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Ferreira-Alfaya FJ. Inequalities in health literacy between European population and newly arrived male sub-Saharan migrants in Europe. Health Promot Int 2024; 39:daae129. [PMID: 39382388 DOI: 10.1093/heapro/daae129] [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] [Indexed: 10/10/2024] Open
Abstract
Increases in migration pressure from sub-Saharan Africa to Europe have increased in recent years. Despite this trend, the health literacy needs of migrants in host communities have not been sufficiently studied. This research aims to explore the health literacy of migrants newly arriving in Europe and compare it with the health literacy levels of the European population, utilizing data obtained from the European health literacy survey. A convenience sampling cross-sectional study was conducted at the Temporary Immigrant Stay Center in Melilla (Spain) in June 2022 using a validated French and Arabic version of the 16-item European health literacy survey questionnaire. A total of 106 sub-Saharan migrants ≥ 18 years of age were surveyed. The general health literacy index of the migrants was 30.02 points (on a scale of 50), placing it in the 'problematic' level. Of the participants, 57.54% had a limited ability to obtain, understand and apply health information and make appropriate health-related decisions. The largest gap compared to European citizens was observed in skills to understand information related to disease prevention. These results reinforce that migrant status is a social determinant of low health literacy and suggest that health professionals should extend their educational role to this vulnerable group.
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Oldhoff-Nuijsink C, Derksen ME, Engelsma T, Peute LWP, Fransen MP. Digital tools to support informed decision making among screening invitees in a vulnerable position for population-based cancer screening: A scoping review. Int J Med Inform 2024; 192:105625. [PMID: 39317034 DOI: 10.1016/j.ijmedinf.2024.105625] [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: 03/25/2024] [Revised: 08/21/2024] [Accepted: 09/06/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Individuals in a vulnerable position are generally less inclined to participate in population-based cancer screening. Digital tools, such as educational videos, narratives or decision aids, show promise in reaching and informing these invitees by tailoring information needs based on their preferences. This review aims to provide an overview of design features and reported outcomes of digital tools intended to support informed decision making among screening invitees in a vulnerable position. METHODS The review was conducted according to the Preferred Reporting Items for Scoping Reviews guidelines. We searched PubMed, Scopus/MEDLINE and Web of Science and included studies when the effectiveness of the digital tool was assessed and focussed on reaching and/or informing screening invitees in a vulnerable position for breast, cervical or colorectal cancer screening. For each included study, the study population, type of digital tool, the development process, reported design features and reported effects were extracted. FINDINGS We found 448 articles, and finally 13 were included in this review after reading full text. Study designs included randomised controlled trials (n = 5), pre-post-test design (n = 7) and experimental design (n = 1). Six different types of digital tools were identified: decision aids (n = 6), educational programs (n = 3), narrative video (n = 1), text-messaging intervention (n = 1), animation video (n = 1), and iPad program (n = 1). A population specific design was applied in 12/13 interventions, such as avoiding jargon and using a voice over function. Reported outcomes measures regarding reaching and informing the target population were: knowledge, attitude, screening intention, self-efficacy, susceptibility, feeling informed, values clarity, and screening uptake. All digital tools reported a significant improvement on at least one of the reported outcome measures. PRINCIPAL CONCLUSIONS The use of digital tools seems to contribute to reach or inform screening invitees in a vulnerable position for cancer screening. However, insufficient evidence was found regarding the development process of the tools and their effects on outcome measures related to reaching and informing the screening invitees in a vulnerable position. Future research may look in to combining multiple digital tools and animated visual information in combination with spoken text to improve reaching and informing screening invitees in a vulnerable position.
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Affiliation(s)
- Corine Oldhoff-Nuijsink
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands; Amsterdam Public Health, Societal Participation & Health, Amsterdam, the Netherlands.
| | - Marloes E Derksen
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Thomas Engelsma
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Linda W P Peute
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Mirjam P Fransen
- Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands; Amsterdam UMC, location University of Amsterdam, Department of Public and Occupational Health, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands; National Institute for Public Health and the Environment, Centre for Prevention, Lifestyle and Health, Department of Behaviour and Health, Antonie van Leeuwenhoeklaan 9, Bilthoven, the Netherlands
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Matsuo R, Fujita K, Miyazono M, Miyasaka K, Yamanaka T, Yakushiji K, Nagai A. Validating the short-version European Health Literacy Survey Questionnaire for community-dwelling older adults in Japan. Health Promot Int 2024; 39:daae105. [PMID: 39180352 DOI: 10.1093/heapro/daae105] [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: 08/26/2024] Open
Abstract
The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is available in multiple languages, and shortened versions have also been developed. This study aimed to examine the reliability and validity of the short version of the questionnaire (HLS-Q12) developed for community-dwelling older adults in Japan. The HLS-Q12 was developed using 12 of the 47 items of the Japanese version of the HLS-EU-Q47. In this study, the survey was conducted by distributing self-administered questionnaires to community-dwelling individuals aged 65 years and older who consented to participate; their responses were collected by mail. The correlation between the HLS-Q12 and the HLS-EU-Q47 was tested to assess criterion validity. To test construct validity, nine novel hypotheses were proposed. We also conducted a confirmatory factor analysis of the HLS-Q12. Based on a resurvey after 5-7 days, test-retest reliability was examined using interclass correlation coefficients (ICCs) and Bland-Altman analysis. In total, 118 individuals provided valid responses to the questionnaire. The Spearman rank correlation coefficient between the HLS-Q12 and the HLS-EU-Q47 was r = 0.98 (p < 0.001), and eight of the nine hypotheses were supported. The ICC was 0.96 (p < 0.001), and the 95% limit of agreement was -0.26 ± 5.9, suggesting no systematic error. Thus, the Japanese version of the HLS-Q12 was found to be reliable with high criterion validity and reproducibility. Hence, the HLS-Q12 is a useful scale for measuring health literacy among older adults in Japan.
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Affiliation(s)
- Rika Matsuo
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Kimie Fujita
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
| | - Mami Miyazono
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Keiko Miyasaka
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Tomi Yamanaka
- Department of Nursing, School of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Kanako Yakushiji
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
| | - Atsushi Nagai
- The Regional Liaison Center for Fukuoka Dental College-Fukuoka Nursing College-Fukuoka College for Health Science, Fukuoka Dental College, Fukuoka, Japan
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Ditshwane B, Janse van Rensburg Z, Jacobs W. Health-related word recognition and pronunciation by patients in Gauteng, South Africa in English and native languages. Afr J Prim Health Care Fam Med 2024; 16:e1-e10. [PMID: 39099270 PMCID: PMC11304165 DOI: 10.4102/phcfm.v16i1.4492] [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: 02/09/2024] [Revised: 03/01/2024] [Accepted: 04/03/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Low health literacy has been found to affect people's ability to take care of their own health and follow the principles of disease prevention. Incomprehension of health education and healthcare instructions may lead to poor health outcomes. AIM The aim of the study was to describe and compare a sample of primary healthcare patient's ability to recognise and pronounce health-related words in English and in his or her native language. SETTING The study was conducted in 12 primary healthcare (PHC) clinics in Gauteng, South Africa. METHODS A prospective, quantitative, comparative research design using a survey method was used to assess the ability to recognise and pronounce health-related words of 401 respondents using the REALM-R (SA) tool. RESULTS Most respondents were 18-29 years (32%) and 30-49 years (53%) old. More than half (54%) of the respondents have completed grade 12 schooling. Adequate English health-related word recognition and pronunciation levels were at 19.5%, while native health-related word recognition and pronunciation levels were far better, ranging between 55.6% and 97.0%. CONCLUSION Respondents showed better word recognition and pronunciation of the health-related words in their native language than in English. Providing health information in the patient's native language and on their level of understanding may therefore improve patient health outcomes.Contribution: The study is the first of its kind to determine word recognition and pronunciation of health-related words in English and a native language of South African PHC patients. Knowing this may assist healthcare professionals to give health education and instructions on the patient's level of understanding.
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Affiliation(s)
- Boitumelo Ditshwane
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg.
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Rooth V, van der Aa H, Wisse RPL, Maarsingh OR, Koopmanschap M, Keunen JEE, Vermeulen H, Klaver CCW, Janssen G, van Rens GHMB, van Nispen RMA. Health economic evaluation of a nurse-assisted online eye screening in home healthcare to reduce avoidable vision impairment (iScreen): study protocol for a cluster randomized controlled trial. Trials 2024; 25:102. [PMID: 38308377 PMCID: PMC10835833 DOI: 10.1186/s13063-023-07882-0] [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: 10/06/2023] [Accepted: 12/15/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Among older people undiagnosed and untreated vision impairment and blindness are common. The leading causes are uncorrected refractive errors and cataracts. Vision problems are associated with a lower quality of life, several health problems, and a higher chance of falling accidents and fractures. To eliminate avoidable vision impairment and blindness, targeted eye screening programs are recommended. Older patients, receiving home healthcare, have not yet been considered as a population at risk who could benefit from eye screening. METHODS A cluster-randomized controlled trial will be conducted to investigate the cost-effectiveness and cost-utility of online nurse-assisted eye screening in home healthcare, compared to care as usual, in reducing avoidable vision impairment. A healthcare and societal perspective will be used. The study will be performed in collaboration with several home healthcare organizations in the Netherlands. The online eye screening consists of near and distance visual acuity, followed by an Amsler grading test. Measurements in both groups will take place at baseline and after 6 and 12 months of follow-up. A total of 240 participants will be recruited. Older men and women (65 +), who receive home-based nursing and are cognitively able to participate, will be included. The primary outcome will be the change of two lines or more on the Colenbrander-1 M visual acuity chart between baseline and 12-month follow-up. DISCUSSION An eye screening for populations at risk contributes to the detection of undiagnosed and untreated vision impairment. This may reduce the health-related consequences of vision loss and the high economic burden associated with vision impairment. TRIAL REGISTRATION ClinicalTrials.gov NCT06058637. Registered on 27 September 2023.
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Affiliation(s)
- Vera Rooth
- Department of Ophthalmology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
- Quality of Care, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands.
| | - Hilde van der Aa
- Department of Ophthalmology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Quality of Care, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Robert P L Wisse
- Department of Ophthalmology, UMC Utrecht, Utrecht, The Netherlands
| | - Otto R Maarsingh
- Quality of Care, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
- General Practice, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Marc Koopmanschap
- Erasmus School of Health Policy & Management, Health Technology Assessment (HTA), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jan E E Keunen
- Department of Ophthalmology, Radboudumc, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboudumc, Nijmegen, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Radboudumc, Nijmegen, The Netherlands
- Department of Ophthalmology, Erasmus MC, Rotterdam, The Netherlands
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | | | - Ger H M B van Rens
- Department of Ophthalmology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Quality of Care, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Ruth M A van Nispen
- Department of Ophthalmology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Quality of Care, Aging and Later Life, Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, The Netherlands
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Zhang H, Chen D, Wu J, Zou P, Cui N, Li D, Shao J, Tang L, Xue E, Ye Z, Wang X. Heterogenous subtypes of health literacy among individuals with Metabolic syndrome: a latent class analysis. Ann Med 2023; 55:2268109. [PMID: 37851734 PMCID: PMC10586064 DOI: 10.1080/07853890.2023.2268109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023] Open
Abstract
Objective To explore the heterogenous subtypes and the associated factors of health literacy among patients with metabolic syndrome.Methods A cross-sectional study was conducted, and 337 patients with metabolic syndrome were recruited from Sir Run Run Shaw Hospital in Zhejiang Province from December 2021 to February 2022. The Social Support Questionnaire, Short version of the Health Literacy Scale European Questionnaire (HLS-EU-Q16), and MacArthur Scale of Subjective Social Status were used for investigation. Latent class analysis (LCA) was performed to explore the heterogenous subtypes of health literacy among Metabolic syndrome patients. Univariate analysis and logistic regression were used to identify the predictors of the latent classes.Results The findings of LCA suggested that three heterogeneous subtypes of health literacy among individuals with metabolic syndrome were identified: high levels of health literacy, moderate levels of health literacy, and low levels of health literacy. The multinomial logistic regression results indicated that compared with low levels of health literacy class, the high levels of health literacy class were predicted by age (OR 0.932, 95%CI[0.900-0.966]), socio-economic status (OR 1.185, 95%CI[1.058-1.328]), and social support (OR 1.065, 95%CI[1.012-1.120]). Compared with low levels of health literacy class, the moderate levels of health literacy class were predicted by age (OR 0.964, 95%CI[0.934-0.995]), socio-economic status (OR 1.118, 95%CI[1.006-1.242]), male (OR 0.229, 95%CI[0.092-0.576]).Conclusion The levels of health literacy among patients with metabolic syndrome can be divided into three heterogenous subtypes. The results can inform policy-makers and care professionals to design targeted interventions for different subgroups among patients with metabolic syndrome who are male, at older age, have less social support, and with disadvantaged socio-economic status to improve health literacy.
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Affiliation(s)
- Hui Zhang
- Department of Nursing, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Dandan Chen
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Jingjie Wu
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Ping Zou
- Scholar Practitioner Program, School of Nursing, Nipissing University, Toronto, Ontario, Canada
| | - Nianqi Cui
- School of Nursing, Kunming Medical University, Kunming, China
| | - Dejie Li
- Department of Nursing, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Jing Shao
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Leiwen Tang
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Erxu Xue
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Zhihong Ye
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Xiyi Wang
- School of Nursing, Shanghai JiaoTong University, Shanghai, China
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Goyal AK, Bakshi J, Panda NK, Kapoor R, Vir D, Kumar K, Aneja P. Accuracy of a self-reported Measure in Psychological Assessment when the Instrument is self-administered by the Patient or when Administrated by the Clinician. Indian J Otolaryngol Head Neck Surg 2023; 75:1266-1270. [PMID: 37274986 PMCID: PMC10235333 DOI: 10.1007/s12070-022-03379-5] [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: 10/10/2021] [Accepted: 12/07/2022] [Indexed: 06/07/2023] Open
Abstract
Background Self-reported measures are the questionnaire-based instrument that are routinely used in the clinical scenario to assess psychological health. Technically, the self-reported measure should be administrated by the patients themselves but due to the complexity of tools and illiteracy among patients, clinicians often tend to interview the patients. Objective Present article aims to compare the accuracy of a self-reported measure in the assessment of the psychological health of a patient when the instrument is self-administrated by the patient and when administrated by the clinician or researcher. Methods We have recruited 43 patients of oral cancer in the study who have a tumor in the buccal mucosa region. The Hindi version of the shame and stigma scale was used to analyse the shame and stigma in patients. The questionnaire was first provided to the patient for the self-administration and after that clinician administrated the questionnaire to the patient by keeping the clinician blinded to the patient self-administrated responses. Results There was no significant difference in the global mean score and mean score of various subdomains of shame and stigma scale in the self-administered and clinician-administered mode of interview. However, the clinician-administered mode could provide more accurate measures as it helps the patient towards a better understanding of questions. Conclusion It is recommended that the newly developed or translated self-reported measure should be tested for both patient administrated and clinician administrated compatibility. Questionnaires could be administrated by the clinician in the case when the patient is illiterate or in the case when the patient does not understand the language of the instrument.
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Affiliation(s)
- Atul Kumar Goyal
- Department of Otolaryngology and Head & Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaimanti Bakshi
- Department of Otolaryngology and Head & Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh K Panda
- Department of Otolaryngology and Head & Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kapoor
- Department of Radiation Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Dharam Vir
- Department of Otolaryngology and Head & Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Kumar
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Aneja
- Department of Hindi, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Bergman L, Nilsson U, Dahlberg K, Jaensson M, Wångdahl J. Validity and reliability of the swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 questionnaires. BMC Public Health 2023; 23:724. [PMID: 37081538 PMCID: PMC10117247 DOI: 10.1186/s12889-023-15519-9] [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: 11/08/2022] [Accepted: 03/24/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Health Literacy is a crucial factor for health. In Europe, many people have limited health literacy (i.e. difficulties with accessing, understanding, appraising and using health information). This study aimed to evaluate the psychometrics of the Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6, instruments that aims to assess health literacy. METHODS In this prospective psychometric study convenience sampling was used, which gave a study population of 347 Swedish-speaking adults. The psychometric evaluation included item distributional statistics, construct validity testing, and principal component analysis to assess structural validity. Internal consistency and test-retest reliability was also investigated. RESULTS For the Swedish version of HLS-EU-Q16, no floor effects were detected but a ceiling effect was noted among 28% of the respondents. Construct validity was supported as four out of five expected correlations was confirmed (educational level, self-perceived health, electronic health literacy and HLS-EU-Q6). In terms of structural validity, the principal component analysis yielded a four-factor structure with most items loading significantly only to one factor. The Swedish version of HLS-EU-Q16 had acceptable internal consistency (Cronbach's α = 0.89, split-half reliability = 0.93) and test-retest reliability showed stability over time (Cohen's κ = 0.822). For the Swedish version of HLS-EU-Q6, neither floor nor ceiling effects were observed. Construct validity was supported as HLS-EU-Q6 correlated as our a priori stated hypothesis. The principal component analysis did not support the unidimensionality of the scale as a two-factor structure was identified. The Swedish version of HLS-EU-Q6 had acceptable internal consistency (Cronbach's α = 0.77, split-half reliability = 0.80) and test-retest reliability showed stability over time (Cohen's κ = 0.812). According to the Swedish version of the HLS-EU-Q16, 71% of the participants were classified as having sufficient comprehensive health knowledge (CHL), while only 33% were classified as having this when the HLS-EU-Q6 was used. CONCLUSIONS The Swedish versions of the HLS-EU-Q16 and HLS-EU-Q6 have acceptable psychometric properties, and based on the results we recommend its use to measure CHL. However, we are hesitant to use Sw-HLS-EU-Q6 in estimating different CHL levels and further studies need to be conducted to establish validity and accuracy of the thresholds of HLS-EU-Q6.
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Affiliation(s)
- Lina Bergman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
| | - Ulrica Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Karuna Dahlberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Josefin Wångdahl
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden.
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
- Aging Research Center, Karolinska Institutet & Stockholm University, Tomtebodavägen 18a, Solna, 171 77, Sweden.
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Andreu-March M, Aguas Compaired M, Mariño EL, Modamio P. Cross-cultural adaptation and validation of the Recognizing And Addressing Limited Pharmaceutical Literacy (RALPH) interview guide in community pharmacies. Res Social Adm Pharm 2023; 19:882-888. [PMID: 36868912 DOI: 10.1016/j.sapharm.2023.02.004] [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: 03/04/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The RALPH (Recognizing and Addressing Limited PHarmaceutical Literacy) interview guide makes it possible to identify patients with limited pharmaceutical knowledge and to assess their skills in the functional, communicative, and critical health literacy domains. OBJECTIVE (s): To perform a cross-cultural validation of the RALPH interview guide in Spanish population; to conduct a descriptive analysis based on patients' responses. METHODS A cross-sectional study of patients' pharmaceutical literacy skills was conducted in three stages: systematic translation, administration of the interview and analysis of psychometric properties. The target population included adult patients (≥18 years) who attend one of the participating community pharmacies in Barcelona (Spain). Content validity was evaluated by an expert committee. Viability was assessed in the pilot test, and reliability was assessed using internal consistency and intertemporal stability. Construct validity was assessed by factor analysis. RESULTS A total of 103 patients were interviewed at 20 pharmacies. Cronbach's alpha values based on standardized items ranged between 0.720 and 0.764. For the longitudinal component, the ICC test-retest reliability was 0.924. The factor analysis was verified by KMO (0.619) and Bartlett's test of sphericity (P-value <0.05). The definitive RALPH guide translated into Spanish maintains the same structure as the original. Some expressions were simplified, and the questions on the comprehension of warnings or specific instructions for use, contradictory information and shared decision-making were reformulated. Pharmaceutical literacy skills were seen to be most limited with regard to the critical domain. The responses of the Spanish patients were in agreement with the original results of the RALPH interview guide. CONCLUSIONS The RALPH interview guide in Spanish complies with the requirements viability, validity, and reliability. This tool may be able to identify the low pharmaceutical literacy skills of patients coming to community pharmacies in Spain, and its use may also be extended to other Spanish-speaking countries.
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Affiliation(s)
- Mònica Andreu-March
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028, Barcelona, Spain
| | - Margarita Aguas Compaired
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028, Barcelona, Spain; Pharmacy Service, University Hospital Sagrat Cor, C. Viladomat, 288, 08029, Barcelona, Spain
| | - Eduardo L Mariño
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028, Barcelona, Spain
| | - Pilar Modamio
- Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, 08028, Barcelona, Spain.
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Pedro AR, Raposo B, Luís L, Amaral O, Escoval A, Simões Dias S. Portuguese Version of the HLS-EU-Q6 and HLS-EU-Q16 Questionnaire: Psychometric Properties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2892. [PMID: 36833587 PMCID: PMC9957295 DOI: 10.3390/ijerph20042892] [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: 01/09/2023] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Health literacy refers to the competencies of individuals and the general population to navigate all the areas of health care, making health decisions. Health professionals need a set of skills and information to adapt to people's health literacy. To succeed, it is crucial to determine the health literacy level of a population, in this case, the Portuguese. This study aims to measure the psychometric properties of the Portuguese version of HLS-EU-Q16 and HLS-EU-Q6 from the long form of HLS-EU-Q47, already validated for Portugal. To analyse these results, a comparison was made with the HLS-EU-PT index. Spearman correlation analysis was performed between the single items and scale scores. Cronbach's alphas for all the indexes were calculated. For the statistical analysis, SPSS (version 28.0) was used. Cronbach's alpha coefficient for HLS-EU-PT-Q16 internal consistency was 0.89 overall, and for HLS-EU-PT-Q6 was 0.78 overall. Indexes were not normally distributed, and the Spearman correlation was computed. The correlation between G HL47 and G HL16 indexes was ρ = 0.95 (p < 0.001), and between G HL6 and HLS-EU-PT-Q6 was perfect. The HLS-EU-PT-Q16 and HLS-EU-PT-Q6 are concise and present adequate psychometric properties to measure the HL level of the Portuguese population. However, more similarities are found between the 47-item and the 16-item forms.
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Affiliation(s)
- Ana Rita Pedro
- NOVA National School of Public Health, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, 1600-560 Lisboa, Portugal
- NOVA National School of Public Health, Public Health Research Center, CISP, NOVA University Lisbon, 1600-560 Lisboa, Portugal
| | - Beatriz Raposo
- NOVA National School of Public Health, Public Health Research Center, CISP, NOVA University Lisbon, 1600-560 Lisboa, Portugal
| | - Luís Luís
- ciTechCare—Center for Innovative Care and Health Technology, Campus 5, Polytechnic of Leiria,
2410-541 Leiria, Portugal
- School of Health Sciences, Campus 2—Morro do Lena, Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Odete Amaral
- UICISA: E Research Centre, Public Health, Family and Community Nursing Unit, Health School of Viseu, Polytechnic Institute of Viseu, 3500-843 Viseu, Portugal
| | - Ana Escoval
- NOVA National School of Public Health, Comprehensive Health Research Center (CHRC), NOVA University Lisbon, 1600-560 Lisboa, Portugal
| | - Sara Simões Dias
- ciTechCare—Center for Innovative Care and Health Technology, Campus 5, Polytechnic of Leiria,
2410-541 Leiria, Portugal
- School of Health Sciences, Campus 2—Morro do Lena, Polytechnic of Leiria, 2411-901 Leiria, Portugal
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Zhuang M, Li CC, Chen SY, Tu XH, Liu L, Chen XL, Xu CW, Wang J. Development and validation of a Systemic Sclerosis Health Literacy Scale. Front Public Health 2023; 11:1038019. [PMID: 36908416 PMCID: PMC9996225 DOI: 10.3389/fpubh.2023.1038019] [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: 09/06/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
Background and aim Health literacy levels are strongly associated with clinical outcomes and quality of life in patients with chronic diseases, and patients with limited health literacy often require more medical care and achieve poorer clinical outcomes. Among the large number of studies on health literacy, few studies have focused on the health literacy of people with systemic sclerosis (SSc), and there is no specific tool to measure health literacy in this group. Therefore, this study plans to develop a health literacy scale for patients with SSc. Methods This study included 428 SSc patients from the outpatient and inpatient departments of the Department of Rheumatology and Immunology, the first affiliated Hospital of Anhui Medical University and the first affiliated Hospital of University of Science and Technology of China. The formulation of the scale was completed by forming the concept of health literacy of SSc patients, establishing the item pool, screening items, and evaluating reliability and validity. Classical measurement theory was used to screen items, factor analysis was used to explore the construct validity of the scale, and Cronbach's alpha coefficient was used to assess the internal consistency. Results Our study population was predominantly middle-aged women, with a male to female ratio of 1:5.7 and a mean age of 51.57 ± 10.99. A SSc Health Literacy scale with 6 dimensions and 30 items was developed. The six dimensions are clinic ability, judgment/evaluation information ability, access to information ability, social support, treatment compliance and application information ability. The Cronbach's alpha coefficient of the scale is 0.960, retest reliability is 0.898, split-half reliability is 0.953, content validity is 0.983, which has good reliability and validity. Conclusion The Systemic Sclerosis Health Literacy Scale may become a valid tool to evaluate the health literacy level of patients with SSc.
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Affiliation(s)
- Meng Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Medical Data Processing Center, Anhui Medical University, Hefei, China
| | - Cheng-Cheng Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Medical Data Processing Center, Anhui Medical University, Hefei, China
| | - Shan-Yu Chen
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xin-Hua Tu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Medical Data Processing Center, Anhui Medical University, Hefei, China
| | - Lian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Medical Data Processing Center, Anhui Medical University, Hefei, China
| | - Xi-Lai Chen
- Department of Statistics, College of Statistics and Applied Mathematics, Anhui University of Finance and Economics, Bengbu, China
| | - Cheng-Wei Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Medical Data Processing Center, Anhui Medical University, Hefei, China
| | - Jing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,Medical Data Processing Center, Anhui Medical University, Hefei, China
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Bouguettaya A, Gethin G, Probst S, Sixsmith J, Team V, Weller C. How health literacy relates to venous leg ulcer healing: A scoping review. PLoS One 2023; 18:e0279368. [PMID: 36652467 PMCID: PMC9847895 DOI: 10.1371/journal.pone.0279368] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The level of personal health literacy of patients with venous leg ulcers is likely to affect their ability to self-manage their condition impacting on their adherence to treatment and influences healing and recovery outcomes. OBJECTIVES To scope existing research that examined the level of health literacy in venous leg ulcer patients, to identify how this may link to self-management behaviours (particularly physical activity and compression adherence), and venous leg ulcer healing outcomes. METHODS This scoping review was based on the PRISMA-ScR six-stage framework. We searched MEDLINE, EMBASE, the Cochrane Library, PsycInfo and Health, Open Grey, and Google Scholar for publications examining general and specific health literacy in those with venous leg ulcers and for those examining any potential links of health literacy with self-management/healing generally, published between 2000-2020. This search was guided by a published protocol; studies that described other types of ulcers or did not examine health literacy were excluded. After applying inclusion and exclusion criteria the initial search identified 660 articles. RESULTS We included five articles. Four studies used randomised controlled trials or experimental designs to test the effect of specific health literacy interventions on venous leg ulcer knowledge, compression therapy use, or healing outcomes. One study was a cross- sectional survey with qualitative elements, assessing health literacy in venous leg ulcer patients. Broadly, the research suggested that health literacy was suboptimal amongst those with venous leg ulcers, and health literacy interventions had limited effects on improving key venous leg ulcer specific outcomes. CONCLUSION This review provides a synthesis of extant literature examining health literacy in patients with venous leg ulcers. We identified a dearth of literature investigating the value of general and specific health literacy interventions in this space. Most importantly, no recent research on general health literacy and venous leg ulcers was identified, despite strong theoretical utility to do so. The few studies identified largely indicated that targeting health literacy of patients with venous leg ulcers is a viable area of research and intervention, encouraging future researchers and clinicians to consider patient health literacy in venous leg ulcer management.
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Affiliation(s)
- Ayoub Bouguettaya
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- * E-mail: (CW); (AB)
| | - Georgina Gethin
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Sebastian Probst
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Care Directorate, University Hospital Geneva, Geneva, Switzerland
| | - Jane Sixsmith
- School of Health Sciences, National University of Ireland, Galway, Ireland
| | - Victoria Team
- Wound Research Group, School of Nursing and Midwifery, Monash University Melbourne, Victoria, Australia
| | - Carolina Weller
- Wound Research Group, School of Nursing and Midwifery, Monash University Melbourne, Victoria, Australia
- * E-mail: (CW); (AB)
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Rathmann K, Wetzel LD, Jordan S. [Health Literacy of People with and without Disabilities and Chronic Diseases in Germany: Results of the Study "German Health Update" 2014/2015-EHIS]. DAS GESUNDHEITSWESEN 2022; 84:1050-1058. [PMID: 35176791 PMCID: PMC11248583 DOI: 10.1055/a-1585-1420] [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: 10/19/2022]
Abstract
BACKGROUND People with disabilities and chronic diseases represent a population group in vulnerable circumstances, and often have difficulty finding, understanding, assessing, and applying health information. The aim of this study was to examine the health literacy of people doubly burdened with both disabilities and chronic diseases in comparison to two other groups, namely people with either disabilities or chronic diseases and people without impairment. MATERIAL AND METHODS Our data is based on the representative survey "German Health Update" 2014/2015-EHIS. The sample consists of n=21,647 people, including 2,875 (13.3%) people with disabilities and chronic diseases, 7,598 people (35.1%) with disability or chronic diseases and 11,174 (51.6%) people without impairment. Health literacy was measured using the short form of the questionnaire of the European Health Literacy Survey (HLS-EU-Q16). Uni, bi- and multivariate analyses were conducted. RESULTS 43.7% of respondents with both disabilities and chronic diseases had quite a lot difficulties in dealing with health information in comparison to people with disabilities or chronic diseases (37.7%) or those with no impairment (33.0%). People with double burdens had a 1.22-fold (CI: 1.10-1.35; p<0.001) and people with a single burden had a 1.08-fold (CI: 1.01-1.16; p=0.031) increased likelihood to find it difficult or very difficult to find, understand, evaluate and apply health-related information compared to people without impairment. CONCLUSION The results show a gradient to the disadvantage of people with disabilities and/or chronic diseases. Health literacy among people with disabilities and/or chronic diseases should be adequately promoted in order to support their health, their participation as well as the quality and efficiency of and the reduction of barriers to access health care.
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Affiliation(s)
- Katharina Rathmann
- Fachbereich Pflege und Gesundheit, Hochschule Fulda, Fulda, Deutschland
- Public Health Zentrum Fulda (PHZF)
| | | | - Susanne Jordan
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
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14
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Pelikan JM, Link T, Straßmayr C, Waldherr K, Alfers T, Bøggild H, Griebler R, Lopatina M, Mikšová D, Nielsen MG, Peer S, Vrdelja M. Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS 19-Q12 Instrument in Seventeen Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14129. [PMID: 36361025 PMCID: PMC9659295 DOI: 10.3390/ijerph192114129] [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: 10/05/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. METHODS For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. RESULTS The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form. CONCLUSIONS The HLS19-Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.
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Affiliation(s)
- Jürgen M. Pelikan
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
- HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Thomas Link
- Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, and HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Christa Straßmayr
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
- HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Karin Waldherr
- Ferdinand Porsche FernFH, A-2700 Wiener Neustadt, Austria
| | - Tobias Alfers
- Department of Education and Psychology, Freie Universität Berlin, 14195 Berlin, Germany
| | - Henrik Bøggild
- Public Health and Epidemiology, Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark
- Unit of Clinical Biostatistics, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - Robert Griebler
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
- HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Maria Lopatina
- National Medical Research Center for Therapy and Preventive Medicine, Ministry of Health of the Russian Federation, 101000 Moscow, Russia
| | - Dominika Mikšová
- Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, and HLS19 International Coordination Center at the Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Marie Germund Nielsen
- Public Health and Epidemiology, Health Science and Technology, Aalborg University, DK-9220 Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, DK-9000 Aalborg, Denmark
| | - Sandra Peer
- Institute for Water Quality and Resource Management, TU Wien, A-1040 Vienna, Austria
| | - Mitja Vrdelja
- National Institute of Public Health, 1000 Ljubljana, Slovenia
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15
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Knottnerus B, Heijmans M, Rademakers J. The role of primary care in informing and supporting people with limited health literacy in the Netherlands during the COVID-19 pandemic: a qualitative interview study. BMC PRIMARY CARE 2022; 23:115. [PMID: 35546226 PMCID: PMC9091153 DOI: 10.1186/s12875-022-01723-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/25/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, people have been confronted with a large amount of information about the virus and the governmental measures against its spreading. However, more than a quarter of individuals have limited health literacy (HL), meaning that they have difficulty finding, understanding, and applying health information. The purpose of this interview study was to investigate how individuals with limited HL acquire information about COVID-19 and governmental measures, what difficulties they experience in understanding and applying it, and what may be needed to overcome these difficulties. We also addressed other problems that they might face as a result of the pandemic. Using our findings, we aimed to make recommendations on the possible role of primary care in informing and supporting patients with limited HL during the pandemic. METHODS Between June and October 2020, 28 individuals with limited HL were interviewed by phone (age range 20-84). The interviews were semi-structured and focused on the first months of the pandemic in the Netherlands (March/April/May 2020). RESULTS The participants generally found COVID-19-related information abundant and complicated, and sometimes contradictory. Information provision by their own health care professionals was highly appreciated, especially in the context of chronic illnesses. General health care problems resulting from COVID-19 measures were postponement of regular care and difficulty with digital contacts. CONCLUSIONS Individuals with limited HL may benefit from provision of COVID-19-related information and support by their own health care providers. This applies in particular to patients with chronic illnesses. Primary care professionals are in the ideal position to take this role.
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Affiliation(s)
- Bart Knottnerus
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.
| | - Monique Heijmans
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
| | - Jany Rademakers
- Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands
- CAPHRI (Care and Public Health Research Institute), Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
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Michou M, Costarelli V. Validity and reliability of the european health literacy survey questionnaire (HLS_EU_Q16) in the greek language. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-211538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Having comprehensive and validated tools to effectively measure levels of Health Literacy (HL) in the general population is of great importance, since HL levels appear to be an crucial determinant of the population’s overall health. OBJECTIVE: The aim of the study was to validate the Greek version of the HLS_EU_Q16 questionnaire. METHODS: A total of 496 participants (81.8% women) participated in a self-administrated online, cross-sectional survey. The participants had to concurrently complete the Greek Version of HLS_EU_Q16 and the New Vital Sign (NVS). Certain socioeconomic and anthropometric characteristics also assessed. For test-retest reliability, 149 of the participants completed the questionnaire twice within a 15-day period. Principal Component Analysis, Cronbach’s a Spearman’s rho were used. RESULTS: All 3 factors assessed by the tool: “Health Care”, “Disease Prevention” and “Health Promotion”, had eigenvalues greater than 1. The Cronbach’s a was 0.884, for the total score of the HLS_EU_Q16 and 0.790, 0.710 and 0.800, for the above 3 subscales, respectively. Finally, test–retest reliability, after 15 days for the HLS_EU_Q16, resulted in Spearman’s correlation coefficient of r = 0.628 (p < 0.0001) which show a high correlation. CONCLUSIONS: Results indicate that the HLS_EU_Q16 is a reliable and valid tool for assessing HL in the Greek population.
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Affiliation(s)
- Maria Michou
- Human Ecology Laboratory, Department of Economics & Sustainable Development, Harokopio University, Athens, Greece
| | - Vassiliki Costarelli
- Human Ecology Laboratory, Department of Economics & Sustainable Development, Harokopio University, Athens, Greece
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Bergman L, Nilsson U, Dahlberg K, Jaensson M, Wångdahl J. Health literacy and e-health literacy among Arabic-speaking migrants in Sweden: a cross-sectional study. BMC Public Health 2021; 21:2165. [PMID: 34823499 PMCID: PMC8614220 DOI: 10.1186/s12889-021-12187-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022] Open
Abstract
Background Health inequities arise when the public cannot access and understand health information in an easy, accessible, and understandable way. Evidence supports that health literacy (HL) is a determinant for health outcomes, and when HL is limited this may have a major impact on morbidity as well as mortality. Migrants are known to have limited HL. Therefore, this study aimed to explore comprehensive health literacy (CHL) and electronic health literacy (eHL) among Arabic-speaking migrants in Sweden. Methods This was a cross-sectional observational study conducted in Sweden. A total of 703 persons were invited to participate between February and September 2019. Two questionnaires – the Health Literacy Survey European Questionnaire (HLS-EU-Q16) and the eHealth Literacy Scale (eHEALS) – and questions about self-perceived health and Internet use were distributed in Swedish and Arabic. Various statistical analyses were performed to determine the associations for limited CHL and eHL. Results A total of 681 respondents were included in the analysis. Of these, 334 (49%) were native Arabic-speaking migrants and 347 (51%) were native Swedish-speaking residents. CHL and eHL differed between the groups. The Arabic speakers had significantly lower mean sum scores in eHL 28.1 (SD 6.1) vs 29.3 (6.2), p = 0.012 and lower proportion of sufficient CHL 125 (38.9%) vs 239 (71.3%), p < 0.001 compared to Swedish speakers. Multiple regression analysis showed on associations between limited CHL and eHL and being Arabic speaking, less Internet use, and not finding the Internet to be important or useful. Furthermore, longer time spent in Sweden was associated with higher levels of CHL among the Arabic speakers, (OR 0.94, 95% CI 0.91–0.98, p < 0.01). Conclusions CHL and eHL differ between Arabic-speaking migrants and native Swedish speakers, but also between Arabic speakers who have lived different lengths of time in Sweden. Though it seems that the eHealth literacy is less affected by language spoken, the Internet is suggested to be an appropriate channel for disseminating health information to Arabic-speaking migrants. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12187-5.
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Affiliation(s)
- Lina Bergman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Box 23 300, 141 83, Huddinge, Sweden.
| | - Ulrica Nilsson
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Box 23 300, 141 83, Huddinge, Sweden.,Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Karuna Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Josefin Wångdahl
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Acceptability, quality of life and cost overview of a remote follow-up plan for patients with colorectal cancer. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 47:1637-1644. [DOI: 10.1016/j.ejso.2020.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/02/2020] [Accepted: 12/28/2020] [Indexed: 11/18/2022]
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Sponselee HCS, Kroeze W, Poelman MP, Renders CM, Ball K, Steenhuis IHM. Food and health promotion literacy among employees with a low and medium level of education in the Netherlands. BMC Public Health 2021; 21:1273. [PMID: 34193103 PMCID: PMC8243473 DOI: 10.1186/s12889-021-11322-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/18/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Prior research indicates a positive association between socioeconomic position and health literacy levels. We hypothesize comparable socioeconomic gradients for food literacy. This study aims to determine the level of self-perceived food literacy and health promotion literacy among adults with a low and medium level of education and from various subgroups, as well as the association between these food and health literacy levels. Furthermore, this study aims to explore the associations of self-perceived food literacy (SPFL) and health promotion literacy (HPL) in BMI. METHODS A cross-sectional study was conducted among employees with a low and medium level of education. Descriptive analyses were performed to compute SPFL and HPL levels. Analyses of variance were performed to test differences between subgroups. The correlation between SPFL and HPL was computed by Pearson's r. Multivariate linear regression analyses were used to explore 1) the association between SPFL and HPL adjusted for demographic characteristics 2) the associations between SPFL and HPL in BMI. RESULTS The majority (63.1%) of all participants (n = 222) scored low on SPFL and 34.5% scored inadequate or problematic on HPL. No significant educational or weight-status differences were found in SPFL or HPL levels. On most levels, women compared to men and older compared to younger employees scored significantly higher. A small positive correlation between the two mean levels was found, r = .25, P < .001 (n = 203). Multivariate linear regression analyses showed a significant association between SPFL and HPL (B = .31, 95% CI = .15-.48). No significant associations between SPFL and HPL in BMI were found. CONCLUSIONS This study suggests there is room for improvement in SPFL and HPL among adults with a low and medium level of education. Future research should consider comparing low and middle socioeconomic with high socioeconomic groups when exploring food and health literacy. Regarding health promotion activities for adults with a low and medium level of education, it is recommended to focus on improving both food and health literacy. Furthermore, more research is needed to explore direct proxies of weight-status to better understand the role of food and health literacy in overweight patterns.
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Affiliation(s)
- Hanne C S Sponselee
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands.
| | - Willemieke Kroeze
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands
- Care for Nutrition and Health Group, School of Nursing, Christian University of Applied Sciences, 6717 JS, Ede, The Netherlands
| | - Maartje P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University and Research, 6700 EW, Wageningen, The Netherlands
| | - Carry M Renders
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Sciences, VU University Amsterdam and Amsterdam Public Health Research Institute, 1081 HV, Amsterdam, Netherlands
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The Sociodemographic Determinants of Health Literacy in the Ethnic Hungarian Mothers of Young Children in Eastern Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115517. [PMID: 34063905 PMCID: PMC8196676 DOI: 10.3390/ijerph18115517] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 11/30/2022]
Abstract
Parental health literacy is a decisive factor for child health and quality of life. Children of parents with limited health literacy are at increased risk of illness and longer recovery periods. The research at the Quality of Life Research Centre is aimed at studying the health literacy of ethnic Hungarian mothers in Eastern Europe (Hungary, Slovakia, Romania) as well as at assessing its socioeconomic and demographic antecedents. The sample size is 894 mothers. Our standardized online questionnaire includes the HLS-EU-16 and the BHLS questions, with the latter intended to screen for inadequate health literacy. Predictors of health literacy in mothers are socioeconomic status, age and partnership status. A key finding is the improvement of health literacy with age. Assessing the association of partnership status and health literacy is a novelty in this region. Our analysis reinforces the role of socioeconomic capital, widely recognized to be associated with health literacy in general and with parental health literacy in particular. Results indicate the necessity of improving caregiver health literacy with a range of health promotional activities in Eastern Europe, especially among mothers with low socioeconomic status. The hardships of young mothers and single mothers should also be considered in this respect.
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Stephanie CJ, Mathieu A, Aurore M, Monique MRT. Outpatients' perception of their preoperative information regarding their health literacy skills and their preoperative anxiety level: Protocol for a prospective multicenter cross-sectional study. Medicine (Baltimore) 2021; 100:e26018. [PMID: 34011104 PMCID: PMC8136983 DOI: 10.1097/md.0000000000026018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/30/2021] [Indexed: 01/05/2023] Open
Abstract
Despite the benefits related to ambulatory surgery such as cost reduction due to lack of accommodation and patient satisfaction due to early home return, it may not lead to these expected benefits. Indeed, this kind of practice can increase responsibility for the person being treated and his or her relatives. It is therefore essential to inform them as well as possible to obtain their adherence to the proposed care protocol. Nevertheless, patients' failures to comply with preoperative instructions or the non-attendance of the patient may result in late cancellation of the scheduled surgery. In order to reduce this kind of dysfunction, the Assistance Publique-Hôpitaux de Paris (APHP) uses a reminder system by Short Message Service (SMS).This study is a descriptive cross-sectional multicenter study that focuses on outpatients' lived experiences of their preoperative preparation and information. It aims to collect patients' perceptions of their ability to follow preoperative instructions received by SMS the day before an operation performed for ambulatory surgery, according to their level of health literacy (HL) and preoperative anxiety. Indeed, poor communication between patients and doctors can contribute to preoperative anxiety, while low health literacy (LHL) can lead to poor understanding of preoperative preparation instructions. Therefore, it seems important to take these 2 criteria into account in this study. This research is designed to interview outpatients undergoing ambulatory surgery in the establishments of APHP. A self-questionnaire will be used for this purpose. The choice of this institution is justified by its decision to use in all care units the reminder of preoperative instructions by SMS.The main outcome is the perception of outpatients with LHL skills regarding preoperative information provided by doctors.French ethics review committee (Comité d'Ethique de la Recherche) of the University of Paris has approved the study protocol (IRB 00012020-14). Results from this study will be disseminated through oral communications and a scientific article in an international peer-reviewed journal.This protocol is registered on researchregistry.com (researchregistry5834). This version number is 1.1 Protocol dated July 22, 2020.
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Affiliation(s)
- Chandler-Jeanville Stephanie
- Sorbonne Paris Nord University, Chaire Recherche Sciences Infirmières, LEPS
- Assistance Publique Hôpitaux de Paris, Avicenne Hospital, Hôpitaux Universitaires Paris Seine-Saint-Denis, Anesthesia Department, Bobigny, France
| | - Ahouah Mathieu
- Sorbonne Paris Nord University, Chaire Recherche Sciences Infirmières, LEPS
| | - Margat Aurore
- Sorbonne Paris Nord University, Chaire Recherche Sciences Infirmières, LEPS
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Dsouza JP, Van den Broucke S, Pattanshetty S. Validity and Reliability of the Indian Version of the HLS-EU-Q16 Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020495. [PMID: 33435372 PMCID: PMC7827499 DOI: 10.3390/ijerph18020495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/17/2020] [Accepted: 01/06/2021] [Indexed: 11/24/2022]
Abstract
Health literacy is a key topic in public health. Several measurement tools exist that operationalize health literacy, but only a few standard tools measure health literacy at a population level, and none of those are currently available for the Indian context. This study aimed to develop and validate an Indian version of the short form of the European Health literacy Questionnaire (HLS-EU Q16). Following the translation of the English version of the questionnaire in Hindi and Kannada by language experts and confirmation of the item content by health literacy experts, the questionnaire was administered to 158 Hindi speaking and 182 Kannada speaking individuals, selected via purposive sampling. Pearson’s correlation was used to confirm test–retest reliability, and confirmatory factor analysis was used to assess the construct validity of the scales in both languages. Cronbach’s alpha was calculated for the scales and their sub-domains, and item-total correlations were used to calculate item discriminant indices. Discriminant validity was examined by comparing scores of participant groups based on educational status and training in health care. Cronbach’s alpha for the Hindi version of the tool (HLS-IND-HIN-Q16) was 0.98, and for Kannada version (HLS-IND-KAN-Q16) 0.97. Confirmatory factor analysis produced fit indices within acceptable limits. The results allowed us to conclude that the two Indian language questionnaires allow valid and reliable measurements of health literacy among the Hindi and Kannada speaking population of India.
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Affiliation(s)
- Jyoshma Preema Dsouza
- Psychological Sciences Research Institute, Université catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
- Correspondence: ; Tel.: +32-486-431-672
| | - Stephan Van den Broucke
- Psychological Sciences Research Institute, Université catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
| | - Sanjay Pattanshetty
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal University, Manipal 576104, India;
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Bas-Sarmiento P, Poza-Méndez M, Fernández-Gutiérrez M, González-Caballero JL, Falcón Romero M. Psychometric Assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic/French-Speaking Migrants in Southern Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218181. [PMID: 33167475 PMCID: PMC7663905 DOI: 10.3390/ijerph17218181] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/21/2020] [Accepted: 10/30/2020] [Indexed: 11/16/2022]
Abstract
Improving health literacy (HL) is critical for addressing health inequalities. Low literacy rates are believed to be more prevalent in ethnic minorities, which may have an impact on people's health. For measures to be implemented in this regard, HL must be evaluated to obtain specific indicators. Our aim, therefore, was to develop a version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16), which is recommended to be used with vulnerable populations, suited to Arabic/French-speaking migrants who reside in south-eastern Spain, and to explore its psychometric properties for assessing health literacy in this population. A cross-sectional survey was carried out in a convenient sample of 205 migrants. The structural validity was calculated by a confirmatory factorial analysis (CFA), which suggested appropriate adjustment indicators, and which indicated that the three-dimensional model is adequately adjusted to the data obtained in the study. The coefficient omega showed high internal consistency in the three HL dimensions (health care, disease prevention, and health promotion). Concurrent validity presented a significant correlation with the Newest Vital Sign test (r = 0.390; p < 0.001). The multigroup CFA showed that the heterogeneity of the sample used was not a problem for establishing the structural validity of the scale. The Arabic/French version showed good construct validity.
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Affiliation(s)
- Pilar Bas-Sarmiento
- Department of Nursing and Physiotherapy, University Institute of Research in Social Sustainable Development (INDESS), University of Cadiz, 11009 Cadiz, Spain;
| | - Miriam Poza-Méndez
- Department of Nursing and Physiotherapy, Faculty of Nursing, University of Cadiz, 11207 Cadiz, Spain;
| | - Martina Fernández-Gutiérrez
- Department of Nursing and Physiotherapy, University Institute of Research in Social Sustainable Development (INDESS), University of Cadiz, 11009 Cadiz, Spain;
- Correspondence: ; Tel.: +34-956-028-122
| | - Juan Luis González-Caballero
- Department of Statistics and Operational Research, Faculty of Medicine, University of Cadiz, 11003 Cadiz, Spain;
| | - María Falcón Romero
- Department of Socio-Sanitary Sciences, University of Murcia, 30100 Murcia, Spain;
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Rolova G, Gavurova B, Petruzelka B. Exploring Health Literacy in Individuals with Alcohol Addiction: A Mixed Methods Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6728. [PMID: 32942763 PMCID: PMC7558488 DOI: 10.3390/ijerph17186728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/08/2020] [Accepted: 09/12/2020] [Indexed: 11/16/2022]
Abstract
This mixed methods research paper explores health literacy (HL) in individuals with alcohol addiction by using the 47-item version of the European Health Literacy Survey Questionnaire (HLS-EU-Q47) and semi-structured interviews concerning health-related competencies (access, understand, appraise, and apply health information), and determines the limitations of the HLS-EU-Q47 when used under specific conditions of clinical practice. The questionnaire survey and the interviews were conducted with individuals of different health literacy levels who were undergoing inpatient alcohol addiction treatment. The findings indicate that individuals with alcohol addiction might require different types of health information according to their health literacy level in terms of quantity and quality of information to recover from alcohol addiction and improve their overall health. The implications for the clinical practice of addiction treatment as well as recommendations for national and regional policy are also discussed.
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Affiliation(s)
- Gabriela Rolova
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Apolinarska 4, 128 00 Prague 2, Czech Republic; (G.R.); (B.P.)
| | - Beata Gavurova
- Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Letna 9, 042 00 Košice, Slovakia
| | - Benjamin Petruzelka
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Apolinarska 4, 128 00 Prague 2, Czech Republic; (G.R.); (B.P.)
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Kosicka B, Deluga A, Bąk J, Chałdaś-Majdańska J, Bieniak M, Machul M, Chrzan-Rodak A, Jurek K, Dobrowolska B. The Level of Health Literacy of Seniors Living in Eastern Region of Poland. Preliminary Study. Healthcare (Basel) 2020; 8:healthcare8030277. [PMID: 32824553 PMCID: PMC7551014 DOI: 10.3390/healthcare8030277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/08/2020] [Accepted: 08/15/2020] [Indexed: 11/16/2022] Open
Abstract
Health literacy (HL) is recognised as an important, modifiable factor in the self-management and health performance of elderly people. The aim of this preliminary study was to identify and analyse the level of health literacy among the elderly living in one of the eastern regions in Poland. The cross-sectional study was conducted among a convenience sample of 200 seniors aged 65+ after cognitive pre-screening with the use of the Montreal Cognitive Assessment (MoCA) scale. To collect data, the Polish version of the HLS-EU-Q47 was used. More than half of the elderly surveyed presented problematic levels of general HL (GEN-HL), and also problematic levels of other dimensions: health care health literacy (HC-HL), disease prevention health literacy (DP-HL), and health promotion health literacy (HP-HL). The level of seniors' HL is dependent on the level of their education, place of living, participation in activities run by Daily Center for the Elderly, and their self-assessment of health condition (p < 0.05). These results imply the important message that there is a need to create initiatives and programs improving health literacy targeted at seniors living in rural areas, those with lower levels of education, and those with poor access to activities organised by institutions supporting seniors.
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Affiliation(s)
- Bogumiła Kosicka
- Department of Management in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Alina Deluga
- Department of Family Medicine and Community Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (A.D.); (A.C.-R.)
| | - Jadwiga Bąk
- Department of Paediatric Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Justyna Chałdaś-Majdańska
- Department of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (J.C.-M.); (M.B.); (M.M.)
| | - Monika Bieniak
- Department of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (J.C.-M.); (M.B.); (M.M.)
| | - Michał Machul
- Department of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (J.C.-M.); (M.B.); (M.M.)
| | - Agnieszka Chrzan-Rodak
- Department of Family Medicine and Community Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (A.D.); (A.C.-R.)
| | - Krzysztof Jurek
- Faculty of Social Sciences, Institute of Sociology, John Paul II Catholic University, 20-950 Lublin, Poland;
| | - Beata Dobrowolska
- Department of Development in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland; (J.C.-M.); (M.B.); (M.M.)
- Correspondence:
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Bollweg TM, Okan O, Pinheiro P, Bröder J, Bruland D, Freţian AM, Domanska OM, Jordan S, Bauer U. Adapting the European Health Literacy Survey for Fourth-Grade Students in Germany: Questionnaire Development and Qualitative Pretest. Health Lit Res Pract 2020; 4:e119-e128. [PMID: 32392350 PMCID: PMC7213025 DOI: 10.3928/24748307-20200326-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/23/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Promoting health literacy in early life is regarded as an important means of sustaining health literacy and health over the life course. However, little evidence is available on children's health literacy, partly due to a scarcity of suitable measurement tools. Although there are 18 tools to measure specific items of health literacy for people younger than age 13 years, there is a lack of comparable, valid, and age-appropriate measures of generic health literacy. OBJECTIVE This study aimed to develop and qualitatively test an age-adapted version of the European Health Literacy Survey Questionnaire (HLS-EU-Q) for German-speaking children age 9 and 10 years. Although validated for adults and adolescents, the HLS-EU-Q has never been age-adapted or used with children. METHODS The content and language of HLS-EU-Q items were adapted for this age range. The literature was consulted to inform this process, and adaptations were developed and selected based on consensus among authors. From an item pool of 102 adapted items, 37 were given to 30 fourth-grade students in a cognitive pretest, which is a standard procedure in questionnaire development aiming to explore how items are interpreted. Participants (18 girls, 12 boys) were mostly age 9 or 10 years (range, 9-11 years). KEY RESULTS Problems with misinterpretation were identified for some items and participants (e.g., items designed to assess participants' perceived difficulty in accessing and appraising health information were partly answered on the basis of knowledge and experience). A final selection of 26 well-performing items corresponded to the underlying HLS-EU-Q framework. CONCLUSIONS This is the first age-adapted version of the HLS-EU-Q. A preliminary 26-item questionnaire was successfully developed that performed well in a cognitive pretest. However, further research needs to verify its validity and reliability. The present findings help to advance the measurement of generic self-reported health literacy in children and highlight the need for cognitive pretesting as an essential part of questionnaire development. [HLRP: Health Literacy Research and Practice. 2020;4(2):e119-e128.] PLAIN LANGUAGE SUMMARY: The European Health Literacy Survey Questionnaire is used for testing adults' health literacy. It was adapted for German-speaking children age 9 and 10 years. Based on a review of the original items and the literature, 26 questionnaire items were developed and tested in interviews with 30 children. Although problems with understanding could be identified, the questionnaire was mostly well understood.
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Affiliation(s)
- Torsten Michael Bollweg
- Address correspondence to Torsten Michael Bollweg, MA, Centre for Prevention and Intervention in Childhood and Adolescence, Faculty of Educational Science, Bielefeld University, Universitaetsstrasse 25, 33615 Bielefeld, Germany;
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Storms H, Aertgeerts B, Vandenabeele F, Claes N. General practitioners' predictions of their own patients' health literacy: a cross-sectional study in Belgium. BMJ Open 2019; 9:e029357. [PMID: 31519674 PMCID: PMC6747646 DOI: 10.1136/bmjopen-2019-029357] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To support patients in their disease management, providing information that is adjusted to patients' knowledge and ability to process health information (ie, health literacy) is crucial. To ensure effective health communication, general practitioners (GPs) should be able to identify people with limited health literacy. To this end, (dis)agreement between patients' health literacy and GPs' estimations thereof was examined. Also, characteristics impacting health literacy (dis)agreement were studied. DESIGN Cross-sectional survey of general practice patients and GPs undertaken in 2016-17. SETTING Forty-one general practices in two Dutch-speaking provinces in Belgium. PARTICIPANTS Patients (18 years of age and older) visiting general practices. Patients were excluded when having severe impairments (physical, mental, sensory). MAIN OUTCOME MEASURES Patients' health literacy was assessed with 16-item European Health Literacy Survey Questionnaire. GPs indicated estimations on patients' health literacy using a simple scale (inadequate; problematic; adequate). (Dis)agreement between patients' health literacy and GPs' estimations thereof (GPs' estimations being equal to/higher/lower than patients' health literacy) was measured using Kappa statistics. The impact of patient and GP characteristics, including duration of GP-patient relationships, on this (dis)agreement was examined using generalised linear logit model. RESULTS Health literacy of patients (n=1375) was inadequate (n=201; 14.6%), problematic (n=299; 21.7%), adequate (n=875; 63.6%). GPs overestimated the proportion patients with adequate health literacy: adequate (n=1241; 90.3%), problematic (n=130; 9.5%) and inadequate (n=4; 0.3%). Overall, GPs' correct; over-/underestimations of health literacy occurred for, respectively, 60.9%; 34.2%; 4.9% patients, resulting in a slight agreement (κ=0.033). The likelihood for GPs to over-/underestimate patients' health literacy increases with decreasing educational level of patients; and decreasing number of years patients have been consulting with their GP. CONCLUSIONS Intuitively assessing health literacy is difficult. Patients' education, the duration of GP-patient relationships and GPs' gender impact GPs' perceptions of patients' health literacy.
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Affiliation(s)
- Hannelore Storms
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Bert Aertgeerts
- Academic Centre for General Practice, Department of Public Health and Primary Care, Leuven, Belgium
| | - Frank Vandenabeele
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Neree Claes
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Faculty Leadership, Health Care Management, Antwerp Management School, Antwerpen, Belgium
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Paiva D, Silva S, Severo M, Moura-Ferreira P, Lunet N, Azevedo A. Validation of the Short Assessment of Health Literacy in Portuguese-speaking Adults in Portugal. GACETA SANITARIA 2019; 34:435-441. [PMID: 31155446 DOI: 10.1016/j.gaceta.2019.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To validate the Brazilian version of the Short Assessment of Health Literacy in Portuguese-speaking Adults (SAHLPA), a 50-item test proposed as a particularly helpful instrument to assess health literacy in people with limited skills, in the Portuguese population. METHODS We used the standard procedure for cultural adaptation and administered the instrument to 249 participants. We examined construct validity using groups with expectedly increasing levels of health literacy (laypersons from the general population, engineering researchers, health researchers, and physicians), and through association with age and educational attainment, dichotomizing scores at the median of the layperson's group. RESULTS Exploratory factor analysis revealed the instrument was one-dimensional and justified reduction to 33 items. SAHLPA-33 displayed adequate reliability (Cronbach's α = 0.73). The frequency of limited health literacy was highest among laypersons and lowest among physicians (p <0.001; p for trend <0.001). The proportion of participants with limited health literacy decreased with increasing education attainment (age- and sex-adjusted p for trend <0.001). Limited health literacy also tended to decrease with age, although the association was non-significant (sex- and education-adjusted p for trend = 0.067). CONCLUSION We culturally adapted a brief and simple instrument for health literacy assessment, and showed it was valid and fairly reliable. In Portuguese low-literate adults, SAHLPA-33 fills the gap in health literacy assessment instruments, and may be used to guide communication strategies with vulnerable patients and communities.
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Affiliation(s)
- Dagmara Paiva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; USF Monte Murado, ACeS Espinho-Gaia, ARS Norte, Vila Nova de Gaia, Portugal.
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | | | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Azevedo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal; Centro de Epidemiologia Hospitalar, Centro Hospitalar São João, Porto, Portugal
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Rouquette A, Nadot T, Labitrie P, Van den Broucke S, Mancini J, Rigal L, Ringa V. Validity and measurement invariance across sex, age, and education level of the French short versions of the European Health Literacy Survey Questionnaire. PLoS One 2018; 13:e0208091. [PMID: 30521552 PMCID: PMC6283623 DOI: 10.1371/journal.pone.0208091] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 11/12/2018] [Indexed: 01/23/2023] Open
Abstract
Background Short versions of the European Health Literacy Survey (HLS-EU) questionnaire are increasingly used to measure and compare health literacy (HL) in populations worldwide. As no validated versions of these questionnaires have thus far appeared in French, this study aimed to study the psychometric properties of the French translation of the 16- and 6-item short versions (HLS-EU-Q16 and HLS-EU-Q6), including their measurement invariance across sex, age, and education level. Methods A consensual French version of the HLS-EU-Q16 and HLS-EU-Q6 was developed by following the current recommendations for transcultural questionnaire adaptation. It was then completed by 317 patients recruited in waiting rooms of general practitioners in the Paris area (France). Structural validity was studied with the Rasch model for the HLS-EU-Q16 and confirmatory factorial analysis (CFA) for the HLS-EU-Q6. Concurrent and convergent validity, respectively, were assessed by scores on the Functional Communicative Critical Health Literacy (FCCHL) questionnaire and the physicians’ evaluations of their patient’s HL. Results The 16 items of the HLS-EU-Q16 were Rasch homogenous but meaningful differential item functioning (DIF) was found across sex, age, and/or education level for eight items. The CFA model fit for the HLS-EU-Q6 was poor. The overall scores for both HLS-EU short versions correlated poorly with the FCCHL scores. Similarly, HL levels defined using either short-version score did not agree with physicians’ HL assessments. Conclusion The French version of the HLS-EU-Q16 has acceptable psychometric properties, despite meaningful DIF for age, sex and education level and a poor discriminative power among subjects with average to high HL level. We recommend its use to measure HL in populations with sufficient reading skills to discriminate between subjects with low to average HL. Also, sensitivity analyses should be performed to evaluate the potential measurement bias due to DIF. Our results did not demonstrate the validity of the HLS-EU-Q6.
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Affiliation(s)
- Alexandra Rouquette
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- AP-HP, Bicêtre Hôpitaux Universitaires Paris Sud, Public Health and Epidemiology Department, Le Kremlin-Bicêtre, France
| | - Théotime Nadot
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Pierre Labitrie
- Université Paris-Saclay, Univ. Paris-Sud, General Practice Department, Le Kremlin-Bicêtre, France
| | | | - Julien Mancini
- Aix-Marseille Univ, INSERM, IRD, UMR1252, SESSTIM, “Cancers, Biomedicine & Society” group, Marseille, France
- APHM, Timone Hospital, Public Health Department (BIOSTIC), Marseille, France
| | - Laurent Rigal
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Université Paris-Saclay, Univ. Paris-Sud, General Practice Department, Le Kremlin-Bicêtre, France
- Institut National d’Etudes Démographiques (INED), Paris, France
- * E-mail:
| | - Virginie Ringa
- Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
- Institut National d’Etudes Démographiques (INED), Paris, France
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[Health literacy: psychometric behaviour of the HLS-EU-Q16 questionnaire]. GACETA SANITARIA 2018; 34:399-402. [PMID: 30473252 DOI: 10.1016/j.gaceta.2018.08.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/25/2018] [Accepted: 08/12/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To describe the psychometric properties and the level of understanding of the health literacy questionnaire HLS-EU-Q16 in Spanish, implemented in the Health Survey of the Valencian Region (Spain) of 2016. METHOD Descriptive cross-sectional study to describe understanding, reliability, structure and internal consistency of the questionnaire on a sample of 5485 subjects, aged 15 or over, who participated in the survey. RESULTS The percentages of understanding without much difficulty were high. Reliability was high (intraclass correlation coefficient:.923; kappa:.814). The factorial analysis suggested a unifactorial structure (79.1% of variability explained by the common factor), with high factorial loads. The consistency was high (Cronbach's alpha: 0.982). CONCLUSIONS The HLS-EU-Q16 in Spanish is a short, adequate and valid instrument to measure the level of health literacy in the population.
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Rew L, Saenz A, Walker LO. A systematic method for reviewing and analysing health information on consumer-oriented websites. J Adv Nurs 2018; 74:2218-2226. [PMID: 29845648 DOI: 10.1111/jan.13726] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 04/04/2018] [Indexed: 11/27/2022]
Abstract
AIM A discussion of a proposed method for analysing the quality of consumer-oriented websites that provide health-related information. BACKGROUND The quality of health information available to consumers online varies widely in quality. In an effort to improve the quality of online information, experts have undertaken systematic reviews on selected health topics; however, no standardized comprehensive methodology currently exists for such review. DESIGN An eight-step method is recommended embracing the following steps: (a) select topic; (b) determine the purpose of the analysis; (c) select search terms and engines; (d) develop and apply website inclusion and exclusion criteria; (e) develop processes and tools to manage search results; (f) specify measures of quality; (g) compute readability; (h) evaluate websites. Each of these steps is illustrated in relation to the health topic of gynaecomastia, a physical and mental health challenge for many adolescent males and young men. IMPLICATIONS FOR NURSING Although most extant analyses of consumer-oriented websites have focused on disease conditions and their treatment, website analysis methodology would encourage analyses that fall into the nursing care domain. CONCLUSION The method outlined in this paper is intended to provide nurses and others who work with specific patient populations with the tools needed for website analytic studies. Such studies provide a foundation for making recommendations about quality websites, and identifying gaps in online information for health consumers.
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Affiliation(s)
- Lynn Rew
- School of Nursing, The University of Texas, Austin, TX
| | - Ashley Saenz
- School of Nursing, The University of Texas, Austin, TX
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