[Health literacy in low- and middle-income countries: a systematic review]

European health literacy survey questionnaire short form (HLS-Q12): adaptation and evidence of validity for the Brazilian context

Health literacy (HL) refers to knowledge, motivation and skills to understand, evaluate and apply health information, enabling appropriate decision making in daily life on health care and health promotion. Studies show that HL is associated with several social determinants, health outcomes, and health promotion. In Brazil, studies on the thematic are still scarce. Thus, the present study aimed to adapt, seek evidence of validity, reliability and estimate the parameters of the items of the European Health Literacy Survey Questionnaire Short Form (HLS-Q12) for the Brazilian context. 770 individuals participated, recruited through advertisements in the media and social networks, 82.1% female, aged between 18 and 83 (M = 35.5, SD = 13.52), from 21 Federative Units of Brazil and the Federal District. The subjects answered the HLS-Q12 and a sociodemographic questionnaire. Exploratory factor analysis indicated a unifactorial structure with good psychometric characteristics (GFI = 0.98; CFI = 0.98; RMSEA = 0.08; RMSR = 0.07). Cronbach's alpha, Guttman's lambda 2 and McDonald's omega reliability indicators were equal to 0.87. We conclude that the HLS-Q12 is an adequate instrument to assess the level of HL in the Brazilian population.

Health literacy dimensions among public health service users with chronic diseases in Piracicaba, Brazil, 2019

Aim: This study analyzes factors associated with dimensions of health literacy (HL) functional, communicative and critical among public health service users with chronic non-communicable diseases. Methods: A cross-sectional analytical research was carried out in Piracicaba, São Paulo, Brazil, with adults and older adults attending Family Health Units (FHU). Data were collected by oral exam (CPOD and CPI) and a questionnaire on systemic conditions, sociodemographic factors, health behaviors and HLS (HLS-14). The outcomes consisted of functional, communicative, and critical HL dimensions dichotomized by median (high and low), which were analyzed by chi-square test (p<0.05) to find associations with the variables studied. Results: The study sample comprised 238 FHU users with 62.7 (± 10.55) mean age, of which 47.5% (n=113) showed high functional HL, 50.0% (n=119) high communicative HL, and 46.2% (n=110) high critical HL. High functional HL was associated with men (p<0.05). Functional and communicative HL were associated with having higher education (p<0.001 and p=0.018, respectively). High communicative and critical HL were associated with regular use of dental and medical services (p<0.05). Individuals with low functional HL were more likely to present poor tooth brushing (p=0.020). High HL (in all three dimensions) was associated with regular flossing and having more teeth (p<0.05). Conclusion: Functional, communicative and critical HL were associated with health behaviors and clinical outcomes, whereas the functional dimension was also associated with sociodemographic factors. HL dimensions allowed to differentiate health-related factors.