Public Health 2021; 200:77-83. [PMID: 34710717 PMCID: PMC8545461 DOI: 10.1016/j.puhe.2021.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/26/2021] [Accepted: 09/14/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Policy-making based on a health literacy approach makes it a priority to develop people-centered public health strategies and programs, particularly in the time of COVID-19 across the world. This is the first study to assess health literacy levels of patients visiting public and private hospitals in Turkey and also compares these levels with sociodemographic and health-related variables by hospital type to suggest health policies aimed at improving the health literacy skills for patients with different socio-economic backgrounds. STUDY DESIGN This is a cross-sectional study. METHODS The study was conducted on 948 outpatients from both hospital types in 2018. Health literacy was assessed using the validated Turkish version of the European Health Literacy Survey Questionnaire with 47 items. The level of health literacy and sociodemographic factors influencing it were analyzed using correlation and binary logistic regression tests. Patients from private hospital had better health literacy index score compared with the public hospital. RESULTS The health-related variables, such as self-reported health and the presence of long-term illness, and sociodemographic characteristics, including education, age, and gender, were associated with health literacy for both public and private hospitals. Age and education were important predictors, whereas gender, long-term disease condition, self-reported health, and perceived income status were statistically significant variables for adequate health literacy in both hospital types. CONCLUSIONS Participants from private hospital had better health literacy than that of public hospital. These findings could be used to help health policy makers to improve the current health literacy policy for patients and develop strategies by stakeholders for reducing barriers to obtaining health-related information.
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Affiliation(s)
- V Durmuş
- Institute of Health Sciences, Marmara University, Istanbul, Turkey.
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Knowledge, beliefs and practices regarding prevention of bacterial meningitis in Burkina Faso, 5 years after MenAfriVac mass campaigns. PLoS One 2021; 16:e0253263. [PMID: 34260604 PMCID: PMC8279338 DOI: 10.1371/journal.pone.0253263] [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: 09/01/2020] [Accepted: 06/01/2021] [Indexed: 11/19/2022] Open
Abstract
Background To adapt communications concerning vaccine prevention, we studied knowledge, beliefs and practices around meningitis risk and prevention in a young adult population in Burkina Faso in 2016, 5 years after the MenAfriVac® mass campaign and one year before the vaccine’s inclusion in the infant immunization schedule. Methods In a representative sample of the population aged 15 to 33 years (N = 220) in Bobo-Dioulasso, Burkina Faso, study nurses administered a standardized paper questionnaire consisting of predominantly open questions, collecting information on meningitis risk factors and prevention, and on exposure to dry air and kitchen fire smoke. We identified themes and analyzed their frequency. We created a meningitis knowledge score (range 0 to 4) based on pre-defined best responses and analyzed the determinants of knowledge score levels ≥2 (basic score) and ≥3 (high score) using multivariate logistic regression. Results Biomedically supported facts and good practices were known by the majority of participants (eg vaccine prevention, 84.5%). Younger women aged 15–20 years had a higher frequency of low scores <2 (17.0%) compared to older women aged 21–33 years (6.3%) and men of both age groups (3.8%). Junior secondary School attendance explained the differences between the two groups of women, the gender gap for the older, but not the young women, and explained score differences among young women. Local understandings and practices for risk and prevention were commonly reported and used (risk from unripe mango consumption and prevention through nasal application of shea nut butter). Discussion This study shows a gender gap in knowledge of meningitis risk and prevention, largely due to education-level inequalities. Women below 21 years had particularly low levels of knowledge and may need interventions outside schools and perinatal care. Our study suggests a strong adherence to local understandings of and practices around meningitis risk and prevention, which should be taken into account by vaccination promotion.
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Malaysian Health Literacy: Scorecard Performance from a National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115813. [PMID: 34071455 PMCID: PMC8197907 DOI: 10.3390/ijerph18115813] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022]
Abstract
Health literacy is an indicator of a society's ability to make better health judgements for themselves and the people around them. This study investigated the prevalence of health literacy among Malaysian adults and provided an overall picture of the society's current health literacy status, which has not been previously assessed. The study also highlighted socio-demographic markers of communities with limited health literacy that may warrant future intervention. A population-based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized a two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above, drawn from the living quarter list, participated in the study. The health literacy score was divided into three levels; limited, sufficient, and excellent. Findings showed a majority of the Malaysian population had a sufficient health literacy level in all three domains-healthcare, diseases prevention and health promotion (49.1%, 44.2%, and 47.5%, respectively)-albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups were prevalent among respondents with older age (68%), lower education level (64.8%), and lower household income (49.5%). The overall health literacy status for Malaysia was categorized at a lower sufficiency level. Future health literacy improvements should focus on communities with a limited health literacy level to improve the overall score.
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Koduah AO, Amoah PA, Nkansah JO, Leung AYM. A Comparative Analysis of Student and Practising Nurses' Health Literacy Knowledge in Ghana. Healthcare (Basel) 2021; 9:healthcare9010038. [PMID: 33406747 PMCID: PMC7823597 DOI: 10.3390/healthcare9010038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022] Open
Abstract
This study examined student and practising nurses’ health literacy knowledge, and its correlates in Ghana. It was underpinned by an adapted version of the Institute of Medicine’s (IOM) conceptual framework of health literacy. We used convenience and snowball sampling techniques to collect data from 876 nurses (477 student nurses and 399 practising nurses) in a cross-sectional survey from February 2019 to June 2019. The respondents were drawn from all the former ten administrative regions of Ghana. Approximately 75.4% of the respondents had heard of health literacy. However, health literacy knowledge was generally low (average score of 6.6 out of 20) among both groups, with student nurses (average score of 5.8 out of 20) having significantly lower scores than practising nurses (average score of 7.4 out of 20). Factors associated with health literacy knowledge among student nurses included gender (male, B = −0.499, p < 0.01), trust in others (B = −0.874, p < 0.001), cultural values (B = 0.276, p < 0.001), year of study (B = 0.244, p < 0.05), and frequency of curative care use (B = −0.236, p < 0.05). For practising nurses, trust (B = −1.252, p < 0.01), cultural values (B = 0.357, p < 0.01), and working experience (B = 0.612, p < 0.01) were associated with their health literacy knowledge. Thus, responses targeted at gaps in health literacy knowledge of student and practising nurses must be sensitive to personal characteristics (e.g., gender), social values (e.g., issues of trust, and cultural beliefs and practices), as well as factors relating to nursing education and experience.
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Affiliation(s)
- Adwoa Owusuaa Koduah
- Center of Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Padmore Adusei Amoah
- Institute of Policy Studies, Asia Pacific Institute of Ageing Studies, and School of Graduate Studies, Lingnan University, Hong Kong SAR, China
- Correspondence:
| | | | - Angela Y. M. Leung
- Centre for Gerontological Nursing, WHO Collaborating Centre for Community Health Services (WHOCC), School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China;
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Amoah PA. The Relationship among Functional Health Literacy, Self-Rated Health, and Social Support among Younger and Older Adults in Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173188. [PMID: 31480487 PMCID: PMC6747074 DOI: 10.3390/ijerph16173188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022]
Abstract
It is well established that health literacy positively affects health outcomes, and social support influences this association. What remains unclear is which aspect of social support (instrumental, informational, and emotional support) is responsible for this effect and whether the influence differs from one population group to another. This study addresses these lacunae. It examines the impact each type of support makes on the relation between functional health literacy (FHL) and self-rated health status among younger and older adults in Ghana. Data were pooled from two cross-sectional surveys, together comprising 521 participants in the Ashanti Region. The results indicated that young adults were more likely to possess sufficient FHL and perceive their health more positively than older adults. While FHL was positively associated with health status, the relation was stronger when young adults received a high level of emotional support. Among older persons, informational support substantially moderated the association between FHL and health status. Thus, social support modifies the relations between FHL and health status among younger and older adults in different ways and to different degrees. Therefore, interventions to improve FHL and health amongst younger and older adults should pay due regard to relevant aspects of social support.
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Affiliation(s)
- Padmore Adusei Amoah
- School of Graduate Studies; Asia Pacific Institute of Ageing Studies; Centre for Social Policy & Social Change, Lingnan University, Hong Kong (SAR).
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