The S-TOFHLA as a measure of functional literacy in patients with mild Alzheimer's disease or mild cognitive impairment

The low health literacy in Latin America and the Caribbean: a systematic review and meta-analysis

BACKGROUND

Health literacy (HL) impacts people's health and well-being. In Latin America and the Caribbean (LAC), there are no general estimates of the prevalence of low HL. This study aimed to estimate the prevalence of low HL among citizens of LAC and identify the tools used to measure it.

METHODS

We included observational studies quantifying the prevalence of low HL in people living in LAC. We searched PubMed, CINAHL, EMBASE, ERIC, LILACS, PsycINFO, Redalyc, SciELO, Web of Science, PQDT, and the reference lists of the included studies in June 2023. Two reviewers independently conducted the selection, extraction, and risk of bias assessment using the JBI Critical Appraisal Tools. Meta-analysis of proportions using random effects models was used to summarize the prevalence of low HL estimated. This prevalence was measured in each study using different classification methods: word recognition items, reading and numeracy comprehension items, and self-reported comprehension items.

RESULTS

Eighty four studies involving 23,914 participants from 15 countries were included. We identified 23 tools to assess HL, and most of the studies were carried out in health services. The pooled prevalence of low HL were 44.02% (95%CI: 36.12-52.24) for reading and numeracy comprehension items, 50.62% (95%CI: 41.82-59.39) for word recognition items, and 41.73% (95%CI: 31.76-52.43) for self-reported comprehension items.

CONCLUSION

Despite the variability in the prevalence of low HL and a diversity of tools, the average of low HL is of concern. Almost half of the participants in the included studies have low HL. Most of the studies targeted users of healthcare services. Further research investigating the prevalence of low HL in the general population and actions focused on health education, communication, and information are necessary.

TRIAL REGISTRATION

PROSPERO (CRD42021250286).

Factors associated with poor health literacy in older adults: A systematic review

OBJECTIVES

To identify factors associated with poor health literacy in older adults.

METHODS

A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy".

PROSPERO - CRD

42022350140.

RESULTS

Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others).

CONCLUSIONS

The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies.

Assessment of functional health literacy in Brazilian carers of older people

Individuals with low health literacy have less knowledge of their own health condition. Carers play a key role in older people's activities of daily living.

Objective

to evaluate the performance of carers of older people using the S-TOFHLA (Short Test of Functional Health Literacy in Adults) and to identify caregiver characteristics associated with low functional health literacy.

Methods

a cross-sectional study was conducted. The S-TOFHLA, a sociodemographic instrument, the Mini-Mental State Exam and the Patient Health Questionnaire-2 were applied to 80 carers of older patients routinely followed by doctors from the Primary Health Care Sector of the City of Botucatu, São Paulo. The multivariate analysis used an ordinal logistic regression model with test (S-TOFHLA) scores as the dependent variable. The level of statistical significance adopted was 0.05.

Results

the individuals had a mean age of 54.6 (± 11.7); 27% of the carers evaluated had inadequate levels of health literacy (S-TOFHLA ≥54). A higher proportion of individuals with low education had inadequate or marginal health literacy (p<0.001).

Conclusion

nearly 1/3 of the carers had marginal or inadequate levels of health literacy. These results highlight the difficulties of many carers in understanding health information.

Assessment of health literacy of municipal employees in Shemiranat, Iran

Background

Health literacy is one of the major determinants of health promotion among individuals and within society.

Objective

The present study is aimed to determine the health literacy status of office employees in Shemiranat using the native instruments of health literacy for Iranian adults (HELIA).

Methods

The present descriptive-analytical cross-sectional study was done in 2016–17. It was conducted on 360 office employees in Shemiranat. The samples were selected using a multi-stage simple random sampling method. Data collection tools in this study included HELIA questionnaire. The data were imported into SPSS v.18 software and then analyzed using descriptive statistical indices (mean, SD, number, and percentage) and inferential statistics (Chi-square, Pearson’s correlation coefficient, Spearman’s correlation coefficient, and Kruskal-Wallis test). Written informed consent was obtained from the employees participating in the study and they were assured about confidentiality. Also, they were informed that participation was voluntary.

Results

The mean and standard deviation of the total health literacy score among the studied individuals was 125.99±16.01. The mean score of health literacy in the areas of reading (15.36±2.89) and evaluation (5.01±2.8) among the studied individuals was lower than other dimensions of health literacy. Based on the Chi-square test, there was a statistically significant relationship between health literacy and education level, occupational rank, work place, and work experience (p=0.0001 in all the cases). The individuals with medium and good levels of health literacy acquired most of their health-related information through the Internet, friends, relatives, physicians, and health staff.

Conclusion

Health literacy status was not sufficient among the studied staff. Thus, it is recommended to perform promotional interventions in order to improve the health literacy status and its dimensions among these staff.