1
|
Lindly OJ, Wahl TA, Stotts NM, Shui AM. Adaptation of a health literacy screener for computerized, self-administered use by U.S. adults. PEC INNOVATION 2024; 4:100262. [PMID: 38375351 PMCID: PMC10875223 DOI: 10.1016/j.pecinn.2024.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/19/2023] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
Objective Health literacy is a critical health determinant, for which few computerized, self-administered assessments exist. This study adapted and tested the reliability of the Newest Vital Sign© (NVS) as a computerized, self-administered health literacy screener. Methods Phase one involved 33 participants to create response options for a computerized, self-administered NVS (C-NVS). Phase two was a randomized crossover trial to test the consistency of C-NVS and original, interviewer-administered NVS (I-NVS) scores in 89 participants. Results Linear mixed-effects regression model results showed a significant carryover effect (p < .001). Crossover trial data from time 1 showed that participants who initially received the C-NVS had significantly higher average scores (M = 5.7, SD = 0.6) than participants who received the I-NVS (M = 4.5, SD = 1.5; t(87) = 5.25, p < .001). Exploratory analysis results showed that when the washout period was longer than 33 days (75th percentile) the carryover effect was not statistically significant (p = .077). Conclusion and innovation Findings suggest learning can occur when health literacy screeners are administered more than once in less than a month's time and computerized, self-administered health literacy screeners may produce ceiling effects. A universal precautions approach to health literacy therefore remains germane.
Collapse
Affiliation(s)
| | - Taylor A. Wahl
- Department of Health Sciences, Northern Arizona University, USA
| | - Noa M. Stotts
- Department of Biological Sciences, Northern Arizona University, USA
| | - Amy M. Shui
- Massachusetts General Hospital Biostatistics Center, USA
| |
Collapse
|
2
|
Hnidková L, Bakalár P, Magda R, Kolarčik P, Kopčáková J, Boberová Z. Adolescents' health literacy is directly associated with their physical activity but indirectly with their body composition and cardiorespiratory fitness: mediation analysis of the Slovak HBSC study data. BMC Public Health 2024; 24:2762. [PMID: 39390406 PMCID: PMC11465870 DOI: 10.1186/s12889-024-20227-z] [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: 12/20/2023] [Accepted: 09/30/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND Health literacy is a core public health issue in relation to children and adolescents associated with multiple health behaviours and health outcomes. The aim of the study is to test the direct associations between health literacy, physical activity behaviour, health outcomes of body composition and cardiorespiratory fitness among Slovak adolescents and possible indirect effect of health literacy on health outcomes of body composition and cardiorespiratory fitness mediated by adolescents' physical activity behaviour. METHODS Data from the Slovak Health Behaviour in School-aged Children (HBSC) study conducted in 2022 were used. For the purposes of this study, a subsample of the adolescents (n = 508; mean age = 14.50; SD = 0.82; 54.3% boys) which provided HBSC questionnaire data on health literacy, moderate-to-vigorous physical activity and vigorous physical activity and participated in body composition (InBody 230) and cardiorespiratory fitness (20-m shuttle run test) measurements. Data were analysed using linear regression analysis. RESULTS The findings showed that higher health literacy of the adolescents was directly associated with higher frequency of physical activity represented by moderate-to-vigorous physical activity and vigorous physical activity and only with the visceral fat area in the crude model. Furthermore, there was an indirect effect of health literacy on cardiorespiratory fitness and most of the body composition variables (except the Body Mass Index) which was mediated by physical activity of the respondents. CONCLUSIONS Health literacy is indirectly associated to body composition and cardiorespiratory fitness through higher frequency of physical activity. It seems that health literacy as cognitive and social competencies need behavioural components to be involved in the proposed causal pathway between health literacy and health outcomes. Our findings may contribute to the process of creating a framework for future health literacy interventions in adolescents.
Collapse
Affiliation(s)
- Lenka Hnidková
- Department of Sports Educology and Humanistics, Faculty of Sports, University of Prešov, 17. novembra 15, Prešov, 08001, Slovakia
| | - Peter Bakalár
- Department of Sports Educology and Humanistics, Faculty of Sports, University of Prešov, 17. novembra 15, Prešov, 08001, Slovakia
| | - Rastislav Magda
- Department of Sports Educology and Humanistics, Faculty of Sports, University of Prešov, 17. novembra 15, Prešov, 08001, Slovakia
| | - Peter Kolarčik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, P.J. Šafárik University in Košice, Trieda SNP 1, Košice, 04011, Slovakia
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, 771 11, Czechia
| | - Jaroslava Kopčáková
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, 771 11, Czechia
- Medical Education Centre, Faculty of Medicine, P. J. Šafárik University in Košice, Trieda SNP 1, Košice, 04011, Slovakia
| | - Zuzana Boberová
- Institute of Biology and Ecology, Faculty of Science, P. J. Šafárik University in Košice, Mánesova 23, Košice, 040 01, Slovakia.
| |
Collapse
|
3
|
Terzi H, Akca A, Ayaz-Alkaya S. Adaptation of the health literacy survey 19-Europe-Q12 into Turkish culture: A psychometric study. J Eval Clin Pract 2024. [PMID: 39373230 DOI: 10.1111/jep.14161] [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: 07/01/2024] [Revised: 08/24/2024] [Accepted: 09/18/2024] [Indexed: 10/08/2024]
Abstract
RATIONALE Misinformation can lead to adverse outcomes on the health beliefs and behaviors of individuals. Therefore, health literacy skills are needed as a central competency to recognize the trustfulness of health-related knowledge in any resources. To ensure this, a time-efficient, skill-oriented psychometric tools are needed to measure the comprehensive general health literacy level of communities. AIMS AND OBJECTIVES This research was conducted to evaluate the psychometric properties of the 12-item Health Literacy Survey-Europe (HLS19-Q12) regarding Turkish culture. METHOD A methodological design was adopted. The population consisted of adult individuals registered to two family health centers in Ankara. The sample was determined based on 5-10 times the number of scale items rule (ntotal = 192). A questionnaire and Health Literacy Survey-Europe-Q12 were used to collect data. Language, content and construct validities and internal consistency reliability tests were performed through IBM-SPSS 25.0 and AMOS 24.0 programs. The content validity was determined via the Davis technique. The construct validity was examined by exploratory (EFA) (n1 = 120) and confirmatory factor analysis (CFA) (n2 = 72). Internal consistency was evaluated using Cronbach's alpha coefficient. Time invariance was evaluated by test-retest method (nretest = 32) 4 weeks later. RESULTS The mean age was 30.17 ± 10.37 (min. 18-max. 61). The Kaiser-Meyer Olkin test result was 0.898, and the Bartlett's Test of Sphericity result was 604.889 (p < 0.001). The model-fit indices showed good fit. The difference between the first and the second measurements was statistically insignificant (t = -1.659, p = 0.107). The Cronbach's alpha was 0.88. CONCLUSIONS The HLS19-Q12-TR was a valid and reliable measurement tool in determining the health literacy level of the Turkish adult population. As one of the social determinants of health, easy measurement and generating a general health literacy map of the population is considered a necessity.
Collapse
Affiliation(s)
- Handan Terzi
- Ankara Medipol University Faculty of Health Sciences, Ankara, Turkey
| | - Ayşegül Akca
- Ankara Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Turkey
| | | |
Collapse
|
4
|
Huang L, Jin Y, Chien CW, Xu Q, Chuang YC, Tung TH. Exploring the Health Literacy Behavior Patterns of Male Patients Using an Interpretable Method. Risk Manag Healthc Policy 2024; 17:2099-2109. [PMID: 39246590 PMCID: PMC11379035 DOI: 10.2147/rmhp.s465702] [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: 04/08/2024] [Accepted: 07/24/2024] [Indexed: 09/10/2024] Open
Abstract
Background Improving overall and individual health literacy is a major focus of national initiatives in China and similar initiatives globally. However, few studies have examined the identification and improvement of individual health literacy levels, especially among patients. Purpose To develop an interpretable method with decision rules to assess the health literacy levels of male patients and identify key factors influencing health literacy levels. Methods Using a convenience sampling method, we conducted on-site surveys with 212 male patients of a hospital in China from July 2020 to September 2020. The questionnaire was developed by the Ministry of Health of the People's Republic of China. A total of 206 of the completed surveys were ultimately included for analyses in this study. The rough set theory was used to identify conditional attributes (ie, key factors) and decision attributes (ie, levels of health literacy) and to establish decision rules between them. These rules specifically describe how different combinations of conditional attributes can affect health literacy levels among men. Results Basic knowledge, concepts, and health skills are important in identifying whether male patients have health literacy. Health skills, scientific health concepts, healthy lifestyles and behaviors, infectious disease prevention and control literacy, basic medical literacy, and health information literacy can be identified as cognitive behaviors with varying degrees of health literacy among patients. Conclusion This model can effectively identify the key factors and decision rules for male patients' health literacy. Simultaneously, it can be applied to clinical nursing practice, making it easier for hospitals to guide male patients to improve their health literacy.
Collapse
Affiliation(s)
- Lizhen Huang
- School of Economics and Management, Fuzhou University, Fuzhou, Fujian, 350108, People's Republic of China
| | - Yanjun Jin
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000 People's Republic of China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, Shenzhen, People's Republic of China
| | - Qinyi Xu
- Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, Shenzhen, People's Republic of China
| | - Yen-Ching Chuang
- Business College, Taizhou University, Taizhou, Zhejiang, 318000, People's Republic of China
- Institute of Public Health & Emergency Management, Taizhou University, Taizhou, Zhejiang, 318000, People's Republic of China
- Key Laboratory of Evidence-Based Radiology of Taizhou, Linhai, Zhejiang, 317000, People's Republic of China
| | - Tao-Hsin Tung
- Key Laboratory of Evidence-Based Radiology of Taizhou, Linhai, Zhejiang, 317000, People's Republic of China
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, People's Republic of China
| |
Collapse
|
5
|
Peng RX, Shen F. Why fall for misinformation? Role of information processing strategies, health consciousness, and overconfidence in health literacy. J Health Psychol 2024:13591053241273647. [PMID: 39175178 DOI: 10.1177/13591053241273647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Health misinformation, defined as false or misleading claims lacking scientific evidence, poses a significant threat to public health. This paper investigates factors associated with the failure to discern misinformation, including health consciousness, information processing strategies, and inaccurate self-assessments of health literacy. Through an online experiment involving 707 English-speaking U.S. participants (mean age = 43 years, 56.2% female), we found that misinformation beliefs about nutrition, vaccination, vaping, and cancer were significantly correlated, implying susceptibility across health topics. Greater susceptibility was associated with higher health consciousness, lower objective health literacy, more elaboration, and more selective scanning. Results provided evidence for the Dunning-Kruger effect and metacognitive monitoring errors, whereby confident individuals were unaware of inadequate health literacy and showed poor misinformation identification. Findings suggest that promoting both health literacy education and cognitive reflection skills among the general adult population could empower them to more critically evaluate online health information.
Collapse
|
6
|
Cheng C, Elmer S, Batterham R, Hawkins M, Osborne RH. Measuring health literacy to inform actions to address health inequities: a cluster analysis approach based on the Australian national health literacy survey. J Public Health (Oxf) 2024:fdae165. [PMID: 39099193 DOI: 10.1093/pubmed/fdae165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/07/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Measuring health literacy can inform interventions to address health inequities. This study used cluster analysis to examine health literacy data to determine if it can provide more insightful information than standard descriptive analysis to better inform intervention development. METHODS Using data from the Australian National Health Survey (2018), this study compared descriptive analysis and cluster analysis results of two states-New South Wales (NSW) and Victoria-generated from the Health Literacy Questionnaire (HLQ). Based on the nine scale scores of the HLQ, a hierarchical cluster analysis using Ward's method for linkage was undertaken. RESULTS The number of NSW and Victoria respondents was 1018 and 923, respectively. The nine HLQ scale full sample mean scores from both states were similar. However, the cluster analyses identified 11 clusters for NSW and 12 clusters for Victoria. While six clusters from each state presented similar health literacy patterns, five and six clusters from NSW and Victoria, respectively, displayed unique health literacy patterns. CONCLUSIONS The results demonstrate that descriptive analysis only provides an overview and may lead to one-size-fits-all interventions. The varying health literacy patterns among subgroups resulting from the cluster analysis pave the way to inform tailored actions to improve health equity.
Collapse
Affiliation(s)
- Christina Cheng
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn 3122, Victoria, Australia
| | - Shandell Elmer
- School of Nursing College of Health and Medicine, College of Health and Medicine, University of Tasmania, Launceston 7250, Tasmania, Australia
| | - Roy Batterham
- Global Health Program, Faculty of Public Health, Thammasat University, Bangkok 10200, Thailand
| | - Melanie Hawkins
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn 3122, Victoria, Australia
| | - Richard H Osborne
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn 3122, Victoria, Australia
| |
Collapse
|
7
|
McKinn S, Chapman N, Sharman JE, Nash R, Nelson MR, Sutton L, Yung C, Doust J, Hawkes AL, Bonner C. How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study. PATIENT EDUCATION AND COUNSELING 2024; 125:108299. [PMID: 38657560 DOI: 10.1016/j.pec.2024.108299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/12/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Low health literacy is associated with worse health outcomes, including for cardiovascular disease (CVD). However, general practitioners (GPs) have limited support to identify and address patient health literacy needs in CVD prevention consultations. This study explored GPs' experiences of patient health literacy needs during CVD risk assessment and management consultations. METHODS Semi-structured interviews with 18 GPs in Tasmania, Australia in 2021. A Framework Analysis approach was used to code transcripts to a thematic framework. RESULTS GPs perceptions on patient health literacy informed three themes: 1. Methods of estimating health literacy; 2. GPs' perceptions about the impact of health literacy on CVD prevention including risk factor knowledge and behaviours; and 3. Strategies for communicating with patients experiencing health literacy challenges. The findings show that while no formal tools were used to assess health literacy in this sample, perceived health literacy can change GPs' communication and prevention strategies. CONCLUSION The findings raise concerns about the equity of choices made available to patients, based on subjective perceptions of their health literacy level. PRACTICE IMPLICATION GPs could be better supported to assess and address patient health literacy needs in CVD prevention consultations.
Collapse
Affiliation(s)
- Shannon McKinn
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia
| | - Niamh Chapman
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Rosie Nash
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Laura Sutton
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Cassia Yung
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia
| | - Jenny Doust
- Australian Women and Girls' Health Research (AWaGHR) Centre, University of Queensland, Queensland, Australia
| | - Anna L Hawkes
- School of Public Health, University of Queensland, Queensland, Australia
| | - Carissa Bonner
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia; Menzies Centre for Health Policy & Economics, University of Sydney, Sydney, Australia.
| |
Collapse
|
8
|
Zhang M, Lu Z, Song C, Ling Y, Li W, Zuo C. Translation and cross-cultural adaptation of the Chinese version of the HLS-EU-Q47. Health Promot Int 2024; 39:daae083. [PMID: 39058422 DOI: 10.1093/heapro/daae083] [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] [Indexed: 07/28/2024] Open
Abstract
The development of health literacy in China is relatively slow, and there are fewer health literacy scales, which is difficult to measure. Therefore, this study aims to promote the development of health literacy in China through the translation and application of the European Health Literacy Survey Questionnaire (HLS-EU-Q47). The scale was translated into Chinese, back-translated, culturally adapted and finally subjected to psychometric evaluation. A multi-stage stratified sampling method was used to select 2504 residents to test the reliability and validity of a questionnaire on health literacy. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the validity of the results, and the back consistency was calculated by Cronbach's alpha coefficient. The EFA revealed that health care, disease prevention and health promotion explained 78.68% of the total variance in health literacy. The scale and its subscales demonstrated strong internal consistency, with high Cronbach's alpha coefficients ranging from 0.947 to 0.983. CFA confirmed the three-factor model's goodness-of-fit for the Chinese population. The dimensions of healthcare, disease prevention and health promotion showed high convergent validity with an average variance extracted values ranging from 0.52 to 0.60 and composite reliability values ranging from 0.94 to 0.96. The reliable and valid Chinese version of the HLS-EU-Q47 (HLS19-Q47-CN) developed and evaluated in this study is an important tool for assessing health literacy levels in the Chinese population. Furthermore, as this tool has global applicability, it has the potential to assess health literacy levels across different countries, enabling practical international comparisons.
Collapse
Affiliation(s)
- Mengjun Zhang
- School of Public Health, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China
- Nanfang Hospital, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China
| | - Zhouyu Lu
- School of Public Health, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China
- Nanfang Hospital, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China
| | - Chunjian Song
- Guangxi Police College, School of Public Administration, the Guangxi Zhuang Autonomous Region, No.6 Juntang Road, Qingxiu District, Nanning, 530028 Guangxi, China
| | - Yuting Ling
- Information Engineering College, Hangzhou Dianzi University, No. 1158, No.2 Street, Baiyang Street, Qiantang District, Hangzhou, 310000 Zhejiang, China
| | - Wenyuan Li
- School of Public Health, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China
- Nanfang Hospital, Southern Medical University, No. 1023-1063, Satai South Road, Baiyun District, Guangzhou, 510000 Guangdong, China
| | - Chao Zuo
- School of Management Engineering and E-Commerce, Zhejiang Gongshang University, No.18 Xuezheng Street, Baiyang Street, Qiantang District, Hangzhou, 310018 Zhejiang, China
| |
Collapse
|
9
|
Congying L, Heli Z, Han Q, Yang L, Xiaoling C, Ruifang L, Baohua L. Nurses' health education competence and health literacy: A cross-sectional survey in Chinese county hospitals. Nurse Educ Pract 2024; 79:104042. [PMID: 39059154 DOI: 10.1016/j.nepr.2024.104042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/14/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024]
Abstract
AIM This study aims to assess the health education competence of nurses in China's county hospitals, examining its relationship with health literacy and other influencing factors, such as receipt of health education training, and acquisition of health knowledge. BACKGROUND Nurses are pivotal in delivering health education, which is crucial for improving health outcomes. In rural China, the prevalent low health literacy, stemming from limited access to health guidance, necessitates an evaluation of nurses' health education competence in county hospitals. Understanding these competencies and their influencing factors is essential to enhance the health literacy of the Chinese population. DESIGN A cross-sectional study. METHODS The study surveyed 692 nurses from nine county hospitals in Shanxi Province, China, using convenience sampling. The analysis employed descriptive statistics, t-tests, ANOVA, Pearson's correlation, and hierarchical multiple linear regression. RESULTS The study revealed a low level of health education competence among the surveyed nurses, with total health education scores averaging 3.77±0.60, and mean scores for knowledge, skills, and attitudes being 3.73±0.67, 3.77±0.64, and 3.89±0.64, respectively. The multiple regression models were significant (P<0.001), with R2 values ranging from 0.143 to 0.197. Key predictors included the incentive mechanism for health education, receipt of health education training, acquisition of health knowledge, and literacies in infectious disease prevention, scientific health concepts, and chronic disease prevention. CONCLUSIONS This study assessed the health education competence of nurses in county hospitals in China and investigated the impact of various dimensions of health literacy on this competence. The findings indicate that the health education competence of nurses in these settings remains relatively low. Additionally, health education training and incentive mechanisms were found to significantly enhance nurses' health education competence in areas lacking medical resources.
Collapse
Affiliation(s)
- Liu Congying
- Department of Cardiology,Peking University Third Hospital, 49 North Garden Road,Haidian District, Beijing 100191, China.
| | - Zhang Heli
- Department of Rehabilitation Medicine,Peking University Third Hospital, 49 North Garden Road,Haidian District, Beijing 100191, China.
| | - Qin Han
- School of Chinese Language and Literature, University of International Business and Economics, No.10, Huixin Dongjie, Chaoyang District, Beijing 100029, China.
| | - Liu Yang
- Department of Cardiology,Peking University Third Hospital, 49 North Garden Road,Haidian District, Beijing 100191, China.
| | - Cui Xiaoling
- Daning County People's Hospital, Daning County, Linfen City, Shanxi 042300, China.
| | - Lei Ruifang
- Daning County People's Hospital, Daning County, Linfen City, Shanxi 042300, China.
| | - Li Baohua
- Nursing Department, Peking University Third Hospital, 49 North Garden Road,Haidian District, Beijing 100191, China.
| |
Collapse
|
10
|
Armache M, Assi S, Wu R, Jain A, Lu J, Gordon L, Jacobs LM, Fundakowski CE, Rising KL, Leader AE, Fakhry C, Mady LJ. Readability of Patient Education Materials in Head and Neck Cancer: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2024; 150:713-724. [PMID: 38900443 DOI: 10.1001/jamaoto.2024.1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Importance Patient education materials (PEMs) can promote patient engagement, satisfaction, and treatment adherence. The American Medical Association recommends that PEMs be developed for a sixth-grade or lower reading level. Health literacy (HL) refers to an individual's ability to seek, understand, and use health information to make appropriate decisions regarding their health. Patients with suboptimal HL may not be able to understand or act on health information and are at risk for adverse health outcomes. Objective To assess the readability of PEMs on head and neck cancer (HNC) and to evaluate HL among patients with HNC. Evidence Review A systematic review of the literature was performed by searching Cochrane, PubMed, and Scopus for peer-reviewed studies published from 1995 to 2024 using the keywords head and neck cancer, readability, health literacy, and related synonyms. Full-text studies in English that evaluated readability and/or HL measures were included. Readability assessments included the Flesch-Kincaid Grade Level (FKGL grade, 0-20, with higher grades indicating greater reading difficulty) and Flesch Reading Ease (FRE score, 1-100, with higher scores indicating easier readability), among others. Reviews, conference materials, opinion letters, and guidelines were excluded. Study quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Findings Of the 3235 studies identified, 17 studies assessing the readability of 1124 HNC PEMs produced by professional societies, hospitals, and others were included. The mean FKGL grade ranged from 8.8 to 14.8; none of the studies reported a mean FKGL of grade 6 or lower. Eight studies assessed HL and found inadequate HL prevalence ranging from 11.9% to 47.0%. Conclusions and Relevance These findings indicate that more than one-third of patients with HNC demonstrate inadequate HL, yet none of the PEMs assessed were developed for a sixth grade or lower reading level, as recommended by the American Medical Association. This incongruence highlights the need to address the readability of HNC PEMs to improve patient understanding of the disease and to mitigate potential barriers to shared decision-making for patients with HNC. It is crucial to acknowledge the responsibility of health care professionals to produce and promote more effective PEMs to dismantle the potentially preventable literacy barriers.
Collapse
Affiliation(s)
- Maria Armache
- Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sahar Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Richard Wu
- Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Amiti Jain
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joseph Lu
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Larissa Gordon
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lisa M Jacobs
- Mixed Methods Research Lab, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christopher E Fundakowski
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kristin L Rising
- Jefferson Center for Connected Care, Thomas Jefferson University, Philadelphia, Pennsylvania
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amy E Leader
- Department of Population Health, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
- Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Carole Fakhry
- Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Leila J Mady
- Department of Otolaryngology-Head & Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| |
Collapse
|
11
|
Lee H, La IS. Association between health literacy and self-management among middle-aged women: A systematic review. PATIENT EDUCATION AND COUNSELING 2024; 123:108188. [PMID: 38354431 DOI: 10.1016/j.pec.2024.108188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE We aimed to review and synthesize the literature on the association between health literacy (HL) and self-management in middle-aged women aged 35-64 years and examine the definitions and measurements of HL. METHODS Eleven electronic databases were used for searching specific terms. Experimental and non-experimental studies in English or Korean were included based on the eligibility criteria. Two authors independently conducted study selection, data extraction, and methodological quality assessment. RESULTS One experimental and 13 non-experimental studies were included. Of the 11 studies that defined HL, nine conceptualized it as reflecting multidimensional HL. Four studies measured HL capturing all dimensions of the concept (i.e., accessing, understanding, appraising, and applying) and two studies used context-specific HL measurements. Women with greater HL challenges generally had lower self-management context, process, and outcomes across the health continuum. CONCLUSIONS Enhancing HL is a critical strategy for improving self-management in middle-aged women. Future research should investigate the effectiveness of HL interventions on self-management considering multidimensional definitions and measures of HL. PRACTICE IMPLICATIONS Health professionals should be alert to middle-aged women's HL and implement HL interventions that provide them with opportunities to access, understand, analyze, and utilize health-related information to effectively improve HL and engage in self-management.
Collapse
Affiliation(s)
- Haein Lee
- College of Nursing, Daegu Catholic University, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Republic of Korea
| | - In Seo La
- College of Nursing Science, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea.
| |
Collapse
|
12
|
Liu R, Zhao Q, Yu M, Chen H, Yang X, Liu S, Okan O, Chen X, Xing Y, Guo S. Measuring General Health Literacy in Chinese adults: validation of the HLS 19-Q12 instrument. BMC Public Health 2024; 24:1036. [PMID: 38622565 PMCID: PMC11017570 DOI: 10.1186/s12889-024-17977-1] [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: 11/10/2023] [Accepted: 02/04/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults. METHODS A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist as a guideline, we tested internal consistency, test-retest reliability, content validity, structural validity, concurrent predictive validity, and convergent validity of the HLS19-Q12. RESULTS Overall, 14,184 participants completed the full survey. The HLS19-Q12 showed excellent internal consistency (Cronbach's α = 0.93), moderate test-retest reliability (intra-class correlation coefficient = 0.54), satisfactory content validity (based on the 12-matrix health literacy model), and strong structural validity (comparative fit index = 0.94, Tucker and Lewis's index of fit = 0.93, root mean square error of approximation = 0.095). Concurrent predictive validity results showed health literacy was associated with both health determinants and health-related outcomes. The HLS19-Q12 had weak to strong correlations (coefficients = 0.24 to 0.42) with the nine scales of the HLQ. Respondents had an average score of 81.6 (± 23.0) when using the HLS19-Q12, with 35.0% and 7.5% having problematic and inadequate levels of health literacy, respectively. CONCLUSIONS The HLS19-Q12 is a reliable and valid instrument to measure health literacy in our sample. Further validation is needed with a more nationally representative sample of Chinese adults. The HLS19-Q12 could be used as a comprehensive, skills-based, and easy-to-administer health literacy assessment tool integrated into population surveys and intervention evaluations.
Collapse
Affiliation(s)
- Rongmei Liu
- Hypertension Prevention and Treatment Centre of Henan Province, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Qiuping Zhao
- Hypertension Prevention and Treatment Centre of Henan Province, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China.
| | - Mingyang Yu
- Hypertension Prevention and Treatment Centre of Henan Province, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Hui Chen
- Hypertension Prevention and Treatment Centre of Henan Province, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Xiaomo Yang
- Hypertension Prevention and Treatment Centre of Henan Province, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
| | - Shuaibin Liu
- Community Health Centre of Chaohe, Zhengzhou, China
| | - Orkan Okan
- School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Xinghan Chen
- College of Basic Medicine and Forensic Medicine, Henan University of Science and Technology, Luoyang, China
| | - Yuhan Xing
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Pediatrics, University of Melbourne, Melbourne, Australia.
| |
Collapse
|
13
|
Vlassak EME, Miteniece E, Keulen JKJ, Gravendeel M, Korstjens I, Budé L, Hendrix MJC, Nieuwenhuijze MJ. Development of the Conversational Health Literacy Assessment Tool for maternity care (CHAT-maternity-care): participatory action research. BMC Health Serv Res 2024; 24:135. [PMID: 38267977 PMCID: PMC10809538 DOI: 10.1186/s12913-024-10612-0] [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: 07/03/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Limited health literacy in (expectant) parents is associated with adverse health outcomes. Maternity care providers often experience difficulties assessing (expectant) parents' level of health literacy. The aim was to develop, evaluate, and iteratively adapt a conversational tool that supports maternity care providers in estimating (expectant) parents' health literacy. METHODS In this participatory action research study, we developed a conversational tool for estimating the health literacy of (expectant) parents based on the Conversational Health Literacy Assessment Tool for general care, which in turn was based on the Health Literacy Questionnaire. We used a thorough iterative process including different maternity care providers, (expectant) parents, and a panel of experts. This expert panel comprised representatives from knowledge institutions, professional associations, and care providers with whom midwives and maternity care assistants work closely. Testing, evaluation and adjustment took place in consecutive rounds and was conducted in the Netherlands between 2019 and 2022. RESULTS The conversational tool 'CHAT-maternity-care' covers four key domains: (1) supportive relationship with care providers; (2) supportive relationship within parents' personal network; (3) health information access and comprehension; (4) current health behaviour and health promotion. Each domain contains multiple example questions and example observations. Participants contributed to make the example questions and example observations accessible and usable for daily practice. The CHAT-maternity-care supports maternity care providers in estimating (expectant) parents' health literacy during routine conversations with them, increased maternity care providers' awareness of health literacy and helped them to identify where attention is necessary regarding (expectant) parents' health literacy. CONCLUSIONS The CHAT-maternity-care is a promising conversational tool to estimate (expectant) parents' health literacy. It covers the relevant constructs of health literacy from both the Conversational Health Literacy Assessment Tool and Health Literacy Questionnaire, applied to maternity care. A preliminary evaluation of the use revealed positive feedback. Further testing and evaluation of the CHAT-maternity-care is required with a larger and more diverse population, including more (expectant) parents, to determine the effectiveness, perceived barriers, and perceived facilitators for implementation.
Collapse
Affiliation(s)
- Evi M E Vlassak
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.
| | - Elina Miteniece
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Judit K J Keulen
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Marjolein Gravendeel
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Irene Korstjens
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Marijke J C Hendrix
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Marianne J Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
- Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| |
Collapse
|
14
|
Kinoshita S, Hirooka N, Kusano T, Saito K, Aoyagi R. Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study. BMC PRIMARY CARE 2024; 25:29. [PMID: 38245688 PMCID: PMC10799471 DOI: 10.1186/s12875-024-02263-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Noncommunicable diseases (NCDs), such as health-related lifestyle diseases, are the leading cause of mortality and societal and economic burdens. Poor lifestyle behaviors, which are modifiable to improve health, can cause diseases, including NCDs. Health literacy has been recognized as an important determinant of health, and studies have shown that higher health literacy is associated with better health outcomes and positive health-related behaviors. However, few studies have investigated the association between health literacy and health-related lifestyle behaviors to understand the mechanistic link between them. Thus, this study investigated the extent to which health literacy at different levels influences health-related lifestyle behaviors. METHODS A cross-sectional study was conducted among Japanese health management specialists (N = 1,920). Functional, critical, and communicative health literacy were measured. Lifestyle behaviors (exercise, diet and nutrition, sleep, rest, smoking, and alcohol intake), in line with the Japanese National Health Promotion Program, were assessed and calculated into a total cumulative score of health-related lifestyle behaviors. Moreover, we analyzed the associations between the three levels of health literacy and lifestyle behaviors using regression analyses by adjusting for socio-psycho-demographic factors. RESULTS Multiple linear regression analyses showed a significant association between the Japanese version of the European Health Literacy Survey Questionnaire and total health-related lifestyle scores (standardized β = 0.160, p < 0.001, R2 = 0.136) after adjusting for sociodemographic factors. Similarly, the association between communicative and critical health literacy and the total health-related lifestyle scores was significant (standardized β = 0.122, p < 0.001, R2 = 0.125). The analysis indicated that individuals who had higher level of health literacy (critical and communicative) than functional health literacy (Japanese version of the Newest Vital Sign score) had higher health-related lifestyle behaviors. CONCLUSIONS A higher level of health literacy is associated with health-related lifestyle behaviors. Health literacy can be a target for interventions to achieve the national goal of lifestyle-related disease prevention and control.
Collapse
Affiliation(s)
- Shunsuke Kinoshita
- Department of General Internal Medicine, Saitama Medical University, Iruma-gun, Japan
| | - Nobutaka Hirooka
- Department of General Internal Medicine, Saitama Medical University, Iruma-gun, Japan.
- Department of Community Medicine, Saitama Medical University, Iruma-gun, Japan.
| | - Takeru Kusano
- Department of General Internal Medicine, Saitama Medical University, Iruma-gun, Japan
| | - Kohei Saito
- Department of General Internal Medicine, Saitama Medical University, Iruma-gun, Japan
| | - Ryutaro Aoyagi
- Department of General Internal Medicine, Saitama Medical University, Iruma-gun, Japan
| |
Collapse
|
15
|
Elbarazi I, Alam Z, Ali N, Loney T, Al-Rifai RH, Al-Maskari F, Ahmed LA. Health literacy among pregnant women in the United Arab Emirates: The Mutaba'ah study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057231224179. [PMID: 38279806 PMCID: PMC10822065 DOI: 10.1177/17455057231224179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 10/09/2023] [Accepted: 12/12/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Health literacy is the degree to which individuals can obtain, process, understand, and communicate health-related information. Health literacy among pregnant women, in particular, may have a significant impact on maternal and child health. In the United Arab Emirates, no previous studies have been carried out to investigate the health literacy levels of pregnant women. OBJECTIVE This study aimed to investigate antenatal health literacy levels and identify associated factors among pregnant Emirati women in the United Arab Emirates. DESIGN This analysis was based on the baseline cross-sectional data for pregnant women participating in the prospective cohort Mutaba'ah Study, recruited between May 2017 and August 2022. METHODS Participants completed a self-administered questionnaire during their antenatal visits that collected sociodemographic and pregnancy-related information. Adequacy of health literacy was assessed using the BRIEF health literacy screening tool with adequate health literacy defined as a score ⩾ 17. Regression modeling investigated the association between the pregnant women characteristics with having adequate health literacy level (ability to read and comprehend most patient education materials). RESULTS A total of 2694 responses to the BRIEF health literacy screening tool were analyzed. Approximately, three-quarters (71.6%) of respondents showed adequate health literacy, followed by marginal (22.8%), and limited (5.6%) health literacy levels, respectively. Higher education levels (adjusted odds ratio (aOR) = 1.74, 95% confidence interval = 1.46-2.08), employment (adjusted odds ratio = 1.35, 95% confidence interval = 1.10-1.65), and adequate social support (adjusted odds ratio = 1.69, 95% confidence interval = 1.26-2.28) were associated with adequate health literacy levels. Participants who expressed worry about birth were less likely to have adequate literacy levels (adjusted odds ratio = 0.70, 95% confidence interval = 0.58-0.85). CONCLUSION Nearly three-quarters of pregnant women have adequate health literacy. Nevertheless, measures including policies to sustain and enhance health literacy levels among all expectant mothers are required, with a specific focus on those having limited health literacy.
Collapse
Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Zufishan Alam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nasloon Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University, Dubai, United Arab Emirates
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatma Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Luai A Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Bin Sultan Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
16
|
Chen X, Winterowd C, Li M, Kreps GL. Identifying Mental Health Literacy as a Key Predictor of COVID-19 Vaccination Acceptance among American Indian/Alaska Native/Native American People. Vaccines (Basel) 2023; 11:1793. [PMID: 38140196 PMCID: PMC10748283 DOI: 10.3390/vaccines11121793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND This study examines how health literacy and mental health literacy associate with the willingness to receive a COVID-19 vaccination among American Indian/Alaska Native/Native American (AI/AN) people. METHODS The data were collected with an online Qualtrics survey in February 2021 (n = 563). A purposive snowball sampling strategy was used by sending recruitment flyers to colleagues and organizations who work with AI/AN communities to share with appropriate potential respondents. We performed linear regression analyses examining the relationships between the willingness to receive a COVID-19 vaccination and socio-demographic characteristics such as age, gender, education, health literacy, mental health literacy, self-rated physical and mental health status, worry about getting COVID-19, perceived COVID-19 susceptibility, and perceived COVID-19 severity. RESULTS Mental health literacy and health literacy predicted 30.90% and 4.65% of the variance (R2adjusted) in the willingness to receive a COVID-19 vaccine, respectively. After holding the self-rated physical/mental health status, worry about getting COVID-19, perceived susceptibility, perceived severity, health literacy, and socio-demographics constant, mental health literacy was still a strong predictor (b = 0.03, p < 0.001) for the willingness to receive a COVID-19 vaccine (model R2adjusted = 40.14%). CONCLUSIONS We identified mental health literacy as a substantial factor associated with the willingness to receive a COVID-19 vaccination among AI/AN respondents.
Collapse
Affiliation(s)
- Xuewei Chen
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Carrie Winterowd
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Ming Li
- Department of Health Sciences, College of Health Professions, Towson University, Towson, MD 21252, USA;
| | - Gary L. Kreps
- Center for Health and Risk Communication, George Mason University, Fairfax, VA 22030, USA;
| |
Collapse
|
17
|
Baumeister A, Aldin A, Chakraverty D, Hübner C, Adams A, Monsef I, Skoetz N, Kalbe E, Woopen C. Interventions for improving health literacy in migrants. Cochrane Database Syst Rev 2023; 11:CD013303. [PMID: 37963101 PMCID: PMC10645402 DOI: 10.1002/14651858.cd013303.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Health literacy (HL) is a determinant of health and important for autonomous decision-making. Migrants are at high risk for limited HL. Improving HL is important for equitable promotion of migrants' health. OBJECTIVES To assess the effectiveness of interventions for improving HL in migrants. To assess whether female or male migrants respond differently to the identified interventions. SEARCH METHODS We ran electronic searches to 2 February 2022 in CENTRAL, MEDLINE, Embase, PsycInfo and CINAHL. We also searched trial registries. We used a study filter for randomised controlled trials (RCTs) (RCT classifier). SELECTION CRITERIA We included RCTs and cluster-RCTs addressing HL either as a concept or its components (access, understand, appraise, apply health information). DATA COLLECTION AND ANALYSIS We used the methodological procedures recommended by Cochrane and followed the PRISMA-E guidelines. Outcome categories were: a) HL, b) quality of life (QoL), c) knowledge, d) health outcomes, e) health behaviour, f) self-efficacy, g) health service use and h) adverse events. We conducted meta-analysis where possible, and reported the remaining results as a narrative synthesis. MAIN RESULTS We included 28 RCTs and six cluster-RCTs (8249 participants), all conducted in high-income countries. Participants were migrants with a wide range of conditions. All interventions were adapted to culture, language and literacy. We did not find evidence that HL interventions cause harm, but only two studies assessed adverse events (e.g. anxiety). Many studies reported results for short-term assessments (less than six weeks after total programme completion), reported here. For several comparisons, there were also findings at later time points, which are presented in the review text. Compared with no HL intervention (standard care/no intervention) or an unrelated HL intervention (similar intervention but different information topic) Self-management programmes (SMP) probably improve self-efficacy slightly (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.50; 2 studies, 333 participants; moderate certainty). SMP may improve HIV-related HL (understanding (mean difference (MD) 4.25, 95% CI 1.32 to 7.18); recognition of HIV terms (MD 3.32, 95% CI 1.28 to 5.36)) (1 study, 69 participants). SMP may slightly improve health behaviours (3 studies, 514 participants), but may have little or no effect on knowledge (2 studies, 321 participants) or subjective health status (MD 0.38, 95% CI -0.13 to 0.89; 1 study, 69 participants) (low certainty). We are uncertain of the effects of SMP on QoL, health service use or adverse events due to a lack of evidence. HL skills building courses (HLSBC) may improve knowledge (MD 10.87, 95% CI 5.69 to 16.06; 2 studies, 111 participants) and any generic HL (SMD 0.48, 95% CI 0.20 to 0.75; 2 studies, 229 participants), but may have little or no effect on depression literacy (MD 0.17, 95% CI -1.28 to 1.62) or any health behaviour (2 studies, 229 participants) (low certainty). We are uncertain if HLSBC improve QoL, health outcomes, health service use, self-efficacy or adverse events, due to very low-certainty or a lack of evidence. Audio-/visual education without personal feedback (AVE) probably improves depression literacy (MD 8.62, 95% CI 7.51 to 9.73; 1 study, 202 participants) and health service use (MD -0.59, 95% CI -1.11 to -0.07; 1 study, 157 participants), but probably has little or no effect on health behaviour (risk ratio (RR) 1.07, 95% CI 0.91 to 1.25; 1 study, 135 participants) (moderate certainty). AVE may improve self-efficacy (MD 3.51, 95% CI 2.53 to 4.49; 1 study, 133 participants) and may slightly improve knowledge (MD 8.44, 95% CI -2.56 to 19.44; 2 studies, 293 participants) and intention to seek depression treatment (MD 1.8, 95% CI 0.43 to 3.17), with little or no effect on depression (SMD -0.15, 95% CI -0.40 to 0.10) (low certainty). No evidence was found for QoL and adverse events. Adapted medical instruction may improve understanding of health information (3 studies, 478 participants), with little or no effect on medication adherence (MD 0.5, 95% CI -0.1 to 1.1; 1 study, 200 participants) (low certainty). No evidence was found for QoL, health outcomes, knowledge, health service use, self-efficacy or adverse events. Compared with written information on the same topic SMP probably improves health numeracy slightly (MD 0.7, 95% CI 0.15 to 1.25) and probably improves print literacy (MD 9, 95% CI 2.9 to 15.1; 1 study, 209 participants) and self-efficacy (SMD 0.47, 95% CI 0.3 to 0.64; 4 studies, 552 participants) (moderate certainty). SMP may improve any disease-specific HL (SMD 0.67, 95% CI 0.27 to 1.07; 4 studies, 955 participants), knowledge (MD 11.45, 95% CI 4.75 to 18.15; 6 studies, 1101 participants) and some health behaviours (4 studies, 797 participants), with little or no effect on health information appraisal (MD 1.15, 95% CI -0.23 to 2.53; 1 study, 329 participants) (low certainty). We are uncertain whether SMP improves QoL, health outcomes, health service use or adverse events, due to a lack of evidence or low/very low-certainty evidence. AVE probably has little or no effect on diabetes HL (MD 2, 95% CI -0.15 to 4.15; 1 study, 240 participants), but probably improves information appraisal (MD -9.88, 95% CI -12.87 to -6.89) and application (RR 1.51, 95% CI 1.29 to 1.77) (1 study, 608 participants; moderate certainty). AVE may slightly improve knowledge (MD 8.35, 95% CI -0.32 to 17.02; low certainty). No short-term evidence was found for QoL, depression, health behaviour, self-efficacy, health service use or adverse events. AVE compared with another AVE We are uncertain whether narrative videos are superior to factual knowledge videos as the evidence is of very low certainty. Gender differences Female migrants' diabetes HL may improve slightly more than that of males, when receiving AVE (MD 5.00, 95% CI 0.62 to 9.38; 1 study, 118 participants), but we do not know whether female or male migrants benefit differently from other interventions due to very low-certainty or a lack of evidence. AUTHORS' CONCLUSIONS Adequately powered studies measuring long-term effects (more than six months) of HL interventions in female and male migrants are needed, using well-validated tools and representing various healthcare systems.
Collapse
Affiliation(s)
- Annika Baumeister
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| | - Angela Aldin
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Digo Chakraverty
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Constanze Hübner
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ina Monsef
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nicole Skoetz
- Cochrane Haematology, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Christiane Woopen
- Center for Life Ethics/Hertz Chair TRA 4, University of Bonn, Bonn, Germany
| |
Collapse
|
18
|
Choi S, Nanda P, Yuen K, Ong K. Bridging the gap in health literacy research: The inclusion of individuals with visual impairments. PATIENT EDUCATION AND COUNSELING 2023; 116:107932. [PMID: 37566948 DOI: 10.1016/j.pec.2023.107932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/09/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES Patient education and health literacy aim to enhance understanding of health and self-care for optimal health outcomes. However, the attention towards populations with visual impairments requiring specialized accommodations for improved health literacy and healthcare access appears to be insufficient METHODS: In an effort to bridge this gap, we conducted a scoping review focusing on health literacy studies undertaken specifically for individuals with visual impairments. RESULTS We encapsulate the main findings and constraints of preceding studies and deliberate on the influence of health literacy research for individuals with visual impairments on healthcare inequalities and health disparities. CONCLUSIONS A health-literate approach, combined with an accessible healthcare environment, can serve as a catalyst to motivate individuals with visual impairments to actively engage in their self-care practices. PRACTICE IMPLICATIONS It is of utmost urgency to develop and validate a health literacy assessment tool for visually impaired individuals, and to utilize it for providing healthcare interventions as well as health education.
Collapse
Affiliation(s)
- Soyoung Choi
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA.
| | - Pearl Nanda
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA
| | - Kelly Yuen
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA
| | - Kristel Ong
- University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, IL, USA
| |
Collapse
|
19
|
Adam HS, Merkin SS, Anderson MD, Seeman T, Kershaw KN, Magnani JW, Everson-Rose SA, Lutsey PL. Personal Health Literacy and Life Simple 7: The Multi-Ethnic Study of Atherosclerosis. AMERICAN JOURNAL OF HEALTH EDUCATION 2023; 54:451-462. [PMID: 38486878 PMCID: PMC10939068 DOI: 10.1080/19325037.2023.2254354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 07/14/2023] [Indexed: 03/17/2024]
Abstract
Background Personal Health literacy (PHL) is essential in cardiovascular risk management. Hindrances in PHL can lead to poor cardiovascular outcomes. Purpose To investigate whether limited PHL is associated with lower likelihoods of i) overall cardiovascular health and ii) individual cardiovascular health components as defined by the American Heart Association's Life Simple (LS7). Methods Multi-Ethnic Study of Atherosclerosis participants (N=3719; median age[range]: 59[45-84]) completed a PHL questionnaire in 2016-2018. PHL was classified as limited (score ≥10) or adequate (score <10). LS7 components were measured in 2000-2002. Robust Poisson regression was employed to compute prevalence ratios and 95% confidence intervals (PR[95%CI]) of LS7 measures. Results 14.7% of participants had limited PHL. Limited PHL was associated with lower likelihoods of optimal LS7 (0.69[0.50, 0.95], p=0.02) and average LS7 (0.95[0.88, 1.02], p=0.15) after adjustment. Limited PHL was significantly associated with a 7% lower likelihood of ideal fasting blood glucose level after adjustment (0.93[0.89, 0.98], p<0.01). Discussion Limited PHL was modestly associated with suboptimal cardiovascular health and elevated blood glucose, independent of income and education. Translation to Health Education Practice Health educators and providers should equitably address PHL barriers to improve cardiovascular management and quality of care for patients and communities.
Collapse
|
20
|
Tamayo-Fonseca N, Pereyra-Zamora P, Barona C, Mas R, Irles MÁ, Nolasco A. Health literacy: association with socioeconomic determinants and the use of health services in Spain. Front Public Health 2023; 11:1226420. [PMID: 37900023 PMCID: PMC10602755 DOI: 10.3389/fpubh.2023.1226420] [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: 05/21/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Background Health literacy (HL) is the set of social and cognitive skills that determine person's level of motivation and the ability to access, understand and use information to promote and maintain good health. The aim of this study is to assess the level of health literacy, and to analyze its relationship with sociodemographic variables, state of health, and use of health services in the population aged 15 and over in the Valencian Community (Spain). Methods Cross-sectional study based on a sample of 5,485 subjects participating in the Health Survey of the Valencia Community. The HLS-EU-Q16 was used. As outcome variables we considered HL categorized into 2 levels: Inadequate or Problematic HL and Sufficient HL and the standardized literacy index. Prevalence rates and HL means were estimated and OR were calculated to analyze the association between variables. Results A total of 12.8% of the subjects surveyed presented an inadequate or problematic degree of HL. This percentage was higher in people >85 years (63.1%), with a low level of education (46.5%), in retired people (27.4%) or in other work situations (25.0%), in foreigners (18.1%), in low-income people (16.2%), with a perception of poor health status (26.9%), chronic disease (18.5%) or with activity limitations (56.4% severe, 19.7% not severe). Significant differences were found. With the exception of chronic disease, all the variables analyzed were associated with HL. Low HL was associated with a lower consumption of medicines, a greater use of health services, general medical consultations, poorer knowledge of new health technologies and fewer preventive health visits. Conclusion The percentage of inadequate or problematic HL was globally not very high, but certain population subgroups notably presented a high degree of inadequate or problematic HL. Raising the HL level of such groups should be regarded as a priority. HL was shown to be associated with the service use and new health technology use. Enhancing the population's HL should lead to the following: a greater probability of adopting preventive practices; improving the use of the health system; and boosting people's abilities to manage and to improve their own health.
Collapse
Affiliation(s)
- Nayara Tamayo-Fonseca
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Pamela Pereyra-Zamora
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Alicante, Spain
| | - Carmen Barona
- Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rosa Mas
- Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Mª Ángeles Irles
- Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain
| | - Andreu Nolasco
- Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Alicante, Spain
| |
Collapse
|
21
|
Litchfield I, Barrett T, Hamilton-Shield J, Moore T, Narendran P, Redwood S, Searle A, Uday S, Wheeler J, Greenfield S. Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes. Int J Equity Health 2023; 22:188. [PMID: 37697302 PMCID: PMC10496394 DOI: 10.1186/s12939-023-01976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/26/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, its important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes. METHODS We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context - the influence and mitigation of a range of individual, socio-cultural, and environmental factors. RESULTS We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities. CONCLUSIONS A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.
Collapse
Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Tim Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
| | - Julian Hamilton-Shield
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 2NT, UK
- The Royal Hospital for Children in Bristol, Bristol, BS2 8BJ, UK
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
- Queen Elizabeth Hospital, Birmingham, B15 2GW, UK
| | - Sabi Redwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Aidan Searle
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Suma Uday
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Jess Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| |
Collapse
|
22
|
Alobaidi A, Yan CH, Kopfman M, Naveed M, Sharp LK, Nutescu EA. The Relationship Between Signature Time and Functional Health Literacy: Results from a Prospective Study of an Urban Low-Income Population Receiving Long-Term Anticoagulation. Adv Ther 2023; 40:3926-3936. [PMID: 37389731 PMCID: PMC10427553 DOI: 10.1007/s12325-023-02556-4] [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: 03/02/2023] [Accepted: 05/16/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Low health literacy (HL) is consistently associated with worse health outcomes. Routine clinical screening with available instruments is impractical because of added time and effort. Prior findings suggested that signature time may be a reliable alternative measure of HL among general medicine patients. METHODS Our aim was to assess the screening performance of signature time and explore optimal thresholds for identifying patients with limited HL in a chronically anticoagulated population. English-speaking patients receiving long-term anticoagulation therapy were recruited. HL was assessed using the Short Test of Functional Health Literacy in Adults (STOFHLA). Signature time was measured using a stopwatch. Logistic regression models and receiver-operating characteristic (ROC) curves were used to evaluate the association and accuracy of signature time compared to HL, respectively. RESULTS Of 139 enrolled patients, mean age was 60.1 years, 70.5% were African-American, 48.9% reported < $25,000 income, and 27.3% had marginal or inadequate HL. Overall, median time to sign was 6.1 s. Signature time was longest with inadequate HL (median 9.5 s) compared to adequate HL (5.7 s; p < 0.01). Longer signature time was significantly associated with lower HL after adjusting for age and education (aOR 0.77, 95% CI: 0.68-0.88, p < 0.01). Signature time demonstrated high accuracy (area under the curve [AUC] > 0.8) in identifying HL levels. Thresholds of 5.1 s and 9.0 s showed appropriate screening performance in distinguishing patients with adequate vs. marginal and marginal vs. inadequate HL, respectively. CONCLUSION Signature time demonstrated strong screening performance and may offer a quick and practical approach to assessing HL among patients receiving long-term anticoagulation management.
Collapse
Affiliation(s)
- Ali Alobaidi
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA.
| | - Connie H Yan
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
| | - Miranda Kopfman
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
| | - Maryam Naveed
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
- Center for Pharmacoepidemiology & Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Edith A Nutescu
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois at Chicago, 833 S. Wood St., Chicago, IL, 60612, USA
- Center for Pharmacoepidemiology & Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA
- Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
23
|
Gill S, Zeki R, Kaye S, Zingirlis P, Archer V, Lewandowski A, Creighton G, Shaw C, Bowman J. Health literacy strengths and challenges of people in New South Wales prisons: a cross-sectional survey using the Health Literacy Questionnaire (HLQ). BMC Public Health 2023; 23:1520. [PMID: 37563584 PMCID: PMC10413686 DOI: 10.1186/s12889-023-16464-3] [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: 02/20/2023] [Accepted: 08/06/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Health literacy is an important factor for enabling people to manage their health and live long fulfilling lives. People in prison are frequently from marginalised communities, often out of reach of conventional community based health organisations, and have poorer health outcomes. It is essential to understanding the health literacy profiles of people in prison, and its contribution to the well-established health inequities and outcomes of this population. This study aimed to use a multi-dimensional health literacy measurement tool to describe the strengths and challenges of adults incarcerated in NSW prisons. METHODS A cross-sectional survey was conducted for people in prison across 14 publicly operated metropolitan prisons. Data were collected from 471 participants using the Health Literacy Questionnaire (HLQ). Participant characteristics and health conditions were also collected. Data were analysed using descriptive statistics. Effect sizes (ES) for standardised differences in means were used to describe the magnitude of difference between participant characteristic groups. RESULTS Participants' median age was 38.0 (range 19 - 91) years. Males comprised 81% of the sample, 21% identified as Aboriginal and/or Torres Strait Islander, and 53% reported a health problem. People in prison had lower scores for all nine HLQ scales when compared to the general Australian population. Small to medium ES were seen for mean differences between most demographic groups. Compared to males, females had lower scores for several of the HLQ scales including 'having sufficient information to manage health' (ES 0.30 [95% Confidence Interval (CI) 0.07, 0.53]), 'ability to actively engage with health care professionals' (ES 0.30 [95% CI 0.06, 0.53]), 'navigating the healthcare system' (ES 0.30 [95% CI 0.06, 0.53]), and, 'ability to find good health information' (ES 0.33 [95% CI 0.10, 0.57]). Differing health literacy scale scores with small to medium ES were found when comparing participants by legal status. Mainly small ES were seen when comparing other participant characteristic groups. CONCLUSIONS This study provides insights into the health literacy strengths and challenges for people in NSW prisons. These findings highlight the important role health literacy could have in addressing health disparities in this vulnerable population and can inform prison health services.
Collapse
Affiliation(s)
- Scott Gill
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia
| | - Reem Zeki
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Panayiota Zingirlis
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Australia
| | - Vicki Archer
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Amy Lewandowski
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Grantley Creighton
- Aboriginal Health, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Caron Shaw
- Adolescent Health, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Julia Bowman
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia
| |
Collapse
|
24
|
Stock S, Shukri A, Altin S, Nawabi F, Civello D, Redaèlli M, Alayli A. Testing a single item screener to support family doctors in identifying patients with limited health literacy: convergent validity of the SILS and the HLS-EU-Q16. BMC PRIMARY CARE 2023; 24:158. [PMID: 37559006 PMCID: PMC10413758 DOI: 10.1186/s12875-023-02112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Low health literacy (HL) is associated with reduced disease self-management skills, worse health outcomes, an increased number of hospitalizations, more frequent use of the emergency room and less utilization of preventive services. To support patients with low HL it is crucial to identify affected patients. HL is a multidimensional construct, which covers different skills and abilities to make informed health decisions. Validated brief screening tools to assess health-literacy-related skills or abilities in primary care settings are currently not available in German. This study aimed to validate a single item screener developed in the US for the German primary care setting. METHODS Our study used cross-sectional data from a survey among mainly chronically ill patients (n = 346) conducted in family practices in the state of North Rhine-Westphalia. We explored the convergent validity between a single item literacy screener (SILS) and the HLS-EU-Q16. The SILS measures functional HL by asking patients about their need for help when reading information materials. The HLS-EU-Q16 is a multidimensional HL measure frequently used for research purposes in Germany. Associations between the two instruments were examined using Spearman's correlations and regression analyses. The diagnostic performance of the SILS relative to the HLS-EU-Q16 was assessed using receiver operator curves (ROC). RESULTS The SILS had a statistically significant correlation with the HLS-EU-Q16 (Spearman ρ: 0.35) and explained 26% of its total variance. Stratified analyses of the convergent validity between both instruments by age, sex, migration background, education level and chronic disease status showed moderate statistically significant correlations in all subgroups (range: 0.223 to 0.428). With an area under the curve of 0.66, the receiver operator curve indicated a satisfactory diagnostic performance of the SILS relative to the HLS-EU-Q16. CONCLUSIONS The SILS provided an acceptable initial assessment of HL limitations among a heterogeneous population of mainly chronically ill patients in a primary care setting. With only one item, the SILS can be a short and effective tool for routine use in primary care and specialized care settings. Future research should test the SILS in other populations and pilot applications of the SILS in routine care.
Collapse
Affiliation(s)
- Stephanie Stock
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Koeln, Germany
| | - Arim Shukri
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Koeln, Germany
| | - Sibel Altin
- AOK Rheinland/Hamburg, Kasernenstraße 61, 40213, Düsseldorf, Germany
| | - Farah Nawabi
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Koeln, Germany
| | - Daniele Civello
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Koeln, Germany
| | - Marcus Redaèlli
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Koeln, Germany
| | - Adrienne Alayli
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Koeln, Germany.
- Clinic of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, Unit of Health Services Research, University Hospital Düsseldorf and Heinrich-Heine-University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| |
Collapse
|
25
|
Novick TK, Barrios F, Osuna M, Emery C, Ramirez D, Palau L, Ravi S, Lubetzky M, Cruz E, Crews DC, Cervantes L. Facilitating Medical Care for Latinx Individuals at Risk for CKD: A Pilot Intervention. Kidney Med 2023; 5:100679. [PMID: 37520781 PMCID: PMC10382664 DOI: 10.1016/j.xkme.2023.100679] [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] [Indexed: 08/01/2023] Open
Abstract
Rationale and Objective Latinx individuals are at a higher risk for kidney failure than non-Latinx White individuals; however, they are less likely to receive pre-kidney failure medical care. The objective of this study was to determine the feasibility and acceptability of a community health worker (CHW) intervention that facilitated access to medical care for Latinx individuals. Study Design Single-arm prospective study. Setting and Participants Latinx adults were found to have albuminuria or risk factors for kidney disease at community screening events in Austin, Texas. Intervention A 6-month CHW intervention that facilitated the following: (1) obtaining medical insurance; (2) medical care coordination with primary and nephrology care; (3) kidney disease education; and (4) connection with local resources to address health-related social needs. Outcomes Recruitment, retention, medical care linkage, and participant and CHW-reported satisfaction with the intervention. Results Of the 173 individuals who attended the 2 community screening events, 49 agreed to participate in the study, of whom, 51% were men with a mean ± standard deviation (SD) age of 45 ± 14 years, and all self-identified as Mexican or Chicano. The mean ± SD estimated glomerular filtration rate (eGFR) was 110 ± 21 mL/min/1.73 m2 and 41% of the participants reported a urine albumin-creatinine ratio of ≥30 mg/g. Among those enrolled, 28 of the 49 (57%) completed at least 1 CHW visit, and 20 of 49 (41%) completed the intervention. 7 individuals who needed assistance with insurance obtained insurance, and 15 of 20 (75%) scheduled an appointment with a primary care physician within 180 days. Participants reported that the US health care previously seemed inaccessible but gained insurance, the ability to navigate the system, and the ability to help others in their community to access medical care because of the program. Limitations Small sample size and a single community may limit generalizability. Conclusions We reported the acceptability of a CHW intervention. We encountered challenges with feasibility and identified strategies to overcome them. Studies are needed to test the effect of CHW interventions on outcomes and kidney health disparities. Funding National Kidney Foundation young investigator research grant to Dr Novick. Plain Language Summary Latinx individuals are at a higher risk for kidney failure than non-Latinx White individuals; however, they are less likely to receive pre-kidney failure medical care. We piloted a community health worker intervention that connected people with risk factors or showed evidence of kidney dysfunction at community screening events with medical care. Our findings indicate the acceptability of the intervention. We encountered challenges with feasibility and identified strategies to overcome them.
Collapse
Affiliation(s)
- Tessa K. Novick
- Division of Nephrology, University of Texas at Austin, Dell Medical School, Austin, TX
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Francisco Barrios
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Michelle Osuna
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Caroline Emery
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Daniel Ramirez
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Laura Palau
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Sanjana Ravi
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Michelle Lubetzky
- Division of Nephrology, University of Texas at Austin, Dell Medical School, Austin, TX
- Department of Internal Medicine, University of Texas at Austin, Dell Medical School, Austin, TX
| | - Evelyn Cruz
- Central Health, Department of Health Management Liasons, Austin, TX
| | - Deidra C. Crews
- Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lilia Cervantes
- Division of General Internal Medicine and Hospital Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO
| |
Collapse
|
26
|
Ramón-Arbués E, Granada-López JM, Antón-Solanas I, Cobos-Rincón A, Rodríguez-Calvo A, Gea-Caballero V, Tejada-Garrido CI, Juárez-Vela R, Echániz-Serrano E. Factors related with nursing students' health literacy: a cross sectional study. Front Public Health 2023; 11:1053016. [PMID: 37275493 PMCID: PMC10234423 DOI: 10.3389/fpubh.2023.1053016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 04/07/2023] [Indexed: 06/07/2023] Open
Abstract
Background Nursing professionals have a crucial role in promoting health literacy in health services, so it is necessary to ensure health literacy skills in future health professionals. Objective The objective of the study was to examine the health literacy of nursing students and its associated factors. Methods A cross-sectional descriptive study was carried out on 460 nursing students. For data collection, a semi-structured questionnaire was obtained on sociodemographic characteristics, perception and health care, use of the health system and lifestyles. In addition, health literacy was assessed using the European Health Literacy Questionnaire. Results 6.1% of the participants had an inadequate level of health literacy and 36.5% problematic. The probability of having sufficient health literacy is directly associated with age; and inversely with smoking, prolonged screen time and living alone (p < 0.05). Conclusion A large percentage of nursing students need to improve their health literacy skills. It is necessary to integrate a greater number of contents in health literacy in the curriculum of nursing students.
Collapse
Affiliation(s)
- Enrique Ramón-Arbués
- Faculty of Health Sciences, San Jorge University, Villanueva de Gállego, Spain
- SAPIENF Investigation Group, Zaragoza, Spain
| | - José Manuel Granada-López
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- GIISA021 Seguridad y Cuidados Investigation Group, Zaragoza, Spain
| | - Isabel Antón-Solanas
- SAPIENF Investigation Group, Zaragoza, Spain
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Ana Cobos-Rincón
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Antonio Rodríguez-Calvo
- Department of Anesthesia, Complex University of Salamanca, Salamanca, Spain
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Community Health and Care Research Group, SALCOM, Valencia, Spain
| | - Clara Isabel Tejada-Garrido
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, University of La Rioja, Logroño, Spain
- Biomedical Research Center of La Rioja, CIBIR, Logroño, Spain
| | - Emmanuel Echániz-Serrano
- SAPIENF Investigation Group, Zaragoza, Spain
- Department of Nursing and Physiatry, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
27
|
Wang Y, Jia Q, Wang H, Zou K, Li L, Yu B, Wang L, Wang Y. Revised Chinese resident health literacy scale for the older adults in China: simplified version and initial validity testing. Front Public Health 2023; 11:1147862. [PMID: 37265518 PMCID: PMC10231683 DOI: 10.3389/fpubh.2023.1147862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/10/2023] [Indexed: 06/03/2023] Open
Abstract
Objective This study aimed to develop a short version of the Chinese Resident Health Literacy Scale focused on older adults in China, and further assess the reliability and validity of this short version. Methods The data was from a cross-sectional community-based older adults health survey conducted in 2020. The total of 5,829 older adults were randomly divided into two parts using for the simplification and assessment of the scale, respectively. Item Response Theory (IRT) and Differential Item Functioning (DIF) were used for item analysis and scale simplification. Cronbach's alpha and McDonald's omega were used to assess the reliability and three factors Confirmatory Factor Analysis (CFA) was used to assess the validity, which were compared to the original version. Moreover, Multi-group Confirmatory Factor Analysis (MCFA) was used to test the model invariance of the short version across groups of gender, age groups, level of education, and cognitive status. Results The simplified version consisted of 27 items taken from 50 original items, of them 11 items from the dimension of knowledge and attitudes, 9 items from the dimension of behavior and lifestyle, and 7 items from the dimension of health-related skills. The overall Cronbach's alpha and McDonald's omega were both 0.87 (95%CI: 0.86-0.88). The goodness-of-fits of CFA in simplified version were still acceptable in CFI, TLI, GFI, and RMSEA, even improved in CFI, TLI, and GFI compared to those of original version. Also, the model was stable and invariant in MCFA across gender, cognitive status, and educational level groups. Conclusion In this study, we formed a simplified instrument for measuring health literacy focused on older adults in China. This short version might be more suitable for the priority recommendation in extended tracking of the dynamic changes on the levels of health literacy in the whole life cycle in public health settings. Further research might be to identify the cut-off values to distinguish the older adults with different levels of health literacy.
Collapse
|
28
|
Kells MR, Davis HA, Todorov S, Wildes JE. Health literacy and eating disorder pathology in women with food insecurity: A preliminary cross-sectional study. Eat Behav 2023; 49:101727. [PMID: 37099830 DOI: 10.1016/j.eatbeh.2023.101727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/28/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Food insecurity (FI), or limited consistent access to food, is associated with eating disorder (ED) pathology; however, the underlying mechanisms of this relationship remain unclear. Health literacy, or the ability to comprehend and apply health-related information to decision making, is linked to FI and has implications for outcomes across a broad range of diagnoses. The purpose of this study was to examine associations between health literacy and ED symptoms in a sample of 99 women with FI. Linear regression tested cross-sectional associations between scores on The Newest Vital Sign (NVS), a measure of health literacy, and scores on the Eating Pathology Symptom Inventory (EPSI) and behaviors reported in the Eating Disorder Diagnostic Interview (EDDI). Logistic regression examined the likelihood of ED diagnosis in relation to NVS score. The sample mean (SD) age was 40.3 (14.3) years, and participants self-identified as 54.5 % White, 30.3 % Black, and 13.8 % other. Respondents self-reported 13.1 % marginal, 28.3 % low, and 58.6 % very low food security. Mean NVS score was 4.45, and significantly higher for White compared to Black individuals (F = 3.96, p = .02, η2 = 0.76), but not between other groups. No difference in NVS score by FI status was observed. EPSI Body Dissatisfaction was positively associated with NVS score. No associations were found between remaining EPSI subscales, eating behaviors, or ED diagnosis. White women, but not other groups, were found to have significant negative relationship between NVS and EPSI restricting. Future longitudinal research including components of health literacy related to eating in individuals with FI is warranted.
Collapse
Affiliation(s)
- Meredith R Kells
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; School of Nursing, University of Rochester, Rochester, NY, USA.
| | - Heather A Davis
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, VA, USA
| | - Sophia Todorov
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| |
Collapse
|
29
|
Chen X, McMaughan DJ, Li M, Kreps GL, Ariati J, Han H, Rhoads KE, Mahaffey CC, Miller BM. Trust in and Use of COVID-19 Information Sources Differs by Health Literacy among College Students. Healthcare (Basel) 2023; 11:healthcare11060831. [PMID: 36981488 PMCID: PMC10048640 DOI: 10.3390/healthcare11060831] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
People’s health information-seeking behaviors differ by their health literacy levels. This study assessed the relationship between health literacy and college students’ levels of trust in and use of a range of health information sources of COVID-19. We collected data from August to December 2020 among college students (n = 763) through an online survey. We used a health literacy measure containing three self-reported survey questions, developed by the CDC. We assessed the extent to which participants trusted and used any of the sixteen different sources of information about COVID-19. Respondents reported high levels of trusting and using COVID-19 information from the CDC, health care providers, the WHO, state/county/city health departments, and official government websites when compared to other sources. After controlling for demographic characteristics (i.e., gender, age, race, ethnicity, and income), those who reported having lower health literacy were significantly less likely to trust and use COVID-19 information from these health authorities when compared to participants who reported having higher health literacy. Students with lower self-reported health literacy indicated not trusting or using official health authority sources for COVID-19 information. Relying on low-quality information sources could create and reinforce people’s misperceptions regarding the virus, leading to low compliance with COVID-19-related public health measures and poor health outcomes.
Collapse
Affiliation(s)
- Xuewei Chen
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
- Correspondence:
| | - Darcy Jones McMaughan
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
| | - Ming Li
- Department of Health Sciences, Towson University, Towson, MD 21252, USA;
| | - Gary L. Kreps
- Center for Health and Risk Communication, George Mason University, Fairfax, VA 22030, USA;
| | - Jati Ariati
- School of Educational Foundation, Leadership, and Aviation, Oklahoma State University, Stillwater, OK 74078, USA;
- Department of Psychology, Universitas Diponegoro, Semarang 50275, Indonesia
| | - Ho Han
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
| | - Kelley E. Rhoads
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK 74078, USA; (D.J.M.); (H.H.); (K.E.R.)
| | - Carlos C. Mahaffey
- College of Health and Human Sciences, Purdue University, West Lafayette, IN 47906, USA;
| | - Bridget M. Miller
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| |
Collapse
|
30
|
Cale AS, Byram JN, Organ JM, Schmalz NA. "A whole new perspective on how the body fits together"-An evaluation of a cadaver laboratory experience for high school students. ANATOMICAL SCIENCES EDUCATION 2023; 16:291-304. [PMID: 36259147 DOI: 10.1002/ase.2229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 08/16/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
The Center for Anatomy and Physiology Education has hosted interactive human cadaver laboratory tours for local high schools (ages 14-18) and undergraduate university students since 2014 to expose students to healthcare careers. Students receive information on the history of body donation and healthcare careers and observe human anatomy on prosections and with isolated organs. The goal of this study was to evaluate students' perceptions of the anatomy laboratory tours and their impact on students' interests in healthcare careers. Students completed pre- and post-tour questionnaires. Responses were analyzed using thematic analysis and linguistic inquiry. Of the 261 students who completed pre-tour questionnaires, 204 (78%) completed the post-tour questionnaire. Before the tour, students anticipated learning about human anatomy and expected to only see but not touch a cadaver. Most students expressed excitement and/or nervousness. A few students viewed the laboratory tour as an opportunity to test if they could see themselves in a healthcare career. After the tour, most students indicated that the tour either met or exceeded their expectations. Students found the laboratory tour to be educational and interesting and were surprised by the opportunity to interact with the donor. Numerous students expressed an increased interest in healthcare careers after the tour. Overall, students perceived the tour as an engaging experience that improved their anatomical knowledge and reinforced/increased their interest in healthcare careers. Academic institutions can positively impact local students by implementing an anatomy tour, sharing access to their in-house human cadaver laboratory, and recruiting instructors to share their anatomy expertise.
Collapse
Affiliation(s)
- Andrew S Cale
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jessica N Byram
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jason M Organ
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Naomi A Schmalz
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical Education, Creighton University School of Medicine, Omaha, Nebraska, USA
| |
Collapse
|
31
|
Abstract
OBJECTIVES People with chronic illness are particularly dependent on navigating and using the health care system. This requires navigational health literacy (HL-NAV). The article aims to examine the distribution and predictors of HL-NAV in a sample of chronically ill individuals. METHODS Data of 1,105 people with chronic illness from the general population in Germany were collected in December 2019 and January 2020. HL-NAV was assessed by 12 items (score 0-100). Bivariate and multiple linear regression analysis were performed. RESULTS HL-NAV score was 39.1 (SD 27.3). In bivariate analyses, HL-NAV was lower among chronically ill persons aged 65 or above, with low education, limited functional health literacy, low social status, financial deprivation, poor social support, multiple chronic conditions, and an illness duration of 6-10 years. In multivariate analyses, advanced age, lower education, less functional health literacy, lower social status, and less social support remained associated with lower HL-NAV. DISCUSSION The results underline the importance of promoting HL-NAV among people with chronic illness. Strategies should aim at strengthening individual competencies taking into account the social and situational factors but also at reducing the demands placed on chronically ill people by providing user-friendly and trustworthy information on the health care system along the illness trajectory.
Collapse
Affiliation(s)
- Lennert Griese
- School of Public Health, Interdisciplinary Centre for Health Literacy Research [ICHL], 9167Bielefeld University, Bielefeld, Germany
| | - Doris Schaeffer
- School of Public Health, Interdisciplinary Centre for Health Literacy Research [ICHL], 9167Bielefeld University, Bielefeld, Germany
| | - Eva-Maria Berens
- School of Public Health, Interdisciplinary Centre for Health Literacy Research [ICHL], 9167Bielefeld University, Bielefeld, Germany
| |
Collapse
|
32
|
Tian CY, Wong EL, Xu RH, Cheung AW, Dong D, Mo PK. Developing a Health Literacy Scale for adults in Hong Kong: A modified e-Delphi study with healthcare consumers and providers. Health Expect 2023; 26:245-255. [PMID: 36345702 PMCID: PMC9854330 DOI: 10.1111/hex.13651] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/12/2022] [Accepted: 10/23/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Health literacy (HL) refers to individuals' abilities to process and use health information to promote health. This study aimed to develop the first HL measurement tool for the Chinese Hong Kong population. METHODS A two-phase methodology was adopted. In Phase I, evidence synthesis with a deductive method was conducted to formulate the item list from the literature. In Phase II, a modified e-Delphi survey was conducted among stakeholders (i.e., healthcare providers and healthcare consumers) to confirm the content validity of the item list. The stakeholders were invited to rate the relevance of each draft item on a 4-point scale and provide suggestions for revisions, removal or adding new items. RESULTS In Phase I, a total of 34 items covering functional, interactive and critical HL were generated. In Phase II, to obtain a balanced view from experts and laypeople, healthcare professionals (n = 12) and consumers (n = 12) were invited to participate in the Delphi panel. The response rates of the three rounds were 100%. After the third round, the consensus was reached for 31 items, and no further comments for adding or revising items were received. All items exhibited excellent content validity (item content validity index: 0.79-1.00; K*: 0.74-1.00). CONCLUSIONS A Health Literacy Scale for Hong Kong was developed. Compared with existing HL scales, the scale fully operationalized the skills involved in functional, interactive and critical HL. The Delphi study shows evidence supporting the high content validity of all items in the scale. In future studies, these items should undergo rigorous testing to examine their psychometric properties in our target population groups. By illuminating the details in the development process, this paper provides a deeper understanding of the scale's scope and limitations for others who are interested in using this tool. PATIENT OR PUBLIC CONTRIBUTION Public as healthcare consumers, in addition to healthcare providers, were involved in developing a new HL scale for this study. The input from the public contributed to examining the scale's content validity by judging whether all items reflected the skills that they need to find and use health-related information in their daily life.
Collapse
Affiliation(s)
- Cindy Yue Tian
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Eliza Lai‐Yi Wong
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| | - Richard H. Xu
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
| | - Annie Wai‐Ling Cheung
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| | - Dong Dong
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| | - Phoenix K.‐H. Mo
- JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
- Center for Health Systems and Policy Research, JC School of Public Health and Primary Care, Centre for Health Systems and Policy ResearchThe Chinese University of Hong KongHong KongChina
| |
Collapse
|
33
|
Friedrich J, Münch AK, Thiel A, Voelter-Mahlknecht S, Sudeck G. Occupational Health Literacy Scale (OHLS): development and validation of a domain-specific measuring instrument. Health Promot Int 2023; 38:7026245. [PMID: 36738454 DOI: 10.1093/heapro/daac182] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Occupational health literacy (OHL) is a domain-specific approach that can empower people to make health-appropriate decisions in the work environment. OHL comprises the knowledge, skills and willingness of people to access and process health-related information and to apply it in work situations. The aim of this study was to evolve a conceptual model and validate a scale for OHL, that can be used in many sectors in the Western industrial countries, which does not yet exist. After piloting, item selection and alteration were carried out in a pretest with n = 163 working adults in diverse small- and medium-sized enterprises in Germany. The resulting OHL items were validated in a main survey with n = 828 participants working in small- and medium-sized enterprises and among them 47.5% people with migration background. The final 12-item questionnaire had good structural characteristics and is reliable and valid for measuring OHL. Using exploratory structural equation modeling, good fit indices (root mean square error of approximation = 0.063, comparative fit index = 0.940) confirmed a two-factor structure: (i) knowledge and skill-based processing of health information (internal consistency α = 0.88) and (ii) willingness and responsibility for occupational health (α = 0.74). The OHL scale fills the gap regarding domain-specific OHL questionnaires for working adults in diverse sectors in Western industrial countries. The Occupational Health Literacy Scale can be used to identify the needs of employees and companies and then to adapt and evaluate health promotion measures. Further research could include validation and use in other countries and large companies.
Collapse
Affiliation(s)
- Julian Friedrich
- Eberhard Karls Universität Tübingen, Institute of Sports Science, Wilhelmstraße 124, 72074 Tübingen, Germany
| | - Anne-Kristin Münch
- Medical University of Tübingen, Institute for Clinical Epidemiology and Applied Biostatistics, Silcherstraße 5, 72076 Tübingen, Germany
| | - Ansgar Thiel
- Eberhard Karls Universität Tübingen, Institute of Sports Science, Wilhelmstraße 124, 72074 Tübingen, Germany
| | - Susanne Voelter-Mahlknecht
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität, Berlin and Humboldt-Universität zu Berlin, Institute of Occupational Medicine, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Gorden Sudeck
- Eberhard Karls Universität Tübingen, Institute of Sports Science, Wilhelmstraße 124, 72074 Tübingen, Germany
| |
Collapse
|
34
|
Tian CY, Mo PKH, Dong D, Cheung AWL, Wong ELY. Development and validation of a comprehensive health literacy tool for adults in Hong Kong. Front Public Health 2023; 10:1043197. [PMID: 36703842 PMCID: PMC9871493 DOI: 10.3389/fpubh.2022.1043197] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Health literacy (HL) refers to an individual's ability to process and use health information to make health-related decisions. However, previous HL scales did not fully cover all aspects of this concept. This study aimed to develop a comprehensive Hong Kong HL scale (HLS-HK) and evaluate its psychometric properties among Chinese adults. Methods A scale of 31-item covering Nutbeam's framework, namely functional and interactive HL (FHL and IHL), and critical HL (CHL) within three subdomains: critical appraisal of information, understanding of social determinants of health, and actions to address social determinants of health, was developed based on previous literature review and Delphi survey. Cognitive interviews were performed to examine all items' face validity in terms of three aspects: comprehensiveness, clarity, and acceptability. A cross-sectional survey was conducted to investigate the scale's psychometric properties, including its internal consistency reliability, factorial structure validity, convergent validity, and predictive validity. Results Nine interviewees participated in the cognitive interviews in October 2021. Based on the input from respondents, two items were deleted, two items were combined, and several items' wording was revised. The other items were clear and readable. Finally, 28 items remained. A total of 433 adults completed the questionnaire survey between December 2021 and February 2022. After excluding one item with low inter-item correlations, the scale's internal consistency reliability was acceptable, with a Cronbach's alpha of 0.89. Exploratory factor analysis produced a five-factor model, as shown in the original theoretical framework. These factors accounted for 53% of the total variance. Confirmatory factor analysis confirmed that the fit indices for this model were acceptable (comparative fit index = 0.91, root mean square error of approximation = 0.06, and root mean square residual = 0.06). The scale is also significantly correlated with theoretically selected variables, including education and self-rated health. Conclusion The HLS-HK is a valid and reliable tool for evaluating HL. Compared with existing tools, this scale extended the operationalization of FHL, IHL, and CHL and fully operationalized the CHL via three subdomains. It can be used to understand the difficulties and barriers that people may encounter when they use health-related information and services.
Collapse
Affiliation(s)
- Cindy Yue Tian
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Phoenix Kit-Han Mo
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Annie Wai-ling Cheung
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,JC School of Public Health and Primary Care, Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Eliza Lai-Yi Wong ✉
| |
Collapse
|
35
|
Tomczyk S, Schlick S, Gansler T, McLaren T, Muehlan H, Peter LJ, Schomerus G, Schmidt S. Continuum beliefs of mental illness: a systematic review of measures. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1-16. [PMID: 35927343 PMCID: PMC9845169 DOI: 10.1007/s00127-022-02345-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/19/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE The continuum of mental health/illness has been subject to scientific debate for decades. While current research indicates that continuum belief interventions can reduce mental health stigma and improve treatment seeking in affected populations, no study has yet systematically examined measures of continuum beliefs. METHODS This preregistered systematic review summarizes measures of continuum beliefs. Following the PRISMA statement, three scientific databases (PubMed, PsycInfo and PsycArticles via EBSCOhost, Web of Science) are searched, instruments are described and discussed regarding their scope, and methodological quality. RESULTS Overall, 7351 records were identified, with 35 studies reporting relevant findings on 11 measures. Most studies examined general population samples and used vignette-based measures. Schizophrenia and depression were most commonly examined, few studies focused on dementia, ADHD, OCD, eating disorders, and problematic alcohol use, or compared continuum beliefs across disorders. Validity was very good for most measures, but reliability was rarely tested. Measures mostly assessed beliefs in the normality of mental health symptoms or the normality of persons with such symptoms but rarely nosological aspects (i.e., categorical v continuous conceptualization of mental disorders). CONCLUSIONS Current research provides psychometrically sound instruments to examine continuum beliefs for a variety of mental disorders. While studies suggest utility for general population samples and mental health professionals, more research is necessary to corroborate findings, for instance, regarding age (e.g., in adolescents), gender, or type of mental disorder. Future research should also compare self-report ratings, and vignette-based measures, include measures of nosological concepts to fully grasp the continuum concept of mental illness. PREREGISTRATION PROSPERO: CRD42019123606.
Collapse
Affiliation(s)
- S. Tomczyk
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - S. Schlick
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - T. Gansler
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - T. McLaren
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - H. Muehlan
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - L.-J. Peter
- grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - G. Schomerus
- grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - S. Schmidt
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| |
Collapse
|
36
|
Lorini C, Buscemi P, Mossello E, Schirripa A, Giammarco B, Rigon L, Albora G, Giorgetti D, Biamonte MA, Fattorini L, Bruno RM, Giusti G, Longobucco Y, Ungar A, Bonaccorsi G. Health literacy of informal caregivers of older adults with dementia: results from a cross-sectional study conducted in Florence (Italy). Aging Clin Exp Res 2023; 35:61-71. [PMID: 36260214 PMCID: PMC9580430 DOI: 10.1007/s40520-022-02271-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/02/2022] [Indexed: 01/11/2023]
Abstract
AIM The aim of this study was to measure the prevalence of inadequate health literacy (HL) in a sample of family caregivers of older adults with dementia, and to assess the relationship of HL with characteristics of caregiver and persons with dementia. METHODS The study followed a cross-sectional design. Persons with dementia and their family caregivers were enrolled in an outpatients' geriatric memory clinic. For the caregivers, the following information was collected: socio-demographic data, level of HL, cognitive impairment (using the Mini-Cog). For persons with dementia, the following data were collected: socio-demographic data, functional status (using the Basic and Instrumental Activities of Daily Living), cognitive impairment (using the Mini Mental State Evaluation, and the Global Deterioration Scale) behavioral and psychological symptoms associated with dementia (assessed using the Neuropsychiatric Inventory). RESULTS A total of 174 person with dementia/caregiver dyads were enrolled. About 45% of the caregivers presented a possibility or a high likelihood of inadequate HL. The percentage of caregivers with inadequate HL was higher among spousal caregivers than in offspring. Female gender, higher age and lower education were independent predictors of low HL. On multiple logistic regression analysis, persons with dementia assisted by caregivers with a high likelihood of limited HL presented higher risk of a more severe disease. CONCLUSION The results of this study suggest that the HL of dementia caregivers has to be included in the comprehensive geriatric assessment, to develop an appropriate individualized care plan. Moreover, public health interventions are needed to increase the HL of dementia caregivers.
Collapse
Affiliation(s)
- Chiara Lorini
- Department of Health Science, University of Florence, Florence, Italy ,Health Literacy Laboratory, Department of Health Science, University of Florence, Florence, Italy
| | - Primo Buscemi
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Enrico Mossello
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, Firenze, Italy ,School of Geriatric Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Annamaria Schirripa
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Barbara Giammarco
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Lisa Rigon
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Giuseppe Albora
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Duccio Giorgetti
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Massimiliano Alberto Biamonte
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Letizia Fattorini
- Medical Specialization School in Hygiene and Preventive Medicine, University of Florence, viale GB Morgagni 48, 50134 Florence, Italy
| | - Rita Manuela Bruno
- School of Geriatric Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gemma Giusti
- Department of Health Science, University of Florence, Florence, Italy
| | - Yari Longobucco
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Ungar
- Division of Geriatric and Intensive Care Medicine, Careggi Hospital, Firenze, Italy ,School of Geriatric Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Guglielmo Bonaccorsi
- Department of Health Science, University of Florence, Florence, Italy ,Health Literacy Laboratory, Department of Health Science, University of Florence, Florence, Italy
| |
Collapse
|
37
|
Strengthening scientific credibility against misinformation and disinformation: Where do we stand now? J Control Release 2022; 352:619-622. [PMID: 36334856 PMCID: PMC9634494 DOI: 10.1016/j.jconrel.2022.10.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
Health behaviors related to COVID-19 prevention measures, especially vaccination, are used to exemplify mechanisms whereby misinformation and disinformation can spark an "infodemic": a situation in which false information can spread more rapidly and widely than its truthful, science-based counterpart. We define key terminologies and identify potential sources that led to the pandemic infodemic, and highlight the harmful implications of such events. Issues related to scientific communication, how the public perceives information, and factors influencing individuals' decision-making are also discussed. This is the first in a series of two perspective articles on this topic.
Collapse
|
38
|
McMillan A, Tregobov N, Shum J, Christie I, Akhtar A, Poureslami I. Exploring chronic airways disease patients' perspectives on self-management topics. PATIENT EDUCATION AND COUNSELING 2022; 105:3540-3549. [PMID: 36100513 DOI: 10.1016/j.pec.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/12/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES In this study, we explored chronic airways disease (CAD) patients' responses to health literacy (HL) communication domain questions within disease self-management scenarios, as part of a larger CAD HL measurement tool development study. METHODS Adult asthma and chronic obstructive pulmonary disease (COPD) patients from specialty care respiratory clinics were initially presented with realistic disease management scenarios and asked to share information they would communicate. Participants' responses were grouped into response categories that were reviewed and verified by key informants. A new cohort of CAD patients then responded to the same scenarios and had their answers placed into the developed response categories by trained interviewers. RESULTS 19 initial stage participants' responses informed response categories for the following self-management topics: Inhaler Use (n = 20); Prednisone Use (n = 30); Flu (Influenza) (n = 35); and Weather Forecasting & Air Quality Index (n = 29). 141 participants' responses were categorised during the second stage. CONCLUSIONS Specialty care CAD patients displayed an understanding of key information to communicate across disease self-management topic. Our two-step, patient-driven approach may interest researchers investigating health-related communication from patients' perspectives. PRACTICE IMPLICATIONS Findings may illuminate potential areas to investigate communication gaps among CAD patients; further investigation is warranted among non-specialty care patients.
Collapse
Affiliation(s)
- Austin McMillan
- Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Noah Tregobov
- Respiratory Medicine Division, University of British Columbia, Vancouver, Canada; Vancouver - Fraser Medical Program, University of British Columbia, Vancouver, Canada
| | - Jessica Shum
- Respiratory Medicine Division, University of British Columbia, Vancouver, Canada
| | - Ian Christie
- School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Alizeh Akhtar
- School of Medicine, University College Cork, Cork, Ireland
| | - Iraj Poureslami
- Respiratory Medicine Division, University of British Columbia, Vancouver, Canada; Canadian Multicultural Health Promotion Society, Vancouver, Canada.
| |
Collapse
|
39
|
Tejero LMS, Siongco KLL, Pinlac PAV, Co KCD, Tolabing MCC. Associations of functional health literacy with socioeconomic and demographic status among Filipinos. BMC Public Health 2022; 22:2198. [PMID: 36443735 PMCID: PMC9703704 DOI: 10.1186/s12889-022-14602-x] [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: 12/10/2021] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Health literacy determines an individual's decision-making process in providing judgment concerning appropriate healthcare. Considering the various purposes of literacy for people, functional health literacy (FHL) was identified as a type of literacy that is measured by the application of literacy skills to health-related materials as a result of health education. The objective of this study was to identify the possible socio-demographic correlates of FHL of Filipinos. METHODS A cross-sectional survey was conducted among 2,303 Filipinos aged 15 to 70 years old in 2018-2019 utilizing the National Health Literacy Survey. Functional health literacy was determined using the FHL-5 Test which measured prose, document, and numeracy skills. Descriptive analysis presented socio-demographic characteristics and level of FHL. Log-binomial regression was used to estimate associations of FHL adequacy with socio-demographic characteristics. RESULTS Overall, the study involved 1,997 (86.7%) qualified participants. Most of them demonstrated prose literacy skills and had adequate FHL. Adjusted regression analyses showed that participants with a college-level education (Adjusted prevalence ratio [APR]: 1.43, 95% confidence interval [95% CI] 1.27-1.60), categorized under domestic service occupation (APR 1.19, 95% CI: 1.03-1.37), and those residing in urban areas (APR: 1.14, 95% CI 1.06-1.24) were significantly more prevalent in exhibiting FHL adequacy. In contrast, male participants and individuals aged 60 years or above were less likely to demonstrate FHL adequacy. CONCLUSIONS The study presents a baseline assessment of the functional health literacy level, measured using the FHL-5 Test, of adults in the Philippines. Majority of the participants demonstrated FHL adequacy, with relatively higher scores in prose than numeracy literacy. The measurement of FHL adequacy can inform policies on methods of health education and communication, emphasizing the need to stratify the audience based on socio-demographic characteristics and adapt the content and design of informational materials for population-based health educational programs.
Collapse
Affiliation(s)
- Lourdes Marie S. Tejero
- grid.11159.3d0000 0000 9650 2179College of Nursing, University of the Philippines Manila, Manila, Philippines ,grid.11159.3d0000 0000 9650 2179Technology Transfer and Business Development Office, the University of the Philippines Manila, Padre Faura Street, Ermita 1000, Manila, Philippines
| | - Kathryn Lizbeth L. Siongco
- grid.11159.3d0000 0000 9650 2179College of Nursing, University of the Philippines Manila, Manila, Philippines
| | - Paul Adrian V. Pinlac
- grid.11159.3d0000 0000 9650 2179College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Kim Carmela D. Co
- grid.11159.3d0000 0000 9650 2179College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - Ma. Carmen C. Tolabing
- grid.11159.3d0000 0000 9650 2179College of Public Health, University of the Philippines Manila, Manila, Philippines
| |
Collapse
|
40
|
Measurement Invariance and Differential Item Functioning of the Health Literacy Instrument for Adults (HELIA): A Large-Scale Cross-Sectional Study in Iran. Healthcare (Basel) 2022; 10:healthcare10102064. [PMID: 36292511 PMCID: PMC9602666 DOI: 10.3390/healthcare10102064] [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: 08/18/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 12/24/2022] Open
Abstract
Health literacy is important for health behavior engagement. Therefore, it is important to have a good instrument assessing health literacy with a theoretical framework. The present study aimed to examine the measurement invariance and differential item functioning (DIF) of a newly developed health literacy instrument; that is, the Health Literacy Instrument for Adults (HELIA). Confirmatory factor analysis (CFA) and Rasch models were used to examine the data collected from a large Iranian sample (N = 9775; 67.3% females; mean age = 36.44 years). All the participants completed the HELIA. CFA was used to examine if the HELIA had a five-factor structure (including reading, access to information, understanding, appraisal, and decision making/behavioral intention factors) and multigroup CFA to examine if the five-factor structure of HELIA was invariant across gender, educational level, accommodation, and age subgroups. Rasch models were used to examine whether each factor of HELIA was unidimensional and DIF contrast in Rasch to examine if the HELIA items were interpreted similarly across the aforementioned subgroups. The CFA results supported the five-factor structure of HELIA, and the Rasch models verified that each HELIA factor is unidimensional. Additionally, multigroup CFA supported the measurement invariance of HELIA across the following subgroups: male vs. female; highly educated vs. poorly educated; city residents vs. suburban residents; and younger age vs. older age. The DIF contrasts in the Rasch models additionally showed that there are no substantial DIF items in the HELIA across aforementioned subgroups. Therefore, the HELIA is a feasible and comprehensive instrument assessing health literacy across different populations in Iran.
Collapse
|
41
|
Sørensen K. From Project-Based Health Literacy Data and Measurement to an Integrated System of Analytics and Insights: Enhancing Data-Driven Value Creation in Health-Literate Organizations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13210. [PMID: 36293791 PMCID: PMC9603602 DOI: 10.3390/ijerph192013210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Health literacy measurement is important to improve equity, health and well-being as part of health system transformation. However, health literacy data of good quality are often lacking or difficult to access for decision-makers. To better inform policy, research and practice, this paper discusses how to move from project-based health literacy data and measurement to an integrated system of analytics and insights enhancing data-driven value creation in health-literate organizations. There is a need for the development of health literacy data pipelines, data dashboards, and data governance mechanisms which are timely and trustworthy. Investing in health literacy data analytics and data governance can pave the way for the integration of health literacy as an acknowledged global health indicator in large-scale surveys, ventures, and daily business. Leadership and management buy-in are needed to steer the process. Lessons learned from decades of measurement research combined with strategic implementation of systematic use of health literacy monitoring may accelerate the progress.
Collapse
Affiliation(s)
- Kristine Sørensen
- Global Health Literacy Academy, Viengevej 100, 8240 Risskov, Denmark
| |
Collapse
|
42
|
Schulz AA, Dresch C, Heiberger A, Wirtz MA. Use of Item Response Models in Assessing the Health Literacy Facet Understanding Health Information for Early Childhood Allergy Prevention and Prevention of COVID-19 Infections by Pregnant Women and Mothers of Infants. DIAGNOSTICA 2022. [DOI: 10.1026/0012-1924/a000298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Abstract. Appropriate parental health literacy (HL) is essential to preventively maintain and promote child health. Understanding health information is assumed to be fundamental in HL models. We developed N = 67 items (multiple-choice format) based on information materials on early childhood allergy prevention (ECAP) and prevention of COVID-19 infections to assess the parental HL facet Understand. N = 343 pregnant women and mothers of infants completed the items in an online assessment. Using exploratory factor analysis for ordinal data (RML estimation) and item response models (1-pl and 2-pl model), we proved the psychometric homogeneity of the item pool. 57 items assess the latent dimension Understand according to the assumptions of the 1-pl model (weighted MNSQ < 1.2; separation reliability = .855). Person parameters of the latent trait Understand correlate specifically with subjective socioeconomic status ( r = .27), school graduation ( r = .46), allergy status ( r = .11), and already infected with COVID-19 ( r = .12). The calibrated item pool provides a psychometrically sound, construct-valid assessment of the HL facet Understand Health Information in the areas of ECAP and prevention of COVID-19 infections.
Collapse
Affiliation(s)
- Anja Alexandra Schulz
- Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Germany
| | - Carolin Dresch
- Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Germany
| | - Andrea Heiberger
- Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Germany
| | - Markus Antonius Wirtz
- Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Germany
| |
Collapse
|
43
|
Barros A, Santos H, Santos-Silva F. A Systematic Review of Health Literacy Measurement Instruments in Portugal. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2022. [DOI: 10.1159/000525890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Introduction:</i></b> Health literacy evaluation is considered a priority issue in the health literacy research field. The complexity of the multiple definitions of health literacy and the diversity of instruments to evaluate health literacy has become a challenge to the establishment of comparisons across different studies. This work aimed to provide a systematic literature review of the existing measurement instruments adapted or developed for different groups of the Portuguese population. <b><i>Methods:</i></b> A comprehensive search of digital databases was conducted to systematize and understand the available knowledge about health literacy measurement in Portugal and to identify assessment tools and studies developed. The selection process was based on PRISMA guidelines. <b><i>Results:</i></b> A total of 17 publications were analysed regarding different aspects, which resulted in the identification of 11 different instruments, that were adapted or developed to measure health literacy in different groups of the Portuguese population, mainly adults, adolescents, and young adults. Seven instruments focusing on general health literacy (including e-health), 2 on mental health literacy, and the other 2 on oral health literacy were identified. <b><i>Discussion/Conclusion:</i></b> This study presents the first general overview of health literacy measurement in Portugal and clearly shows that to deepen our knowledge of health literacy in the Portuguese population it is essential to broaden the scope and the target of health literacy assessment to have a comprehensive understanding that will allow transforming our reality regarding health and disease.
Collapse
|
44
|
Perrin A, Damiolini E, Schott AM, Zermati J, Bravant E, Delahaye F, Dima AL, Haesebaert J. Considering health literacy in cardiovascular disease management: a qualitative study on healthcare professionals' and patients' perspectives. BMC Health Serv Res 2022; 22:1121. [PMID: 36064395 PMCID: PMC9446730 DOI: 10.1186/s12913-022-08455-8] [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: 12/11/2021] [Accepted: 08/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Implementing practices adapted to patient health literacy (HL) is a promising avenue for improving their outcomes in the context of cardiovascular diseases (CVD). The health communication skills of healthcare professionals (HCPs) and the quality of information provided are essential for low-HL patients. We aimed to explore HCP knowledge about HL, patients’ and HCPs’ views on current practices regarding low-HL patients, and facilitators and barriers to adapting communication to patients’ HL level, in order to prepare the implementation of a complex intervention dedicated to improve CVD management for low-HL patients. Methods We conducted face-to-face semi-structured interviews with HCPs practicing in cardiology units and patients hospitalized for CVD. The study design and analysis were based on the Theory of Planned Behavior for HCPs and on the framework of Health Literacy and Health Action for patients. Deductive and inductive thematic analysis were used. Barriers and facilitators were structured into an Ishikawa fishbone diagram and implementation strategies were selected to address resulting themes from the Expert Recommendations for Implementing Change (ERIC). Results Fifteen patients and 14 HCPs were interviewed. HCPs had partial knowledge of HL dimensions. Perceptions of HCPs and patients were not congruent regarding HCP-patient interactions and information provided by hospital and community HCPs. HCPs perceived they lacked validated tools and skills, and declared they adapted spontaneously their communication when interacting with low-HL patients. Patients expressed unmet needs regarding communication during hospital discharge and at return to home. Conclusion To implement HL-tailored practices in this setting, our results suggest that several implementation strategies will be valuable at individual (engaging patients and their family), interactional (educating and training of HCPs about HL), and organizational levels (creating a multidisciplinary HCP interest group dedicated to HL). Trial registration ClinicalTrials.gov, (NCT number) NCT03949309, May 10, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08455-8.
Collapse
Affiliation(s)
- Adèle Perrin
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Eléonore Damiolini
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France
| | - Anne-Marie Schott
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France
| | - Jéremy Zermati
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Estelle Bravant
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France
| | - François Delahaye
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Hôpital Louis Pradel, Service de cardiologie, F-69500, Lyon, France
| | - Alexandra L Dima
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Julie Haesebaert
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France. .,Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.
| |
Collapse
|
45
|
Tavousi M, Mohammadi S, Sadighi J, Zarei F, Kermani RM, Rostami R, Montazeri A. Measuring health literacy: A systematic review and bibliometric analysis of instruments from 1993 to 2021. PLoS One 2022; 17:e0271524. [PMID: 35839272 PMCID: PMC9286266 DOI: 10.1371/journal.pone.0271524] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/04/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND It has been about 30 years since the first health literacy instrument was developed. This study aimed to review all existing instruments to summarize the current knowledge on the development of existing measurement instruments and their possible translation and validation in other languages different from the original languages. METHODS The review was conducted using PubMed, Web of Science, Scopus, and Google Scholar on all published papers on health literacy instrument development and psychometric properties in English biomedical journals from 1993 to the end of 2021. RESULTS The findings were summarized and synthesized on several headings, including general instruments, condition specific health literacy instruments (disease & content), population- specific instruments, and electronic health. Overall, 4848 citations were retrieved. After removing duplicates (n = 2336) and non-related papers (n = 2175), 361 studies (162 papers introducing an instrument and 199 papers reporting translation and psychometric properties of an original instrument) were selected for the final review. The original instruments included 39 general health literacy instruments, 90 condition specific (disease or content) health literacy instruments, 22 population- specific instruments, and 11 electronic health literacy instruments. Almost all papers reported reliability and validity, and the findings indicated that most existing health literacy instruments benefit from some relatively good psychometric properties. CONCLUSION This review highlighted that there were more than enough instruments for measuring health literacy. In addition, we found that a number of instruments did not report psychometric properties sufficiently. However, evidence suggest that well developed instruments and those reported adequate measures of validation could be helpful if appropriately selected based on objectives of a given study. Perhaps an authorized institution such as World Health Organization should take responsibility and provide a clear guideline for measuring health literacy as appropriate.
Collapse
Affiliation(s)
- Mahmoud Tavousi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Samira Mohammadi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Jila Sadighi
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Fatemeh Zarei
- Faculty of Medical Sciences, Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Ramin Mozafari Kermani
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Rahele Rostami
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, ACECR, Iranian Institute for Health Sciences Research, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran
| |
Collapse
|
46
|
Chouinard MC, Lambert M, Lavoie M, Lambert SD, Hudon É, Dumont-Samson O, Hudon C. Measuring Health Literacy in Primary Healthcare: Adaptation and Validation of a French-Language Version of the Brief Health Literacy Screening among Patients with Chronic Conditions Seen in Primary Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137669. [PMID: 35805333 PMCID: PMC9265285 DOI: 10.3390/ijerph19137669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/13/2022] [Accepted: 06/20/2022] [Indexed: 02/05/2023]
Abstract
Background: The Brief Health Literacy Screening (BHLS) is a short self-report instrument developed to identify patients with inadequate health literacy. This study aimed to translate the BHLS into French Canadian (BHLS-FCv) and to evaluate its psychometric properties among patients with chronic conditions in primary care. Methods: The BHLS was translated into French using the Hawkins and Osborne’s method. Content validity was evaluated through cognitive interviews. A validation study of the BHLS-FCv was conducted in two primary care clinics in the province of Quebec (Canada) among adult patients with chronic conditions. Psychometric properties evaluated included: internal consistency (Cronbach’s alpha); test–retest reliability (intraclass correlation coefficient); and concurrent validity (Spearman’s correlations with the Health Literacy Questionnaire (HLQ)). Results: 178 participants completed the questionnaire at baseline and 47 completed the questionnaire two weeks later over the telephone. The average score was 13.3. Cronbach’s alpha for internal consistency was 0.77. The intraclass correlation coefficient for test–retest reliability was 0.69 (95% confidence interval: 0.45–0.83). Concurrent validity with Spearman’s correlation coefficient with three subscales of HLQ ranged from 0.28 to 0.58. Conclusions: The BHLS-FCv demonstrated acceptable psychometric properties and could be used in a population with chronic conditions in primary care.
Collapse
Affiliation(s)
- Maud-Christine Chouinard
- Faculté des Sciences Infirmières, Université de Montréal, 2375, Chemin de la Côte-Ste-Catherine, Montréal, QC H3T 1A8, Canada;
| | - Mireille Lambert
- Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean, 305 Saint-Vallier, Saguenay, QC G7H 5H6, Canada;
| | - Mélissa Lavoie
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, 555, Boulevard de l’Université, Saguenay, QC G7H 2B1, Canada; (M.L.); (É.H.)
| | - Sylvie D. Lambert
- Ingram School of Nursing, St. Mary’s Research Centre, 680 Sherbrooke West, Suite 1800, Montréal, QC H3A 2M7, Canada;
| | - Émilie Hudon
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, 555, Boulevard de l’Université, Saguenay, QC G7H 2B1, Canada; (M.L.); (É.H.)
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC J1H 5N4, Canada
| | - Olivier Dumont-Samson
- Département de Médecine de Famille et de Médecine d’Urgence, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC J1H 5N4, Canada;
| | - Catherine Hudon
- Département de Médecine de Famille et de Médecine d’Urgence, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, QC J1H 5N4, Canada;
- Correspondence:
| |
Collapse
|
47
|
Evolution of Therapeutic Patient Education: A Systematic Scoping Review and Scientometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106128. [PMID: 35627665 PMCID: PMC9140728 DOI: 10.3390/ijerph19106128] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 01/04/2023]
Abstract
Therapeutic patient education (TPE) aims to empower the patients and their caregivers to effectively care for and manage their conditions. Such educational programs have been shown to improve health behaviors, disease outcomes, and quality of life among different patient populations. The field of TPE has evolved extensively over decades, owing to interdisciplinary research. No study so far has been done to map this field, to identify the stakeholders and gaps requiring future research. By leveraging the theory of co-citation, CiteSpace was used to visualize the bibliographic data pertaining to TPE research. A total of 54,533 articles published in English language were analyzed to identify influential funders, regions, and institutes contributing to this field. Besides these, significant theoretical and empirical contributions that shaped this field were mapped. Our analysis revealed several important insights. Most of the important theories that helped shape TPE were inspired from the social sciences. Five important research themes were identified: disorders, study designs utilized in TPE research, the scope of the TPE literature and outcomes, and populations. The research focused on improving perceptions, behaviors, and attitudes toward health promotion, reducing stigma, self-management and medication adherence. Most of the research was developed in the context of high-income countries. Future research should involve patients and use digital technology. Meta-analytical studies need to be done to identify the effectiveness and moderators of TPE interventions across different disorders. Further research should involve low and middle-income countries (LMIC) to ensure knowledge and technology transfer.
Collapse
|
48
|
Valero-Chillerón MJ, Mena-Tudela D, Cervera-Gasch Á, González-Chordá VM, Soriano-Vidal FJ, Quesada JA, Castro-Sánchez E, Vila-Candel R. Influence of Health Literacy on Maintenance of Exclusive Breastfeeding at 6 Months Postpartum: A Multicentre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095411. [PMID: 35564807 PMCID: PMC9104596 DOI: 10.3390/ijerph19095411] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
Background: International organizations recommend initiating breastfeeding within the first hour of life and maintaining exclusive breastfeeding for the first 6 months. However, worldwide rates of exclusive breastfeeding for 6-month-old infants is far from meeting the goal proposed by the World Health Organization, which is to reach a minimum of 50% of infants. Education is one of the factors affecting the initiation and continuation of breastfeeding, and incidentally, it is also related to lower health literacy. This study explored the influence of health literacy on maintenance of exclusive breastfeeding at 6 months postpartum. Methods: A longitudinal multicenter study with 343 women were recruited between January 2019 and January 2020. The first questionnaire was held during the puerperium (24−48 h) with mothers practicing exclusive breastfeeding, with whom 6-month postpartum breastfeeding follow-up was performed. Socio-demographic, clinical and obstetric variables were collected. Breastfeeding efficiency was assessed using the LATCH breastfeeding assessment tool. The health literacy level was evaluated by the Newest Vital Sign screening tool. A multivariate logistic regression model was used to detect protective factors for early exclusive breastfeeding cessation. Results: One third of the women continued exclusive breastfeeding at 6 months postpartum. Approximately half the participants had a low or inadequate health literacy level. An adequate health literacy level, a high LATCH breastfeeding assessment tool score (>9 points) and being married were the protective factors against exclusive breastfeeding cessation at 6 months postpartum. Conclusion: Health literacy levels are closely related to maintaining exclusive breastfeeding and act as a protective factor against early cessation. A specific instrument is needed to measure the lack of “literacy in breastfeeding”, in order to verify the relationship between health literacy and maintenance of exclusive breastfeeding.
Collapse
Affiliation(s)
- María Jesús Valero-Chillerón
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Desirée Mena-Tudela
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
- Correspondence:
| | - Águeda Cervera-Gasch
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Víctor Manuel González-Chordá
- Department of Nursing, Universitat Jaume I, Av. de Vicent Sos Baynat, 12071 Castelló, Spain; (M.J.V.-C.); (Á.C.-G.); (V.M.G.-C.)
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Department of Nursing, University of Alicante, 03080 Alicante, Spain
- Department of Obstetrics and Gynaecology, Hospital Luis Alcanyis, 46819 Xàtiva, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain;
| | - Enrique Castro-Sánchez
- Health Protection Research Unit in Healthcare-Associated Infection and Antimicrobial Resistance at Imperial College London, London W12 0NN, UK;
- College of Nursing, Midwifery and Healthcare, University of West London, Brentford TW8 9GA, UK
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46010 Valencia, Spain; (F.J.S.-V.); (R.V.-C.)
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO-SP), 46020 Valencia, Spain
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| |
Collapse
|
49
|
Stock S, Isselhard A, Jünger S, Peters S, Schneider G, Haarig F, Halbach S, Okan O, Fischer F, Bollweg TM, Bauer U, Schaeffer D, Vogt D, Berens EM, Ernstmann N, Bitzer EM. [DNVF Memorandum Health Literacy (Part 2) - Operationalisation and Measuring of Health Literacy from a Health Services Research Perspective]. DAS GESUNDHEITSWESEN 2022; 84:e26-e41. [PMID: 35472769 PMCID: PMC9050455 DOI: 10.1055/a-1807-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Das vorliegende „DNVF Memorandum Gesundheitskompetenz (Teil 2) –
Operationalisierung und Messung von Gesundheitskompetenz aus Sicht der
Versorgungsforschung“ des Deutschen Netzwerks Versorgungsforschung e.V.
(DNVF) stellt die Fortführung des Memorandums „DNVF Memorandum
Gesundheitskompetenz (Teil 1) – Hintergrund, Gegenstand und
Fragestellungen in der Versorgungsforschung“ dar. Neben den allgemeinen
Anforderungen an die Messung der Gesundheitskompetenz, beschäftigt sich
dieses Memorandum auch mit den speziellen Anforderungen, wie die Abgrenzung zu
verwandten Konstrukten, den Unterschieden zwischen performanzbasierten und
Selbsteinschätzungsverfahren, den Unterschieden zwischen generischen und
spezifischen Instrumenten, dem Einsatz von Screeninginstrumenten sowie der
Messung der Gesundheitskompetenz bei speziellen Personengruppen. Weiterhin
werden Besonderheiten bei der Messung der digitalen Gesundheitskompetenz,
Potenziale qualitativer und partizipativer Forschungszugänge sowie
forschungsethische Gesichtspunkte bei der Messung der Gesundheitskompetenz
erarbeitet. Ein besonderer Wert wird auf den Praxisbezug gelegt, der am Ende der
jeweiligen Abschnitte mit einem Fazit für die Versorgungsforschung
aufgegriffen wird. Abschließend wird einen Blick auf Herausforderungen
und Forschungsdesiderate im Zusammenhang mit der Messung von
Gesundheitskompetenz im Rahmen der Versorgungsforschung geworfen.
Collapse
Affiliation(s)
- Stephanie Stock
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln, Cologne, Germany
| | - Anna Isselhard
- Institut für Gesundheitsökonomie und klinische Epidemiologie, Universitätsklinikum Köln, Cologne, Germany
| | - Saskia Jünger
- Department of Community Health, Hochschule für Gesundheit, Bochum, Germany
| | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Hürth Efferen, Germany
| | - Gundolf Schneider
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Standort Berlin, Berlin, Germany
| | - Frederik Haarig
- Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Carl Gustav Carus der Technischen Universität Dresden, Dresden, Germany
| | - Sarah Halbach
- Bundeszentrale für gesundheitliche Aufklärung (BzgA), Köln, Germany.,Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn
| | - Orkan Okan
- Fakutät für Sport- und Gesundheitswissenschaften, Technische Universität München, München, Germany
| | - Florian Fischer
- Institut für Gerontologische Versorgungs- und Pflegeforschung, Hochschule Ravensburg-Weingarten, Weingarten, Germany
| | - Torsten Michael Bollweg
- Fakultät für Erziehungswissenschaft, AG 2 Sozialisation, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Bielefeld, Germany
| | - Ullrich Bauer
- Fakultät für Erziehungswissenschaft, AG 2 Sozialisation, Interdisziplinäres Zentrum für Gesundheitskompetenzforschung (IZGK), Zentrum für Prävention und Intervention im Kindes- und Jugendalter (ZPI), Universität Bielefeld, Bielefeld, Germany
| | - Doris Schaeffer
- Interdisziplinäres Zentrum für Gesundheitskompetenzforschung, Universität Bielefeld, Bielefeld, Germany
| | - Dominique Vogt
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Eva-Maria Berens
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld
| | - Nicole Ernstmann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Universitätsklinikum Bonn, Bonn
| | - Eva Maria Bitzer
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg, Germany
| |
Collapse
|
50
|
Candemir B, Yıldırım F, Yaşar E, Erten Y, Göker B. Relationship between Health Literacy and Frailty in Older Adults with Chronic Kidney Disease. Exp Aging Res 2022; 49:201-213. [PMID: 35467490 DOI: 10.1080/0361073x.2022.2068326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with an increased risk of frailty, morbidity, and mortality in older adults. Limited health literacy (HL) is a condition that can cause frailty in CKD. Frailty leads to a decreased resistance to stress situations caused by activities of daily living and increased morbidity and mortality. The aim of this study was to investigate the relationship between HL and frailty in older adults with stage 4-5 CKD. METHODS A total of 109 patients with stage 4-5CKD were included. All patients underwent a comprehensive geriatric assessment. Health literacy was assessed by the Turkish version of the European Health Literacy Questionnaire. Frailty status was measured using the Fried Frailty Index. RESULTS The median age was 72 (68-80) years and 72 patients (66.1%) had lowHL. Forty-six patients (42.2%) were frail, and frailty was more common in the low HL group. CONCLUSION The present study demonstrated that low HL level was common in geriatric patients with stage 4-5 CKD and was associated with frailty, as well as a decrease in daily and instrumental life activities, decrease in acceptance of illness scale, and compliance with medical treatment.
Collapse
Affiliation(s)
- Burcu Candemir
- Department of Geriatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Funda Yıldırım
- Department of Geriatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Emre Yaşar
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Yasemin Erten
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Berna Göker
- Department of Geriatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|