Modelling health literacy on conceptualizations of scientific literacy

Translation, cross-cultural adaptation, and validation of the Chinese version of the COVID-19 health literacy scale in nursing students

BACKGROUND

Effective communication is an essential component of high-quality nursing care. Health literacy, the ability to access, describe, evaluate and apply health information to make informed decisions, is an important component of effective communication in nursing. Nurses, including student nurses, with good levels of health literacy (HL) are well positioned to communicate reliable public health-related information effectively, at times like the COVID-19 global pandemic. At this time, many nursing students have been at the frontline of patient education, as such, it would be expected that they have high levels of HL. However, it has been suggested that there is the need to improve HL levels in nursing students.

AIMS

The aim of this study was to analyse the structure of item response of a back translated Chinese version of the COVID-HLS-Q22 questionnaire and to assess the coronavirus-related HLof Chinese speaking nursing students in Hong Kong using the COVID-HLS-Q22-CN.

METHODS

A cross-sectional study of 97 undergraduate nursing students was conducted using two self-reported questionnaires. The HLS-EU-16 scale, with face validity already established, was used to assess scale equivalence Using a cross-over study approach, student participants were randomly assigned in sequential order. The validation process was performed in five phases: direct translation, translation synthesis, back translation, consolidation with experts, and testing with the students. The intended outcome of this study will be a formally tested model of the Chinese version of the COVID-HLS-Q22-CN, that can be replicated in Chinese population.

RESULTS

Factorial equivalence was present across language versions in both questionnaires. Internal consistency was excellent for COVID-HLS-Q22-CN (coefficient alpha for Chinese version of questionnaire, 0.957 and English version, 0.953). This suggested that the four subscale are stable across the two questionnaires.

CONCLUSION

The COVID-HLS-Q22-CN has proven to be a feasible and reliable tool in the assessment of Hong Kong based Chinese speaking nursing students. The emergence of issues around COVID-related HL further highlights the need to include the teaching of critical health literacy skills within nurse education, preparing the healthcare professionals of the future for public health emergencies.

Factors related with nursing students' health literacy: a cross sectional study

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.

Health literacy affected the residents' knowledge, attitude, practice for prevention and control of COVID-19 in Shanxi Province, China

Multistage stratified random sampling was used to explore the relationship of health literacy with novel coronavirus disease 2019 (COVID-19) prevention and control knowledge, attitude and practice (KAP) in residents aged 15-69 years old in Shanxi Province. The questionnaire, which was issued by the Chinese Center for Health Education, consisted of a health literacy questionnaire and a COVID-19 prevention and control KAP questionnaire. According to the national unified scoring method, the participants were divided into two groups: those who with adequate health literacy and those who with inadequate health literacy. The results of the answer to each KAP question were compared between the two groups by Chi-square test or Wilcoxon rank sum test. Binary logistic regression was used to control confounding effects of socio-demographic characteristics to draw relatively reliable conclusions. A total of 2700 questionnaires were distributed, and 2686 valid questionnaires were returned, with an efficiency rate of 99.5%. Health literacy qualified was identified for 18.32% (492/2686) in Shanxi Province. Compared with the inadequate health literacy group, people with adequate health literacy had a higher corrected answer rate in 11 knowledge-related questions (all P < 0.001); showed more positive answer to each attitude-related question in the three aspects, namely, responsibility for the prevention and control of infectious disease transmission, evaluation for COVID-19-related information release and reporting, and evaluation for the government's COVID-19 prevention and control results (all P < 0.001); and acted more actively in the practice concerning appropriate self-prevention and control behaviors during the COVID-19 outbreak (all P < 0.001). Logistic regression analyses confirmed that with adequate health literacy played a positive role in each of the contents of COVID-19 prevention and control KAP (ORs were between 1.475 and 4.862, all P < 0.001). Health literacy is closely related to COVID-19 prevention and control KAP in the general population of Shanxi Province. People with high score of health literacy were generally better able to grasp COVID-19 prevention and control knowledge, have more positive attitudes toward prevention and control, and perform better prevention and control behaviors. Promoting residents' health literacy by targeted health education can play an important and positive role in dealing with the threat of major infectious diseases outbreaks.

Exploring the Relationship between Medical Research Literacy and Respondents' Expressed Likelihood to Participate in a Clinical Trial

Medical research literacy (MRL) is a facet of health literacy that measures a person's understanding of informed consent and other aspects of participation in medical research. While existing research on MRL is limited, there are reasons to believe MRL may be associated with a willingness to participate in medical research. We use data from a racially balanced sample of survey respondents (n = 410): (1) to analyze how MRL scores vary by respondents' socio-demographic characteristics; (2) to examine how MRL relates to respondents' expressed likelihood to participate in a clinical trial; and (3) to provide considerations on the measurement of MRL. The results indicate no differences in MRL scores by race or gender; younger (p < 0.05) and more educated (p < 0.001) individuals have significantly higher MRL scores. Further, higher MRL scores are associated with significantly lower levels of expressed likelihood to participate in a clinical trial. Additionally, the MRL scale included both true and false statements, and analyses demonstrate significant differences in how these relate to outcomes. Altogether, the results signal that further research is needed to understand MRL and how it relates to socio-demographic characteristics associated with research participation and can be measured effectively.

Understanding, Trusting, and Applying Scientific Insights to Improve Your Health: A Latent Profile Analysis Approach

Various leading causes of death can be prevented or delayed through informed decision-making and lifestyle changes. Previous work has, to some extent, linked such health-promoting behavior (HPB) with variables capturing individuals' understanding of science, trust in science, and capacity to apply evidence-based information in the health context. However, empirical research on the relationship between scientific knowledge, trust in science, health literacy, and HPB is scarce. Additionally, no study has investigated whether these characteristics interact to form homogeneous, high-risk subgroups of the population. The present online study (N = 705) revealed that trust in science and health literacy were positively related to a wide array of HPBs (e.g., healthy nutrition, physical activity, stress management), while scientific knowledge was only positively associated with COVID-19 vaccination intention. Furthermore, the results of latent profile analyses yielded four subgroups (i.e., low, moderate, and high levels of all three variables and a varied profile exhibiting very low trust in science, low health literacy, and moderate scientific knowledge). The identified subgroups differ significantly in HPB and variables determining profile membership (e.g., political conservatism). Hence, the present study offers some guidance on which groups may be targeted with public health campaigns and how they may be designed.