Knowledge of and barriers to health literacy in Illinois

Health literacy-related knowledge, attitude, perceived barriers, and practice among primary care doctors in Malaysia

This study aimed to assess the health literacy (HL) related knowledge, attitude, perceived barriers, and practice among primary care doctors (PCDs) in Malaysia, and to determine the factors associated with HL-related practice. A cross-sectional study was conducted using an online questionnaire. Sociodemographic and work-related details were collected. HL-related knowledge, attitude, perceived barriers, and practice were assessed. Descriptive and inferential analyses using linear regression were performed. 373 PCDs were included in the study with a mean (SD) age of 37.9 (8.1) years old. The mean (SD) HL-related knowledge, attitude, and practice scores were 6.89 (1.27), 36.33 (7.04), and 30.14 (4.7), respectively. 90.9% of the participants had good HL-related knowledge scores, and 89.5% had positive HL-related attitude. More than 80% of participants found that "time constraint to implement health literacy screening" and "lack of human resources to administer HL screening tools in their settings" were among the barriers for them to implement HL practices. PCDs of Chinese and other ethnicities had lower HL-related practice scores compared to those of Malay ethnicity (adjusted b = - 1.74; 95% CI - 2.93, - 0.54, and - 2.94; 95% CI - 5.27, - 0.60, respectively). PCDs who had heard of the term "health literacy" were associated with higher HL-related practice scores (adjusted b = 2.32; 95% CI 1.17, 3.47). Age (adjusted b = 0.10; 95% CI 0.04, 0.16) had significant linear positive relationship with HL-related practice. In conclusion, the HL-related knowledge, attitude, and practice among PCDs in Malaysia were at an acceptable level. Along with educating PCDs on HL, the perceived barriers identified need to be addressed to improve the HL-related practice and ultimately patient care.

Participation factors for asthma education programs - a cross sectional survey

Background

Although the impact of asthma education on important outcomes (e.g. emergency visits) has been well established, only an estimated quarter of asthma patients in Germany have received patient education yet. The aim of the study was to identify patient factors that could increase participation in asthma education programs.

Methods

This cross-sectional study investigated participation factors and differences between trained (n = 64) and untrained (n = 65) asthma patients from a large outpatient center in Germany. The survey included answers to asthma-related questions and open questions on patient education as well as such about knowledge of health literacy and eHealth.

Results

Mean age of participants was 55 ± 19 years and 61% were female. Trained patients were more likely to participate in disease management programs (odds ratio (OR) 6.85; 95%CI 2.17–21.59), were more frequently non-smokers (OR 0.07; 95%CI 0.01–0.85) and more often had an asthma action plan (OR 20.2; 1.55–263.41). Open questions’ analysis of untrained asthma patients revealed that patients felt they were not adequately informed about asthma education (37%). About one-third of all patients (27%) showed openness to online asthma education. Analysis of HL and eHealth showed no difference between the groups.

Conclusion

Untrained asthma patients should be informed even more intensively by their physicians about the importance and value of asthma education. Asthma education does not seem to benefit patients’ health literacy. Online asthma education is of interest to approximately one-third of asthma patients. This should be motivation to develop and implement online asthma education concepts.

Health Literacy-Related Knowledge, Attitude, and Perceived Barriers: A Cross-sectional Study among Physicians, Pharmacists, and Nurses in Public Hospitals of Penang, Malaysia

Introduction

Patients’ health literacy (HL) has emerged as a critical determinant of health outcomes and becoming one of the core competencies of health-care providers. Therefore, this study aimed to assess among Malaysian physicians, pharmacists, and nurses, their HL-related knowledge, attitude, and perceived barriers, and also to determine the associated factors.

Methods

A cross-sectional study design was used to enroll 600 eligible respondents using stratified sampling from 6 public hospitals in Penang, Malaysia. A validated self-administered questionnaire was used for data collection. Descriptive and inferential analysis was performed with statistical significance defined as p < 0.05.

Results

The response rate was 87.6% with 526 questionnaires completed. Of these, 34.2% had poor knowledge, and more than half had negative attitude (51.9%) toward HL with no significant differences among physicians, pharmacists, and nurses. The majority of the respondents perceived time constraints and lack of human resources as major HL barriers. Respondents who had heard the term or concept of HL had significantly higher level of knowledge (p < 0.001) and more positive attitude (p < 0.001). While longer service years (≥11 years) significantly contribute to the higher level of HL knowledge among health-care providers (p = 0.028).

Conclusion

The study findings supported the concern on inadequate knowledge and substantially negative attitude toward HL among study health-care providers with highest cited barriers were time constraint and human resources. Thus, efforts to improve their perspective about HL to be effective patient educators are highly advocated.

The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies

AIM

Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers.

METHODS

CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality.

RESULTS

A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients.

CONCLUSION

Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities

BACKGROUND

An expanding body of literature is exploring the presence and impact of health and health care disparities among marginalized populations. This research challenges policy makers, health professionals, and scholars to examine how unjust and avoidable inequities are created at the societal, institutional, and individual level, and explore strategies for mitigating challenges.

OBJECTIVES

Recognizing the significance of this broader conversation, this scoping review provides an overview of pharmacy-specific research attentive to health-related disparities.

METHODS

Following Arksey and O'Malley's framework, a rigorous screening process yielded 93 peer-reviewed and 23 grey literature articles, each analyzed for core themes.

RESULTS

Lending critical insight to how pharmacy practice researchers are conceptualizing and measuring health inequities, this review highlights three paths of inquiry evident across this literature, including research focused on what pharmacists know about marginalized groups, how pharmacists perceive these groups, and how they provide services. Striving to drive research and practice forward, this review details research gaps and opportunities, including a need to expand the scope of research and integrate knowledge.

CONCLUSIONS

As pharmacists endeavor to provide equitable and impactful patient care, it is essential to understand challenges, and build strong evidence for meaningful action.

Health literacy: health professionals' understandings and their perceptions of barriers that Indigenous patients encounter

BACKGROUND

Despite the growing interest in health literacy, little research has been done around health professionals' knowledge of health literacy or understandings of the barriers to health literacy that patients face when navigating the health care system. Indigenous peoples in New Zealand (NZ), Canada and Australia experience numerous inequalities in health status and outcomes and international evidence reveals that Indigenous, minority, and socio-economically disadvantaged populations have greater literacy needs. To address concerns in Indigenous health literacy, a two-pronged approach inclusive of both education of health professionals, and structural reform reducing demands the system places on Indigenous patients, are important steps towards reducing these inequalities.

METHODS

Four Indigenous health care services were involved in the study. Interviews and one focus group were employed to explore the experiences of health professionals working with patients who had experienced cardiovascular disease (CVD) and were taking medications to prevent future events. A thematic analysis was completed and these insights were used in the development of an intervention that was tested as phase two of the study.

RESULTS

Analysis of the data identified ten common themes. This paper concentrates on health professionals' understanding of health literacy and perceptions of barriers that their patients face when accessing healthcare. Health professionals' concepts of health literacy varied and were associated with their perceptions of the barriers that their patients face when attempting to build health literacy skills. These concepts ranged from definitions of health literacy that were focussed on patient deficit to broader definitions that focussed on both patients and the health system. All participants identified a combination of cultural, social and systemic barriers as impediments to their Indigenous patients improving their health literacy knowledge and practices.

CONCLUSIONS

This study suggests that health professionals have a limited understanding of health literacy and of the consequences of low health literacy for their Indigenous patients. This lack of understanding combined with the perceived barriers to improving health literacy limit health professionals' ability to improve their Indigenous patients' health literacy skills and may limit patients' capacity to improve understanding of their illness and instructions on how to manage their health condition/s.