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McKinn S, Chapman N, Sharman JE, Nash R, Nelson MR, Sutton L, Yung C, Doust J, Hawkes AL, Bonner C. How do general practitioners manage patient health literacy differences in cardiovascular disease prevention consultations? An interview study. PATIENT EDUCATION AND COUNSELING 2024; 125:108299. [PMID: 38657560 DOI: 10.1016/j.pec.2024.108299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/12/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Low health literacy is associated with worse health outcomes, including for cardiovascular disease (CVD). However, general practitioners (GPs) have limited support to identify and address patient health literacy needs in CVD prevention consultations. This study explored GPs' experiences of patient health literacy needs during CVD risk assessment and management consultations. METHODS Semi-structured interviews with 18 GPs in Tasmania, Australia in 2021. A Framework Analysis approach was used to code transcripts to a thematic framework. RESULTS GPs perceptions on patient health literacy informed three themes: 1. Methods of estimating health literacy; 2. GPs' perceptions about the impact of health literacy on CVD prevention including risk factor knowledge and behaviours; and 3. Strategies for communicating with patients experiencing health literacy challenges. The findings show that while no formal tools were used to assess health literacy in this sample, perceived health literacy can change GPs' communication and prevention strategies. CONCLUSION The findings raise concerns about the equity of choices made available to patients, based on subjective perceptions of their health literacy level. PRACTICE IMPLICATION GPs could be better supported to assess and address patient health literacy needs in CVD prevention consultations.
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Affiliation(s)
- Shannon McKinn
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia
| | - Niamh Chapman
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Rosie Nash
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Mark R Nelson
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Laura Sutton
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Cassia Yung
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia
| | - Jenny Doust
- Australian Women and Girls' Health Research (AWaGHR) Centre, University of Queensland, Queensland, Australia
| | - Anna L Hawkes
- School of Public Health, University of Queensland, Queensland, Australia
| | - Carissa Bonner
- Sydney Health Literacy Lab, University of Sydney, Sydney, Australia; Menzies Centre for Health Policy & Economics, University of Sydney, Sydney, Australia.
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Istiko SN, Remata S, Ndayizeye A, Moreno MEV, Kirunda V, Hollingdrake O, Osborne R, Hou JZ, Abell B, Mullens AB, Gu Z, Debattista J, Vujcich D, Lobo R, Parma G, Howard C, Durham J. Developing critical HIV health literacy: insights from interviews with priority migrant communities in Queensland, Australia. CULTURE, HEALTH & SEXUALITY 2024; 26:936-951. [PMID: 37950430 DOI: 10.1080/13691058.2023.2265960] [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: 03/13/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).
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Affiliation(s)
- Satrio Nindyo Istiko
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Simeon Remata
- Queensland Positive People, Brisbane, Queensland, Australia
- ACON, Sydney, New South Wales, Australia
| | - Aimable Ndayizeye
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Miguel Eduardo Valencia Moreno
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vanessa Kirunda
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Olivia Hollingdrake
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard Osborne
- Department of Health and Medical Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jenny Zhengye Hou
- Faculty of Creative Industries, Education, and Social Justice, School of Communication/Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bridget Abell
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy B Mullens
- Centre for Health Research, School of Psychology and Wellbeing, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Daniel Vujcich
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gianna Parma
- True Relationships & Reproductive Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Jo Durham
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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Borge CR, Larsen MH, Osborne RH, Aas E, Kolle IT, Reinertsen R, Lein MP, Thörn M, Lind RM, Groth M, Strand O, Andersen MH, Moum T, Engebretsen E, Wahl AK. Impacts of a health literacy-informed intervention in people with chronic obstructive pulmonary disease (COPD) on hospitalization, health literacy, self-management, quality of life, and health costs - A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2024; 123:108220. [PMID: 38458089 DOI: 10.1016/j.pec.2024.108220] [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: 07/07/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To compare the effect of motivational interviewing (MI) and tailored health literacy (HL) follow-up with usual care on hospitalization, costs, HL, self-management, Quality of life (QOL), and psychological stress in people with chronic obstructive pulmonary disease (COPD). METHODS A RCT was undertaken in Norway between March 2018-December 2020 (n = 127). The control group (CG, n = 63) received usual care. The intervention group (IG, n = 64) received tailored HL follow-up from MI-trained COPD nurses with home visits for eight weeks and phone calls for four months after hospitalization. Primary outcomes were hospitalization at eight weeks, six months, and one year from baseline. The trial was registered with ClinicalTrials.gov (NCT03216603) and analysed per protocol. RESULTS Compared with the IG, the CG had 2.8 higher odds (95% CI [1.3 to 5.8]) of hospitalization and higher hospital health costs (MD=€ -6230, 95% CI [-6510 to -5951]) and lower QALYs (MD=0.1, 95% CI [0.10 to 0.11]) that gives an ICER = - 62,300. The IG reported higher QOL, self-management, and HL (p = 0.02- to <0.01). CONCLUSION MI-trained COPD nurses using tailored HL follow-up is cost-effective, reduces hospitalization, and increases QOL, HL, and self-care in COPD. PRACTICE IMPLICATION Tailored HL follow-up is beneficial for individuals with COPD and the healthcare system.
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Affiliation(s)
- Christine R Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal Hospital, Oslo, Norway.
| | - Marie H Larsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway
| | - Richard H Osborne
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Eline Aas
- Department of Health Management and Health Economics, University of Oslo, Norway; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | | | | | | | - Oda Strand
- Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Torbjørn Moum
- Department of Behavioral Sciences in Medicine, University of Oslo, Norway
| | - Eivind Engebretsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway
| | - Astrid K Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway
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Hogan A, Hughes L, Coyne E. Nurses' assessment of health literacy requirements for adult inpatients: An integrative review. Health Promot J Austr 2024; 35:504-517. [PMID: 37443427 DOI: 10.1002/hpja.780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
ISSUE ADDRESSED This paper reviews current research which examines nurses' assessment of patient's health literacy in the acute hospital setting. Research highlights, that patients with low health literacy have more frequent hospitalisations and are more likely to be re-admitted. Within the healthcare team, nurses are primarily responsible for teaching patients and deciphering health communication, to enhance understanding. Within the acute care setting, there remains a disparity in patient understanding of information, despite nurse-led education. The health literacy assessment and tailoring of information by nurses, is becoming more important with shorter stays, plus limited family visits and the wearing of masks with COVID-19 related changes. METHODS An integrative review across four nursing databases, from 2010 and June 2022 was conducted. The integrative framework included problem identification, literature search, data evaluation, data analysis with thematic analysis, and results presentation. RESULTS Nine studies were included. Common themes were nurses' overestimation of patients' health literacy, the use of universal precautions, and adapting communication techniques to improve education moments. CONCLUSION The findings of this review indicate a tendency among nurses to overestimate their patients' health literacy levels, which can result in ineffective health education and inadequate discharge planning. SO WHAT Nurses decipher health communication for their patients. Designing tailored patient communication and education could potentially be a cost saving measure for hospitals by reducing length of stay and reducing readmissions. Health literacy training should be incorporated into nursing practice.
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Affiliation(s)
- Alana Hogan
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- Caboolture Hospital, Caboolture, Queensland, Australia
| | - Lynda Hughes
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
| | - Elisabeth Coyne
- School of Nursing and Midwifery, Griffith University, Nathan, Australia
- School of Nursing and Midwifery, University of Southern Denmark, Odense, Denmark
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Vlassak EME, Miteniece E, Keulen JKJ, Gravendeel M, Korstjens I, Budé L, Hendrix MJC, Nieuwenhuijze MJ. Development of the Conversational Health Literacy Assessment Tool for maternity care (CHAT-maternity-care): participatory action research. BMC Health Serv Res 2024; 24:135. [PMID: 38267977 PMCID: PMC10809538 DOI: 10.1186/s12913-024-10612-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/17/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Limited health literacy in (expectant) parents is associated with adverse health outcomes. Maternity care providers often experience difficulties assessing (expectant) parents' level of health literacy. The aim was to develop, evaluate, and iteratively adapt a conversational tool that supports maternity care providers in estimating (expectant) parents' health literacy. METHODS In this participatory action research study, we developed a conversational tool for estimating the health literacy of (expectant) parents based on the Conversational Health Literacy Assessment Tool for general care, which in turn was based on the Health Literacy Questionnaire. We used a thorough iterative process including different maternity care providers, (expectant) parents, and a panel of experts. This expert panel comprised representatives from knowledge institutions, professional associations, and care providers with whom midwives and maternity care assistants work closely. Testing, evaluation and adjustment took place in consecutive rounds and was conducted in the Netherlands between 2019 and 2022. RESULTS The conversational tool 'CHAT-maternity-care' covers four key domains: (1) supportive relationship with care providers; (2) supportive relationship within parents' personal network; (3) health information access and comprehension; (4) current health behaviour and health promotion. Each domain contains multiple example questions and example observations. Participants contributed to make the example questions and example observations accessible and usable for daily practice. The CHAT-maternity-care supports maternity care providers in estimating (expectant) parents' health literacy during routine conversations with them, increased maternity care providers' awareness of health literacy and helped them to identify where attention is necessary regarding (expectant) parents' health literacy. CONCLUSIONS The CHAT-maternity-care is a promising conversational tool to estimate (expectant) parents' health literacy. It covers the relevant constructs of health literacy from both the Conversational Health Literacy Assessment Tool and Health Literacy Questionnaire, applied to maternity care. A preliminary evaluation of the use revealed positive feedback. Further testing and evaluation of the CHAT-maternity-care is required with a larger and more diverse population, including more (expectant) parents, to determine the effectiveness, perceived barriers, and perceived facilitators for implementation.
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Affiliation(s)
- Evi M E Vlassak
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.
| | - Elina Miteniece
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Judit K J Keulen
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Marjolein Gravendeel
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Irene Korstjens
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Marijke J C Hendrix
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
| | - Marianne J Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands
- Maastricht University, Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
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Dijkman EM, ter Brake WWM, Drossaert CHC, Doggen CJM. Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review. Healthcare (Basel) 2023; 12:11. [PMID: 38200917 PMCID: PMC10778720 DOI: 10.3390/healthcare12010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Assessment of (digital) health literacy in the hospital can raise staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools should ideally address multiple domains of health literacy, fit to the complex hospital context and have a short administration time, to enable routine assessment. This review aims to create an overview of tools for measuring (digital) health literacy in hospitals. A search in Scopus, PubMed, WoS and CINAHL, following PRISMA guidelines, generated 7252 hits; 251 studies were included in which 44 assessment tools were used. Most tools (57%) were self-reported and 27% reported an administration time of <5 min. Almost all tools addressed the domain 'understanding' (98%), followed by 'access' (52%), 'apply' (50%), 'appraise' (32%), 'numeracy' (18%), and 'digital' (18%). Only four tools were frequently used: the Newest Vital Sign (NVS), the Short Test of Functional Health Literacy for Adults ((S)TOFHLA), the Brief Health Literacy Screener (BHLS), and the Health Literacy Questionnaire (HLQ). While the NVS and BHLS have a low administration time, they cover only two domains. HLQ covers the most domains: access, understanding, appraise, and apply. None of these four most frequently used tools measured digital skills. This review can guide health professionals in choosing an instrument that is feasible in their daily practice, and measures the required domains.
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Affiliation(s)
- Eline M. Dijkman
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Department of Surgery, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Wouter W. M. ter Brake
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
| | | | - Carine J. M. Doggen
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
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7
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Gorter A, Bakker MM, ten Klooster PM, Boonen A, Vonkeman HE. The impact of health literacy: associations with disease activity and medication prescription in patients with rheumatoid arthritis. Rheumatology (Oxford) 2023; 62:3409-3415. [PMID: 36825825 PMCID: PMC10547512 DOI: 10.1093/rheumatology/kead094] [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: 11/15/2022] [Revised: 01/25/2023] [Accepted: 02/14/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore the longitudinal associations between health literacy profiles and disease activity and medication prescription in patients with RA. METHODS Patients with RA who previously completed the Health Literacy Questionnaire (HLQ) and were assigned 1 of 10 distinct health literacy profiles based on cluster analysis were further aggregated into three groups: 'several health literacy limitations', 'some health literacy limitations' and 'good health literacy'. Linear mixed modelling (LMM) was used to analyse the association between health literacy groups and disease activity over the course of 1 year. Chi-squared tests and logistic regression analyses were used to compare medication prescriptions between the groups. RESULTS A total of 108 patients with RA were included. LMM showed a significant effect of health literacy group on disease activity over time (P = 0.010). Patients with 'good health literacy' had significantly lower disease activity over time [28-joint DAS with ESR (DAS28-ESR) = 2.4] than patients with 'several health literacy limitations' (DAS28-ESR = 3.1), independent of age, gender and education level. Patients with 'good health literacy' were most often prescribed a biologic DMARD (50%), whereas patients with 'some health literacy limitations' more commonly received a conventional synthetic DMARD only [72.7%; odds ratio (OR) 4.24], and patients with 'several health literacy limitations' were more often prescribed prednisolone (52.4%; OR 3.56). CONCLUSION Significant differences in longitudinal disease activity and medication prescription were observed between groups with different health literacy levels. These results stress the importance of insights into the role of health literacy in treatment and outcomes in patients with RA.
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Affiliation(s)
- Anne Gorter
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Mark M Bakker
- Department of Internal Medicine, Rheumatology Division, Maastricht University Medical Center+, Maastricht, The Netherlands
- Care & Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Peter M ten Klooster
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Annelies Boonen
- Department of Internal Medicine, Rheumatology Division, Maastricht University Medical Center+, Maastricht, The Netherlands
- Care & Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Harald E Vonkeman
- Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Enschede, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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Jawahar Z, Elmer S, Hawkins M, Osborne RH. Application of the optimizing health literacy and access (Ophelia) process in partnership with a refugee community in Australia: Study protocol. Front Public Health 2023; 11:1112538. [PMID: 36895685 PMCID: PMC9989023 DOI: 10.3389/fpubh.2023.1112538] [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: 11/30/2022] [Accepted: 02/03/2023] [Indexed: 02/23/2023] Open
Abstract
Refugees experience health inequities resulting from multiple barriers and difficulties in accessing and engaging with services. A health literacy development approach can be used to understand health literacy strengths, needs, and preferences to build equitable access to services and information. This protocol details an adaptation of the Ophelia (Optimizing Health Literacy and Access) process to ensure authentic engagement of all stakeholders to generate culturally appropriate, needed, wanted and implementable multisectoral solutions among a former refugee community in Melbourne, Australia. The Health Literacy Questionnaire (HLQ), widely applied around the world in different population groups, including refugees, is usually the quantitative needs assessment tool of the Ophelia process. This protocol outlines an approach tailored to the context, literacy, and health literacy needs of former refugees. This project will engage a refugee settlement agency and a former refugee community (Karen people origin from Myanmar also formerly knowns as Burma) in codesign from inception. A needs assessment will identify health literacy strengths, needs, and preferences, basic demographic data and service engagement of the Karen community. This community will be engaged and interviewed using a semi-structured interview based on the Conversational Health Literacy and Assessment Tool (CHAT) will cover supportive professional and personal relationships, health behaviors, access to health information, use of health services, and health promotion barriers and support. Using the needs assessment data, vignettes portraying typical individuals from this community will be developed. Stakeholders will be invited to participate in ideas generation and prioritization workshops for in-depth discussion on what works well and not well for the community. Contextually and culturally appropriate and meaningful action ideas will be co-designed to respond to identified health literacy strengths, needs, and preferences of the community. This protocol will develop and test new and improved methods that are likely to be useful for community-based organizations and health services to systematically understand and improve communication, services and outcomes among disadvantaged groups, particularly migrants and refugees.
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Affiliation(s)
- Zaman Jawahar
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Shandell Elmer
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Melanie Hawkins
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
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Bakker MM, Putrik P, Dikovec C, Rademakers J, Vonkeman HE, Kok MR, Voorneveld-Nieuwenhuis H, Ramiro S, de Wit M, Buchbinder R, Batterham R, Osborne RH, Boonen A. Exploring discordance between Health Literacy Questionnaire scores of people with RMDs and assessment by treating health professionals. Rheumatology (Oxford) 2022; 62:52-64. [PMID: 35438147 PMCID: PMC9788830 DOI: 10.1093/rheumatology/keac248] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES We studied discordance between health literacy of people with rheumatic and musculoskeletal diseases (RMDs) and assessment of health literacy by their treating health professionals, and explored whether discordance is associated with the patients' socioeconomic background. METHODS Patients with RA, spondyloarthritis (SpA) or gout from three Dutch outpatient rheumatology clinics completed the nine-domain Health Literacy Questionnaire (HLQ). Treating health professionals assessed their patients on each HLQ domain. Discordance per domain was defined as a ≥2-point difference on a 0-10 scale (except if both scores were below three or above seven), leading to three categories: 'negative discordance' (i.e. professional scored lower), 'probably the same' or 'positive discordance' (i.e. professional scored higher). We used multivariable multilevel multinomial regression models with patients clustered by health professionals to test associations with socioeconomic factors (age, gender, education level, migration background, employment, disability for work, living alone). RESULTS We observed considerable discordance (21-40% of patients) across HLQ domains. Most discordance occurred for 'Critically appraising information' (40.5%, domain 5). Comparatively, positive discordance occurred more frequently. Negative discordance was more frequently and strongly associated with socioeconomic factors, specifically lower education level and non-Western migration background (for five HLQ domains). Associations between socioeconomic factors and positive discordance were less consistent. CONCLUSION Frequent discordance between patients' scores and professionals' estimations indicates there may be hidden challenges in communication and care, which differ between socioeconomic groups. Successfully addressing patients' health literacy needs cannot solely depend on health professionals' estimations but will require measurement and dialogue. VIDEO ABSTRACT A video abstract of this article can be found at https://www.youtube.com/watch?v=ggnB1rATdQ4.
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Affiliation(s)
- Mark M Bakker
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC.,CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC.,CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht
| | - Cédric Dikovec
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC
| | - Jany Rademakers
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht.,Nivel Netherlands Institute for Health Services Research, Utrecht
| | - Harald E Vonkeman
- Department of Psychology, Health and Technology, University of Twente, Enschede.,Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente, Arthritis Center Twente, Enschede
| | - Marc R Kok
- Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam
| | | | - Sofia Ramiro
- Department of Rheumatology, Leiden UMC, Leiden.,Department of Rheumatology, Zuyderland Medical Center, Heerlen
| | - Maarten de Wit
- Tools2Use Patient Association, Amsterdam, The Netherlands
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University.,Monash Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Australia
| | - Roy Batterham
- Faculty of Public Health, Thammasat University, Bangkok, Thailand
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht UMC.,CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht
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Finbråten HS, Nowak P, Griebler R, Bíró É, Vrdelja M, Charafeddine R, Griese L, Bøggild H, Schaeffer D, Link T, Kucera Z, Mancini J, Pelikan JM. The HLS 19-COM-P, a New Instrument for Measuring Communicative Health Literacy in Interaction with Physicians: Development and Validation in Nine European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11592. [PMID: 36141865 PMCID: PMC9517091 DOI: 10.3390/ijerph191811592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sufficient communicative health literacy (COM-HL) is important for patients actively participating in dialogue with physicians, expressing their needs and desires for treatment, and asking clarifying questions. There is a lack of instruments combining communication and HL proficiency. Hence, the aim was to establish an instrument with sufficient psychometric properties for measuring COM-HL. METHODS The HLS19-COM-P instrument was developed based on a conceptual framework integrating HL with central communicative tasks. Data were collected using different data collection modes in nine countries from December 2019 to January 2021 (n = 18,674). Psychometric properties were assessed using Rasch analysis and confirmatory factor analysis. Cronbach's alpha and Person separation index were considered for reliability. RESULTS The 11-item version (HLS19-COM-P-Q11) and its short version of six items (HLS19-COM-P-Q6) fit sufficiently the unidimensional partial credit Rasch model, obtained acceptable goodness-of-fit indices and high reliability. Two items tend to under-discriminate. Few items displayed differential item functioning (DIF) across person factors, and there was no consistent pattern in DIF across countries. All items had ordered response categories. CONCLUSIONS The HLS19-COM-P instrument was well accepted in nine countries, in different data collection modes, and could be used to measure COM-HL.
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Affiliation(s)
- Hanne Søberg Finbråten
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, 2418 Elverum, Norway
| | - Peter Nowak
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Robert Griebler
- Competence Centre for Health Promotion and Health System, Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, H-4028 Debrecen, Hungary
| | - Mitja Vrdelja
- Communication Unit, National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia
| | - Rana Charafeddine
- Department of Public Health and Epidemiology, Sciensano, 1050 Brussels, Belgium
| | - Lennert Griese
- Interdisciplinary Centre for Health Literacy Research [ICHL], School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
| | - Henrik Bøggild
- Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Doris Schaeffer
- Interdisciplinary Centre for Health Literacy Research [ICHL], School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
| | - Thomas Link
- Department of Quality Measurement and Patient Survey, Austrian National Public Health Institute, A-1010 Vienna, Austria
| | - Zdenek Kucera
- Czech Health Literacy Institute, Sokolská 490/31, 120 00 Prague, Czech Republic
| | - Julien Mancini
- Aix Marseille University, APHM INSERM, IRD, ISSPAM, SESSTIM, Cancer, Biomedicine & Society Group, Ligue 2019 Accredited Team, F-13009 Marseille, France
| | - Jürgen M. Pelikan
- WHO-CC Health Promotion in Hospitals and Health Care, Austrian National Public Health Institute, A-1010 Vienna, Austria
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11
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Perrin A, Siqueira do Prado L, Duché A, Schott AM, Dima AL, Haesebaert J. Using the Brief Health Literacy Screen in Chronic Care in French Hospital Settings: Content Validity of Patient and Healthcare Professional Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E96. [PMID: 33375574 PMCID: PMC7795429 DOI: 10.3390/ijerph18010096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022]
Abstract
Person-centered care has led healthcare professionals (HCPs) to be more attentive to patients' ability to understand and apply health-related information, especially those with chronic conditions. The concept of health literacy (HL) is essential in understanding patients' needs in routine care, but its measurement is still controversial, and few tools are validated in French. We therefore considered the brief health literacy screen (BHLS) for assessing patient-reported HL in chronic care settings, and also developed an HCP-reported version of the BHLS with the aim of using it as a research instrument to assess HCPs' evaluation of patients' HL levels. We assessed the content validity of the French translation of both the patient-reported and HCP-reported BHLS in chronic care within hospital settings, through cognitive interviews with patients and HCPs. We performed qualitative analysis on interview data using the survey response Tourangeau model. Our results show that the BHLS is easy and quick to administer, but some terms need to be adapted to the French chronic care settings. Health-related information was observed to be mainly communicated orally, hence a useful direction for future literacy measures would be to also address verbal HL.
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Affiliation(s)
- Adèle Perrin
- Health Services and Performance Research, Université Claude Bernard Lyon 1, 69100 Lyon, France; (A.P.); (L.S.d.P.); (A.D.); (A.-M.S.); (A.L.D.)
| | - Luiza Siqueira do Prado
- Health Services and Performance Research, Université Claude Bernard Lyon 1, 69100 Lyon, France; (A.P.); (L.S.d.P.); (A.D.); (A.-M.S.); (A.L.D.)
| | - Amélie Duché
- Health Services and Performance Research, Université Claude Bernard Lyon 1, 69100 Lyon, France; (A.P.); (L.S.d.P.); (A.D.); (A.-M.S.); (A.L.D.)
| | - Anne-Marie Schott
- Health Services and Performance Research, Université Claude Bernard Lyon 1, 69100 Lyon, France; (A.P.); (L.S.d.P.); (A.D.); (A.-M.S.); (A.L.D.)
- Pôle de Santé Publique, Hospices Civils de Lyon, 69002 Lyon, France
| | - Alexandra L. Dima
- Health Services and Performance Research, Université Claude Bernard Lyon 1, 69100 Lyon, France; (A.P.); (L.S.d.P.); (A.D.); (A.-M.S.); (A.L.D.)
| | - Julie Haesebaert
- Health Services and Performance Research, Université Claude Bernard Lyon 1, 69100 Lyon, France; (A.P.); (L.S.d.P.); (A.D.); (A.-M.S.); (A.L.D.)
- Pôle de Santé Publique, Hospices Civils de Lyon, 69002 Lyon, France
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12
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Jensen NH, Aaby A, Ryom K, Maindal HT. A CHAT about health literacy - a qualitative feasibility study of the Conversational Health Literacy Assessment Tool (CHAT) in a Danish municipal healthcare centre. Scand J Caring Sci 2020; 35:1250-1258. [PMID: 33314213 PMCID: PMC9290499 DOI: 10.1111/scs.12943] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/04/2020] [Accepted: 11/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding individual health literacy needs is crucial when designing supportive and effective health care. However, tools assessing health literacy in practice are lacking. The Conversational Health Literacy Assessment Tool (CHAT) was recently developed, but its ability to assess health literacy remains unexplored. We aimed to investigate the implementation and adoption of CHAT, its ability to increase awareness of health literacy among healthcare providers, and if CHAT could assess health literacy needs in patients. METHODS We performed a qualitative feasibility study of CHAT among healthcare providers (nurses, physiotherapists and occupational therapists) who provide rehabilitation services for patients with noncommunicable diseases in a municipal healthcare centre in Denmark. The study used the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to structure interview guide and analysis. We collected qualitative data from four small focus groups with healthcare providers (n = 11). The data were analysed using a deductive thematic three-step method for organising and interpreting data. All informants provided written informed consent prior to data collection. RESULTS CHAT seems to be a feasible and efficient tool for assessing health literacy needs among individuals with different socio-demographic characteristics and with different diagnoses. CHAT was easiest implemented and adopted by healthcare providers, who were already familiarly with the concept of health literacy. The informants emphasised that an introduction to CHAT and health literacy as concept was valuable for the adoption. Some of them felt frustrated that they did not have opportunity and options to meet the health literacy needs identified by CHAT. CONCLUSIONS CHAT is a promising tool for assessing individual health literacy needs and increasing awareness of health literacy among healthcare providers. For successfully implementation of CHAT, we recommend developing a structured implementation programme, including an introduction to health literacy and an outline of the options for acting upon CHAT results.
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Affiliation(s)
| | - Anna Aaby
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Knud Ryom
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Health Promotion, Steno Diabetes Centre Copenhagen, Gentofte, Denmark
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13
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Smith JA, Merlino A, Christie B, Adams M, Bonson J, Osborne RH, Drummond M, Judd B, Aanundsen D, Fleay J, Gupta H. Using social media in health literacy research: A promising example involving Facebook with young Aboriginal and Torres Strait Islander males from the Top End of the Northern Territory. Health Promot J Austr 2020; 32 Suppl 1:186-191. [PMID: 32946620 PMCID: PMC7984039 DOI: 10.1002/hpja.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/17/2020] [Accepted: 09/10/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- James A Smith
- Freemasons Centre for Male Health & Wellbeing - Northern Territory, Menzies School of Health Research, Casuarina, NT, Australia.,Charles Darwin University, Darwin, NT, Australia
| | - Anthony Merlino
- Freemasons Centre for Male Health & Wellbeing - Northern Territory, Menzies School of Health Research, Casuarina, NT, Australia
| | - Ben Christie
- Freemasons Centre for Male Health & Wellbeing - Northern Territory, Menzies School of Health Research, Casuarina, NT, Australia
| | - Mick Adams
- Edith Cowan University, Joondalup, WA, Australia
| | - Jason Bonson
- Northern Territory Department of Health, Darwin, NT, Australia
| | | | | | - Barry Judd
- Charles Darwin University, Darwin, NT, Australia.,University of Melbourne, Melbourne, VIC, Australia
| | | | - Jesse Fleay
- Edith Cowan University, Joondalup, WA, Australia
| | - Himanshu Gupta
- Freemasons Centre for Male Health & Wellbeing - Northern Territory, Menzies School of Health Research, Casuarina, NT, Australia
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14
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Stømer UE, Wahl AK, Gøransson LG, Urstad KH. Exploring health literacy in patients with chronic kidney disease: a qualitative study. BMC Nephrol 2020; 21:314. [PMID: 32727397 PMCID: PMC7392653 DOI: 10.1186/s12882-020-01973-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022] Open
Abstract
Background Patients with chronic kidney disease make day-to-day decisions about how to self-manage their disease. Chronic kidney disease (CKD) includes a risk for progression towards end-stage renal disease and the development of comorbidities, such as cardiovascular disease, which represents the leading cause of death among these patients. To reduce these risks, CKD patients are recommended to follow a healthy lifestyle with physical activity, food and fluid restrictions, and adherence to complex medication regimes throughout all phases of the disease. To manage the complexity of this health situation, health literacy (HL) is considered essential. The current prevailing understanding is that HL is a multidimensional concept and comprises a range of cognitive, affective, social, and personal skills that determine the motivation and ability to gain access to, understand, and use health information. Recently, we investigated multiple aspects of HL in CKD patients in a quantitative cross-sectional study utilizing the Health Literacy Questionnaire (HLQ) and observed that finding good health information and appraising health information were the most challenging aspects of HL. This study aimed to explore CKD patients’ lived experiences of different dimensions of HL presented in the HLQ. Methods This qualitative study utilized in-depth semistructured interviews. Twelve patients with different levels of HL were included. The interviews were analyzed using thematic analysis as described by Braun and Clarke. Results We identified three main themes that were significant for CKD patients’ HL: 1. Variation in people’s attitudes and behavior as health information seekers, 2. The problem of fragmented healthcare in the context of multimorbidity makes the healthcare system challenging to navigate, and 3. The value of a good relationship with healthcare providers. Conclusion CKD patients take different approaches to health information. Limiting or avoiding health information may be a strategy used by some individuals to cope with the disease and does not necessarily mean that health information is inaccessible or difficult to understand. Comorbidity and a fragmented healthcare system can make the healthcare system challenging to navigate. A good and trusting relationship with healthcare providers seems to promote several aspects of HL and should be promoted to optimize CKD patients’ HL.
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Affiliation(s)
- Une Elisabeth Stømer
- Faculty of Health Science, University of Stavanger, Stavanger, Norway. .,Department of Nephrology, Stavanger University Hospital, Stavanger, Norway.
| | | | - Lasse Gunnar Gøransson
- Department of Nephrology, Stavanger University Hospital, Stavanger, Norway.,Faculty of Medicine, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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15
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Abstract
PURPOSE Cardiac rehabilitation (CR) is effective at reducing further cardiac events. However, dropout rates are high, and maintenance of behavioral change post-CR is challenging. Health literacy (HL) may influence self-management of cardiac risk, yet few studies have explored this association. This study aimed to describe HL among CR attendees; first to describe the HL profiles of people commencing CR and second to examine HL changes between program entry and completion. METHODS CR attendees in Melbourne, Australia, completed the Health Literacy Questionnaire (HLQ) at program admission and completion. The HLQ measures HL across 9 scales. Cluster analysis grouped participants according to their HL profile. Effect sizes were used to determine changes in HLQ scores. Post-program interviews explored the role of HL in participant recovery. RESULTS Participants completed baseline (n = 60) and post-program (n = 38) data collection. Mean age was 60.3 ± 11.7 yr, and 38.3% had myocardial infarction and/or percutaneous coronary intervention. Approximately 18% of participants did not complete the program. Five HL clusters were revealed. The clusters most likely to drop out were confident users of the health system. The cluster least likely to drop out reported lower confidence in their ability to find health information and navigate services. Information-seeking ability improved over time, but no other HL improvements were seen. CONCLUSION There is a wide range of HL profiles in people attending CR. Findings suggest that CR programs should consider a variety of approaches to meet the diverse HL requirements of attendees.
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16
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Smith JA, Merlino A, Christie B, Adams M, Bonson J, Osborne R, Judd B, Drummond M, Aanundsen D, Fleay J. 'Dudes Are Meant to be Tough as Nails': The Complex Nexus Between Masculinities, Culture and Health Literacy From the Perspective of Young Aboriginal and Torres Strait Islander Males - Implications for Policy and Practice. Am J Mens Health 2020; 14:1557988320936121. [PMID: 32583723 PMCID: PMC7318825 DOI: 10.1177/1557988320936121] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/28/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
Health literacy is generally conceptualized as skills related to successfully navigating health - ultimately linked to well-being and improved health outcomes. Culture, gender and age are considered to be influential determinants of health literacy. The nexus between these determinants, and their collective relationship with health literacy, remains understudied, especially with respect to Indigenous people globally. This article presents findings from a recent study that examined the intersections between masculinities, culture, age and health literacy among young Aboriginal and Torres Strait Islander males, aged 14-25 years in the Northern Territory, Australia. A mixed-methods approach was utilized to engage young Aboriginal and Torres Strait Islander males. The qualitative components included Yarning Sessions and Photovoice using Facebook, which are used in this article. Thematic Analysis and Framework Analysis were used to group and analyse the data. Ethics approval was granted by Charles Darwin University Human Research Ethics Committee (H18043). This cohort constructs a complex interface comprising Western and Aboriginal cultural paradigms, through which they navigate health. Alternative Indigenous masculinities, which embrace and resist hegemonic masculine norms simultaneously shaped this interface. External support structures - including family, friends and community engagement programs - were critical in fostering health literacy abilities among this cohort. Young Aboriginal and Torres Strait Islander males possess health literacy abilities that enable them to support the well-being of themselves and others. Health policymakers, researchers and practitioners can help strengthen and expand existing support structures for this population by listening more attentively to their unique perspectives.
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Affiliation(s)
- James A. Smith
- Menzies School of Health Research, Casuarina, NT, Australia
- Charles Darwin University, Casuarina, Australia
| | | | - Ben Christie
- Menzies School of Health Research, Casuarina, NT, Australia
| | - Mick Adams
- Menzies School of Health Research, Casuarina, NT, Australia
- Edith Cowan University, Mt Lawley, Australia
| | - Jason Bonson
- Menzies School of Health Research, Casuarina, NT, Australia
- Northern Territory Department of Health, Casuarina, Australia
| | - Richard Osborne
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Barry Judd
- Charles Darwin University, Casuarina, Australia
- University of Melbourne, Melbourne, Australia
| | | | | | - Jesse Fleay
- Edith Cowan University, Mt Lawley, Australia
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17
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Voigt-Barbarowicz M, Brütt AL. The Agreement between Patients' and Healthcare Professionals' Assessment of Patients' Health Literacy-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072372. [PMID: 32244459 PMCID: PMC7177784 DOI: 10.3390/ijerph17072372] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 12/26/2022]
Abstract
Healthcare professionals (HCPs) can play a key role in promoting health literacy (HL) in patients to help them navigate the healthcare system effectively. This involves assisting patients to locate, comprehend and evaluate health information. HCPs should assess patients’ health literacy needs and check the patient´s understanding to communicate adequate health information. This review investigates the agreement between the patients’ and HCPs assessment of patients’ HL. A systematic literature search in PubMed, Scopus, PsycINFO, CINAHL and the Cochrane Library was performed in November 2019. The search yielded 6762 citations, seven studies met the inclusion criteria. The following HL measurement instruments were completed by the patients in the included studies: REALM (n = 2), REALM-R (n = 1), S-TOFHLA (n = 1), NVS (n = 1), SILS (n = 1), HLSI-SF (n = 1) and HLS-EU-Q16 (n = 1). The HCPs assessed patients’ HL by answering questions that reflect the content of standardized tools. Six studies reported that a high proportion of patients assigned to have HL needs based on their self-report were overestimated by their HCPs in terms of the HL level. The results demonstrated that HCPs had difficulty determining patients’ HL adequately. Differences between the HL estimation of HCPs and the actual HL skills of patients might lead to communication problems.
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